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Digital INR meters

Just a quick heads up for those that don't do a blood draw to check your INR. I went in last Thursday and had mine tested on the digital meter and I came back at a 5.4. I asked the lady when was the last time they used a test strip on it and she said that she didn't know. I asked if we could try it on another one. After doing it on the second machine I was at 2.7. That is a big difference. She was going to have me not take my next to doses before we did the recheck. Thank god we did because I would have been really low. I was a 4.4 and 4.8 on the test the two previous weeks so I am pretty sure the machine had been bad for awhile. Moral of the story is, if you test really high asked to be rechecked on a different machine.

Dave

Replies

NWHUNTER
NWHUNTER

They use the one with the strip. Put it in the machine and drop some blood and wait for the INR #..
deleted_user
deleted_user

That is scary. This is a reminder to me that I should probably get checked by something other than my machine every few months. Thanks for bringing up this very important point.

Do you know what kind of machine it was? The one I have now (inratio2) touts the following:
"The monitor performs the PT test AND 2 quality control tests (normal and therapeutic) simultaneously, and determines whether the controls are within preset limits. If they are, strip integrity is verified, and the monitor reports the PT test result. If they are not, the monitor displays an ERROR message."

This has given me some assurance that the values are correct, but I assume it could malfunction like anything else.
NWHUNTER
NWHUNTER

Not sure what brand it is, but I'll find out tomorrow when I go in to get tested.. I'll let you know..

Dave
NWHUNTER
NWHUNTER

Chris it's an Inratio, but didn't see anything saying it was a 2. I had my blood checked today and was at 4.1 then tested on another one and I was 1.2. I had them do a blood draw so I guess i will find out soon what it really is. I hope It's not at 1.2 though. I think I am done with those meters at this place. Two weeks in a row and the shit is all messed up. Be careful to all of you who use them meters....

Dave
jan11965
jan11965

Two weeks in a row would make me nervous too. Did they not take the malfunctioning machine out? I'm tested on a similar machine. Something to think about...
deleted_user
deleted_user

Wow...and how many people are being managed by that clinic? What a mess...people's INR all over the place, and trying to make the proper adjustments, then nothing making sense. Your dosage could be increased, only to see your INR drop.

I will mention one thing with my meter. Each test strip has a code on it. After putting in the strip, I have to confirm the code...maybe they haven't been entering the code correctly?

By the way, what was the result of the blood draw?
NWHUNTER
NWHUNTER

Just got word on the blood draw and I was 3.3.. Neither one of the meters were close. They are making it sound like I am the only one this has happened to.. They seem to think it's something with my blood and want me to draws from now on. He said make an appointment for next Wed. and to come back in for the results on Fri. I told him to fly a kite and that he could just tell me over the phone. He replied " I guess we could do that, but would like to know how you are feeling and if you are having pain in your legs." I then said I could tell him when they call with the results.. What a smart one!!
deleted_user
deleted_user

Sophie, I just realized I never answered your question regarding the test strips. No, I don't have any test strips. I think the machine is supposed to calibrate automatically on every test.

I did speak to a hematologist yesterday, and he told me they won't use digital INR meters in their clinics as they are too unreliable.

I've been reviewing my recent readings, and I'm starting to get suspicious. On the same dose I have swung back and forth between 1.8 and 3.9 over the last several months.

Here is something I have always wondered...as soon as the drop starts pooling on the tip of my finger, doesn't it start to clot? What if one week it takes me 5 seconds from prick to reading, and the next it takes 35 seconds...would that skew the results? I'm guessing the meter must not rely on a fixed window...but I'm curious none the less. I need to look into how those machines actually work. If anyone knows, I'd love to hear.
deleted_user
deleted_user

hello: i ran across this discussion while researching purchase of a home INR/PT meter. I have a long experience with Protein S disorder and DVT's, etc. from resulting clotting episodes. I have also worked in clinical labs for years.
fingerstick INR meters typically work this way:
when blood enters the test chamber, clotting is initiated by thromboplastin in the chamber (built into the test strip). Then magnetic fields move the blood around or measure the conductivity of the sample, or both, until the numbers do not change anymore. this indicates clot formation, as the iron in the blood or iron particles in the test chamber are no longer mobile.
quality control and calibration are automatic in all home-user devices i found, without the use of a calibration strip or liquid.
Testing i have seen on the Roche CoaguCheck series indicates it becomes very non-linear (inaccurate) at 4.0 or greater INR.
Inaccuracy increases if the finger stick to sample time exceeds 15 seconds (i believe most meters have a timer to eliminate over-aged samples).
Another factor in all fingerstick type tests (glucose, INR, etc) is the sample collection: milking of the finger, to oust a stubborn droplet from the wound, will decrease accuracy. Instructions state a "free hanging drop" for that reason.
I am thinking that with my target INR being 3.6, home testing is not for me yet. I'll take the monthly dr. visit for now.
deleted_user
deleted_user

I'm bringing this great thread back to life because of all the INR testing issues I am having.

I go to a clinic that has normally done blood draws sent to the lab for me, but because they had one patient who had trouble with the draws, they bought an INRatio 2 meter, which just happens to be the one I purchased.

At first I thought, "great! they have my meter! I won't need as much blood taken now!" - but I soon realized this is not good news, because the lab techs didn't know what the hell they were doing with the meter when they tried it with me last week, and I was horrified by this!!!

I actually had to tell them how to do it. My life is going to be in the hands of them and their misuse of the meter? No thanks. So today I have to go back there to get my INR checked, and I am going to insist that I only have a blood draw again like I used to. If they refuse, I will walk. Because I tested 1.3 when they did their botched reading, and when I got home, I tested 1.9 on mine. For me that's a big difference because I must be in 2.0-3.0 range.

I'm at least relieved to see that i'm not the only one here who has been through this. It is very frustrating to feel like my life is in the hands of people who don't know what they're doing and aren't detail-oriented enough to read the instructions properly or get proper training!
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