Pnuemonia and Pleural Effusion

[emeric delczeg]

I doubt I should be taking this while taking a blood thinner. Im not sure when I will be if over off the blood thinner...

Only after you are of blood thinner.

Byron Wilson M.D Medical Oncology/ Hematology in Redwood City. 650-368-0520 35 minutes driving south from SF.

 

[RoyHobbs]

A little bit of inaccurate and outdated information in this thread...

- 0.5-1.5% of therapeutic level anti-coagulated pt's still present with a clot
- hearing/coumadin/elloquis/etc do not break up clots they prevent future clots while the current clot is reabsorbed which can take a long time as I saw someone state. TPA is the only drug used to dissolve clots and is 99% of the time used for a small percent of ischemic stroke pt's.
- d-dimer has a low specificity and is not an accurate predictor thus it is no longer being recommended. Chest CT is gold standard for PE diagnose. - dimer does not guarantee no clot and + dimer means you get scanned anyway.
- there is no benefit of IVC filter over anticoagulant in long term mortality studies. they are equally beneficial. there is also no benefit to combination therapy. some pt's are just not suited for one therapy over the other.
- aspirin is an anti platelet once thought to be miraculous at preventing platelet aggregation in CAD pt. While still used it is not as effective as once thought. Platelet aggregation is a physiologically separate process from the coagulation cascade and ASA use would have no therapeutic effect on prevention of DVT/PE
- coagulation disorder is rare given the circumstances of his case. like many others stated flight/venous stasis, aas use, bad luck likely caused the clot. insurance may not approve a hematology consult as it is likely not needed and this is a singular incident. long term anticoagulation or monitoring would be best as DVT/PE presentation puts you at increased risk/likelihood of future clot

Glad you're on the road to recovery and it wasn't more serious!

 

[Getnbiggger]

A little bit of inaccurate and outdated information in this thread...

- 0.5-1.5% of therapeutic level anti-coagulated pt's still present with a clot
- hearing/coumadin/elloquis/etc do not break up clots they prevent future clots while the current clot is reabsorbed which can take a long time as I saw someone state. TPA is the only drug used to dissolve clots and is 99% of the time used for a small percent of ischemic stroke pt's.
- d-dimer has a low specificity and is not an accurate predictor thus it is no longer being recommended. Chest CT is gold standard for PE diagnose. - dimer does not guarantee no clot and + dimer means you get scanned anyway.
- there is no benefit of IVC filter over anticoagulant in long term mortality studies. they are equally beneficial. there is also no benefit to combination therapy. some pt's are just not suited for one therapy over the other.
- aspirin is an anti platelet once thought to be miraculous at preventing platelet aggregation in CAD pt. While still used it is not as effective as once thought. Platelet aggregation is a physiologically separate process from the coagulation cascade and ASA use would have no therapeutic effect on prevention of DVT/PE
- coagulation disorder is rare given the circumstances of his case. like many others stated flight/venous stasis, aas use, bad luck likely caused the clot. insurance may not approve a hematology consult as it is likely not needed and this is a singular incident. long term anticoagulation or monitoring would be best as DVT/PE presentation puts you at increased risk/likelihood of future clot

Glad you're on the road to recovery and it wasn't more serious!

Thanks! Feeling stronger every day. Endurance is improving.

 

[rehh]

Wow scary situation, I have my fair share of health problems.

Good luck

 

[Getnbiggger]

Got blood work back and all the clotting studies were normal. No other blood abnormalities detected.

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[maldorf]

Got blood work back and all the clotting studies were normal. No other blood abnormalities detected.

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That is great news. So what is the doctor's advise to you to avoid having any more clots? All steroids, including testosterone, raise the chance of blood clots. Im not worried too much now taking my HRT because I am also on coumadin for life. I feel fairly safe because of that.

 

[Getnbiggger]

That is great news. So what is the doctor's advise to you to avoid having any more clots? All steroids, including testosterone, raise the chance of blood clots. Im not worried too much now taking my HRT because I am also on coumadin for life. I feel fairly safe because of that.

Im trying to find a good hemo/Endocronologist in the SF bay area that can guide me going forward in whatever way is safe.

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[maldorf]

Im trying to find a good hemo/Endocronologist in the SF bay area that can guide me going forward in whatever way is safe.

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Once you find one I would be honest about your use so that he can guide you safely. It will impact your treatment I think.

 

[Getnbiggger]

Once you find one I would be honest about your use so that he can guide you safely. It will impact your treatment I think.

