more faffing around

I’m a long-term warfarin user.  If you're not interested in the finer points of warfarin use then stop reading now; all you need to know is that what follows involves a lot of numbers and a lot of faffing.  Much like my blip.

Anyone on warfarin will know about the importance of regular blood tests to ensure that the blood does not thin too much, to the extent that the slightest thing can cause a serious hemorrhage - anything from a nosebleed or a slip with the razor when shaving - or a surgeon’s knife.  Or in my case next week, a catheter inserted into a vein or artery in my groin and then pushed all the way up my body until it reaches my heart.

At my pre-op assessment in Oxford on monday my blood was tested to check the rate at which it clots (aka the INR value).  I’m given a target value of between 2 and 2.9.  Anything outside this range will mean that the procedure is cancelled.  They tell me that my INR is 3.1 and give me two days to get it below 2.9.  Which means another blood test today.  

Now, I have a slight problem with all this.  I simply cannot understand how my INR is 3.1.  I  am meticulous about checking my blood and have over 4 years worth of data - both INR  values and warfarin doses.  For the past year or so I’ve been testing my blood myself, using a hand-held device every two weeks.  I haven’t overdosed lately on spinach or curly kale - two veggies which will really screw up the INR values - or taken antibiotics and other medicines known to interfere with the results.  I’m pretty confident that I know what sort of number to expect.  And 3.1 is not one of them.

So I test my blood myself when I get back from Oxford.  My machine gives a value of 2.5.  This is a big difference - and an even bigger problem.  It simply would not change that much in a matter of a few hours.  So either Oxford got it wrong, or there’s a problem with my machine.  The latter is more serious as far as I’m concerned because it throws into question the freedom I’ve been allowed by my GP over the past year to undertake my own tests; if I’ve been getting it wrong all this time then I’ve been taking the wrong doses of warfarin.  Which could have serious consequences.  

And if my machine is at fault I’m going to be spending the next few days faffing around trying to find out what’s wrong with it as well as fit in another blood test at the surgery.  There’s more; this weekend Anniemay’s sister Mollymay and husband Glyn and daughter Sara fly in from Australia on a family visit and we’re dashing between MK and Manchester then down to Midhurst next week, to take them to various relatives.  

I need to sit cross-legged beneath a tree for a while and find some inner peace.  Which is probably a bit ambitious given the timescale as (a) I don’t currently do yoga and (b) would struggle to get back up again.

In the meantime, I ring the surgery on tuesday morning and they manage to fit me in for a blood test today.  I’m lucky to have a supportive practice and arrange to bring my machine in so that I can test mine alongside the nurse’s.  I reduced my warfarin on monday and tuesday evenings so now expect a value lower than 2.5 - if my machine is right.  If the Oxford result is correct then it should be around 2.7- 2.8.  

The nurse’s machine shows a value of 2.2 and mine registers 2.1.  She thinks that this is close enough to suggest that my machine is fine and puts a note to this effect on the system.  I’m free to continue my own testing.  And clear to go ahead next wednesday.

Which just leaves the Oxford result - does she tell them that they’ve got it wrong or do I?