liketraveling Posted May 13, 2014 #1 Share Posted May 13, 2014 Does anyone know if there is INR testing facilities on the Amsterdam. Is there a paticular department at HAL that I would need to contact? I am leaving on the Amsterdam on May 18th. My INR is slightly off and my ACC clinic would like to have me tested midway the cruise. I would e-mail my ACC clinic the results and they would adjust my warafin. Thanks for any help you can give me. Link to comment Share on other sites More sharing options...
teacher43 Posted May 13, 2014 #2 Share Posted May 13, 2014 While I don't know for sure, I would call ship services at 1-800-541-1576. They might be able to tell you if this is possible and maybe even the approximate cost should this be possible. Good luck and I hope your tests can be done. Susan Link to comment Share on other sites More sharing options...
IRL_Joanie Posted May 13, 2014 #3 Share Posted May 13, 2014 (edited) Does anyone know if there is INR testing facilities on the Amsterdam. Is there a paticular department at HAL that I would need to contact? I am leaving on the Amsterdam on May 18th. My INR is slightly off and my ACC clinic would like to have me tested midway the cruise. I would e-mail my ACC clinic the results and they would adjust my warafin. Thanks for any help you can give me. They are equipped to do INR's (Blood Drawn with syringe and then drop onto strip, instead of the pin prick, drop to strip method) However, they will not do it unless they (HAL Dr(s)) have given someone a medication (read antibiotics) when passenger is on Coumadin or Warfarin. Our second cruise I was injured and the Passenger Dr treating me placed me on antibiotics and had an INR done every other day. Our last cruise I asked the medical center if they could do INR's if it was someone like me that just needed it checked once every 2-4 weeks (because CC members had asked the question, just as you are) and was informed no. The Dr said that if you need an INR you would have to have it done at a shore side hospital or Urgent Care. I now make sure all of our cruises are not scheduled for the time frame I am currently on for testing, every 6 weeks. Joanie Edited May 13, 2014 by IRL_Joanie Link to comment Share on other sites More sharing options...
liketraveling Posted May 13, 2014 Author #4 Share Posted May 13, 2014 Thanks Joannie I go every 4 weeks and my INR is usually where it is suppose to be. On Friday and it was slightly high. I have been dealing with a sprain and taking Tylenol. So that is what the think is throwing things off. I just got a call from the doctor to reduce the amount of Tylenol. The ACC clinic told me she would give me an order. At least this is a port intensive clinic. I am wondering if HAL might be able to assist me with the urgent care clinics in the ports? This really sucks! Sorry to whine! Link to comment Share on other sites More sharing options...
happyglobetrotter Posted May 13, 2014 #5 Share Posted May 13, 2014 (edited) Thanks Joannie I go every 4 weeks and my INR is usually where it is suppose to be. On Friday and it was slightly high. I have been dealing with a sprain and taking Tylenol. So that is what the think is throwing things off. I just got a call from the doctor to reduce the amount of Tylenol. The ACC clinic told me she would give me an order. At least this is a port intensive clinic. I am wondering if HAL might be able to assist me with the urgent care clinics in the ports? This really sucks! Sorry to whine! HAL and the port agent will recommend a clinic in port and they will even arrange an appointment for you (through the port agent). I am doing the WC every year (4 months duration) and this situation occurs quite often amongst long cruise passengers, so just meet the HAL nurse at the beginning of the cruise, not a problem. Edited May 13, 2014 by happyglobetrotter Link to comment Share on other sites More sharing options...
IRL_Joanie Posted May 13, 2014 #6 Share Posted May 13, 2014 Thanks Joannie I go every 4 weeks and my INR is usually where it is suppose to be. On Friday and it was slightly high. I have been dealing with a sprain and taking Tylenol. So that is what the think is throwing things off. I just got a call from the doctor to reduce the amount of Tylenol. The ACC clinic told me she would give me an order. At least this is a port intensive clinic. I am wondering if HAL might be able to assist me with the urgent care clinics in the ports? This really sucks! Sorry to whine! Whine away:) Believe me I do understand!! The Ship Drs, both Passenger and Crew Dr's will be able to tell you where the nearest Clinic or hospital is. I was getting a bit anxious as our last cruise approached. It was an 11 day cruise and I was being tested every week from August through the 18th of November. On the 18th, the Coumadin Clinic Dr decided I did not have to be retested until I got back from the cruise:) Joanie Link to comment Share on other sites More sharing options...
