Edema after thrombosis

Hello, my name is Maxim, I live in New York, USA. I already wrote Yevgeny Ilyukhin to email your question. And very grateful for a very quick and complete answer:


Zdravstvyite yvajaemii Evgenii! Menya zovyt Maksim, ya projivau v gorode New York, USA, mne 23 goda. 06.10.08 bil gospitalizirovan s diagnozom DVT (tromboz glybokih ven). Mne naznachyali nizkomolekylyarnie geparini v techenii 6 dnei + 5mg koumadin. 12.10.08 - vipisali, posle vipiski prinimal 5mg v techenii nedeli, posle sledyushego analiza krovi na MNO (20.10.08) vrach podnyal dozy koumadina do 6mg, eshe cherez dve nedeli (04.11.08) do 7mg. Bespokoit eta sityaciya, volnyus, podnyatie dozi oznachaet, chto chto-to idet ne tak?

Noga nemnogo opyhshaya + bolit chast nogi nijegoleni (ne stopa, a kak bi sverhy) pri sgibe stopi vverh, podnyatii. Opyhaet systav ktorim golen krepitsya k stop, i torchit venka vo vnytrennei nijnei storone goleni.

moi resyltati analiza krovi, provedennogo 10/07/08
Antitrombin III - 116-v norme (80-120% normal), Protein S activity - 109 - v norme (70-150% normal)
Protein C activity 37 - nizkaya (70-180% normal)

PTT-LA Screen - 69 - visokoe (<or 40seconds - normal)
DRVVT Screen - 52 - visokoe (<or 42seconds - normal)
Hexagonal Phase Confirm - positive * (Negative - normal)
DRVVT Confirm - negative (Negative - normal)

Vrach naznachil tolko koumadin i bolshe nichego,propisali diety (otsytstvie prodyktov s vitaminom K, tolko v nebolshih i nemenyaushihsya dozah mojno, zapret na klykvennii sok, alkogol, bolshe ypotreblyat ribi) + lifestyle (ne stoyat, sidet s podnyatimi na stol nogami, v krainem slychae raspravlennimi, lejat s podnyatimi nogami , tyajesti ne podnimat, bolshe pit jidkosti, delat probejki) skazal na priem cherez 2 mesyaca. A posle 6 mesyacev terapii gematologicheskoe obsledovanie.

ps: iz rodstvennikov, tolka y papi bil tromboz, vizvannii perelomom, bolshe niykogo ne bilo.
pps: ya do gospitalizacii stradal bolyami v spine, i moi pervii doctor pomimo lechenia skazal bolshe pokoya. Ya mnogo sidel v neydobnoi pozicii - rabota s komp'uterom. moglo li eto sprovocirovat DTV ili vse-taki nasledstvennoe? podskajite pojalyista! i gde lychshe lechitsya? zdes - v USA ili v Rossii?

zaranee izvinyaus' za translit i formylirovki, no a staralsya.

