When she was diagnosed with Atrial Fibrillation and placed on the blood thinning medication warfarin, Patty Borkowski began regular trips to the Anticoagulation Clinic at Froedtert Hospital in Milwaukee, Wisconsin. She didn't realize her experience was different from that of other women on blood thinners.
A consistent and controlled blood thinner level is essential for a patient's health and safety. If the blood is too thin, there is the danger of excessive bleeding from small injuries or of internal bleeding. Regular blood tests are required. Yet, regular testing can be intrusive on a woman's lifestyle, especially when she is juggling a family and career as well as her health.
Patty is scheduled for a five-minute appointment at the anticoagulation clinic during which a very minimal amount of blood is drawn from a prick in one finger. The blood goes into a machine, which produces results in forty-five seconds.
A pharmacist is on hand to consult with her and make immediate adjustments to her dosage. At the end of her visit, Patty receives a print-out with her INR number (International Normalized Ratio a measure the thinness of her blood), new warfarin dosage along with a number to call with any questions.
The information, immediate results and access to an expert allows Patty to feel like she is in the driver's seat in her own health. “It allows me to do what I can to be sensible and smart.”
“That sounds heavenly, compared to what most of us go through!” exclaimed Mellanie True Hills, founder of the American Foundation for Women's Health.
For most women, regular testing means getting to the lab during a small window of time in the morning, having a significant amount of blood drawn from the arm, and then waiting for a nurse to call with the results later in the afternoon. The inconvenience often causes women not to be tested as often as they should. The large blood draw causes bruising and the wait can waste precious time in resolving a problem.
Remarking on the importance of having a consistent INR level, Mellanie said, “It's great that you are getting that instant feedback and can make adjustments right away.”
In addition, to making testing more convenient, any time Patty sees a physician in the system she is reminded to call the anticoagulation clinic to discuss any new medication.
When recently diagnosed with pneumonia, Patty's warfarin dose was immediately cut in half based on the new medications she was prescribed. “It never would have occurred to me to check in with the clinic. It would have been a while until my next appointment and it isn't a pleasant thought to think what might have happened.”
“Just to be able to walk out of there with no questions and everything so thorough, and have it on the papers there for you – that's just amazing,” shared heart attack survivor Kay Marie Kortas.
According to Patty, “It makes a difference in everyday living.”
“Once we have our acute problem solved, we still have to live every day,” said Eliz Greene. “When our doctors and health care facilities can help us do that better, that's the real key. I lived on Coumadin® (a brand of warfarin) for two years and then was able to be put on Plavix®, which was a huge improvement just not having to go in and be tested.”
Read more about the Patient's Perspective on Blood Thinners in the Patient's Perspective Magazine or download the Special Report on anticoagulation clinics. You may also listen to the discussion on anticoagulation clinics or the full conversation on blood thinners.
Please share your thoughts on anticoagulation clinics or suggest topics for future Patient's Perspective calls by making a comment below. Thanks!
The Patient's Perspective is a monthly teleconference addressing the challenges faced by women living with heart disease. The teleconferences are hosted by Eliz Greene, Director of the Embrace Your Heart Wellness Initiative. Find out more at www.EmbraceYourHeart.com
Building on rapid office based testing with a simple finger stick - patients should discuss weekly home monitoring with their doctor. This allows patients to easily and accuarately obtain an INR test results in their home. For more information and to see how this works to support improved Coumadin safety email me: Gary B Liska
at [email protected]
Posted by: Gary B Liska | August 27, 2007 at 02:15 PM
Thanks Gary! I checked out your website at www.PTINR.com and it is fantastic! Having the ability to test at home would vastly improve the qualify of life for women living on blood thinners -- I'm delighted you shared this information with us.
Thanks,
Eliz
Posted by: Eliz Greene | August 27, 2007 at 06:52 PM
This is not news. Many of us have been testing like this for 10 years or more. The question should be why nobody told her about this before.
Posted by: Al Lodwick | August 28, 2007 at 03:28 PM
You are right Al. That IS a better question! So far I haven't talked to a patient who has even heard of home INR testing, and I've been asking around. Obviously, more people need to know.
Posted by: Eliz Greene | August 28, 2007 at 11:10 PM
Several years ago, I read about home INR monitors, which seemed to be a perfect solution to my challenge of having to track down labs for weekly INR testing while traveling the country in our motorhome. My doctors, however, felt that home monitoring was too unreliable and too expensive, and thus could not recommend it.
Fourtunately, atrial fibrillation surgery eliminated my need for Coumadin® several years ago. In the meantime, there has been a lot of progress with home INR testing. My sense is that many doctors still believe that home monitoring is unreliable and expensive, which is why they don't recommend it to their patients.
I believe that the ability to test on demand could prevent strokes and save lives.
Mellanie, Founder of www.StopAfib.org atrial fibrillation patient resource
Posted by: Mellanie True Hills | September 03, 2007 at 02:02 PM