Mytime2014 Posted May 13, 2014 #7 Share Posted May 13, 2014 Does anyone know if there is INR testing facilities on the Amsterdam. Is there a paticular department at HAL that I would need to contact? I am leaving on the Amsterdam on May 18th. My INR is slightly off and my ACC clinic would like to have me tested midway the cruise. I would e-mail my ACC clinic the results and they would adjust my warafin. Thanks for any help you can give me. You might see about renting a INR machine and self test - if you go to a clinic/urgent care or lab off ship and they aren't on your preferred provider list/or you are out of area for your insurance, you could have a big [to huge] co-pay. And if your levels stay wonky, you'd have the tester in case you needed more than one adjustment. Link to comment Share on other sites More sharing options...
sail7seas Posted May 13, 2014 #8 Share Posted May 13, 2014 I am not on warfarin but I read on a heart forum. Many people with valve replacements who require coumadin/warfarin therapy own their own finger prick INR test machines and travel with them. In U.S., you need a Rx from your doctor but they are very easy to use and those people that use them FAR prefer that to constantly going to clinics. Many even dose themselves now. Link to comment Share on other sites More sharing options...
taxmantoo Posted May 13, 2014 #9 Share Posted May 13, 2014 They are equipped to do INR's (Blood Drawn with syringe and then drop onto strip, instead of the pin prick, drop to strip method) However, they will not do it unless they (HAL Dr(s)) have given someone a medication (read antibiotics) when passenger is on Coumadin or Warfarin. Our second cruise I was injured and the Passenger Dr treating me placed me on antibiotics and had an INR done every other day. Our last cruise I asked the medical center if they could do INR's if it was someone like me that just needed it checked once every 2-4 weeks (because CC members had asked the question, just as you are) and was informed no. The Dr said that if you need an INR you would have to have it done at a shore side hospital or Urgent Care. I now make sure all of our cruises are not scheduled for the time frame I am currently on for testing, every 6 weeks. Joanie Not quite correct according to our experience. My wife is on warfarin medication because of an artificial aortic valve that was implanted 3 years ago. She has had INR tests done on the Eurodam (twice), the Noordam and the Nieuw Amsterdam without any trouble. Just go down to the clinic and ask. I seem to recall there was a charge but it was reimbursed by our insurance company once we got home. We have now bought our own INR machine (similar to that used by diabetics but a lot more expensive approx. $600 + $8 for each strip) and she can now take it whenever she wants and e-mail the results to her clinic who will recommend she adjust her warfarin dosage or not. Link to comment Share on other sites More sharing options...
IRL_Joanie Posted May 13, 2014 #10 Share Posted May 13, 2014 If you use the self test INR thing that others have mentioned, keep in mind that you, not being the specialist trained in dosing, would still need a doctor to calculate how much more or less blood thinner to dose and how often and for how long. I asked both my Coumadin Clinic and Personal Physician if I should buy one and they both said no. Because eavery person is different not only in their body weight, age and needs, the store bought INR test kit can tell them if they are higher or lower than their body needs, but cannot tell them how much more or less of the medication they need. Only a trained Coumadin Clinic or Doctor can tell you that. Joanie Link to comment Share on other sites More sharing options...
taxmantoo Posted May 13, 2014 #11 Share Posted May 13, 2014 If you use the self test INR thing that others have mentioned, keep in mind that you, not being the specialist trained in dosing, would still need a doctor to calculate how much more or less blood thinner to dose and how often and for how long. I asked both my Coumadin Clinic and Personal Physician if I should buy one and they both said no. Because eavery person is different not only in their body weight, age and needs, the store bought INR test kit can tell them if they are higher or lower than their body needs, but cannot tell them how much more or less of the medication they need. Only a trained Coumadin Clinic or Doctor can tell you that. Joanie It seems that you are not very aware of the purpose of the INR test machine. Nobody ever suggested that the INR machine would advise them to increase or decrease their drug intake. The purpose of the machine is to obtain your INR reading yourself (without attending a clinic) which you then transmit to a physician that prescribes the correct dosage. Link to comment Share on other sites More sharing options...
liketraveling Posted May 13, 2014 Author #12 Share Posted May 13, 2014 Thanks everyone for your help. I just got off the phone with shipboard services and they said they have INR testing available so I can e mail the results to my Coumadin clinic to make what ever adjustments. I wouldn't be able to get an INR machine this trip but it is something to look into. There is no way I would ever dream of doing my own adjusting. There are too many variables between diet and meds. I took a cruise two month ago and had my regular check the day before I left. I was in perfect range. The fact that I was traveling the had me come in a couple of days after the cruise and it was perfect. Thanks again for your help! Link to comment Share on other sites More sharing options...
