The path to self-testing

At home in Toronto, at home around the world

For many years, Laura S. (71) enjoyed travelling to distant countries. However, after suffering a stroke and having to take warfarin, the professional veterinarian always worried that her INR might get out of balance while she was abroad. But then she became a self-tester and is now back to discovering the world in a relaxed state.

The airplane started moving slowly along the runway at the Toronto airport. On my way to Singapore, a place that I have visited many times before, which became very familiar. I have always been fascinated by foreign countries. I lived in Australia for 10 years and spent much time in Asia. Nowadays, I can enjoy my travels again in a relaxed state. But this was not always the case. In 2007, I suffered a stroke and was placed on anticoagulants. From that day on, I became very uneasy, because my levels always doubled whenever I traveled abroad.

I discovered very quickly that in addition to the different food, the different climate greatly affected my INR. Getting tested locally was very arduous: in Singapore, there are no family doctors. I had to go to a laboratory for the tests, but these were closed on weekends. And it took days before I finally got the results. In view of the ups and downs of my levels, I began to wonder whether my beloved travels might pose a grave health risk for me. You can imagine how relieved I was when I heard about self-testing.

The training as a self-tester was fabulous: I learned a great deal about what happens in my body and, now, I am managing the CoaguChek^® so well that my levels remain constant, no matter where I am or what I am doing. I feel secure. Even in my home city of Toronto, I move around a lot. After the many years I spent abroad, I am now acting as a tourist guide, showing tourists from all over the world around my city. Instead of worrying about my levels, I am continuing to go on discovery tours — together with the participants in my city tours or on my own as a traveller abroad.

The world is my home. And one ought to feel well and safe at home.

*Fictitious patient

More time for the good things in life

For Alex S. (72), one thing was always of utmost importance: his independence. However, when he developed a cardiac arrhythmia, he started worrying about losing his freedom. But then, the bon vivant and former radio moderator heard about self-testing and became his own master again.

I started painting a few years ago. When I do this, I am able to relax completely. I have always been an admirer of fine arts. They have accompanied me through life in a variety of different ways, whether as a radio moderator or when I was working at my shop. Above all, I have always been an active person and was used to making my own decisions.

In 2005, I received this diagnosis: because of my cardiac arrhythmia, I needed to start taking warfarin immediately. My independence had always been very important to me. So, I was very worried that the illness would restrict my freedom. It was not just that the regular visits to the doctor robbed me of part of my independence. The other thing was that my veins were usually hard to find — and the blood-drawing was, therefore, very difficult. I was fed up with the constant testing, because I came home with bruises every time.

When I read in a leaflet at the pharmacy that it is possible to measure your levels by yourself with a small drop of blood from your fingertip, I wanted to learn more about self-testing. My doctor was skeptical at first, but I did not give up and finally convinced him that self-testing was the right thing for me. The day I started my training was a turning point for me: I have got to know my body much better and understand its reactions now. My levels are much more balanced than they were.

Self-testing sometimes sounds more complicated than it is. Blood glucose monitoring works almost the same way and patients are trusted to be able to manage this. Self-testing is not difficult and is an enormous relief. I have fewer complications and more time for the nice things in life. And above all, I have control over my life again.

A few words to Healthcare Professionals: have more confidence in your patients!

*Fictitious patient

Enjoying life together

The favourite travel companion of Stephen D. (74) is his wife, to whom he has been happily married for over 50 years. They have been travelling around together in a camper for over a decade. And another trusty companion always travels with them: his CoaguChek^® measuring device.

Happiness is travelling along the road, behind the wheel, eyes firmly on the horizon, seeing beautiful countryside out of the window — and my wife next to me. This is what I consider freedom. We have taken many trips in our camper over the years and have discovered the most beautiful spots. I owe a great part of my independence to self-testing — this is what makes the long trips possible in the first place.

How did it all happen? The date was August 11, 1999. Many people prepared for this day by making sure they had protective eyeglasses. After all, the total eclipse of the sun was expected shortly. For me, too, this day engraved itself into my memory, but for a different reason: on this morning I received an artificial aortic valve because of a heart valve defect. Since then, I have had to take warfarin. While I was still in rehab, I enquired about coagulation self-testing and convinced my doctor that I would monitor my levels myself right from the beginning. Maybe one of the reasons was that as a self-employed plumber, I was used to handling things myself.

After the training session, I discovered how uncomplicated coagulation self-testing was, and this was the start of a new life for me. My motivation was to be independent and to take long vacation trips — and to have a better understanding of my body. If I only went to the doctor every few weeks, I would not know whether my INR was stable or not.

Unaccustomed climates during a vacation, different food or small infections are no longer problems.

Even though I take the measurements myself, I have shown my wife how self-testing works. We have been happily married for 50 years — this only works if you take care of one another. We have created a small ritual: every Sunday, my wife asks me about my level to make sure that I don’t forget to test it. With self-testing, we can lead our joint life the way we wish — without any restrictions.

*Fictitious patient

Regaining her independence

Katherine was born with a condition that affects her heart valves, so regular hospital visits are something she’s had to get used to. She and her mom explain how CoaguChek^® has given her independence and the chance to live the life she’s always wanted. Watch her story.

An instant result was just magic, absolute magic.

On two wheels through Europe

Every summer Michael G. (46) discovers Europe during tours lasting several weeks. What is unusual? He is a warfarin patient and completes each tour on a recumbent a bicycle. The professional nurse at no time considered giving up his active life — that is why he decided to take his life in hand as a self-tester.

