Posted , 4 users are following.
my dad has been treated for approximately 3 months with this tablet form anticoagulant and is due to stay on it until August. The swelling in his legs have not only, not reduced but have gone worse. I would have expected to see some improvement. The doctors say very little. Is anyone familiar with this treatment and can you advise if we should see an improvement of the swelling?
0 likes, 11 replies
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Vivi3nne helen12352
Posted
Hi Helen, anticoagulants are not a treatment for a blood clot, they stop the clot worsening and stop new clots forming, there is no treatment for the clot, your body naturally breaks it down itself. If your dad's legs are worsening it sounds like he is developing post thrombotic syndrome which is quite common after a clot and I am afraid is quite debilitating. Does he wear stockings? You should wear the stockings for at least two years after a clot, they help greatly to prevent PTS.
helen12352 Vivi3nne
Posted
Hi Vivienne. Thank you that's helpful. He is very old and at first they used stockings but decided it was too swollen and there was the risk of the clot moving. Thanks for your response
sheila91262 helen12352
Posted
Hi Helen, it is correct the anti coagulant does not reduce the DVT. There is a clot removal process but it is not suitable for all and only some places do it. The PTS is diagnosed by scanning. The measured compression stocking helps to relieve the symptoms of swelling and pain and help to exercise. The body developes collaterals which are small veins which get bigger to help return the blood upwards to the heart instead of pooling in the foot and lower leg. The vascular Consultant at Guys and St Thomas London suggested exercise such as walking and swimming to my son and this helped with the swelling and he was able to exercise more with less discomfort. He was treated there by stents being fitted in his upper leg to open up the scarred vein left over after the DVT had gone. Mr Stephen Black and his team were very helpful and the treatment a success. My son was referred to G&StT by his GP on our request. It is a minor surgery where the stent is injected into the vein by the knee and pushed upwards, he is on anticoagulenas for about a year. I hope this helps, very few GPs and hosps know about the treatment. My son's leg is now almost completely back to normal. We were very lucky, not everyone is able to have this treatment but at the very least a proper diagnosis and advice helps. Hope this helps. Sheila.
helen12352 sheila91262
Posted
Hi Sheila. Thank you. Your response is helpful and both responses have given me more to look into. Dad has other complications and is immobile so unfortunately is very limited to what he can do physically. Thank you for taking the time to reply. It's much appreciated
Vivi3nne helen12352
Posted
misswoosie helen12352
Posted
Hi Helen,
I wonder if they were concerned that a compression stocking would interfere with your Dad's arterial blood supply to his feet, as you say he's elderly and has other problems. Maybe he has Peripheral vascular disease and/or diabetes, in which case compresison stockings need to be used with caution. Technically (and this is how I was taught and practised) before anyine has a compresison stocking put on the Ankle Brachial Pressure Index ABPI should be carried out. This is to determine if the arterial blood supply to the foot is significantly worse than in the arm. If you're Dad is immobile,, can he sit or lie with his foot slightly higher than his hips? That might help with the swelling. Did he have ankle swelling before the DVT due to other problems? I'm not sure how you might go about getting them, but the devices (electronic) that give intermittent compression (they wrap around the lower leg and intermittently inflate for a short period every so often) might be suitable. Google "Intermittent compression devices" but these are really for use to prevent DVT in immobile people ie peri post surgery and on intensive care etc. Who is manageing your Dad's DVT? GP, Haematologist. hospital Doctor? I can't say really, but if your Dad has a lot of problems then Rivoroxaban might not be the best drug. Smetimes if patients are particulalrly poorly it's better for them to be on daily heparin injections. The effect is more predicatable ,been around for donkeys years and it has a shorter period of action, so if you stop it one day the drug will be out of the body system 24 hrs later. Anticoagulants are the standard approved treatment for DVT. Whilst they don't dissolve the clot, they should prevent it getting any bigger and prevent new clots. I believe that there will be less evidence from research regarding the effectiveness and safety of the new oral anticoag's (v warfarin or heparin) as most of the clinical trials probably excluded people over 80 and those with either multiple or serious health problems.
helen12352 misswoosie
Posted
Thank you for your advice. I know they couldn't do a Doppler test for the same reasons as the stockings. We do get dad to move his legs whilst in his chair (as advised by physio) and raise his legs regularly. I will definitely look into the intermittent compression device. This is really helpful. Thanks
misswoosie helen12352
Posted
michelle181170 helen12352
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hi Helen, sorry to hear about your dad my own experience with rivaroxeban was not a successful 1 and that anticoagulant did nothing to improve my DVT in fact it worsened whilst on it and i too have swelling especially when i do anything i would advise your father to go to A&E and get it checked as if like you say it has worsened then chances are the medication may not be working for him. Has he had ultra sound scan done yet ? it takes time with swelling trust me i know so make sure he rest with his feet higher than hip height when ever he can too.Let me know how you get on.
helen12352 michelle181170
Posted
hi Michelle. Thanks for your advice. The GP is going to visit so I will ask about another ultra sound as I don't think he's had one done since his first diagnosis
thanks
michelle181170 helen12352
Posted