sail7seas Posted May 13, 2014 #13 Share Posted May 13, 2014 If you use the self test INR thing that others have mentioned, keep in mind that you, not being the specialist trained in dosing, would still need a doctor to calculate how much more or less blood thinner to dose and how often and for how long. I asked both my Coumadin Clinic and Personal Physician if I should buy one and they both said no. Because eavery person is different not only in their body weight, age and needs, the store bought INR test kit can tell them if they are higher or lower than their body needs, but cannot tell them how much more or less of the medication they need. Only a trained Coumadin Clinic or Doctor can tell you that. Joanie It seems that you are not very aware of the purpose of the INR test machine. Nobody ever suggested that the INR machine would advise them to increase or decrease their drug intake. The purpose of the machine is to obtain your INR reading yourself (without attending a clinic) which you then transmit to a physician that prescribes the correct dosage. This actually is not exactly correct either. Just for the sake of clarification. Many self-test warfarin users become very adept at self-dosing with their doctor's approval. Lots of doctors say no to permitting it for a variety of reasons and they include the patients lack of ability to fully understand about dosing due to lack of experience, education or simple ability. There is also the revenue factor. Clinics have a smooth flow of fees from testers who must go on a regular basis. There is also the confused, elderly patient etc that cannot always be counted on to remember to test and take their medication let alone dose it. The very active heart board where I 'read', has some hugely knowledgable coumadin users who know more about the medication and how to handle it than many professionals. That is one serious medication that is woefully misunderstood by far too many health care providers. So, my point here is that you can be tested on the ships. Some have a finger prick machine that works very much like diabetic testing. Others are vein draw. Many senior people use warfarin/coumadin and the infirmaries know it is important they be able to test INR. If a guest who uses INR has an illness or accident, it is very important the doctor can get INR reading. A stroke, a heart attack, a bleed...... common sense tells us they have to have INR machines in an emergency infirmary. Link to comment Share on other sites More sharing options...
taxmantoo Posted May 13, 2014 #14 Share Posted May 13, 2014 This actually is not exactly correct either. Just for the sake of clarification. Many self-test warfarin users become very adept at self-dosing with their doctor's approval. I am not at all disputing your statement nor do I doubt it is well founded. I do however doubt VERY MUCH that any doctor in CANADA would suggest that a patient self-dose WARFARIN themselves. Link to comment Share on other sites More sharing options...
sail7seas Posted May 13, 2014 #15 Share Posted May 13, 2014 (edited) This going too far off topic but I think it possible there are more Canadians that self-test and dose than Americans at least as represented on the forum I reference. U.S. doctors seem more resistant than Canadian from my small 'snapshot' view gleaned from the posters who are active on that forum. It is my impression in Australia, heart valve surgical patients who will require anti-coagulation (mechanical valvers) are sometimes provided the test machines right from their hospital post surgery. My only reason for responding now is for cruisers from Canada who have an interest in having their own machines for testing should know in a great many cases, they need only ask their cardiologist. Many people are unaware it is a possibility. Edited May 13, 2014 by sail7seas Link to comment Share on other sites More sharing options...
Jalex63 Posted October 1, 2014 #16 Share Posted October 1, 2014 It is not my intention to throw fuel on to the fire, but I see many mis-understandings being presented and so feel it necessary to address this subject. First, I have been taking Coumadin since 1993 so am very experienced in dosing it. Usually when I go in to the doctors office for an INR and it is off I end up telling the nurse what I need to do and she will run it by the doctor who has always agreed with me. Secondly, cruise ships can and do perform INR's at passenger request. Last year I was on a cruise where I suspected my INR might be high so I went to the infirmary and had it checked. It was high and I reduced my does for a couple of days then followed up with another INR on the ship. Of course they do charge for this service.:) Link to comment Share on other sites More sharing options...
Krazy Kruizers Posted October 1, 2014 #17 Share Posted October 1, 2014 It is not my intention to throw fuel on to the fire, but I see many mis-understandings being presented and so feel it necessary to address this subject. First, I have been taking Coumadin since 1993 so am very experienced in dosing it. Usually when I go in to the doctors office for an INR and it is off I end up telling the nurse what I need to do and she will run it by the doctor who has always agreed with me. Secondly, cruise ships can and do perform INR's at passenger request. Last year I was on a cruise where I suspected my INR might be high so I went to the infirmary and had it checked. It was high and I reduced my does for a couple of days then followed up with another INR on the ship. Of course they do charge for this service.:) Thank you for the information. Which ship were you on? Link to comment Share on other sites More sharing options...
