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INR tests while on camino

george.g

Active Member
Camino(s) past & future
French way 10, 11
Norte 12
Vdlp 13
Levante 14
Mozarabe/Malaga 15
Augusta 16
Mozarabe/Almeria 17
#1
I have to take a daily dose of warfarin to maintain a INR level. I have to have my INR tested quite often as for whatever reason my INR varies a lot.
Has anyone walked recently with the same issues?
I accept that I may have to buy a portable test machine, but are there any other options available?
Regards
George
 

MikeyC

Active Member
Camino(s) past & future
CF - September 2016
CF - April May 2017
Shikoku - October 2017
Kumano Kodo - October 2017
#2
Perhaps you could see your GP about changing to one of the Xa medicines such as Apixaban. I use this to inhibit a DVT and no INR testing is required.
 
Camino(s) past & future
Primitivo June 2013
SJPP - Logroño June 2014
Ingles July2016
#3
In Spain the INR control is made in the Centros de Salud. In the Comunidad de Madrid, where I live, is made under appointment. In Castilla León, Galicia; Navarra I think that it wil be the same but If you allege you are a pilgrim and you need it I think you'll be assisted (but I am not sure for free).
There are Centros de Salud in every big town.
 

george.g

Active Member
Camino(s) past & future
French way 10, 11
Norte 12
Vdlp 13
Levante 14
Mozarabe/Malaga 15
Augusta 16
Mozarabe/Almeria 17
#4
Hi Mike,
I’ve been down this route already, according to my consultant an alternative therapy isn’t suitable, I wish it was, it would make managing the condition so much easier, but thanks anyway.

Regards
George
 

george.g

Active Member
Camino(s) past & future
French way 10, 11
Norte 12
Vdlp 13
Levante 14
Mozarabe/Malaga 15
Augusta 16
Mozarabe/Almeria 17
#5
Hi Pelegrín,
So if I contacted the Centro de Salud a day or two before I arrived I might be able to get a test? I have noticed that most towns of any size have a C de S.
As to paying, that’s not an issue, any idea of cost?
Thanks for your swift reply, luckily I have some time to plan, I intend to start walking at the south coast, then via Salamanca, onto the Torres.
Regards
George
 
Last edited:
#6
Hi Pelegrín,
So if I contacted the Centro de Salud a day or two before I arrived I might be able to get a test? I have noticed that most towns of any size have a C de S.
As to paying, that’s not an issue, any idea of cost?
Thanks for your swift reply, luckily I have some time to plan, I intend to start walking at the south coast, then via Salamanca, onto the Torres.
Regards
George
I never had to make an appointment, I've just showed up at a local Centro de Salud and explained the need to get a reading. I did this along the Norte in 2017 in several towns, even in Santiago. What is important is to have your European Health Card with you, otherwise they will make you pay the bill.

I have since been trained in taking a reading (with a portable device) and in self-dosage. I find this much easier as you can take a reading as frequently as you wish.

By the way, it is quite normal that your rates fluctuate during walking. I usually end up taking up to half my usual dosage when on the Camino. The same happened this summer in Peru when walking in the Andes. My device even worked at altitudes above 4000m although the instructions said it wouldn't. Travel and changes in diet in general can also influence your INR findings.
 
Camino(s) past & future
Primitivo June 2013
SJPP - Logroño June 2014
Ingles July2016
#7
Hi Pelegrín,
So if I contacted the Centro de Salud a day or two before I arrived I might be able to get a test? I have noticed that most towns of any size have a C de S.
As to paying, that’s not an issue, any idea of cost?
Thanks for your swift reply, luckily I have some time to plan, I intend to start walking at the south coast, then via Salamanca, onto the Torres.
Regards
George
No I think it is not posible to make an appointment in a C.S. if you don´t have any Seguridad Social card.
If you do like @LTfit just showing up then you may need a good level in Spanish to explain what you need at the office and another problem would be how to charge you directly (credit card or money). Probably they would send you a bill at home but I don´t know if that is possible for a C.S.
Be prepared to probably spend a long time at the C.S. and if at the office they don´t understand what a INR test is, then tell them :
"Necesito control del Sintrom" (that is the medicine taken in Spain).
 
