PT INR Blood Testing In Bahamas

[pesarsten]

I am on Coumadin and need monthly testing for anticoagulant levels. I plan on cruising in the northern Carribean this spring.

Can anyone offer advice on getting my blood tests done in remote areas?

Has anyone dealt with the VA while cruising away from the US?

Paul

[FSMike]

If you're going to be in the Bahamas it should be easy to get a blood test in Nassau, not sure about anywhere else.
If you're going to be in the northern Caribbean I don't have any info for you.

[CaptTom]

I understand the "finger stick" tester (much easier than drawing blood!) is now available for about $800. Not a smart investment if you're always near a lab and your insurance pays for tests anyway, but may be well worth it if that's not the case.

[DutchIV]

Brand new to this forum and I've been sneaking around trying to find answers to the same question.
While cruising, the INR meter might be useful since likely there are diet changes, maybe more alcohol drinks, more or less exercise. I am a bit concerned about the communication between the home clinic and me about dosing changes and although I am perfectly capable of dosing myself, they easily might drop me as a patient due to liability (have been booted out before since the lab was unreliable faxing my INR over). Maybe I making too much out of this and would like to hear from others.

[Geitz]

Ask your doctor about Coaguchek from Roche. I got one after heart valve replacement and test every other week, then report results to the website. The coumadin clinic reviews the results and calls me if I need to make a change in dosage.

[DutchIV]

Originally Posted by Geitz

Ask your doctor about Coaguchek from Roche. I got one after heart valve replacement and test every other week, then report results to the website. The coumadin clinic reviews the results and calls me if I need to make a change in dosage.

Thank you, I will definitely look into it.

[HankOnthewater]

A couple of months ago there was another similar thread here
http://www.cruisersforum.com/forums/...-154229-2.html

[hellosailor]

My father had one of the first private-party INR testers. The cartridges needed to be kept refrigerated and in-date, I think ordered monthly. And the machine itself had to be calibrated, tested against a same-day lab test to have it reset properly, either every 30 or maybe 90 days.


I'm sure they've improved by now, but they are nowhere near the convenience of a blood-sugar fingerstick kit.


From the benefits.va.gov web pages:
"
Health Care for Veterans Living Abroad (Excluding the Philippines)

The Foreign Medical Program (FMP) Office is responsible for determining eligibility for reimbursed medical treatment while traveling or residing abroad, except in the Philippines. Reimbursed medical care for U.S. Veterans residing or traveling in Canada and other foreign countries is limited to treatment for VA rated service-connected disabilities only. Generally, as long as the service is medically necessary for the treatment of a VA rated service-connected condition, it will be covered."


So unless your Coumadin is the result of a service injury...it sounds like they will have no facilities and no reimbursement. You might try calling the US embassy in each of the major spots you plan to visit, and asking what is the most reliable hospital or testing lab in that location, then comparing their costs to what a machine, plus cold-packed air express supplies, plus calibrations, would cost you.


IIRC there's a fairly new drug being pushed as an alternative to Coumadin for some users, which does NOT require the frequent testing. If your doctor is unaware of it, try someone who is more up to the times.

[Geitz]

With Coaguchek, there are strips that you have to apply the blood sample to after using a spring loaded Lancet on your finger. They don't need to be refrigerated, but need to be protected from high heat, as I understand.

[Geitz]

A good resource for info on self checking INR is www.valvereplacement.org.

[Geitz]

Also, how long will you be cruising? You could tell whomever is managing your dose about your trip and change the timing of your INR test. Maybe test just before your departure, then again when you get home, I guess depending on the length of your cruise.

[GordMay]

Greetings and welcome aboard the CF, Dutch.

[Ray Majors]

Hi. You could also ask your doctor if switching to Xarelto or Eliquis is an option .
Neither requires monitoring INR.



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[DutchIV]

Thank you all for the replies and the welcome.
I did look into home monitoring systems as suggested and there are many available. Not cheap, but I think it's the best option for me, rather than walking into some lab, somewhere. Because of a mechanical valve I have to take warfarin.
Truly my concern is mostly communication between a clinic and me when cruising and unreliable phone/internet service. Warfarin is a great drug for what it does but can be dangerous and I can't blame the GP for not want to Rx it if I can't keep my end of the deal, i.e show up or call in a timely fashion with meter results. Obviously people have done this before and again, I may be making too much of it.
So, onto my next project; find INR monitoring system. Of course now I can obsess over one where the strips need to be kept cold and meters calibrated, another CF thread....Uff Da!
Thank you all, Irma

[pesarsten]

Thanks for all the helpfully info. My heart problems are due to my service so any medical care anywhere is covered.

I used to take pradaxa , but the Va Drs switched me to warfarin since pradaxa is not trialed for replaced valves, mine is tissue. I have laid it on the line and told them I was leaving, with or without meds, so get busy and find a solution.

I wanted to know if anyone else was able to solve this type of problem with the VA.