What you need to know:

What is the treatment for DVT and PE?

The most common and effective treatment is to administer anticoagulants (clotting prevention agents). These drugs block the formation of new clots. Over time the body’s natural processes will begin to dissolve the clots that have already formed. Initially, injections of heparin or low-molecular weight heparin are used because they act within hours. For the longer term, the most common medication is warfarin, often sold under the brand name Coumadin, and taken orally. Unlike, heparin or low-molecular weight heparin, Coumadin 3-5 days is needed before Coumadin reaches full therapeutic effect.

Can my clots be dissolved or removed?

The safest way to dissolve a clot is to let the body’s own clot-dissolving processes take effect. This can take anywhere from weeks to years. In the case of massive or life-threatening clotting, thrombolytic or clot dissolving drugs can be administered via catheter directly into the blocked blood vessels to dissolve recently formed clots. Thrombolytic drugs do have a risk of bleeding.  In certain emergency situations clots can be removed surgically, but this increases the risk of further clotting.

What are the risks of blood clots recurring?

The chances of a recurrent VTE is dependent on the circumstances leading up to the first VTE. For example, if the blood clot occurred as a result of surgery or trauma, then the chances of reoccurrence is relatively low. On the other hand, for people who developed spontaneous VTE and have terminated warfarin treatment after 6 months, the chance of recurrence is approximately 20% in the first 4 years and roughly 30% after 10 years. These figures emphasize the importance of continued warfarin treatment; the rate of recurrent DVT is less than 1% for patients who stay on warfarin.

What are the risks of taking warfarin?

Warfarin has been in use for over 50 years and there are no known long-term side effects. There is an increased risk of bleeding, which is reduced by avoiding contact sports, or sports that can result in head trauma such as downhill skiing or bicycling. A small percentage of patients are not helped by Warfarin and use other anticoagulants.

Despite the alarming statistics, fortunately for most people, there are simple, inexpensive and effective treatments and preventions to manage this prevalent disease. In many ways, management is akin to the blood sugar management of a diabetic. What is often unrecognized about patients who have experienced a thrombosis is the anxiety and fear that they experience. This is that the most challenging experience for many of them.

“I went in to the hospital’s emergency room with pain in my back and side.  I did not have any of the usual symptoms (no swelling or trouble breathing).  Tests were done and the only one that was abnormal was my D-Dimer.  I had ultrasounds, and a CT Scan. The emergency room doctor said he did not see anything wrong and sent me back home.

When I returned home I received a call to come back to Emergency.  They had found a clot in my lung.  I returned to the hospital and the attending doctor taught me how to give myself injections of low molecular weight heparin.  I was released from the hospital with the understanding that I needed to return every week for an INR check to make sure I was properly anti-coagulated.  That was 3 years ago.

I was in a daze for the first six months.  I was afraid, I didn’t understand why this had happened to me, I didn’t understand the information that was given to me, and I hated taking warfarin.  I blamed myself. I was afraid, couldn’t think clearly and felt I had done something to make it happen.  I was always looking for some underlying problem.  Although the doctor and his wonderful team took care of me physically, emotionally and mentally I did not recover for several years.

Eventually I did read the information that was given to me and realized it was thorough and made sense.  I learned about the importance of wearing my compression stockings, as well as exercising and eating correctly, staying hydrated, taking my medicine, and having my INR checked. 

I read, researched, asked questions, checked what I can and cannot eat, looked up interactions with herbs that I use, had counseling, acupuncture, prayer, meditation, and, finally, understood that this happens to people every day.  With time it has become manageable.

I find that it is sometimes difficult for people who work in hospitals or clinics to understand how fearful a person can become and how paralyzing that can be.  Most of us, who are not doctors, don’t understand the medical terminology and don't even know the right questions to even ask.”