#8
No I think it is not posible to make an appointment in a C.S. if you don´t have any Seguridad Social card.
If you do like @LTfit just showing up then you may need a good level in Spanish to explain what you need at the office and another problem would be how to charge you directly (credit card or money). Probably they would send you a bill at home but I don´t know if that is possible for a C.S.
Be prepared to probably spend a long time at the C.S. and if at the office they don´t understand what a INR test is, then tell them :
"Necesito control del Sintrom" (that is the medicine taken in Spain).
I do speak Spanish but they all understood what INR is. It takes but a few minutes to test. I never had a problem in this regard.
 

kestrel39

New Member
Camino(s) past & future
CP October 2018
#9
My husband takes Warfarin. We did the Portuguese route in October from Porto. He was tested before we left home (California), then tested again in Santiago de Compostela. He just walked in to a private laboratory there (Laboratorio Clinico Compostela) and got the test on the spot. I think it was maybe 20 - 25 euros. He carries a letter from his doctor explaining that he takes Warfarin and needs INR tests. He's been tested all over (island of Crete, Paris, a small town in Italy) and it has always been easy -- we just look on google maps for a laboratory, phone to see that they're open, and off we go. They usually have the results later the same day or the next morning.

He did find his INR a little out of whack at the end of the Camino, I think because we eat way more vegetables and green salads at home than we did on the Camino. But he just adjusts the meds and re-tests.
 
#10
I was on Warfarin for about 15 years and suddenly my INR started going up and down.
I heard about a friend,86 years old who had an operation and the consultant surgeon put him on Edoxaban. The surgeon explained that G.P's would not use this drug,because of the high cost. I asked my G P if I could go on this drug as it is self regulating and you do not need blood tests.
He of course said "no". I said, "If you are worried about the cost, how much do you think my 18 tests in 6 months has cost the NHS?". He said"I'll read your notes and come back to you". I was then put on Edoxaban.
If you have to have blood tests often ,try it.
 

george.g

Active Member
Camino(s) past & future
French way 10, 11
Norte 12
Vdlp 13
Levante 14
Mozarabe/Malaga 15
Augusta 16
Mozarabe/Almeria 17
#11
Thanks everyone for replying, I like to think I may just go with the Centro de Salud option, however family pressure may make the purchase of a tester a Camino condition, coagucheck have them on sale at £299, plus about £70 for 24 test strips.
I have to take warfarin because just having returned from walking the Mozarabe from Almeria in June 2017 I had a DVT in my right calf but didn’t recognise the symptoms, put the swollen calf and pain down to a muscle pull or something, a post Camino injury, stupidly took a couple of painkillers and decided to “walk it off” That didn’t work! spent the next couple of weeks in hospital having suffered a major PE.
My consultant told me I was “lucky” and if I hadn’t been as fit as I was then there could have been a different outcome, so maybe the Camino saved my life!
Regards
George
 
#12
Thanks everyone for replying, I like to think I may just go with the Centro de Salud option, however family pressure may make the purchase of a tester a Camino condition, coagucheck have them on sale at £299, plus about £70 for 24 test strips.
I have to take warfarin because just having returned from walking the Mozarabe from Almeria in June 2017 I had a DVT in my right calf but didn’t recognise the symptoms, put the swollen calf and pain down to a muscle pull or something, a post Camino injury, stupidly took a couple of painkillers and decided to “walk it off” That didn’t work! spent the next couple of weeks in hospital having suffered a major PE.
My consultant told me I was “lucky” and if I hadn’t been as fit as I was then there could have been a different outcome, so maybe the Camino saved my life!
Regards
George
You were lucky indeed!

