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Thread: Is it possible to get a new dvt while taking cumadin?

  1. #1

    Is it possible to get a new dvt while taking cumadin?

    In the past two years, I've had two dvts. I started having symptoms in the spring (2006). At that time, we thought my lymphedema was getting worse. My doctor had dopplers done to rule out a possible blood clot and at that time, they came back negative. I continued to have symptoms throughout the summer with occasional doctor visits, including my physiatrist. By September that year, I went to my primary care doctor again, with my thigh extremely swollen, red and painful. He said he didn't know what else to do . . . and on my insistence that there must be something that could be done, he referred me to a vascular surgeon. There was a 6 week wait for an appointment, but when I finally got there, she had more dopplers done. By this time, my entire femoral vein was completely clogged, and the clot went into the iliac as well. She sent me back to my primary care doctor for him to treat this. He started me on a regimen of levanox and coumadin, which worked pretty well. In april, he took me off the coumadin, because it had been 6 months and told me if I were to get another dvt, I would go on coumadin for life.

    In June, I started having the massive swelling and pain again and went back to my primary care doctor. He said that he really didn't think it was a new clot, and he added that it was probably just effects of the old clot that would be ongoing because the old clot had been so bad. He then said that he would order dopplers again, just in case. It turned out to be a new clot, and I was started on the levanox and coumadin again.

    Now my leg is feeling a lot like it did the other two times and the only relief I get from the swelling is if I keep it elevated. I went in to the primary care doctor yesterday and he said it couldn't be a clot because I was already on coumadin and he wouldn't do anything until he saw the results of my pro-time. (It had been low two weeks ago at my regular screening.) When he got the results back, he called and said my INR was fine and to continue at the dose of coumadin that I've been taking for the last two weeks. When I pointed out that he didn't think there was a new clot the last time and there was one, he responded that I hadn't been on coumadin at that time.

    What should I do? Can I have dopplers done without a dr's order? Or is he right that as long as my INR is above 2.0, I'm not at risk of new clots?

  2. #2
    Yes, you can get a new DVT even if you are on anticoagulants. I would anticipate that you need to stay on Coumadin forever at this point, and may also need to consider a permanent Greenfield type filter to be on the safe side.

    I would seek consultation with both experts in DVT/Vascular conditions and with a hematologist at this point. A second (or even third) opinon should be sought. Consider doing this at a major teaching (university) hospital.

    (KLD)

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