Coagucheck vs Protime?

[Lorraine]

Hi Everyone,

I went for my year check up, a few months late and everything is looking good. The cardio said I'm clicking just fine. My INR was 2.7 which was fine with the cardio. I myself rather see it at 3.0 to feel safer. Anyway, I have a question. I talked to my cardio about getting a Protime machine and he's willing to sign the papers. When I was talking to the nurse about it she said I should try to get a Coagucheck, which is what they use. I thought I had read on The Forum that they were available to patients again. I had mentioned to the nurse that at one time they were no longer available. Does anyone know the phone number, email address oe website so I can contact them? I thought I had read on The Forum that they were available to patients again. Was that from you Marty? I can't remember. So it looks like if the insurance is willing to pay, I'll be able to get one. I would rather have the Coagucheck just because I'm already very familiar with it. Not that the Protime isn't good, Hank! I felt that worked fine too. What was my reading in Nashville? 3.2. That was great! Any help with be deeply appreciated. Take care and God Bless!

[Hank]

Hi Lorraine,

As far as I know, the coaguchek is only available in Europe. I'm sure someone will correct me if I am wrong.

[Lisa in Katy]

It's available here now, just not the S model. I have a number, but I don't have it with me right now. I will try to remember to post later.

[DickV]

Lorraine, check out this site. I believe Lisa is correct. You now can get one in the states, just not the "S" model. Lisa and I use the same cardio group and they use a Coaguchek.


http://www.coaguchek.com/

[Marty]

Lorraine, I get my supplies from First Diagnostic in Indianapolis.
1-800-428-5076. Last week I helped a lady 8 weeks post AVR with a St. Jude get her Coaguchek-S up and running. I have the old standard model and it works fine but I really liked the S. The ladies husband is an M.D. orthopedic specialist and I think he got the unit through his office. I'm still not sure how the Coaguchek sells to lay people, how the support and training are supposed to work. If I find out I will let you know.1-800-428-5076

[DickV]

Marty, my cardio has an "S" and I was in last week and asked the nurse if anybody ever pegged out at 8, the max range of an "s" and she said all the time - three times that week. She said when they peg out at 8 then they do the blood draw to see how much more than 8. Some were in the 10 and 11 INR range. Thats pretty scary.

I like my "S". Sort of like the sport coupe version of the regular machine.

Also, the office had a gizmo called an Electronic Quality Control made by Roche. It is a small electronic device which you insert into the slot for the strip and runs electronic controls and replaces the need for liquid controls. She said when you go through as many boxes of strips as they do, it is worth the money not to have to run liquid controls each time. She made me a copy of the users manual. Ever heard of it?

[Marty]

Hi Dick, I heard about the device last week for the first time when I checked out the lady with the recent AVR(St. Jude). The device is a good idea to check out the monitor. I still think you need at least one set of liquid controls per box to check out the test strips.

[DickV]

Marty, "S" models only have one set of liquid controls. I understand the other model has two. From what I understand from the office nurse, these are not required with the electronic controls. She said she also tests the machine by poking herself. Since she is not medicated, she should be a 1.0 and she said the machine always regesters .9 or 1.0. What dedication.

[Igor]

I am thinking about buying a test unit and after all these emails the question is which unit would you recommend to purchase: PROTIME or COAGUCHEK? - Igor

[Christina]

Igor,

Some of us have the Protime and some of us have the Coaguchek. The people that have the Coaguchek say that it does well for them and like it very much. I have a Protime myself (Coaguchek wasn't available at the time in the USA) and I like that. I find it to be very user friendly and I trust it. I haven't been to a lab in almost a year now. I have never seen a Coaguchek so never used one. I am sure someone will come along and tell you all about their experience with the Coaguchek. (Gina, Marty??)

Christina
Congenital Aortic Stenosis
AVR's 8/7/00 & 8/18/00
St.Jude's Mechanical

[DickV]

They are both good machines. I have used both and they basically perform the same task. The Protime is probably easier to get here in the states.

