By Julie A. Evans with Paula Rasich, The New York Times Special Features
Thanks to technical advances, you can measure your blood
pressure, predict when you're ovulating, and even learn if you have
a life-threatening illness such as hepatitis C -- all within the
comfort of home. Some tests can save your life, while others just
waste your money. Here are some worth taking -- and two that just
aren't worth it:
+ Blood Pressure Monitor
High blood pressure is usually symptomless. If untreated,
however, it can cause serious -- even lethal -- damage.
Some people have high blood pressure in the doctor's office and
normal blood pressure at home. Their condition is called ``white
coat hypertension,'' and its caused by anxiety.
Enter the home blood pressure monitor: It may help you avoid
treatment for a condition that you don't have, or assure prompt
treatment for one that you do.
There are three at-home options: aneroid units (which require
the use of a stethoscope), electronic monitors with manual
inflation and electronic monitors with autoinflation.
The most convenient are the electronic units, which are
``reasonably accurate and easy to use,'' says Dr. Thomas G.
Pickering, cardiologist and professor of medicine at New York
Presbyterian Hospital in New York City. Autoinflation is a good
feature, especially if arthritis or weakness in your hands makes it
hard for you to inflate the cuff manually. The machine inflates the
cuff and displays your numbers on a digital screen. Stick with
cuffs that fit around your upper arm. Avoid cuffs for the wrist and
finger, which aren't as accurate, Pickering says.
The cost ranges from about $20 for the aneroid unit to more than
$90 for an electronic monitor with autoinflation.
+ Fecal Occult Blood Test
When accompanied by a flexible sigmoidoscopy, an annual fecal
occult blood test, starting at age 50 and then once every five
years, saves lives.
Your doctor will supply you with a take-home FOBT and should
instruct you on certain foods to avoid during testing, such as red
meat, certain fruits and vegetables, and aspirin. You take a stool
sample once a day for three consecutive days, placing each sample
on a card in the test kit. The samples will be sent to a lab,
either by you or your doctor, and tested for the presence of blood.
There are over-the-counter FOBTs that require you to drop a test
tissue into the toilet. If blood is present, the tissue will change
color. These tests may seem more convenient, but there's no good
evidence that they really save lives, says Dr. Gabriel E. Feldman,
national director of colon and prostate cancer control for the
American Cancer Society in Atlanta. Both tests are available only
from doctors.
+ Urinary Tract Infection Test
Urinary tract infections are almost as prevalent as the common
cold. Symptoms can include a frequent urge to urinate, a burning
sensation during urination, fatigue and an uncomfortable pressure
above or behind the pubic bone. Left untreated, a UTI can cause
permanent kidney damage. UTIs are more common among women.
Home tests for UTIs measure the byproducts of bacteria or of
white blood cells in your urine either of which could indicate an
infection, says Dr. Lindsey A. Kerr, director of the Vermont
Continence Center in Colchester.
You pass a chemically treated strip through your urine stream or
collect a sample and dip the strip into the container. If the strip
changes color, you may have an infection. If results are positive
(or if symptoms persist despite a negative test result), call your
doctor.
No prescription is required, and the test costs about $9 to $13.
+ Blood Glucose Monitor
Blood glucose monitors for home use help diabetics to oversee
drug therapy and allow you to adjust insulin doses. They also alert
you to any needed changes in exercise or diet between office
visits.
You apply blood from a finger prick to a chemically active test
strip. Then you place the strip in a meter that analyzes and
displays your glucose level. Depending on the type and severity of
your diabetes, you may need to check your blood sugar several times
a day.
Monitors vary in terms of price and features. But whether you
purchase a simple monitor or one with many features, the results
are generally accurate, says Dr. Bruce R. Zimmerman, president of
the American Diabetes Association and professor of medicine and
consultant at the Mayo Clinic in Rochester, Minn. If, however, you
have a meter that's more than five years old, think about replacing
it for newer technology.
No prescription is required, but some insurers and Medicare
require one for reimbursement.