Another day of my tour is coming to an end and another milestone has been reached: I have arrived at the French pilgrimage site Saintes-Maries-de-la-Mer. The heat of the day is slowly easing up. Young and old get together at the city squares and the boardwalk. People play boules and chess and drink a glass of wine in the gentle evening breeze.

During my travels, I discover the world at my own pace. Once a year, I travel around on my bicycle. Last year it was around 1,500 kilometres through France. I can stop wherever I want, meet new people — living one day at a time. I know many people who enjoy this freedom and independence on their travels, and yet I am different from most of these in one respect: in 1998, I received an artificial heart valve after an inflammation of the inner heart valves was discovered. Since then I have been dependent on taking warfarin. How have I managed to retain my independence? For me, self-testing was the key.

Shortly after my heart valve operation, I heard about self-testing. After that, everything happened rapidly. As a nurse, I already possessed a certain amount of medical knowledge. But for patients who don’t have this experience, training is very valuable. They may not know that even an ordinary flu or a climate change can affect their INR. From the training online, you not only find out important things about self-testing, but also about the interactions of warfarin with food, medications and much more. This removes the uncertainty and makes you more flexible.

Nowadays, I measure my levels myself quickly and easily and do not waste my time sitting around waiting rooms. This is precious time that I can spend preparing for my next trip. What’s next? Travelling from Bavaria to Rome.

What makes the training so valuable? The participants not only learn everything important about self-testing, but also a lot about their bodies.

*Fictitious patient

Return to the Sugar Loaf

Following a stroke, regular doctor visits and fluctuating INR values dominated the daily life of Pierre B. (70). But now, he is trained as a self-tester and able to fulfill a dream thanks to the freedom he regained: to return to Brazil, the land of the Copacabana and the samba.

I have always been attracted by distant places: in my 20s, I spent two years in Brazil as an aid worker. Brazil has become my ideal destination. It was my dream to return there one day. There is a lot that inspires me in this place: the people’s joie de vivre, the fact that they always have time for a smile, the special attitude towards life and the natural surroundings. Professionally, I was also on the go a lot and worked within a creative and dynamic environment. I worked in marketing as an advertising coordinator for an international technology company.

But then, I suffered a stroke in 2009 and was placed on long-term warfarin. In the first months, my doctor monitored my INR “conventionally” at his office. This was a difficult time — not just for me but also for my wife. Since I was no longer able to drive after my stroke, my wife had to take me to the doctor’s office and wait for me there. I received excellent care from my family doctor. However, the blood test through the vein always resulted in bruises and I started getting scarring in my veins. Then my doctor told me about the option of self-testing for which all you needed was one drop of blood from the fingertip for the coagulation test. My new life as a self-tester could begin.

After I completed the training online, a lot changed for me. My wife also participated in the training. Now she can understand my illness much better. This is very helpful to us in daily life. We know which specific foods can affect my INR and have adjusted our diet accordingly. My values have become much more stable and dangerous complications like bleeding or clot formation have become far less likely. I have been doing my own testing for seven years and my INR is within 90% of the therapeutic range.

With this regained security, we were able to fulfill our dream: to return to Brazil. By that time, I had already become a self-tester and did not have a single problem with my levels locally. I simply did a test spontaneously whenever I had the feeling that the food, the heat or our new daily rhythm might have an effect on my coagulation. With self-testing I have been able to adjust warfarin therapy to my life — instead of the reverse!

With the regained freedom we were able to fulfill our dream and return to Brazil.

*Fictitious patient

The coagu-checker

Peter G. (61) has been a “coagu-checker,” as he describes himself, for almost 20 years. Regardless whether at work or on vacation trips, with coagulation self-testing he is enjoying his independence.

Juggling is my version of meditation. Several balls, various objects and throwing heights — there are lots of variations, but the secret behind it is always the same: coordination and balance. This is what it has in common with self-testing, which has accompanied me for almost 20 years. Here too, it is a matter of maintaining balance and control.

It all started with an inflammation of my inner heart valves in the spring of 1981, after which I had an artificial plastic valve implanted. I have been taking warfarin ever since. The regular trips to my family doctor were difficult and restrictive — and they certainly did not have a positive effect on my working days as an administrative assistant. But by pure chance, I came across coagulation self-testing.

I went to visit my mother at a rehab clinic and was asked by the physician whether I would be interested in monitoring my levels myself. Despite my initial doubts, I soon realized how simple self-testing is. After seven years on warfarin and many doctor’s visits I became a “coagu-checker” and am now an expert! This independence is a great benefit not only at work, but also during sports, which were always very important to me. The same applies to vacation travel. I took the first long vacation with my wife — four weeks in the Caribbean — before I had become a self-tester. But there was so much uncertainty because of the change in routine and diet. After two weeks, I went to our hotel physician for the required check. The dosage was reduced, but the uncertainty remained. So I was very relieved when the check at home showed that everything was all right again.

These worries are in the past. Today, the CoaguChek^® measuring device accompanies me on all my travels. I can react to changes and keep my levels balanced on my own — just the way I keep the balls balanced in my juggling.

The secret is the right balance — whether in juggling or during self-testing.

*Fictitious patient

More convenience, less anxiety

After an aortic valve replacement, Bob was placed on life-long anticoagulant therapy. When he heard about self-testing, he was immediately interested. Self-testing has finally given this avid traveller the convenience and peace of mind he’s wanted. Watch his story

We need to ask our doctors about monitoring and the options around it. Because there are options.