[QAS]

Hello,

The ProTime and the CoaguChek are both excellent monitors that allow Dr's and patients to better manage anticoagulation. In regards to differences, I know that the CoaguChek requires a $300.00 training course and you have to purchase controls. However, it is an excellent device that has proven it's worth over the years. I am sure that it will be available to patients when Medicare covers next month, along with Johnson and Johnson and our ProTime Microcoagulation System. If anyone would like to compare the monitors, please feel free to call us at 800-298-4515, or you can reach Roche at www.coaguchekusa.com.

Lance

[Hank]

I have used both the Coaguchek and the Protime monitors. I personally like the ProTime better because the options it presents on the menus are more user friendly. I also like the way it does quality controls with each test and doesn't require me doing anything in order for that to take place.

Y'all may think I'm just saying that because QAS who provides the ProTime monitor is a sponsor of the site. Well, that's just a plus for us that we have them here, they are a great company.

If Roche started sponsoring us at the same time, I would still like the ProTime.

[Gisele]

Don't get me wrong, I love my Protime machine, but I still definitely have a problem with trying to get my lab and my machine to be in the same range. When I first got my machine my cardio made me go to the lab when I tested myself to compare the readings. He was not happy with what he saw. The lab drew my blood stat as the two had to be done within 1/2 hr to be considered comparible. I think I had to go something like for 15 weeks. It seemed that when my results were low, the two results were very close, but the higher my INR--the wider the range difference. Last week I had to go to the hospital to have LFT's done, so I had an INR done, just to spot check & compare, and now I am wishing I hadn't. I got a reading with my Protime of 3.4, and the lab got 4.3. Big difference! Now my cardio really won't believe my machine at all! I am baffled how other members of this board can get their machine and their labs to match so closely. Could there be some kind of malfunction with my machine?I have never had to go on Lovenox prior to my machine, and now I have to keep a supply on hand due to low readings. And I did have that bleed in my hip on the Lovenox. Maybe I really got a false low reading??? Any suggestions???? Anyone else have this problem?
Gisele

[Marty]

First, an answer to Gisele. I was told by Roche technicians that my Coaguchek was most accurate around INR 3.0 as INR went up Coaguchek would possibly give a slightly off but higher reading than the standard lab procedure and at the lower levels it would err on the low side. However I have also talked to experts who say discrepancies like yours ,Gisele the Protime has as much chance to be right as the labs reading.

Now, let me make myself clear. I like the Protime and particularly like Lance and Brian. If you purchase a Protime you get great support.

However if you are determined to buy a Coaguchek( non professionals cannot get the new S model in the USA);Roche will let you have the standard Coaguchek monitor that Gina and I have. Its a good unit that has stood the test of time. Roche however still does not make it easy to buy. Here's what you do.

#1. Obtain a prescription from your M.D.
#2. Initiate training by first paying $300 to Laboratory Compliance Consultants Raleigh NC run by Ann Pontius. 919-859-3793.
#3.Successfully complete training.They will make an appointment for you with a specially trained professional in your area.
#4. Pay $1295 and they will send you the monitor. Test strips and controls will be shipped and billed separately.

Good luck!

[Perrster]

Looks to me like the Protime is the clear-cut winner in this competition. I can't wait to get mine. The good folks at QAS are doing all the work for me and I'm just waiting for my insurance company's response. Whether it be positive or negative, I am buying the Protime.

Hopefully this Thursday will be my last ever need to see the clinic's vampire bats.

Cheers!

[Marty]

Perry , you will love self testing and hopefully self management one day soon. You'll wonder why you waited so long.

