Dvt

[FiveMoreMinutesPlease]

Hi,
So DH is at a and e having just had a scan and he's been diagnosed with a blood clot. This is his second - his first was diagnosed in Jan. He's not overweight, he exercises and eats healthily. Yes, he travels for work but he's been taking breaks and if in a plane he follows precautions. Why has it happened again?
I'm with DC at home and he's just waiting to speak to the dr. I just feel so fed up for him.
Does anyone have any experience of this? Will he be on medication for life now?

I've had DVT twice and am now on Warfarin for life. I had the first as a post partum complication and the second about 6 years later. After all usual blood tests, I'm not sure there is a reason. There is a medication. You can take that means you don't need to attend an anticoagulation clinic. You can only take this if you've never had kidney problems.

Thanks Text! Do you have any side effects being in medication? And what's an anticoagulatikn clinic?

What treatment did your DH have in Jan?

If your DH has to take Warfarin, that medication reacts with everything. I'm given a range to stay between and I go for regular tests to test this. In my area this is an anticoagulation clinic. I go weekly, every other week because I'm not stable because of other medications I take. If you are stable, I think you can go longer; 2/4 times a year. I can't really drink alcohol and have to watch my diet.

Does he travel a lot for work by plane? Out of interest, what type of travel insurance did he use?

I'm not sure what he had last time but it wasn't warfarin. It was a 3 mth treatment. When he went back after those three months he had a scan and blood test. Blood was flowing nicely but he did have scarring from the clot. Perhaps this is what is causing it.
New clot is in upper leg this time so they've given him an injection, referee him back to the ambulatory clinic for 9am tomorrow where I suppose they will investigate more.
He does fly with work but hasn't since June. He flies to USA and Europe. His work know about it and have sorted out the insurance so I'm not sure where he get it from.
He does travel across U.K once a week but always stops half way to walk around. It's so bloody frustrating as he took all the Drs advice.
He sounds quite upbeat.
It sounds tricky for you if you have to manage the dosage. Thank you for replying 😊

It might be clexane. I asked about flying/insurance because of diagnosis. I couldn't fly for a year afterwards. I'm fine to fly now. It's good he's back at 9am for more information and treatment. Hope it goes well.

Has he been tested for clotting disorders? There are many so I would push for diagnostic blood tests

Thanks Text!
Apples, I will tell him to ask tomorrow. Can clotting disorders be treated?

Has he been tested for Factor V Leiden?

I don't know sorry - I don't think cured - more you treat to live normally with I think.
Google clotting disorders and you can see the range of them including factor v.

@Mrs no he hasn't. Hopefully he'll have tests tomorrow and they'll come up with something. Although I think we're prepared to being on medication for life. It's just a horrible thought. But if it keeps him going then we'll take it.
I'm probably being too dramatic. I know many people live their lives dependant on medication. It's just it's the first time it'll have happened to us.

Thanks for all you replies 🙏

I have Factor V. I'm not on any medication, just have to be aware and take asprin before flying, keep calves active on long journeys, and advise the hospif I meed an operation. Others have variation on the theme so there might be a need for ongoing meds, but it becomes the same as having morning coffee.

@mrs it's good you're not on medication.
He's had the blood tests and they've come back normal although I done see how it can be normal that his blood is sticky. So he's on anti coagulants (rivaroxaban) for life. It's a bit of a blow and make you realise your mortality but plenty of people are on life saving medication e.g. Diabetes.

What did they say is actually the issue? I was going to recommend the Facto V FB group if it'd been that. Whatever it is there's bound to be a group who can provide a handhold and share experiences.

They haven't said as far as I can get from him. He's a typical man and doesn't ask questions. However, he has to go back for a follow up appt next week so he might get some more info then. I may go with him if I can get time off work so I can bombard the dr with questions.

He might have less/no regular blood testing with rivaroxaban.

Life long mediation is the recommended treatment following a second dvt. I would have though testing for conditions is standard too. Hopefully you should will get a better update next week.

Strange that they have put him on rivaroxaban rather than warfarin - are you in the US? Are you sure that all the clotting screen results are back as it usually takes at least a few days for some of them to come back (even in private hospitals)? Being put on anti-coagulants for life after only two episodes also seems sudden without the haematologist having diagnosed a cause - haematologists are usually reluctant to do this in my experience.

The obvious question with clotting disorders is, is there a family history of clotting, heart attacks or strokes at a young age (under 40)? I have atiii and there is a strong family history for it and I have been warfarinised for the past 17 years - it can be difficult to manage at times but you do get used to it.

I've tried to move into an alternative because the anti-coagulation clinics are a pain in the arse to fit around full time employment. It costs 70 times more than Warfarin and I've not managed a change yet ( plus I've had a kidney infection).

I was told to dvts mean lifelong mediation.

We in the U.K and there's no family history. His dad died of a stroke but he was in his 50s. I will ask him to pursue a diagnosis as something must be causing it.

Not necessarily lifelong text - depends on what they think caused it, for example after a broken limb then probably not but if you have an inherited thrombophilia and then a clot, then most likely lifelong treatment. You can buy an INR monitor (similar to what diabetics use) and the test strips are available on prescription - I have one and it is very straightforward to use.

I have a friend who must have had about four dvts now and is still not on warfarin long-term.

Strokes can be associated with atiii. They prefer to test for it though when the DVD has stabilised as the clexane in the bloodstream can affect the test result.

@bear what's atii?

Dehydration can do this.

If there's no underlying cause and there's no definitive answer, they start to look at diet and hydration.

Maybe he's had a second because he had a first brought on from flying and his vein was scarred. Could that be a reason? I'm just guessing.

Rivaroxaban is our drug of choice locally, unproked thrombus should warrant thrombophilia referral. All of those of warfarin who would like to switch should have a say in it. Only thing is there is no reversal agent but lots of other things to remove drug. Check out NICE guidelines for venous thromboembolism for definitive treatment plans