Sometimes technology can really change your life for the better

Self-testing my INR on my portable monitor is one of those technologies. In 1992 I was in heart failure because my mitral valve fell apart (Myxomatous degeneration).

I was short of breadth, couldn't walk and had to rest after speaking a few words. My valve was replaced with a St. Jude Valve on February 8th, 1993. I was back at work in 4 months at Columbia University in New York as a physician at the student health service. I am on lifetime warfarin to prevent blood clots in my reengineered heart. I was thrilled to be alive but dependant on monthly lab visits and having to hustle to find labs when we traveled.

I worked for 25 years as a student health physician at two Universities. I had also worked in Bangladesh, Thailand, Ethiopia and Nicaragua.

On a trip to Hawaii in 1998 I went to a local lab and when I received my results 2 days later showing a very high INR level I felt panicked about adjusting my warfarin dose.

Soon after that trip, I read a medical article about portable INR monitors.  It took 2 years of appeals to my health insurance company to get my first monitor (in 2001). Since I began doing weekly INR self-testing my wife and I have traveled to many beautiful and exotic countries. See the photo at the Pushkar Camel Fair in India in 2006.

I have learned a lot about warfarin from exchanging emails with other patients & providers. One person in the UK said that his anticoagulation program gives all their patients 3 different strength warfarin tablets so that they can easily adjust doses. In the US, my health care providers have suggested splitting my pills to make adjustments.

Recently I decided to put together a video showing me doing my weekly INR test. I'm sure this is familiar to the many ISMAAP patients and visitors to the website. Here is a link to our YouTube video "Coumadin (the brand name of warfarin) Self-Testing Monitor". It is in real time and is 3:36 minutes long:
Michael (February 4th, 2010)