Pulmonary Embolism Support Group
By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.
I was just wondering if most of you were being monitored by your regular doctor or by an anticoagulation clinic? I have been being followed by the clinic at the hospital my PE occured at, but after my last blood test they told me that since I had a stable INR now, my GP could follow me from now on. Today was my first time I was going to get my results from my gp, so I went and got my test done this morning and called my doctors office and told them to keep an eye out for the results. By 3:30 they still hadn't called me yet with my results, so I called them back and they were like "oh actually there is no doctor in the office today so you will have to wait till tomorrow." (I guess she didn't feel the need to tell me this in the morning when I called?) So now I am like are you kidding me. I mean we are only told how much warfarin to take until our next blood test and this is the longest I have ever gone between tests so I am a bit nervous. I found this ridiculous and called the clinic who also got sent my results and they told me it is actually common for doctors offices to not call with the result the same day of the test. Is this true? Do they expect me to just guess how much warfarin to take until they find it convienent to call me? The clinic seems much more reliable to me than my doctors office, but they seem to ditch you once you are stable. Are most people referred to their doctor once they are stable?
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Look at what my best friend did with my picture!
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We all have 24 hours in a day. How we spend these hours is important. Watching a little bit of a video about how sitting affects us made me aware of how much sitting and laying down I do. Gonna have to work on that.Your turn. Tell me another truth.
I go to a coumadin clinic with nurse practitioners (?), they test me using the coagucheck machine, give me my results and dosage (or usually keep me where I am at), and schedule the next appointment.
Things are going to change though, I am actually taking the steps to go to home testing, and at least according to my pulmonologist, I'll only report if the test is out of range. We'll see...
Chris
I go to my general doctor who has indicated he has treated many patients on Coumadin, I always get the results the next day and it doesn't bother me. One day's dose really doesn't matter all that much to get excited about unless you have a super high or low INR.
Good luck
Robert
Once on long-term (probably lifer) I went through what it took to go to home testing. I was willing to work with the AC clinic but their policy is they do not support self-testing, so it had to fall back on the GP. I rarely get dips in the INR, only spikes. It takes 2-3 days to get authorization for a dose adjustment, so I use quick fixes of high vitamin K foods for those occasional high INR readings, call the doctor, and test again in a day or two. When I stay in range, I update the GP by faxing in a copy of the updated INR worksheet.
Also, she works in an office with another doctor, who I also sometimes see. One of them is always there, so someone always calls with my results, even my doc is off for the day.
Honestly, I don't even know if there are coumadin clinics in Denver. Never used one, never been referred to one.
That said, you have to get a set-up that you trust. If you don't feel things are being handled in a way that is comfortable to you, find something else that will work.
I think someone else said that taking the same dose for another day shouldn't be a problem. I would just continue on the same dose until you get your results. An extra day shouldn't be a problem, especially if you have been stable for a while.
I've always used my primary care doctor, but I did switch doctors because the staff at my last PCP was awful when it came to my INR and warfarin management. My current doc is great, as is his team. They're definitely with the program. They get the results from the lab usually the same day and call me. My lab opens at 7:00am so I am able to go before work.
You also have to understand how your doc's office works. Like, I never test on Tuesday or Wednesday, because I know my doc isn't in the office on Wednesdays to look at the results. I never test on Fridays in the off chance the results come in later that day and then I'd have to wait until Monday to get them which to me makes those results worthless.
I considered going to a warfarin clinic at the hospital that treated my PE/DVT. So I met with someone there and I got a very overbearing vibe from them, plus with my insurance, it was costly compared to going to my doc's lab. Since I've met my ded and my lab is in-network, I think I pay $2 a visit to the lab. Before I met the ded, it was something like $12 a visit to the lab. But every insurance is different, of course.
I'm facing a bit of dilemma right now because I am permanently moving to London next week and need to arrange somewhere to get my INR tested. My hospital at home will continue to handle my after-care regarding the PE which is good. Because I know and trust my current clinic I would love to find somewhere to do the test and just phone the results through each time. However I'm having a bit of trouble finding a GP that does INR-testing where I am going to be living.
My employer has said we can't take any days off for the 6 week training programme so I am trying to find somewhere close to work too, but I will no doubt be late at least a few times for INR checks. Hope they don't mind!