I totally agree

 

[RoyHobbs]

That is great news. So what is the doctor's advise to you to avoid having any more clots? All steroids, including testosterone, raise the chance of blood clots. Im not worried too much now taking my HRT because I am also on coumadin for life. I feel fairly safe because of that.

Coumadin has a 2% failure rate in patients with a therapeutic INR. That would be increased with anyone who has increased risk factors.

I don't have data on the mortality rate of the associated failure but am just point out that anticoagulation does not guarantee freedom of clots.

 

[Getnbiggger]

Coumadin has a 2% failure rate in patients with a therapeutic INR. That would be increased with anyone who has increased risk factors.

I don't have data on the mortality rate of the associated failure but am just point out that anticoagulation does not guarantee freedom of clots.

I am taking apixaban which also has about a 2% rate of repeat clots. It Significantly reduces possible future clots but not to zero. .

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[maldorf]

Coumadin has a 2% failure rate in patients with a therapeutic INR. That would be increased with anyone who has increased risk factors.

I don't have data on the mortality rate of the associated failure but am just point out that anticoagulation does not guarantee freedom of clots.

No, but it is the best thing on earth for my condition. Nothing is 100%.

 

[LK3]

glad to see youre doing a bit better bud!

keep us posted

 

[warlock]

So sorry to hear you had to go through all of that. Scary for sure, but glad you are doing and feeling so much better.

 

[j2048b]

Wow sorry to hear this, its tuff and odd when this happens and leaves u pretty confused and perplexed as it did me when i found out i had a dvt in my left calve

I took a thinner for 3 mnths, it made me loose 30 lbs or so, and this was 1-2 yrs ago, also took like 37 vials of blood from me and all tests came back regular

I still feel pain at certain times in my left calve and it freaks me out still


I hope for the best for u, and hope they can help u figure everything out

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[Getnbiggger]

Wow sorry to hear this, its tuff and odd when this happens and leaves u pretty confused and perplexed as it did me when i found out i had a dvt in my left calve

I took a thinner for 3 mnths, it made me loose 30 lbs or so, and this was 1-2 yrs ago, also took like 37 vials of blood from me and all tests came back regular

I still feel pain at certain times in my left calve and it freaks me out still


I hope for the best for u, and hope they can help u figure everything out

Sent from my SM-G935V using Tapatalk

Thanks. I'm seeing improvement.

Sent from my VS995 using Tapatalk

 

[Delt123]

That is to much test. Once you are of of the blood thinner try Nattokinase.

https://video.search.yahoo.com/sear...=88abd850ca1fe824ded34f576f9daa33&action=view

Would you use it as a matter of prevention even if there is no history of clotting/ embolisms etc?

 

[blkhrt_jordan]

All steroids, including testosterone, raise the chance of blood clots.

Im not sure this statement is true. Apparently RBC increase from gear doesn’t increase clotting like it would if you had a medical clotting condition. I know it sounds counter intuitive but the doc who explained it specializes in treating steroid users. Just repeating what I have been told by a knowledgeable medical professional.

 

[Pissbrainiac259]

medikal skool

Hmmm....sounds like a medical thingy or something. Good thing there's no need for med school anymore when there's WiFi. :a:tion-sm

 

[maldorf]

Hmmm....sounds like a medical thingy or something. Good thing there's no need for med school anymore when there's WiFi. :a:tion-sm

"Researchers found that men taking the male hormone seem to have a 63 percent increased risk of a blood clot forming in a vein, a condition known as venous thromboembolism (VTE)."

That is testosterone, some drugs are even worse.
https://www.cbsnews.com/news/testosterone-therapy-may-be-linked-to-serious-blood-clots/

There are many studies that have demonstrated this. If you look at the drug insert that comes with testosterone, blood clots are listed as a possible side effect.

"The U.S. Food and Drug Administration in June 2014 required that all approved testosterone products carry a warning about VTE risk, researchers said in background notes.
Since then, the FDA has expanded its testosterone warning to include increased risk of heart attacks, personality changes and infertility."

"No one is sure why testosterone might help cause blood clots, the experts agreed.
One theory holds that testosterone in some way interferes with the enzymes that break up blood clots, particularly in people already inclined toward VTE, Martinez said.
“Future research is needed to confirm this temporal increase in the risk of venous thromboembolism,” Martinez said. Studies should also investigate the risk in first-time testosterone users, determine how long this risk persists and whether the risk is related to the reason for starting testosterone treatment, he added."