Deep Vein Thrombosis (DVT) Support Group
Deep-vein thrombosis, also known as deep-venous thrombosis or DVT, is the formation of a blood clot ("thrombus") in a deep vein. It can be caused by something preventing blood from circulating or clotting normally. Join the support group if you are coping with DVT and find others who are going through the same challenges.
Like some other long-time users of rat poison, I have made a successful transition to the use of an INRatio INR/PT self-test monitor which was prescribed through http://inrselftest.com/content/ . My first uses of the lancet last week were cumbersome and I laid waste to three test strips. This week I got the whole thing done on the first try and called in the INR to the GP office.
I would like to share these pseudo-random tips with anyone considering the same.
1. Start from your physician. If you have insurance, ensure the provider is within your plan, preferably in-network.
2. You may have the choice of buying the meter outright or having it loaned to you as part of a service. If you choose the former option then your physician must agree to allow you to call in your INR regularly. With the latter option, the service takes your INR and alerts your physician if you fall out of range. I recommend buying it outright.
3. It may take 2 months to get the meter past your insurance.
4. You can read the instructions and get your INR as an out-of-the-box experience, but it is still beneficial to walk through the training with the nurse practitioner, even if it is over the phone.
5. I took a sample test in the Drs office and also had them do a blood draw test. The two were within INR 0.3 of each other. Actual variance between two methods may approximate that, or even be as great as 0.8 on some occasions without either method being characteristically "wrong". Any test method is only approximate and is subject to irregularities, even more so if the actual INR is high.
6. Guidelines such as Medicare and private insurance will provide supplies and reimbursements to support weekly testing with the meter, which allows you to track your INR target compliance much more frequently than is possible at the clinic.
7. Eliminating work-hours appointments at the clinic helps with your continuing employability and insurability. It also gets the management cost under control in case you have to pick up more of the tab on your own someday.
8. In my case, med appointments may shrink from 18 per year down to 4 per year.
9. People at the clinic may read you the riot act about meters being inaccurante and dangerous, which is misleading. They are desperately protecting their jobs and denying the way of the future. There are several FDA-approved INR meters which have been through several trials proving them sufficiently accurate and safe. Diabetics encountered similar resistance when they gained self-management tools 30 years ago, and as a group they have much better chances for healthy living now.
10. At least in USA, such meters are by prescription only. If you buy one on the secondary market, such as on Ebay, the manufacturer will not support the device.
11. As much as it sucks being stuck with a chronic condition, regaining some independence is a shining bright spot in the whole thing. Freedom is good.
I would like to share these pseudo-random tips with anyone considering the same.
1. Start from your physician. If you have insurance, ensure the provider is within your plan, preferably in-network.
2. You may have the choice of buying the meter outright or having it loaned to you as part of a service. If you choose the former option then your physician must agree to allow you to call in your INR regularly. With the latter option, the service takes your INR and alerts your physician if you fall out of range. I recommend buying it outright.
3. It may take 2 months to get the meter past your insurance.
4. You can read the instructions and get your INR as an out-of-the-box experience, but it is still beneficial to walk through the training with the nurse practitioner, even if it is over the phone.
5. I took a sample test in the Drs office and also had them do a blood draw test. The two were within INR 0.3 of each other. Actual variance between two methods may approximate that, or even be as great as 0.8 on some occasions without either method being characteristically "wrong". Any test method is only approximate and is subject to irregularities, even more so if the actual INR is high.
6. Guidelines such as Medicare and private insurance will provide supplies and reimbursements to support weekly testing with the meter, which allows you to track your INR target compliance much more frequently than is possible at the clinic.
7. Eliminating work-hours appointments at the clinic helps with your continuing employability and insurability. It also gets the management cost under control in case you have to pick up more of the tab on your own someday.
8. In my case, med appointments may shrink from 18 per year down to 4 per year.
9. People at the clinic may read you the riot act about meters being inaccurante and dangerous, which is misleading. They are desperately protecting their jobs and denying the way of the future. There are several FDA-approved INR meters which have been through several trials proving them sufficiently accurate and safe. Diabetics encountered similar resistance when they gained self-management tools 30 years ago, and as a group they have much better chances for healthy living now.
10. At least in USA, such meters are by prescription only. If you buy one on the secondary market, such as on Ebay, the manufacturer will not support the device.
11. As much as it sucks being stuck with a chronic condition, regaining some independence is a shining bright spot in the whole thing. Freedom is good.
As an example, after my hip replacement, several times I had an INR of 4.3 once I finally became therapeutic. The Coumadin Nurse ordered a PT/INR blood draw which revealed a 3.1 INR. They found inaccurancies with their particular INR machine when INR's were higher then 3.0. Such is not the case with all machines.
Overall, studies have shown that home INR testing is just as accurate as lab testing. If you look at the discovery health CME website, there is a whole broadcast about Anticoagulation Management. Dr. Jack Ansell, NATT's Medical and Scientific Advisory Chairman, is one of the speakers. Pretty good stuff if it's still available (abou 1/2 hour show viewable online through Discovery Health CME).
http://videos.howstuffworks.com/discovery-health/33542-cme-anticoagulation-self-testing-video.htm
Locally, OSU hospitals has been on the leading edge of self testing, but my care to date has been through a different health system. Some are getting on board, some are not.
Curiously, even after all these decades some diabetics are not suitable for self-testing. It is not for everyone and never will be.
In our case, anyone who may be on rat poison for several months or more can get the investment to pay for itself.
You Betcha! I've run into this with my hematologist who said he's a blood doctor so he would never recommend patients test themselves (he's honest anyway). And the nurse at my PCP's clinic, when I asked if there was any way I could test myself, just giving me a flat out "no". Either she blatantly lied to me or is woefully ignorant on the subject.
Being self-employed, insured, and less than 2 minutes from my clinic pretty much steals the thunder from my fight. If it were even a little inconvenient for me, I would put up a huge fuss to get my way. Since this is a life-long treatment for me though, who knows what the future will bring.
Safety is the other big bonus - certainly testing every week is better than once a month when you're dealing with a drug that is notoriously difficult to manage. You'd think from that standpoint alone doctors and insurance companies would be all over self-testing. Anyway, congrats on your new found freedom!
http://lifeafterdvt.forumotion.com/video-gallery-f38/effectively-managing-anticoagulants-t477.htm