Pt (prothrombin) Test For Coumadin/warfarin

[peekint]

My 80 year old mother has just moved to live in Chiang Mai. She takes coumadin/warfarin for a heart condition and needs regular testing for her clotting time (PT).

In the USA, the doctors office did the test using a hand-held meter much like a blood sugar meter (it was from HemoSense). However, at Chiang Mai Ram hosptital they still do a full blood draw for this test. This is a problem for my mother, since she's a cancer survivor and has very thin collapsing veins as a result of chemotherapy 25 years ago.

Does anyone know of a doctor or hospital in Chiang Mai that uses the Hemosense or other meter to do PT testing?

This is important, since it's just not going to be possible for her to have blood drawn every 2-4 weeks to monitor her PT if they have to find a vein to do it!

Thank you!

[PeaceBlondie]

I take 600 mg of aspirin every day, have regular bleeding under my skin, and bleed for an hour or two if I cut myself shaving. Never heard of a clotting test.

[orang37]

I take 600 mg of aspirin every day, have regular bleeding under my skin, and bleed for an hour or two if I cut myself shaving. Never heard of a clotting test.

Sawasdee Khrup, Khun Blondie,

mmmm ... are you sure you are doing the right thing there : if, god forbid, you were in some kind of accident and needed surgery, this might prevent/delay surgery for some time. perhaps this is true for anyone, however, who needs to take any kind of blood thinner.

best, ~o:37;

[orang37]

My 80 year old mother has just moved to live in Chiang Mai. She takes coumadin/warfarin for a heart condition and needs regular testing for her clotting time (PT). ... snip ... Does anyone know of a doctor or hospital in Chiang Mai that uses the Hemosense or other meter to do PT testing?

Sawasdee Khrup, Khun Peekint,

imho the right place to look, now that you've excluded Chiang Mai Ram (great doctors, and an administration, imho, which is an "extortion racket" for farangs) is the Sriphat Medical Center within the Maharaj Nakorn Chiang Mai Hospital Center : this site appears to give information (and e-mail addresses) of their Cardiology faculty :

http://www.med.cmu.ac.th/dept/intmed/engl/staff-eng.html

For general information :

http://www.med.cmu.ac.th/about/maharaj.htm

Chiang Mai University, Maharaj Nakorn Chiang Mai Hospital, Family Health Clinic

110 Intavaroros Road

Sripat Building, 11th floor

66-53-221-966

(sometimes referred to as "Suan Dok Hospital" because it is close to the famous Wat Suan Dok) on Thanon Suthep here.

There have been many posts in this forum on Sriphat, and its connection with the medical school, the quality of its doctors, etc. Just do a search on this forum. For example see :

http://www.thaivisa.com/forum/Maharaj-Nako...al-t199724.html

best, ~o:37;

[PeaceBlondie]

My regular physician at Sripat is a neurology professor at CMU, but tries not to overdose me. Bleeders are more careful.

[siam2007]

My 80 year old mother has just moved to live in Chiang Mai. She takes coumadin/warfarin for a heart condition and needs regular testing for her clotting time (PT).

In the USA, the doctors office did the test using a hand-held meter much like a blood sugar meter (it was from HemoSense). However, at Chiang Mai Ram hosptital they still do a full blood draw for this test. This is a problem for my mother, since she's a cancer survivor and has very thin collapsing veins as a result of chemotherapy 25 years ago.

Does anyone know of a doctor or hospital in Chiang Mai that uses the Hemosense or other meter to do PT testing?

This is important, since it's just not going to be possible for her to have blood drawn every 2-4 weeks to monitor her PT if they have to find a vein to do it!

Thank you!

try to get this one and you have all you need for a stress-free PT/INR-check:

www.coaguchek.com

will probably not be available for sale in Thailand, but maybe somebody from those many Western countries who travels to Thailand can bring it to you, or the manufacturer may send it to you....

[Sansai Sam]

I have had both my hips replaced and need to take 7 ml of coumadin per day. I also need a PT test frequently. I have always had it done through a blood draw even in the US. I am interested to know if you find an easier way. Good luck!

[Bill97]

There is a simple test where the blood is obtained by a small jab on a finger tip. At Sri Phat there is a cardiologist, he has been mentioned on this forum previously, search and you will find, he has a night clinic on Chotonaa Road about 90 meters from Chaang Puak Gate on the right side where he has the equipment for the test. Probably other cardiologist clinics have it too.

[CMDR]

www.coaguchek.com

Coaguchek as mentioned above is the only finger prick test for PT/ INR that I know.

Have seen in BKK but not sure in CM.

[hmficc]

I take 600 mg of aspirin every day, have regular bleeding under my skin, and bleed for an hour or two if I cut myself shaving. Never heard of a clotting test.