[Gisele]

QA was working with me to track the difference when I first got the unit, but to be truthful, there was no clear resolution to my problem. QA questioned the hospital accuracy, and my MD questioned my unit's accuracy. Who do you believe??? MD naturally will lean towards the hospital, and does not believe my results that I am able to obtain at home. He deals with it as he has no choice, but he isn't happy. It would have been so much easier for me if the two (lab & unit) were somewhat closer in range. I do everything right, curvette's are refrigerated, warmed for a min of one hour, puncture is done properly etc..... I just can't figure it out.
If anyone has any suggestions, I would be glad to listen.
Thanks. Gisele

[RobThatsMe]

Hi,

I have one suggestion to offer, and that is to change the place that you are using to measure the lab results. Go to another lab, or hospital, have that facility compared against your unit.

If you still have a large varience between results, perhaps obtain a different Protime unit and compare those results against the lab, and even your original Protime Unit.

First though, I would try going to a different lab and comparing their results. Also, you should be comparing INR results, not protime results, the INR results should be very close, the protime results could be different based on the median (SI) used at the lab versus your unit. the INR is the universal standard measure, not the protime.

Good luck, Hope this made sense, I am still on my first cup of coffee <smile>

Rob

ps. I was in Boston for 5 days last week. Hmmmm.. wish I thought of it, we could have met and compared the results of your unit against mine. Maybe someone else has one that is in your area and could try this with you.

[Gisele]

I am comparing INR results. I never look at PT results as the results vary depending on the control. I could use another hospital in the area, but I wonder if using a different unit would help. Everyone else seems to be right in line, and I am using a hospital lab, having my results done stat so that they don't sit around, and I am testing within a half hour of both tests. Not sure how else I can make sure they are comparable.
Will try to obtain an order for Lowell Gen. Hospital. Anyone in the northeastern Massachusetts, southern NH area with a Protime unit??
Thanks Gisele

[Marty]

Giselle, the top hematologist clotting guru in the country is right in your backyard.He's one of the pioneers in patient self testing. He's at Boston U. Med Center. His name is Jack Ansell. Four years ago when I was just starting with my coaguchek I would Email questions and get prompt replies. Then I had a chance to meet him while at a medical meeting in DC and discussed this whole busines of central labs vs. home monitors. As Rob says don't put blind trust in your hospital lab.When I tested my Coaguchek against my own lab a few months ago there was a discrepancy that worried me. Later that day the chief lab tech came into my office and sheepishly admitted she found an error that they made because they were very busy and did not program their computer properly.I was ready to change my dose!

[Gisele]

Do you have his e-mail address? I just don't know who to believe anymore, and after having that problem on Lovenox, I wonder if I really needed it at all! Then a few weeks ago after finishing about 4 or so days of Lovenox, I had appt with new PCP. I had all kind of abnormal labs. They might not be related, but then again-who knows? My GGTP was 550 among other things. Went for repeat labs to rule our hepatitis, plus iron studies which came back normal. Haven't heard from PCP on what next step will be.
I think I am starting to fall apart, but I still have my sense of humor!
Thanks Gisele

[Zipper]

Gisele,

I don't know if you saw my post on my experiment, but maybe you could do this. It was very reassuring for me and my Lab tech checked to see if the same calibration (or something..not sure) were being used. He said it's important in order to compare readings. I'm sure Marty or Al would know what mean.

I took my Protime unit to my lab..they did a draw...from that draw he placed drops in the 'funnel'..now we had two readings..I then did the finger stick for a third reading...They were all very close..not enough difference to matter. I always use the same lab since I work at the hospital and the same lab tech, as I understand method of drawing (easy/clean, or need to 'probe/difficult) can also produce different readings.

Maybe this experiment would work for you to see exactly why your readings don't match up. I hope this is of help..I can understand your frustration!!!!

Take care, Zipper

[Marty]

Giselle, Dr. Ansells E-mail is: Jack.Ansell@bmc.org
His office is at Boston University Medical Center
88 East Newton Street, Boston 02118-2395
I note that his latest honor was being elected President of
the ISMAA (International Self-Monitoring Association For Anticoagulant therapy) at the meeting of the International Society of Thrombosis and Hemostasis April 2001 in Bad Homburg Germany.

