Oral Anticoagulant test

[Coachman]

Had a bit of a bummer this afternoon bearing in mind we leave this Sunday to go to France. Wife's test showed she has to have another this Monday, the other test have been anything up to 6 weeks between but her reading has shot up to 5.7. Any advice would be appreciated, i reckon we will be around Charleville-Mezieres where a Aire is. (No 31 in French Aires book)

[naittaw]

I presume you are talking about Warfarin or similar ? I will be glad to see any advice that picks this thread up. I should be in France now but after a bit of a dizzy was put on Warfarin two weeks ago. All other tests show heart sound but a bit of an erratic heart beat. I am told that it will take 6 weeks of weekly tests to stabalise the dosage. I fear that the summer may pass before I get on the move. I'm told that a change of diet will affect the INR, and of course an overdose of alcohol or any quantity of Cranberry Juice. Hope you get things stabalised and all goes well.

[Randonneur]

Coachman, you have left it a bit late for advice but I will try to help.

 

If you can get a letter from your Doctor stating the tests that you require to be done then you can go to any Laboratoire wherever you are and they will do the blood tests for you. Usually you get the results the same day. If there isn't time for you to get the letter then go to any Doctor in any town and explain what you need to do and he will then give you the 'Ordonnance' to take to the local Laboratoire.

 

Whichever way you go, there will be a charge for the Doctor approx 22€ and then a charge for the blood tests maybe 28€. These amounts will probably be able to be reclaimed at some point.

 

Don't be afraid of going to a French Doctor as the majority of them speak good English although they don't like using it.

[Coachman]

Many thanks for advice, she is getting herself in a tizzy over it espeially as its been at such notice.

[flicka]

Coachman - 2010-05-07 7:03 PM

 

Many thanks for advice, she is getting herself in a tizzy over it espeially as its been at such notice.

 

Hi Coachman

It's quite understandable your wife is concerned. I don't want to alarm you, but make sure you are aware of potential problems.

It is important that you wife has regular INR tests at the start of her treatment.

 

My wife was put on Warfarrin (?) and her Doctor told her we were OK to go on a pre-booked holiday without explaining things & I admit we were niave.

She had 3 days of Warfarrin & a test on the Friday, with instructions to ring the following Tuesday for results (Bank Holiday weekend) By Monday she was an emergency admission to Torquay hospital with an INR off the scale & informing us that the slightest knock / cut could have resulted in her bleeding to death.

When the hospital rang her Doctor to check they were told the Doctor had been trying to contact us AT HOME, despite us giving our Mobile No. & they were aware we were going on holiday.

Fortunately after 3 days Torquay hospital stabilised my wife after 4 days as an inpatient. Then with daily lunchtime tests by a District Nurse, with the results back to us by 5pm.

[KeithR]

dont know anything about medicine, but

the aire at charleville-mezieres is good, and right outside the campsite if thats your bag. its a free boat ridde or pleasant short walk into town.

 

[weldted]

is her safe range 2.5 to 3.5, my mum's is every now and again it goes haywire, small things like most cough medicenes, allergy tablets for hay fever, even paracetamol can influence a change, great care has to be taken when outside the safe range, so I would excersise caution! Not wishing to be a kill joy but playing safe!!

[art338]

Coachman,

 

Keep it simple is the first comment. Do not get wildly unhappy about it.

 

Changes in the weather produce body changes which cause our metabolism to fluctuate. With ladies there is often a rapid rise due to the excitement and concern over the pending travelling arrangements.

 

Several factors can produce fluctuating blood count readings, birthdays, deaths and aniversaries are but a few. Changes in atmospheric pressure and temperature are often causes.

 

The election, a rough sea, a wet weather forcast, all add up.

 

You should find within a short while it will revert to 'normal'.

 

Art

[naittaw]

Hi Welted,

I was told that Paracetamol and any product containing it was a no no ! Aspirin is OK.

[colinfrier]

Here in Spain the wife is on Sintrom (same as Warfrin) we go to the local medical centre they have a small machine that gives an instant readout I understand these machines are available but very expensive.

As to pain killers the only one allowed is Paracetamol Asprin is a big NO NO as it thins the blood also alcahol consumption should be minimal

[naittaw]

Apologies for my last input. Asprin only under doctor's prescription. Paracetamol OK.

[Coachman]

Again thank you to all replied, a little bit of her history might help.She had a bad attack 3/09 with AF and has been on Warfarin since with regular INR checks, she has gone from 1.7 then up and down till Nov' last year where it levelled out to around 2.5 which is her aim, it had stedded so much that there was an interval from19/2/10 till this Friday which went to 5.7 and that was what shook her, and as said going to France did not help. Her next check from our hospital is 28/5 but to see someone in France in between.

[naittaw]

I have been told, off the record, that kits are available for self test, but that clinics reluctant to supply them. Might be worth asking ?

[jhorsf]

this may be worth a read

 

http://www.cks.nhs.uk/anticoagulation_oral/management/scenario_anticoagulation_oral/training_for_self_testing

[naittaw]

Thanks Jhosrf, that's a very interesting and helpful reference.

[eljay]

Hi Coachman,

 

I was in a similar situation a few years ago and pondered what to do. My local anti-coagulant testing service suggested finding somewhere to get the test done. At the time the test was due I was stopping overnight in Bordeaux and went direct to the University hospital and asked around for the Clinique Anti-coagulant. There I found that i could have the test done "on the spot" and all I had to do was to telephone later that day for the results. I was fortunate that my results showed that my INR was stable, but the doctor was ready to give advice on what level of Warfarin (branded as Coumadine in France and only available in 2mg tablets).

 

At that time my knowledge of the language was very limited, but I found people were very helpful in trying to get me to the location of the right department in the hospital. Oh yes, the bill for €9.87 was sent to my home address in the UK.

 

Good luck with your trip.

 

J

 

[peterjl]

Hi

 

you can buy the machines to test yourself - works from a pin prick in the finger - downside the machines cost about £700 from Roche diagnostics + about £2.50 per test strip (which have to be kept refrigerated).

 

Stabilazation on doseage takes at leats a couple of weeks and in theory should settle down so that you only need a test about once a month but my wife never really stabilised and had to be tested every couple of weeks.

 

Things to think about -

Is she on warfarin permamnently or for a fixed period - typically 6 months

the doseage range will vary according to reason why prescribed warfarin.

 

My wife was only on for 9 months in the end but we went to Europe in the motorhome - i just discussed with the nurses beforehand to make sure we were ok - a test before we went and booked in for a test on return.

 

You can also arrange tests whilst abroad - i set up one by email who i found through a google search.

 

If travelling in UK you will find that some GP surgeries can do the test - if you need to organise try and phone the surgery and talk to the anticoag nurse - she may have to discuss with GP but the NHS allows for this under the temporary resident scheme.

 

Try and make sure you have the "yellow book" which details all the tests plus reasons, doseage range etc - these yellow books are great but they are being phased out however some GP's surgeries give a printout each time you have a test and this gives the info. Try and keep a record of all the test results and any doseage changes as another dovtor looking at at any test results will need an accurate history to prescribe the doseage.

 

With my wife doseage went up and down like a fiddlers elbow - it is not necassarily diet but diet does effect so get info from the nurses - they should provide full education during the stabilisation period. eg Broccoli can effect as can alcohol but off course if you just continue to eat drink as usual this is reflected in the doseage.

 

No oral test at present but an alternative to warfarin is in trials - albeit it has been talked about for ages so don't hold your breath.

 

Roche Diagnostics are helpful and i used to know someone who monitored themselves although not sure if doctors approved!

 

Hope that helps

 

Peter