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Getting Coumadin checked in Croatia and Slovenia

Hi,
We have planned a three week trip with another couple in June to Croatia and Slovenia that we have had to cancel two other years because of family emergencies. However, we just found out that my husband has afib and will need to be on Coumadin. I would appreciate any information on whether, where and how it's possible to get his INR checked while we are away.
Thank you, Cin

Posted by
1834 posts

If it is in the form of pill or capsule you will not have any trouble especially if it is in a prescription container. Between the two of us we have several prescriptions and none of them have ever even been looked at anywhere. One is hydrocodone, another is Celebrex, and there are several more. I don't know about INR.

Posted by
507 posts

Cin,

I am on Warfarin (generic of Coumadin). Be sure you meet the cardiologist's "no-fly" time before your trip. My dr grounded me for 6 months after I began the med.

Do you or your friends have acquaintances in the areas you are visiting & they can give you the name of a dr there? Your dr could establish a working relationship with the referral.

I go in for my INR check on Monday. I will ask my cardiologist how I would handle INR checks if I were to be gone overseas for 3 months.

Chemists overseas will not fill prescriptions written in the US so I have read on this forum. I would definitely take hubby's medical records RE: the Coumadin with you. Possibly a dr where you are at would honor your dr's written request to do a finger stick (as opposed to a blood draw) to check the INR & make any necessary adjustments to the dosage. :-)

You could go as far as to make an appt w/a dr in the area you are in for an office visit & INR check. {Edit: If you are in a country that has socialized medicine, the visit may not cost you anything since you are a visitor.}

[Edit: My INR reading is currently done at the dr's office using a portable machine similar to the machine & strips diabetics use for their readings.]

"Where there is a woman, there is a way."

Posted by
8 posts

Dear Colette,
Thank you so much! Your advice was really helpful. We haven't discussed anything about traveling with the doctor yet because my husband is still getting tests done....I am really hoping he will give him permission to fly and go for three weeks, but we shall see ....we aren't visiting friends, but will try ,if we do go , to make arrangements beforehand to find doctors and set up appts for the blood draws/tests.
Thank you again
Cin

Posted by
1994 posts

I have been on Coumadin most of my adult life, although I do NOT have an underlying cardiac condition (so my situation is different from your husband's). There are a few things I do that make me feel safer when I travel.

I joined the International Association for Medical Assistance to Travelers. It provides names of qualified English-speaking doctors in various countries; it can also answer some questions and provide other services. They may be able to provide some suggestions for your doctor about testing while you're traveling. The cost is very nominal.

I know that portable self-test devices have been developed, although I'm not sure how available they are. I'd suggest asking your cardiologist about that, and if he doesn't know, try to get an answer from a hematologist.

I carry a very good medical evacuation policy. With most medical evacuation policies, a clerk at the insurance company decides if you need to be evacuated. I use Medjet Assist, which allows me or a family member to make the decision about whether I should be evacuatEd – provided the doctors agree that it is safe. I've never had to use it, but it's worth it for peace of mind. It also will cover domestic travel, as long as I'm 150 miles from home.

I bring two times the amount of Coumadin that I will need, and I divide it and store it in separate places. That way, if one stash vanishes, I have the back up. I started doing that after my medications got lost in a chaotic security inspection. At that time, Italy only sold 5 mg tablets, which was a little challenging since my dose was 3.5 mg.

Finally, about 6 weeks before I leave on my trip, I modify my diet so it reflects what I expect to eat while I'm traveling. Typically that means reducing the amount of high vitamin K food that I eat. That allows me to adjust the dose if necessary before leaving. However, I've been doing this a long time, and my protime doesn't shift dramatically with diet; I wouldn't suggest you try it without talking to your doctor.

I hope everything works out happily – both with your husband's health and your travel plans. If you have any questions, feel free to send me a PM.

Posted by
8 posts

Dear Sherry,
Thank you so much for all your helpful and encouraging information. I am always deeply impressed with how helpful these forums are and that kind people like you, and the others who have responded, take the time to do so and share your experience which is invaluable. I am sorry to hear that you have had to be on coumadin, but glad that you have been able to live your life and travel reasonably well while on it.....We are just at the beginning of a long learning and living curve which at the moment feels a bit daunting. I will get right on looking up the organizations who suggested, and because of your recommendations, we will have more relevant questions to discuss with the cardiologist when we next meet. I wish you a lifetime of joy filled trips!
Thank you
Cindy

Posted by
1994 posts

Cin, I think you may be happily surprised about how little Coumadin has to affect your life. Really the only concessions I make during travel are to avoid activities with obvious risk of injury – I avoid biking, and a couple of times I have not continued on a hike because the footing was so unstable – and maintain a relatively stable vitamin K intake through diet. People like to share war stories about medical issues – I think they are best ignored.

Posted by
8 posts

Dear Sherry,
Thank you again for your encouraging message and helpful info. We are so grateful for your input and feel like we have a jump start on how to proceed. Best of luck to you and happy trails!
Cindy

Posted by
507 posts

International Association for Medical Assistance to Travellers has not been mentioned on this forum to my knowledge since I joined last year. I wish I had known about it before as the need for an English-speaking medical person has arisen before during my travels. I plan to join after reading their goal.

Thank you, Sherry, for bringing this organization to my attention.

Suggestion: Begin another thread about this organization where more readers will take notice of it. :-)

Posted by
507 posts

My dr said if one of his patients needed to have INR checked while out of The States for an extended period of time, the patient would need to find a dr in the area they are visiting to do the test.

I wish you a fun trip!

Posted by
80 posts

If your husband is going to be on Coumadin long-term, he may be able to get a home testing kit paid for by insurance. The kit is not terribly large, easily packable. It is really nice to be able to check your INR yourself without having to go to the doctor regularly.

Posted by
8 posts

thank you! The self kit is a great idea! I now feel fully armed with questions, concerns and recommendations to discuss with our doctor. Thank you all for responding!
Cindy