Inr blood test

[Chrijan]

Hi my son had a mechanical aortic valve fitted in August . His inr levels are up and done quite a bit . He’s been offered a job in which he didn’t want to have time off in the mornings (weekly) to have his inr blood test . Can the blood test be done in the evening

[MichaelJH Heart Star]

Hello and welcome to the forum! I have assumed your son is on Warfarin. Some people control their INR by home monitoring. It is mentioned part way down this page

bhf.org.uk/informationsuppo...

and is probably worth discussing with his clinic. Tight control of diet can so help stabilise things.

[Chrijan in reply to MichaelJH]

He is very controlled with his diet infact I think sometimes to controlled . I think it all came a such a shock that he had a heart problem and all happened so fast from finding out and then an op . I think he gets so stressed about it all . I will look into the home testing thank you

[Fredders]

Hi, I also have a mechanical valve and am on warfarin. I have a home testing machine. I do the test myself then phone the result through to the clinic and they let me know if I need to change my dose. Ask your clinic if they support home testing. I had to buy my own machine, lancets and test strips but it does vary a lot from surgery to surgery. My gp isn’t allowed to prescribe the test strips but some other local surgeries can, just depends on their budget. I have to go to the clinic once every six months to get my machine checked against theirs, I prefer to go to the session they hold at my gp surgery and the clinic only runs until 4pm so I have to leave work early, but they do run sessions all over Lincoln and there could be something nearer work. Worth checking whether his clinic runs any sessions nearer where he works if he can’t home test.

Wendy

[Chrijan in reply to Fredders]

I’m going to have a look at buying a machine . I all been so stressful for him . Which probably doesn’t help his inr results . Thank you I’m pleased I’ve found this forum

[Fredders in reply to Chrijan]

The machine I’ve got is a CoaguChek, which is the same make as my clinic uses, just smaller. Very easy to use.

Wendy

[Chrijan in reply to Fredders]

Thank you I will have a look at that

[Nathan53]

There are alternatives to warfarin where INR monitoring is not required. The attached BHF article gives more information. bhf.org.uk/informationsuppo...

[Chrijan in reply to Nathan53]

Thank you I will have a look

[Fredders in reply to Nathan53]

Unfortunately I think they can only use warfarin for mechanical valves, not sure why now but I do remember reading about it before I had my mechanical valve installed.

Wendy

[Nathan53 in reply to Fredders]

Hi Wendy - thanks for your comment. The attached link seems to support your memory of alternative anti coagulants not being suitable when a mechanical valve is used. Just thought you may be interested. ahajournals.org/doi/10.1161...

[Fredders in reply to Nathan53]

It was a very useful interesting article, thank you. I think I’m one of the lucky ones as my inr levels have been within range since I left hospital in November 2017, but the information is very useful.

[Nathan53 in reply to Fredders]

Just a further point as Dressers says alternative anti coagulants to warfarin may not be suitable when as mechanical replacement valve has been used. You could still discuss with GP / Cardiologist but maybe warfarin and home testing is preferable.

[Chrijan in reply to Nathan53]

Thank you I will get him to discuss it next week when he’s back up there . It’s been good advise on this forum and nice to here peoples views. I had not realised how stressful this all is .

[Mary_Janet in reply to Fredders]

Other anti coaggulants other than warfarin have been tried and researched and were found to cause clots forming around the valve so the research was stopped very quickly. So it's warfarin for those of us with mechanical valves.

I also home test and find it very good. Surgery very supportive , I too have coaggu check but in my case the surgery provide bothstrips and lancets. Best wishes. Mary

[Chrijan in reply to Mary_Janet]

Thank you .

[glezz]

I am an anticoagulation specialist nurse.

It would depend on who is managing his Warfarin and what time their clinics are open. I know that my organisation offers clinics both morning and afternoon.

Self testing may be worth looking at.

He could have his own meter and simply test himself and ring or email his result in for dosing.

[Chrijan in reply to glezz]

Thank you . I now the other surgery we can go to does it now in the evening so hopefully he can go there .

[Hanibil]

Hi I’ve had a mechanical valve since 2005 I would highly recommend a home tester, he will soon be able to work out what amount of drug he needs to take. And if he is ever in doubt he simply rings the clinic for advice. This should cut his visits to hospital to around two a year.

[Ang1967]

I have a mechanical valve and self test - my doctor provides the strips on prescription it’s changed my life! I see the nurse about once every couple of months for an Inr check and review

[Fortepiano]

I would also recommend self testing. This is also useful because you can test more easily with illness or new drugs e.g antibiotics.

When you say your son is very careful about his diet, does he try to omit foods containing vitamin k?

I only ask because this can be a cause of unstable INR levels. INRs are more stable on a normal healthy diet which is consistent and which includes vitamin k. Such diets need a higher warfarin dose but have fewer ups and downs.

The key is to be consistent.

[ILowe]

If you have a self-test kit you can test any time. Then there is the question of dosing. There are many ways of arranging that and you will have to negotiate with what your health provider wants. Ideally, you should do the dosing decision the same day you take the blood sample. That is less likely if you test in the evening and phone through the results to your surgery.

Some people also self-dose. This gives the greatest freedom. Self-dosing is easy, but doctors etc are usually nervous about it.