Hi! My husband takes warfarin (Coumadin) and has to have his blood drawn for a monthly protime (blood thickness level) several times a month. We will be spending two months in England, Netherlands, Switzerland, and Scotland. How easy is it to find a medical facility to accommodate this? I'm assuming we will have to pay out-of-pocket and then submit claims to our health insurance for reimbursement. Does any one know the approximate cost to have this test done? Any information would be greatly appreciated!
Here is one example, which offers the test at 31 locations in the UK. Appears to be on special offer today ...
(No personal experience or recommendation - just to give you a guide.)
How easy is it to find a medical facility to accommodate this?
This is a very specific & serious medical question that might be better answered by your doctor or his/her medical office. Know before you go.
I'm assuming we will have to pay out-of-pocket and then submit claims
to our health insurance for reimbursement.
On what are you basing your assumption? This seems easy to address. Call your insurance company to verify what percentage it reimburses (if anything at all) of the blood drawn and the lab work performed on facilities overseas.
Does any one know the approximate cost to have this test done? Any
information would be greatly appreciated!
Once you know which medical facilities in the countries you mentioned above that will draw the blood and do the lab work, contact the billing department of each facility directly to ascertain the entire cost of the blood work.
Have all of this information researched, answered and IN WRITING BEFORE you leave for Europe.
Has your husband talked to his doctor/hematologist about getting a home-testing kit? I've got one from Roche and, though I haven't had to travel with it, it's nicely compact and wouldn't take up tons of room in a suitcase. The test is easy to do, and you would just need access to the Web in order to report his INR. And, of course, the doctor would also need to be able to communicate with your husband regarding any dosage changes.
I can't speak for the other two countries, but to reassure your husband about the UK, Warfarin is available at pharmacies in various different doses, colour coded, of 1s, 5s, and 10s as well as others. It is tightly controlled.
Also available in various syringe doses is Clexane.
INRs are done by venous samples but often available are instant finger-prick scanners. Anti-coagulation departments normally expect at least every ten samples be venous.
I've not seen the name "Protime" or "Coumadin" here.
The anti-coagulant yellow cards are in wide use and widely recognised here by all medical and ambulance staff. I was told they would be recognised throughout Europe and that Clexane is available on the Continent.
Coumadin is just a brand name product of warfarin.
Protime = prothrombin time. How long it takes your blood to coagulate
INR = international normalized ratio. The number that is the Protime reading.
Clexane = Lovenox in the US and is an injectable blood thinner by prescription only.
Not familiar at all with the "yellow card" and was not provided one by my doctor while taking either warfarin or Lovenox.
I had to have the test done as well over several years (thankfully no more as I have moved to simple aspirin). I was allowed to avoid having the test done while traveling by my doctor because my readings were stable and within the range they decided would be where I needed to be. Had the test day before departure and day after return from my month long stay. Might be an option.
Anthem has lists of providers for overseas travel. Perhaps other insurance carriers do too. I contacted Amex for a dentist last October and was given a list near where we were staying. Your credit card may provide this service, too.
Yes, Marco is correct that Coumadin is just a brand name for warfarin. But, warfarin is on the WHO List of Essential Medicines should be available as a generic pretty much anywhere. Here in the good old USA, it is a common ingredient of rat poison. It frequently causes problems in dogs, but the antidote is widely available-Vitamin K. I am a veterinarian and interestingly, the last 50 pound dog I had to treat, cost about $50.00 for the generic Vitamin K. The owner wanted to save money and priced it at Walmart-$21,000.00. We went with the vet product.
Your husband should have a medic alert writs band, or something
Have you discussed with your MD., using one of the alternatives to warfarin, that does not require repetitive testing?
I'm late to this as have just returned from a two week trip to Central America (deeply fab!) and am jet-lagged to bits. However, I'd suggest Theresa is right on the money and getting a self testing kit and e-mailing the results in might very well be the best way to go. As a patient of the NHS here in the UK having had two blood clots (DVTs) previously, I'm medicated on warfarin for life - because to paraphrase Oscar Wilde, having one is unfortunate, having two looks like carelessness! - and I can't tell you how freeing it is to be able to have your own finger prick self testing kit. Normally, like my current/recent trip, I have no need to carry it with me, but the testing kit and all its bits and pieces would fit into your hand luggage with no problem for a longer trip, and would then only require you having internet access to e-mail in the results.
I do carry my Anti Coagulant Therapy booklet with me on my travels - this might be the 'yellow card' people are mentioning, although the booklet is more comprehensive and contains records of your tests/readings and for my own part explains why I'm carrying what appears to be industrial quantities of drugs with me, although frankly, I've never needed it's back up. Costa Rican security were much more concerned with my part-used bug repellent aerosol (which they confiscated) and never apparently batted an eye over the several slides of tablets I had in my hand luggage (plus 'emergency reserve' in my checked bag).
I'd consult my doctor about a self test kit - I banged on about it for years before they eventually granted me one, when, paradoxically,I could attend the relevant clinic, held during working hours, due to retirement. As I am a patient treated by the NHS (one of our better ideas, God bless 'em) my kit and its consumables come free, gratis and for nothing (yes, I appreciate we pay all our working lives into the fund in reality) it would be worth shelling out for the technology assuming it's not going to cost the proverbial arm and leg for the freedom and peace of mind it would bring.
Hope you can effect a satisfactory, self administered, solution and that it is no more than a minor issue in what I also hope will be a great trip.
The yellow card to which I referred (now in the past because after my one-and-only DVT(so far!!) I was eventually taken off the Warfarin, although I need to take Clexane prophylactically on long trips) is issued by the anticoagulant unit in conjunction with the yellow book. I was told I had to carry it all the time I was under that drug therapy so that paramedics, first responders and other medical staff would know of the propensity to bleed, especially internally. I was told that it is universally recognised.
'parently not. Ho hum.
Anyway, for the OP, bearnbun, it may be handy to have some sort of easily findable information for medical professionals in case of difficulty. I think in North America a lot of people have bracelets or dog tags?