Sawasdee Khrup, Khun Blondie,

mmmm ... are you sure you are doing the right thing there : if, god forbid, you were in some kind of accident and needed surgery, this might prevent/delay surgery for some time. perhaps this is true for anyone, however, who needs to take any kind of blood thinner.

best, ~o:37;

Blondie,

You are doing toooo much of a good thing. 600 every other day is plenty. YOU COULD HAVE A BLEEDER IN YOUR BRAIN TRYING TO PREVENT YOUR NEXT HEART ATTACK. Check with a Dr. or go online. NO ONE suggest that amount.

p.s. You answer was nonresponsive.

[CMDR]

I take 600 mg of aspirin every day, have regular bleeding under my skin, and bleed for an hour or two if I cut myself shaving. Never heard of a clotting test.

Sawasdee Khrup, Khun Blondie,

mmmm ... are you sure you are doing the right thing there : if, god forbid, you were in some kind of accident and needed surgery, this might prevent/delay surgery for some time. perhaps this is true for anyone, however, who needs to take any kind of blood thinner.

best, ~o:37;

Blondie,

You are doing toooo much of a good thing. 600 every other day is plenty. YOU COULD HAVE A BLEEDER IN YOUR BRAIN TRYING TO PREVENT YOUR NEXT HEART ATTACK. Check with a Dr. or go online. NO ONE suggest that amount.

p.s. You answer was nonresponsive.

Strongly agreed!

Primary prophylaxis for Heart attack and stroke in DM and/or HT and/or Dyslipidemia in late 50 individuals is ASA grain I ( ~75 mg)

Seconady prophylaxis dose of ASA for heart attack and stroke in folks with old MI or old CVA is about 300 mg.

However many experts prefer low dose(75-80 mg) for secondary prophylaxis and it is effective!

[cmjantje]

I take 600 mg of aspirin every day, have regular bleeding under my skin, and bleed for an hour or two if I cut myself shaving. Never heard of a clotting test.

Sawasdee Khrup, Khun Blondie,

mmmm ... are you sure you are doing the right thing there : if, god forbid, you were in some kind of accident and needed surgery, this might prevent/delay surgery for some time. perhaps this is true for anyone, however, who needs to take any kind of blood thinner.

best, ~o:37;

Blondie,

You are doing toooo much of a good thing. 600 every other day is plenty. YOU COULD HAVE A BLEEDER IN YOUR BRAIN TRYING TO PREVENT YOUR NEXT HEART ATTACK. Check with a Dr. or go online. NO ONE suggest that amount.

p.s. You answer was nonresponsive.

I take 500 Mg every day...advise of my heart doctor at university hospital.

[peekint]

Final Jeopardy Answer...

CM Ram does have the test in the fourth floor clinic, but first floor was clueless about it. After a bit of pushing there was a lightbulb moment and we got connected. So, tomorrow Mom goes up to the fourth floor for her test, gets the result, and then goes back down to the first floor for her meeting with the cardio guy.

Some brief comments.

1) I, too, prefer sripat. Unfortunately, the physical environment is not suitable for the frail or elderly (when are they going to spend a penny on that?)

2) Coumadin (warfarin) is prescribed for a number of conditions. The most common is for a leaky heart valve which does not require surgery. The eddies in the heart caused by the backwash in a leaky valve can cause small clots to form. If these clots go to the brain, they can cause ischemic stroke. Coumadin is used as a prophylactic measure. The PT/INR test is done regularly to make sure that the prothrombin time (clotting time) is not excessive, causing difficulties with healing of day-to-day injuries. ( Indeed, warfarin is "rat poison" and kills the rats by making the blood not clot. Their daily bumps and bruises then causes them to hemorrhage internally and die. )

3) There is now a PT/INR meter available for purchase in Thailand for personal use. However, the cost is rather prohibitive. Here are the details the company emailed me:

Meditop Co. Ltd is the distributor for INRatio2; PT/INR Monitoring System from USA. I am attaching its brochure for your view.

We have not yet introduced INRatio2 in Chiangmai. We have a plan to introduce at a private hospital; Chiangmai-Ram Hospital. However, we are not sure of the time frame. May I know the name of the hospital your mother is going?

It would be convenient for home monitoring. INRatio is designed for home use. We also sell the meter.

INRatio2 Meter : THB 20,972.00

INRatio Test Strip-Box of 48 : THB 11,812.80

Best Regards,

Pornthip Leammukda(Mrs)

Vice President

Meditop Co.Ltd

02-933-1133

081-8042587

www.meditopthailand.com

PS - special thanks to the ThaiVisa correspondent who messaged me privately and clued me in on how to "find" the test at Ram!

