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Wondering if anyone else in a similar situation.
I am male, young (30s), had an unprovoked popliteal DVT and possibly a small asymptomatic PE. INR very well controlled (never out of range). Still have compromised flow (15 months later) and occasional mild PTS.
So, do I discontinue coumadin or not? My hematologist has basically given me the choice.
I am male, young (30s), had an unprovoked popliteal DVT and possibly a small asymptomatic PE. INR very well controlled (never out of range). Still have compromised flow (15 months later) and occasional mild PTS.
So, do I discontinue coumadin or not? My hematologist has basically given me the choice.
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Look at what my best friend did with my picture!
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We all have 24 hours in a day. How we spend these hours is important. Watching a little bit of a video about how sitting affects us made me aware of how much sitting and laying down I do. Gonna have to work on that.Your turn. Tell me another truth.
Check out Clot Connect. This may help you: http://professionalsblog.clotconnect.org/2012/02/27/new-accp-guidelines-%E2%80%93-dvt-and-pe-highlights-and-summary/
I don't think anyone here can really tell you whether to stay on it or not. I think you have to evaluate the anticoagulant risks against the risk of getting another clot and go from there.
Sometimes when a doc tells me I have a choice but I'm not sure what to do, I pull out the old, if it was your wife, sister, daughter, mother, etc what would you tell her. That seems to evoke an actual opinion. Obviously you'd not say daughter since you're a dude, but you get the picture.
"I don't think anyone here can really tell you whether to stay on it or not. I think you have to evaluate the anticoagulant risks against the risk of getting another clot and go from there."
There are intermediate options to consider though - staying on Coumadin at reduced dose 1.5 - 2.5 INR range for example, or do away with the coumadin dose altogether, but take a daily aspirin which has been shown to be beneficial at preventing clotting.
Also, consider what general predispoing factors you may have - Are you really tall? Overweight? Smoker? Frequent long haul traveler? Any or all of these factors may make you lean more towards continuing therapy.
The opposite is true as well - do you juggle chainsaws as a hobby? :-) Work as a meat cutter? Race car driver? Etc... Those factors would make you lean more towards discontinuing coumadin therapy.
Whatever the case, it is good you have options and good that you are thinking it through carefully.
Unprovoked (idiopathic) DVT: long-term, if risk for bleeding not very high. Re-evaluation every so often (once per year?) to determine whether long-term treatment is still the right thing to do.
Given my controlled INR and lack of any real dangerous activities, I would think I am a low risk of bleeding. In addition I recall finding a paper that said a similar thing, especially for males, whereas for women it would be more appropriate to d/c treatment.
My discontinue option would be the aspirin regimen, then re-check d-dimer after 1 month. My main worry is that I can be a bit of a worrywart, and I wonder if every time I get a leg cramp I'm going to be running to the hospital to get my d-dimer checked.