Rachel’s adventures with a sharp pointy object and lots of plasters
How hard can it be stabbing your finger with a sharp object and then putting the resulting blood that collects on a strip of plastic?! Harder than it looks, is the simple answer. The long version of it is below.
Due to Factor V Leiden (FVL), a genetic clotting disorder I have, and the fact that I’ve had two DVTs and a pulmonary embolism in the past, I’m now on warfarin for life. Since I went to an information session on INR self-testing in June, I’ve been trying to persuade the hospital’s anticoagulation clinic, my GP, and the local PCT to let me do INR self-testing.
When you’re on warfarin you have to have regular blood tests to make sure you’re on the right dosage of warfarin, and that your blood’s not either too thick or too thin, with a test called an INR (International Normalized Ratio) test. Depending on how stable your results are, and how sensitive you are to changes in warfarin dosage and what you’re eating and drinking and how much activity you’re doing, and even the weather (various food and drinks can affect INR, as can the weather, as naturally your blood thins in hot weather) sometimes you need to have the blood tests done quite regularly. At other times you can go for weeks or even a few months between needing blood tests, but it’s always time consuming, going to the clinic, having the blood test, and waiting for your results, and can be very disruptive to your life because either you need time off work for appointments or have to plan other things around your appointments.
When I first found out about self-testing, I was very excited about it, because it’s been thoroughly researched and has been shown to be just as accurate as lab tests, means you’re more in control of your treatment and your life, and waste less time hanging around waiting for blood tests etc., and patients who self-test have been shown to be in their therapeutic range (the values of INR you’re supposed to be between so your blood’s not too thick or too thin) a lot more of the time than patients monitored by their local hospital.
INR self-testing machines are similar to the ones diabetics use to monitor their blood glucose – you get a blood sample from your finger by using a lancing device, and put the sample on a testing strip that goes in the machine, which about a minute later gives you your result. Providing you follow the instructions, it’s fairly idiot-proof (though as I’ve discovered, the lancing bit isn’t as easy as it looks).
The problem with self-testing though is that you have to buy the machine yourself (nearly £400) and that the testing strips for them are very expensive. From going to the information event though I had got a £100 off voucher, and the testing strips are theoretically available on prescription. The problem is though that many PCTs block GPs from prescribing them, presumably on cost grounds.
The local hospital’s anti-coagulation clinic were dead against the idea, and did everything to put me off going ahead with it (even at one point giving me information which I knew was wrong because I’d already researched it in depth myself), but after presenting my GP with all the information I’d gathered on it and the benefits of it, I got my GP on-side, but since June we’ve been trying to get a decision from the PCT on whether he can prescribe the testing strips for me (I have the campaign pack produced by the UK anticoagulation charity to help with campaigning to change their mind if they say no though). Anyway, in the meantime, I’ve stopped going to the hospital’s anticoagulation clinic and I’m being monitored by my GP until we get a decision on the testing strips. In the meantime though I went ahead and got the testing machine, as my voucher expired at the end of August.
Though I’m being monitored at the surgery at the moment, last week when I saw my GP we agreed that this week I’d test myself just to try out the machine and how me ringing in with the result worked, and Thursday was to be “I-Day”, the first time I’d test my own INR…
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