Treatment and Anticoagulants
Treatment aims to prevent:
· The blood clot growing and becoming larger
· The blood clot from moving and travelling to the lungs causing a Pulmonary Embolus
· New incidents of DVT
· Post-thrombotic syndrome
Once diagnosed, the process of treatment of DVT begins with a blood test to discover your natural INR (International Nationalised Ratio). Which will be recorded for reference, normally in a Anticoagulant record, this will be given to you and needs to be kept up to date with your current INR levels. You must take this record with you everywhere, and inform doctors, dentists and health professionals that you are being treated for Anticoagulation prior to receiving any treatment. Your doctor will then ascertain your body weight and estimate the amount of anticoagulant required, to achieve an INR of between 2 and 3.
The most commonly used anticoagulant is Warfarin which is administered orally, but as it takes a few days to get into the system, to begin with you may also be treated with Low Molecular Weight Heparin, which is administered in injection form.
Thrombolytics can also be used, but as they carry high risk of bleeding they are only used in very severe cases. These medicines are used to dissolve blood clots.
For the first few days after diagnosis your INR may need to be taken on a daily basis. The dosage of Warfarin, unlike other medication is patient specific, and it may take a while to stabilise your INR between the desired therapeutic range.
Once your correct dosage is established, blood test become less frequent, as long as there are no dramatic changes in your INR. Blood tests can then be done between every six and eight weeks.
Anticoagulants DO NOT dissolve the clot, the body will do that naturally over time, anticoagulants stop the clot from growing and moving which could result in the more dangerous, often life threatening Pulmonary Embolism (PE). Anticoagulants also stop new clots from forming. By thinning the blood, your blood moves at the same rate through your veins, but due to a lower viscosity and density will travel around the clot.
You may also be prescribed with Compression Stockings, which may relieve pain and swelling, and to prevent post thrombotic syndrome. Following a DVT, compression stockings may need to been worn for two or more years to prevent later damage to the veins
Duration of treatment may vary from 3 months to life depending on the size of the clot and your personal history.
When your doctor decides to take you off Warfarin ask the question WHY?, as unless you understand the reasons behind why you got a DVT in the first place, you may be putting yourself at further risk.
The current standard procedure in the U.K is not to prescribe Warfarin long term to a patient who has only had one clot. The procedure is to take you off Warfarin and wait and see if you have another clot. So please ensure you understand your risk factors and cause of your DVT before coming off anticoagulants.
The main side effects of Warfarin are that you may bleed profusely and/or bruise easier, so you may have to decide which is worse your risk of getting another blood clot, or the risk of excessive bleeding if you were to be involved in an accident.