Jalex63 Posted October 1, 2014 #18 Share Posted October 1, 2014 Thank you for the information. Which ship were you on? This last time I happened to be on a Seabourn Ship, but I have had it checked on a HAL ship a couple of years back, I don't recall which one it was, think it might have been aboard the Rotterdam because that was a 30 day cruise. Point is I know I have had it done on HAL. Link to comment Share on other sites More sharing options...
Krazy Kruizers Posted October 1, 2014 #19 Share Posted October 1, 2014 This is good information. For a time DH had to take Coumadin. We weren't cruising at that time. If the situation should arise again, now I now that he can be tested and watch his levels. I don't worry about charges -- one does what one needs to do. Link to comment Share on other sites More sharing options...
curlyhead666 Posted May 14, 2016 #20 Share Posted May 14, 2016 They are equipped to do INR's (Blood Drawn with syringe and then drop onto strip, instead of the pin prick, drop to strip method) However, they will not do it unless they (HAL Dr(s)) have given someone a medication (read antibiotics) when passenger is on Coumadin or Warfarin. Our second cruise I was injured and the Passenger Dr treating me placed me on antibiotics and had an INR done every other day. Our last cruise I asked the medical center if they could do INR's if it was someone like me that just needed it checked once every 2-4 weeks (because CC members had asked the question, just as you are) and was informed no. The Dr said that if you need an INR you would have to have it done at a shore side hospital or Urgent Care. I now make sure all of our cruises are not scheduled for the time frame I am currently on for testing, every 6 weeks. Joanie 5/15/16 Hi Joanie, We called the medical dept of Holland America and they told us they do perform INR testing. All you need is a script from your doctor and recent dosing information. We were told this both last year and just last week 5/8/16. If anyone is uncertain call HAL medical Service Dept at 661-753-2680 Curlyhead666 Link to comment Share on other sites More sharing options...
curlyhead666 Posted May 14, 2016 #21 Share Posted May 14, 2016 (edited) INR testing is done on all HAL. We checked last year and just this past week with their Medical Service Dept on 5/8/16. All you need is a script from your doctor and your recent dosing information. If in doubt, call their medical services dept at 661-753-2680 for any concerns about their medical capabilities. Mary Rose posted 5/14/16 Edited May 14, 2016 by curlyhead666 Link to comment Share on other sites More sharing options...
Rare Copper10-8 Posted May 14, 2016 #22 Share Posted May 14, 2016 This actually is not exactly correct either. Just for the sake of clarification. Many self-test warfarin users become very adept at self-dosing with their doctor's approval. Lots of doctors say no to permitting it for a variety of reasons and they include the patients lack of ability to fully understand about dosing due to lack of experience, education or simple ability. There is also the revenue factor. Clinics have a smooth flow of fees from testers who must go on a regular basis. There is also the confused, elderly patient etc that cannot always be counted on to remember to test and take their medication let alone dose it. The very active heart board where I 'read', has some hugely knowledgable coumadin users who know more about the medication and how to handle it than many professionals. That is one serious medication that is woefully misunderstood by far too many health care providers. So, my point here is that you can be tested on the ships. Some have a finger prick machine that works very much like diabetic testing. Others are vein draw. Many senior people use warfarin/coumadin and the infirmaries know it is important they be able to test INR. If a guest who uses INR has an illness or accident, it is very important the doctor can get INR reading. A stroke, a heart attack, a bleed...... common sense tells us they have to have INR machines in an emergency infirmary. Good to see you back here in old form S7S! ;) Link to comment Share on other sites More sharing options...
sail7seas Posted May 14, 2016 #23 Share Posted May 14, 2016 Idon't hav e the need for testing but beelieve ther nutse in l the infirmaaaaaaaaaaaaaaaaaaaries on all HAL ships has at testing machine anc will tesgt your INR for you. Link to comment Share on other sites More sharing options...
sail7seas Posted May 14, 2016 #24 Share Posted May 14, 2016 (edited) some POSTS IN THIS threadare two and more years old. Edited May 14, 2016 by sail7seas Link to comment Share on other sites More sharing options...
Rare Copper10-8 Posted May 14, 2016 #25 Share Posted May 14, 2016 some POSTS IN THIS threadare two and more years old. Shame on me for not checking those dates! :( All the best S7S! :) Link to comment Share on other sites More sharing options...
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