[Asmerom]

I take 600 mg of aspirin every day, have regular bleeding under my skin, and bleed for an hour or two if I cut myself shaving. Never heard of a clotting test.

I take 75mg which seems to be the going dose. It was originally prescribed in th UK. I agree that 600mg does seem excessive.The doctors at RAM clearly think that 75mg is effective, as I was recently in there three days with a gall bladder infection and they said they would have operated the same day had I not been taking aspirin, admittedly in conjunction with another blood thinner-Plavix. They recommend ceasing asprin 5 or 6 days prior to an operation.

I cannot understand how you think a drug which causes blood to leak into surrounding tissue is acceptable. That surely can't be right. Excessive aspirin also attacks the lining of the stomach; but I'm sure you will be aware of that.

Still, the doctors know all this ; you must be a special case.

Edited August 30, 2009 by Asmerom

[PeaceBlondie]

Sorry to be taking peekint's thread off topic

When I have had lacunar infarctions (twice so far) the neuro prof has put me on Plavix for a month or more; then aspirin. Once I mistakenly took both, which he said was an overdose. 600 mg daily is prescribed. I have a cast-iron stomach. Checking websites, I found no upper limit for aspirin dosage. And it's cheap.

[Asmerom]

Sorry to be taking peekint's thread off topic

When I have had lacunar infarctions (twice so far) the neuro prof has put me on Plavix for a month or more; then aspirin. Once I mistakenly took both, which he said was an overdose. 600 mg daily is prescribed. I have a cast-iron stomach. Checking websites, I found no upper limit for aspirin dosage. And it's cheap.

With apologies to peekint..............Strange; my own understanding is that its cheap and... dangerous. I must search out the evidence. I trust you know that generic PLAVIX called Apolets, is available at 30 baht per tablet as opposed to the real thing at 90 baht.

[hmficc]

Sorry to be taking peekint's thread off topic

When I have had lacunar infarctions (twice so far) the neuro prof has put me on Plavix for a month or more; then aspirin. Once I mistakenly took both, which he said was an overdose. 600 mg daily is prescribed. I have a cast-iron stomach. Checking websites, I found no upper limit for aspirin dosage. And it's cheap.

With apologies to peekint..............Strange; my own understanding is that its cheap and... dangerous. I must search out the evidence. I trust you know that generic PLAVIX called Apolets, is available at 30 baht per tablet as opposed to the real thing at 90 baht.

My USA cardio guy has me on 164 ml. asprin and plavex every day. I am taking anothet med that may block the plavex. However Dr. thinks 164 asp 5 years after a stint was put in a heart supplying artery is enough. In the past I was, for a short time, on high dose asprin after hip replacement.

[PeaceBlondie]

apolets...no result on wiki or google; result for Apotex firm, but better as generic Plavix http://en.wikipedia.org/wiki/Plavix

[CMDR]

Final Jeopardy Answer...

CM Ram does have the test in the fourth floor clinic, but first floor was clueless about it. After a bit of pushing there was a lightbulb moment and we got connected. So, tomorrow Mom goes up to the fourth floor for her test, gets the result, and then goes back down to the first floor for her meeting with the cardio guy.

That's great for you and your mom.

However, here I have found the Roche Coagucheck

Price 26000 Baht

Strip 150 each

rediculous price, isnt it?

[justcruisin]

For the information of other "bleeders" I (now age 52) have been on about 6Mg Coamadin/Warfarin for a number of years after several DVT's following extensive orthapedic surgery(severe motorcycle accident)

Have been using Lanna Hospital,3 monthly checks now,arterial blood taken,pretty good service,wait 1 hour for lab result,cost for INR check varies between 470 Bt and 570 Bt.

I really dont know why the variance in cost for the same procedure over the last 18 months.

The medication is available without prescription from most chain store pharmacys for near 1/3 the cost of what the hospital charges,I use a locally manafactured generic now.

IMHO there is definately a need for less invasive blood tests Ie finger prick,but the cost of the Coagucheck alone would pay for hospital test for the next 12 years.

[THAILIBAN]

www.coaguchek.com

Coaguchek as mentioned above is the only finger prick test for PT/ INR that I know.

Have seen in BKK but not sure in CM.

you have seen it for sale ?

may I ask where that was ? and how much was the retail price ? thanks

[CMDR]

www.coaguchek.com

Coaguchek as mentioned above is the only finger prick test for PT/ INR that I know.

Have seen in BKK but not sure in CM.

you have seen it for sale ?

may I ask where that was ? and how much was the retail price ? thanks

Actually I know they have it at the hospital, not for sale.

The price from the rep as above, tax excluded.

Not sure how much for retail price.

Please PM me if you need more details.