I walked my first Camino in 2010 (SJPDP-Finisterre) with a DVT in my left calf! I had symptoms prior to leaving and went to my GP but he said that it was impossible with my high activity level. As a physiotherapist I know the signs and knew that it was not a muscle injury but my case did not fit the general pattern (my leg does not get red or warm). The walking luckily improved the blood flow. Once home the symptoms started up again. This time I did not leave my GP'S office without a referral for a Doppler test. Result? A DVT as I thought! It took my GP a half hour of excuses to admit his mistake.

Since then I have had 2 more DVT's (left calf and thigh) and so must take blood thinners for the rest of my life. I have no history in my family and been tested for every illness possible, including scans and x-rays and there is no explanation for the clots. Luckily it hasn't prohibited me from walking about 9,000 km in the past 9 years.

p.s. here in NL we don't have to buy the tester or supplies, they are covered by our health insurance, which we of course pay for dearly. In the end it is cheaper and easier as you don't have to involve anyone else.
 
#13
Thanks everyone for replying, I like to think I may just go with the Centro de Salud option, however family pressure may make the purchase of a tester a Camino condition, coagucheck have them on sale at £299, plus about £70 for 24 test strips.
I have to take warfarin because just having returned from walking the Mozarabe from Almeria in June 2017 I had a DVT in my right calf but didn’t recognise the symptoms, put the swollen calf and pain down to a muscle pull or something, a post Camino injury, stupidly took a couple of painkillers and decided to “walk it off” That didn’t work! spent the next couple of weeks in hospital having suffered a major PE.
My consultant told me I was “lucky” and if I hadn’t been as fit as I was then there could have been a different outcome, so maybe the Camino saved my life!
Regards
George
Hola George

I think it sounds like a wise decision to buy on if that is an aoption.
On the Camino anything can happen, so it could potentially become an uncomfortable stressful plan to depend on the local Centro de Saluds.
The again, I'd say it all depends on the person. Some people only got to have their INR measured once every week, while others may have to measure it much more often.

Do have alook here:
https://labtestsonline.org/news/inaccurate-results-inr-meters-prompt-new-information-fda
Some information about some products.
And I saw some on sale on ebay for 130$ or so while others cost 600+.
I take it that teh right decision would be to buy one that works as intended.

Buen Camino
Lettinggo
 

george.g

Active Member
Camino(s) past & future
French way 10, 11
Norte 12
Vdlp 13
Levante 14
Mozarabe/Malaga 15
Augusta 16
Mozarabe/Almeria 17
#14
An update for any fellow Camino addicts.
My original post was concerning INR checks while on Camino.
Well after another way out of range result (7.5) I am to start transitioning to “apixaban” or something starting Monday, the implications of this other treatment has been explained (no rapid antidote in case of bleed)
Were I a cynic, then I might begin to think that the cost of the new medication influenced the prescribing of Warfarin?
If you are on Warfarin as I was it may be worth while having an in depth dialogue with your doctor as to other options!
Regards to all.
George
 

MikeyC

Active Member
Camino(s) past & future
CF - September 2016
CF - April May 2017
Shikoku - October 2017
Kumano Kodo - October 2017
#15
Hi George
I started on Rivaroxaban after a DVT earlier this year but found it gave me sudden onset headaches.
Switched to Apixaban and no discernible side effects. The only, very minor, downside is it requires a tablet twice daily whereas Rivaroxaban (trade name Xarelto) was a single daily tablet.
Buen camino
 

george.g

Active Member
Camino(s) past & future
French way 10, 11
Norte 12
Vdlp 13
Levante 14
Mozarabe/Malaga 15
Augusta 16
Mozarabe/Almeria 17
#16
Hi MikeyC,
Sounds like a no brainier, compared to Warfarin, especially if you can’t maintain a level INR like me, it would range from 1.5 to 7.5 with no good reason, I was very careful re diet and alcohol and it would still vary to the point that I was at a coag clinic every week.
Regards
George
 

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