[Gisele]

#1, Zipper, I have brought my unit on one occasion to the hospital lab so I could do both at the exact same time. I think the prob. with your method is, even though if I understand you correctly, you are saying use the same draw for both tests?? BUT regardless if I stick my finger, or I have a venipucture they should both equal the same. It is unrealistic to say a venipucture draw will result in a different INR reading, and a finger stick will give a lower or higher reading. The machine is made to give an accurate Inr result.
Coincidently, yesterday QA called me to check up on how I am doing with my unit. (I have had it for nearly one year). I explained everything that was going on and she is going to try to replace the unit for me just in case there is a problem with my Protime. I guess she has to check with the "higher ups", but I might feel more comfortable making sure my unit is OK. Of course that would mean that I would have to retest against the lab again in order the verify the accuracy, but it is worth a shot.

Matrx, thanks for that e-mail address. I will try to e-mail him this weekend to see if he can shed any light on this. All I can say, is either the hospital is incorrect, or my unit is wrong. It has to be one or the other and proving which one is difficult.
Thanks for your help...........................Gisele

[Zipper]

Sorry Gisele..I guess I was not clear...the point was to have a three way reading...finger stick and draw used in unit and draw analyzed by lab. It worked for me to see how close the unit matched up with the lab. The other consideration was the technique of the person drawing the blood..it can make a difference from I've been told.

Your dilemma may be solved by a new unit...I sure hope so since so many of us, thankfully, have had good results with home testing! Hang in there...Wishing you good luck and answers soon!

Zipper

[Gisele]

I think I will wait to see if they ship me a new unit. Afterwards, I know my MD will make me go to the lab at least a dozen times. Hopefully, things will work out. If I see that it isn't working out, I will ask the lab if I can compare a finger stick vs venipuncture blood to see if they analyze the same. But my question is: Why would it differ?? They always put a small amt of blood in a red top first to discard, then draw the blue top. Tourniquet is never on too long prior to draw. Is there anything else I should be looking for??
Thanks, Gisele

[Zipper]

Gisele,

I don't know..LOL! My lab tech said technique of draw can matter so suggested this 3 way thing as a matter of testing every possible way it could vary. Yikes...you must be fit to be tied...I'm thinking your anxiety level is the culprit now..jus' kiddin' !!!

I'm with you...wait for new unit and start fresh. Hopefully, it will work out quickly and your Doc will be co-operative after a couple of tests! I'll be thinking of you when I stick my finger tomorrow!

Take care,

Zipper *~*

[Lorraine]

Hi Everyone,

I wrote that post and then was on vacation for four days and when I got back I was swarmed at work so I looked at the forum but didn't get any posting in.
I want to Thank eveyone for their responses. MArty, thanks for the phone number. I'll give them a call this week and see if I can get the paperwork to get a Coagucheck. If not I will get the Protime. Reading your responses, it probably won't make any difference. My cardios head nurse just suggested the same kind they use because she said with the Coagucheck, you don't need to draw as much blood. Myself, I didn't really notice much difference in the blood being drawn from the Coagucheck, and when Hank did it last fall with the Protime. Plus it sounds like the Protime is overall cheaper. My only obstacle now will be to get my Blue Cross/Blue Shield PPO to pay for it I guess. Reading the post it sounds like they may not. My cardio said he would write whatever he needed to write to convince them I need a home unit. So at least he's on my side.
I feel real nervous right now going once a month to get checked. Like I had said, my last reading was 2.7 and the cardio was happy with that. I wasn't. I rather be around 3.0 to 3.5. I have two valves replaced and I rather my blood be a little on the the thinner side.
I had another question. With summer here is the Coumadin and INR affected by hot weather and not wanting to eat as much? I know everyone says to get checked before you go on a trip and afterwards because your eating habits and dailey rituals change. Well, isn't this true with it being summer too? I don't know about everyone else but I don't care to eat much, especailly my evening meal. I may just want a yogurt. Would be too afraid to do a salad more than once a week.
Thanks again for the responses and take care!