I have seen several questions about getting treatment for A.fib whilst on holiday outside of the UK.

[paolina]

Whilst on holiday in the UK last summer I had to have a INR test and to be quite honest I found it quite difficult, the blood testing could be either done in the hospital without an appointment or I could register as a temporary resident and have it done at the doctors surgery. I had been told in Italy to get the results and fax it to them and they would then send me the dose of Warfarin to be taken and when I should have the next test which all sounded very easy. My sister in England made an appointment at the drs. surgery, the earliest being the day after the test was due, the results would then be sent to the drs. and I would have the results the day after (2 days late) I would then have to fax them to Italy & wait for their reply (another day). The nurse told my sister that I could get it done at the hospital, which I decided to do, I had been told by the Italian dr. that I could anticipate the blood test. I had the test done and was told I could go back for the results later that morning, like in Italy, the only difference being that in the UK they don't give you the results they give you a nice yellow book with the warfarin dosage in. The dr did write the PT when I explained but she was rather perplexed as to how I should be treated, and whether I should pay (which I would do willingly) and advised me that it would be easier for them if I had registered with a GP.No-one even looked at the European Medical card which we are supposed to use. Luckily I am English but I wondered how lost someone would feel in this situation if there English wasn't quite as good. The next problem was finding a fax machine,in Italy every other Tabbacharia has one, no-one seemed to know and it was actually me,the non-resident, who remembered the Library. I had gone to the hospital at 8 am and surprisingly I had got the fax off before midday! and got the reply from Italy by e.mail that afternoon. By the way I was using taxis (very cheap in UK) and public transport (not so cheap). I had tried to find out if I could get it done privately (in Italy there are private testing places for practically everything) but with negative results. Pauline

[meadfoot]

Sorry to hear you had such a hassle Pauline. Not what I would expect from the UK NHS. Just goes to show that we aren't as wonderful in the UK as we tend to feel we are.

[Beancounter Volunteer]

Hi Paoloina,

I'm glad the hospital sorted you out, I suspect it was easier for them to do that, and of course for Europeans there is no question of payment, it's free for you as it is for us. I understand doctors and hospitals are being asked to do more checks now, but they are reluctant.

I can relate to having a child ill in Spain (appendicitis) when the medical care was fantatastic and so was the aftercare, we were insured but it really wasn't quite necessary.

Re Fax? it's a bit old fashioned to be honest, very rapidly disappearing with the avent of scan and email so much easier.

I'm old enough to remember the very first fax machines which used to use a heated pointer to write on clay lined paper (kieselguhr if I remember correctly) they smelt revolting as they were used

Glad it went well in the end

Ian

[tk11]

Purchase a coaguchek xs machine from Roche.Get your anticoagulation team to help with initialization whilst at home. Do your own testing when travelling anywhere, just ring the results to your team to set the doseage....easy!

[Terjo]

That's what I did when I had to go on warfarin for six weeks before cardioversion . Peace of mind and saving time and knowing the exact dose needed was worth every penny. Terjo

[MarkS]

Even easier, work out your own doseage. If you're reasonably stable then it's easy peasy. With a Coaguchek you can monitor every week so your INR should not change much anyway. I've been all over Europe, the US and India with mine and stayed in range the whole time. Two minutes per week is all it takes.

I'm not surprised you had trouble finding a fax machine, I haven't used one in years. I use a website and email to tell the Anti-coag clinic my latest result and dose every 3m.

Mark

[paolina in reply to MarkS]

The e.mail service is run by the Padovan Anti-coag Association and is run by volunteers so probably the cost of having someone there & printing etc. would be quite high compared to faxing it.

I was under the impression that the Coagucheck was quite expensive.

Pauline

[MarkS in reply to paolina]

Hi Pauline,

The cost is £299 in the UK, though I'm not sure about Italy. The strips are free on the NHS. Overall the cost is a lot less than blood draws and lab testing.

I'm not quite sure why an email should be more expensive than a fax. Surely someone needs to be there regardless? Or emails can be handled anywhere unlike faxes.

The Coaguchek is the best thing I've ever bought as it has enabled me to do so many things that would have been very difficult otherwise. Being able to keep my INR in range 99% of the time has also probably halved by risk of stroke compared with standard warfarin stroke risk.

Mark

[Bagrat]

I have voiced this before. I am happy to buy a coaguchek machine - esp. as OH is on warfarin too but my GP is very reluctant. I'm not a very assertive person sadly and don't want to rock the boat and have great faith in him apart from a slight doctor knows best slant.. He did tell my husband the strips were expensive to prescribe! I know the website does a list of things to discuss with GP if buying and his reluctance is even more strange as the surgery uses the coaguchek and the software spits out my dose.

He muttered about what if I forgot to phone in the result - as if.....( I am a retired nurse)

and to get back on course of this thread, it is easy to get tested anywhere!! I know if I go to my daughter's ( in UK) it is the old venous blood, result in 24 hours etc. My INR's are monthly at present so I agree Mark it could be here there and everywhere in that time.

Really must try again with GP

Wendy

[paolina in reply to Bagrat]

I'd probably have problems similar to yours Bagrat, also the very expensive strips would definitely not be on prescription. I was hoping to eventually go on one of the new drugs but have been told by my GP that these will eventually be prescribed by the Dr at the anti-coagulant clinic (when they have been passed) and will still have to be checked - nothing is made easy in Italy!

[Bagrat in reply to paolina]

Not that good here either .My consultant said a newer anticoagulant was my choice and shouldn't depend on cost but he cannot prescribe now - that is up to GP -where cost is a big factor I think!!!

Take Care Wendy

[meadfoot]

I must be very fortunate, my Cardiologist skipped warfarin when it was decided I needed anticoagulation and recommended Rivaoxaban straight away. My GP totally agreed regardless of cost to the practice and prescribed it immediately. Been on it, side effect free, since Feb '13 and all blood work after 6 weeks was fine.

Biggest issue initially was finding a chemist who actually stocked it. Tried large national and small independent chemists with the same outcome - we will get it for you but it is expensive and we don't stock it.

This will get easier as more GP's prescribe it. My local chemist is stocking it now as demand increases and says several more patients have been prescribed it recently.

No objection in principle to warfarin but the new ones do negate the INR issue.