as an aside, I think everyone should have "extra" warfarin, in the case of a major natural disaster, it is possible that supply chains may or will be interrupted and access to meds may be delayed. I am still working on gettnig that set up (i.e., a rotating extra month's worth in our earthquake supplies).

That said, anyone self adjusting would have to be self testing. Funnily enough, my pulmonologist originally said he would be OK with me making micro adjustments to dosage based on test results. The nurse at my clinic said no. So there ya go :)

I think some people already self manage in a way with food intake, as if you know your body's reaction (thru self testing) you can make small adjustments thru diet.

Chris

Self adjusting the amount of warfarin.... Are you serious??
This means that we would no longer need drs or pharmacists
These people are specially trained to decide on how much is require d

As for having extra meds... An interesting idea but insurance companies already balk at paying for more than is required at a time
Typically they only pay for a month or 3 months at a time
What if someone left that job and wasn't covered by there insurance plan any longer..... How would an insurance company recoup the drugs or funds???

"What we've got here is a failure to communicate."

~Struther Martin in Cool Hand Luke

Let me try to unconfuse skihillguy but I'll need someone's help.

He has put me in his 'ignore list' I'm sure (smart move!) but he now thinks that cjmenjou was advocating self-management, when all he was doing was commenting on something I posted from stoptheclot.org and what that site said.

Would some kind soul please clarify this to skihillguy? Someone not in his kill-filter? (grin)

Chris----I'm the 'odd person out' here---- someone who does manage small changes in INR via Vit K adjustments in my diet with my coag nurses approval.

No one else here seems to do that but it IS possible.

May I ask how you can stockpile any warfarin? (It's o.k. to send me a private message)
I don't think my insurance would allow that.

But, yes---- a natural disaster (even a small one) can delay medication. I've often thought about that----- because sometimes I forget to reorder my Coumadin rx until I'm almost out---- and if it falls on a 3 day holiday------ I worry. So far I've managed to skate through but------- just think the problems if there's a huge earthquake/flood etc!
I think you're wise to think of that.

If there were a natural disaster, usually the affected state will issue a disaster directive that goes out to health and property/ casualty insurers. Often states will include in that directive that health insurers and pharmacy benefit managers have to allow for early refills to ensure people have their meds during whatever the directive time frame is.

I don't know much about lifers on warfarin but I would THINK that if' you've been on this medication for a long time, you can kind of guess what affects your levels to go up and down, food, sickness, whatever.

I am not a fan of self-management particularly, since I think that we will need those doctors and nurses, and pharmacists to be there if we have a question or a problem.

I think you'd probably have to pay for an extra 30 day supply for an emergency kit out of your own pocket. Not sure how it would work prescription wise... still trying to work that out.

Rachel, yeah, I'd like to think that the EMS systems would work properly. My wife took a community CERT class recently with the fire department and became CERT certified, they recommended that everyone plan on being self sufficient for a certain period of time, maybe a week to 10 days, until things get sorted out. If there is a massive earthquake here in so cal, the roads may be unpassable.

I also think perhaps that coumadin might not be considered on the same level as say some other drugs that may be more vital to the immediate sustenance of life. Although honestly I don't think I am going to clot up and die if I missed a week, since that's not how I ever presented (small showers), I guess I'd rather be safe than sorry on this.

I guess for the record, I have no problem with people that are aware of their INR levels, and aware of how their body reacts to the coumadin and food, based on experience, making micro (as in 2.5 or less) adjustments to their dosage. I do not believe that such micro adjustments present an appreciable danger. YMMV.

Chris

And skihillguy, I don't think that if you lose your job but the insurance has paid for a 3 month supply that they are going to come and repo the drugs. I could be wrong though, but I cannot fathom that happening.

By the way, I don't know what's going on between various members, who's got who blocked (and don't want to know), so I really have no idea who's reading what, LOL

Sorry, tacking on to my post above, I don't advocate to anyone that they do this without medical approval, it's just my .02 on the topic.

So newbies and anyone else reading don't think I am telling you to do that.

Whew....

Chris

I know when a person leaves a workplace say mid month that there insurance runs out at the end of the month
I can it fathom an insurance being willing to supply drugs or whatever past that point voluntarily
That's why they typically only are willing to provide for a 30 day supply

And to cagey. Z Bring it on buddy, man up cause my attorneys want your information

Bringing this topic back 'on topic' does anyone have any knowledge if that's been adopted here in the U.S. yet?

Evidently some countries in Europe plus Canada and maybe AU will allow self-management (probably with selected compliant patients).

Anyone know if 'it's in the works"?

Yeah, Chris, I see what you're saying about the systems not up an running and that's where there's an issue.

Just recently, I was looking up warfarin shelf life on line because I have a whole bottle of 5mgs from a long time ago that I never used (not sure why; I think it was from the early days when I was on 15mgs a day). Anyway, so I'm looking up shelf life and I came across this survivalist forum, and some guy asked how you make warfrin, you know, in case everything goes to hell and you're the last person standing. I think a fellow survivalist responded to him that given the nature of that drug, you may not want to try making a batch and experimenting to see how it works on you.

And your right. I don't think they try to recoup the drugs if you lose your job. Technically, the service was rendered when your prescription coverage was still inforce. Unless you've got some kind of provision in your coverage that states otherwise.

Yikes... home made warfarin... LOL You first. No, you first.

I have some leftover 7.5s from when I was in the hospital, as my just in case. What is the shelf life if you found anything out? I should probably eitehr rotate or get rid of...

And cave, i doubt there's been any adoption of self management of the dose in the US. Too many liability issues I can see. I've noticed large differences in how people are allowed to manage their own medical care in the US as opposed to some other countries.

Chris

And it isn't approved in Canada either
So maybe cagey you need to do your research

Thank you, skihillguy for that information.

I'll check that out.