Deep Vein Thrombosis (DVT) Support Group
Deep-vein thrombosis, also known as deep-venous thrombosis or DVT, is the formation of a blood clot ("thrombus") in a deep vein. It can be caused by something preventing blood from circulating or clotting normally. Join the support group if you are coping with DVT and find others who are going through the same challenges.
Hi all,
I haven't posted on here in a while, (which I guess is a good sign as I've been doing well thankfully :):)
I have been on warfarin for nearly 7 months now, and at my next appointment in november my haematologist will discuss how long more I need to stay on it or if I can come off it then. He has done some of the genetic testing (only the tests that can be done while on warfarin) and thankfully they have all come back clear, and I also had a D-dimer test done, which I will get the result of in November. He said that the result of the D dimer test will tell if I need to stay on warfarin for longer or not, My question is this: the day I had my D dimer test done my INR was too high (3.65). I am wondering if the INR level will effect the results of the d dimer test or if it is a totally separate thing. (Generally my INR level has been too low, but it was too high that day).
One other thing: today my INR came back too low again (1.4). My neck and shoulders have been very sore the last few days, particularly on my left side. I'm sure its just tension knots from sitting at my computer. When I asked the nurse in the warfarin clinic she agreed, but she did say to get it checked if it didn't subside. At that time she didn't know my INR result. I'm sure it's fine and I don't want to go to the docs unless its really necessary...anyone else experience this, and if so, was it clot-related?
Thanks so much for all the great support and advice :)
I haven't posted on here in a while, (which I guess is a good sign as I've been doing well thankfully :):)
I have been on warfarin for nearly 7 months now, and at my next appointment in november my haematologist will discuss how long more I need to stay on it or if I can come off it then. He has done some of the genetic testing (only the tests that can be done while on warfarin) and thankfully they have all come back clear, and I also had a D-dimer test done, which I will get the result of in November. He said that the result of the D dimer test will tell if I need to stay on warfarin for longer or not, My question is this: the day I had my D dimer test done my INR was too high (3.65). I am wondering if the INR level will effect the results of the d dimer test or if it is a totally separate thing. (Generally my INR level has been too low, but it was too high that day).
One other thing: today my INR came back too low again (1.4). My neck and shoulders have been very sore the last few days, particularly on my left side. I'm sure its just tension knots from sitting at my computer. When I asked the nurse in the warfarin clinic she agreed, but she did say to get it checked if it didn't subside. At that time she didn't know my INR result. I'm sure it's fine and I don't want to go to the docs unless its really necessary...anyone else experience this, and if so, was it clot-related?
Thanks so much for all the great support and advice :)
Glad you are doing well.
The D-dimer test normal value range is lower than 0.5mg/l; usually, when you are on warfarin, the value is lower than 0.250mg/l.
So the fact that your INR was 3.2 is not a problem.
But I do't understand why your doctor told you that you will be off or on warfarin based on the D-dimer test result. This test done right before you are supposed to discontinue the warfarin, and then another one in 3 weeks time after the treatment is stopped, is an useful tool to know if you are likely to have another blood clot or not in the near future(they say that if you have a d-dimer result lower than 0.250 while on warfarin and a value under 0.5 after you stop the treatment, and it stays like this several months in a row, provided that you take the test once a month, most probably you will not have another clot.
Unfortunately, the studies done regarding the length of time one should stay on anticoagulants, show that no matter how long your treatment is, even if you take warfarin for 2 years, the risk of recurrence remain unchanged (the same like for 6 moths only).
That's why the most important fact when you doctor is considering to take you off the warfarin is if you have or you have not a blood clotting disorder. The d-dimer test can help when trying to asses the risk of having another blood clot.
About your question regarding the neck and shoulder pain, I do't know, I don't think you have a PE, but considering the fact that your INR is low, better to check it though.
Take care and keep us posted.
Thank you so much for the information on the D-Dimer test, it makes it all much clearer. I found some extra information on the reasons why some doctors use d dimer test results to clarify whether or not warfarin treatment should be (dis)continued here:
http://www.clotcare.com/faq_ddimertest.aspx
This doctor states:
"Finally, there is emerging data to support the use of the d-Dimer test as a way to stratify patients who may be at risk of a recurrent clotting event. When the treatment course for a patient's first blood clot is nearing completion, some clinicians will do a d-Dimer test just before stopping anticoagulation and then periodically after the anticoagulation has been stopped. If the d-Dimer remains normal (does not become elevated), that appears to be an indication that the patient is at a low risk of developing another clot. Alternatively, if the d-Dimer level is elevated at the time the anticoagulation is stopped, or if the d-Dimer level goes up after the anticoagulation is stopped, that may suggest that the patient is at an increased risk of developing another clot. Some clinicians think that if the d-Dimer increases in that setting, it may be reasonable to consider resuming the anticoagulation".
Just thought I'd post it for anyone who might be interested :)
And thank you both for the advice on the shoulder pain. I have been using arnica which has helped a lot, so I think it's just a tension knot, but I'll keep an eye on it :)
Thanks again :)