HANCOCK - Blood tests are a fact of life for patients undergoing Coumadin/warfarin therapy.
Until January, patients at Portage Health had to undergo their tests the old-fashioned way, with blood drawn out by the needle and taken to the lab, which was both painful and time-consuming. But nurses now use a finger stick test, which gives a reading within seconds, instead of the day- or sometimes weekend-long wait before.
"It's a lot easier than the needle," said patient Dorothy Brulla of Rabbit Bay, who was in for a test Wednesday morning.
Garrett Neese/Daily Mining Gazette
Dana Bethancourt, a nurse at Portage Health, performs a blood test on Dorothy Brulla Wednesday at Portage’s new Anticoagulation Management Service.
The test are part of Portage's new Anticoagulation Management Service.
The drug is given to patients with atrial defibrillation, deep-vein thrombosis, pulmonary embolisms or mechanical heart valve. So far, there are about 45 patients, said registered nurse Dana Bethancourt, part of a team of two nurses and a pharmacist at the clinic.
While useful, the drug can be dangerous, requiring monthly or even weekly monitoring. So patients welcomed a less painful alternative to the needle.
"How many times did I have to get stabbed?" Brulla asked Bethancourt. "One day it was five times."
The finger test gives Bethancourt the patient's INR, or international normalized ratio. Those ranges typically fall within 2 to 3 for patients with atrial defibrillation, deep vein thrombosis and pulmonary embolism; for patients with mechanical heart valves, it's 2.5 to 3.5. Too high, the patient runs the risk of bleeding or hemorrhage; too low, blood clots, heart attack or strokes.
Brulla's was a 2.5, falling perfectly in the middle. But if it hadn't, Bethancourt said, the quick turnaround time means she's able to help more quickly with adjustments.
"Let's say the dose is out of range, and it's high or low, you can make an immediate change to get it back," she said.
Because the INR can change depending on diet and medication intake, it's important for close monitoring, Bethancourt said. That's where the clinic comes in handy.
"It's much easier to get through to me than a desk nurse, who's handling 400 patients," she said.
At first, they did the finger stick tests in conjunction with the old lab tests. But the results correlated so well that the full lab tests are only used when tests come in very low or very high.
The clinic should be here to stay, Bethancourt said. Brulla was glad to hear it.
"I'd hate like heck to see it stop now," she said.
The service is available Mondays, Wednesdays and Fridays from 8 a.m. to 2 p.m. and Tuesdays and Thursdays from 1 p.m. to 5 p.m. The AMS program is accepting patients from Portage Health family medicine providers. For more information, call 483-1249.