Jordan,
I don't even begin to mess with patients in terms of their coumadin unless they are FULLY on board with my care and are willing to do a huge panel of coagulation factors through Hemex.com . To do so would put a huge target on me that the MDs would gladly shoot at again and again.
You'd need to find a doctor who really understands this process and a patient who will comply. Sorry to say, I don't find elderly patients to be very compliant at all (whether by choice or by inability to comprehend/learn new habits).
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