Hello, Maxim!
While there are no results for INR, but there is time - I will answer your basic questions.
Coumadin drugs lowerblood coagulability (in Russia, the analogue is warfarin). Closure at their reception is controlled only by INR (INR). Usually INR should be in the range of 2-3. Below 2 - more likely to repeat thrombosis, above 3 - higher risk of bleeding. Therefore, at the beginning of treatment coumadin always often quite often supervise INR and adjust the dose of the medicine. The dose is individual within a wide range, there are patients who have enough 1.5 mg per day, and there are those who drink 13 to 15 mg per day! The only thing is that at the beginning of the treatment I prescribe the control of INR more often - on average 2 times a week, in order to bring the patient to the desired level faster. Additionally, you can read here http://www.phlebo-union.ru/phpforum/viewforum.php?f=12 -? 1; attached? 7; sections of the forum on warfarin were made by me specifically for such cases as yours.
Edema and mild pain are a natural satellite of DVT. As far as I know, our American colleagues (like us) usually focus on compression, compression treatment. I consider this element to be one of the most important in treatment. If the swelling is strong - start with elastic bandages, then go to the special. knitwear. Sometimes you can immediately start using jersey. Check with your doctor for this question.
Attention is drawn to the reduced protein activityC. It is possible that this is the cause of thrombosis, but you can finally judge this by knowing the circumstances of thrombosis and performing genetic studies (those that you plan to do in six months). There is no rush in this, genetics is often delayed so that the reception of coumadins does not affect the result of some analyzes.
By the way, in some cases with protein C deficiency it makes sense to take low-mice. Heparins until the INR reaches 2.0. But these are nuances, only according to the doctor's prescription.
Tests for lupus antibodies (PTT-LA Screen, DRVVT, Hexagonal Phase Confirm,
DRVVT Confirm) they do not tell me anything. This diagnosis of antiphospholipid syndrome as one of the causes of DVT, in our conditions, the phlebologist seeks help from a hemostasist (a specialist in clotting) or a rheumatologist (because in principle antiphospholipid syndrome refers to rheumatological diseases). Diagnosis of it is carried out in parallel treatment by DVT.
Regarding the regime - the activity is veryit is very welcome. No additions, though the legs on the table in my understanding - a little bust))) Although, if there are conditions to put them on a horizontal surface (that is, working sitting with legs stretched out side by side) - not bad at all.
In the absence of other reasons, sedentary work does not lead to thrombosis. Because you are examined on the ASF and thrombophilia.
To be treated it is necessary in the USA - competent experts on this question there it is more, and treatment in your case conservative - jersey, warfarin.

Read the information on the forum of the Associationphlebologists of Russia. If there are questions, ask in the same place, since the answers to your questions can help others, and in the answers for you, not one doctor, but several.

The site of the American Venous Forum (AVF)there is a search section for a doctor http://veinforum.org/index.php?page=find-a-doctor Another resource on this topic is the American College of Phlebology: http://www.phlebology.org/patientinfo/conditions.html. there is also something like that.

Good luck, Ilyukhin Evgeniy Arkadevich.

P.S. if you want, you can use the virtual keyboard for the Russian language http://freesoft.ru/?id=10124

Doctors made a diet to maintain, andpreventive maintenance and possible restoration of work of veins, valves and vessels. They told me so to eat all my life. With all do you agree? if so, then perhaps it will help the other ones.

diet (vitamin K, to control those who take coumadin):

Peanuts, sprouted grains of rye and wheat (K 2.3 per 120 grams),
yolks (K 0.1 to 16 g), Pineapple juice (K - 0.2 per 250 g)
tomatoes (canned, paste without salt - 29.9 for 260grams), almonds

lemons (0), oranges (K - 0.1 juice 250gr, 0 - fruit),
grapefruit (0), red pepper (K ​​- 7.3 to 149 g), dill

lemons (0), oranges (K - 0.1 juice 250gr, 0 - fruit),
grapefruits (0), gr. Nuts (K 0.8 14 halves), black tea.

cherry, cherry (K - 8.9 10)

mussels, shrimps, crabs, beets (K - 0.3 per 170 g)
tomatoes (canned, pasta without salt - 29.9 for 260grams
raw - 14.2 per 180 grams), juice - 5.6 per 243grams),
mushrooms (0), salmon (0.

Water, Orange juice (K - 0.1), Pineapple juice (K - 0.2 per 250 g)
Apple (To 0.173 for 250), tea

Apples (K 0.3 to 138 g), Carrots (Juice to 36.6 per 250gr, vegetable - 9.5 to 72g),
Brown rice (To 1.2 by 195 gr) Bread from whole grains (To 2.3 by 25gr)

You can not or strongly limit:

fatty, floury and sweet
meat boiled broths, marinades, smoked products, salt, spicy, canned
coffee fritter to 1-2 cups a day;
alcoholic beverages, beer.

PS: Can I go to the pool, and how often?