The prices range from $34 to $115 for the monitoring kit
(one-time purchase) and about $65 to $70 for 100 disposable strips.
+ Ovulation Prediction Kit
This over-the-counter kit measures luteinizing hormone in the
urine to predict when a woman is most likely to ovulate. LH is
secreted during the monthly ovulation cycle and usually rises 20 to
48 hours before ovulation, reaching its peak when the egg is ready
for fertilization, explains Janet P. Engle, associate dean for
academic affairs at the University of Illinois College of Pharmacy
in Chicago. A positive test alerts you to the best time to
conceive, she says.
Prior to using the kit, keep a written record of your menstrual
periods for two or three months to determine when you're most
likely to ovulate. Then test your urine daily, beginning two or
three days before ovulation is expected. Some brands ask you to
collect the urine in a cup and dip a test strip into the sample.
Other brands require a midstream urine sample.
No prescription is required, and it costs from $15 to $60.
+ Hepatitis C Test
Earlier this year, the Food and Drug Administration approved the
first at-home blood collection kit for testing for antibodies to
the hepatitis C virus, the nation's most common chronic bloodborne
infection. Individuals at high risk of infection from hepatitis C
include those who received blood transfusions or organ transplants
prior to 1992. Other risk factors include injecting illegal drugs
with shared needles, getting pricked with an infected needle and
undergoing long-term hemodialysis. Engaging in sexual behavior with
multiple partners may also contribute to transmission.
Hepatitis C can cause cirrhosis of the liver, liver cancer or
liver failure.
You collect a blood sample from a finger prick at home and mail
it to a designated laboratory for analysis. Wait 10 business days,
then call a toll-free telephone number to get the results
anonymously. Home Access Health produces the only FDA-approved kit.
No prescription is required, and it costs $76.
+ Blood Clotting Test
Blood thinners such as Coumadin are prescribed to treat patients
with artificial heart valves, irregular heartbeat and other
conditions that may lead to excessive blood clotting.
Patients on blood-thinning medication need to be monitored
closely by their doctors to make sure that they get the right dose.
If the dose is too high, the patient can hemorrhage. If its too
low, clots may form and block blood vessels, causing stroke or even
death.
The home version of a test for blood clotting, known as the
prothrombin time test, is now available to make sure that patients
are getting the optimal dose.
Having a home test for blood clotting means faster results,
according to Cathy McGowan, anti-coagulation nurse at New York
Presbyterian Hospital in New York City. And quick results are
important when it comes to tracking Coumadin doses.
You stick your finger to draw blood, then run a sample through a
small electronic device that checks how fast your blood is
clotting. Results are displayed on a screen to indicate if you are
within the range established by your doctor.
A prescription is required, and the cost is about $1,200 to
$1,700 for the machine, plus $12 to $18 per use for disposable
cartridges. Medicare does not currently cover the test, but many
private insurers will reimburse some or all of the cost.
NOT WORTH IT
+ Cholesterol Test
Home cholesterol tests give you your total cholesterol, but
don't provide information about your HDL -- the good cholesterol
that protects against heart attacks. Without knowing your HDL, you
and your doctor can't calculate your total cholesterol/HDL ratio,
the number that's most important when evaluating your risk.
At least one home test that measures total cholesterol and HDL
may be on store shelves soon. At press time, the HealthCheck Total
and HDL Cholesterol Test was undergoing clinical trials. It will
become available subject to FDA clearance, possibly later this year
or early in 2000.
+ Bone Markers
If you see a home test that measures bone loss through a urine
sample, pass on it. Doctors routinely use this test of bone markers
-- chemicals that reflect the creation or breakdown of bone -- to
help assess the current bone turnover of someone who has been found
to have low bone density.
But bone markers are not useful to start with as a home test
because they don't reflect bone loss that may have occurred in the
past, says Dr. John P. Bilezikian, professor of medicine at
Columbia-Presybterian Medical Center in New York City.
To be meaningful, a test of your bone markers should be
evaluated by your doctor only after bone-density testing has taken
place.
