Recently I’ve been trying to be a bit more proactive about my own health and decided it was time to review my ongoing anticoagulation. The idea of being on Warfarin for the rest of my life kind of scares me (even though I’m repeatedly told by the doctors that there are no side effects). It just seems unlikely to me that being on any sort of medication for years and years (I plan to live to a nice ripe old age) wouldn’t produce any side effects. That said, I don’t want to clot again and I’ve got some factors working against me in that department, so it really is a crap shoot.
A few weeks ago, I met with Dr. Smith at the DVT clinic to review my case and talk about my risk factors. It was very interesting and he gave me some studies to read and we discussed different statistics about who is more likely to clot, etc. etc.
Another interesting thing was, for the first time in two years, he examined my legs, and just by looking at them, pointed to my left calf (the one that is always giving me grief) and said “you’ve had a DVT in that leg. No question.” and then he pointed out all the reasons he could tell this just by looking at it. It was kind of creepy and yet, just confirmed something I’ve known in my heart for a long time.
Anyway, I think in the back of my mind I just want someone to say “yes, you 100% need to be on anticoagulants or you will die!” – or – “no, you don’t need them anymore – you will never clot again, I guarantee it!” Of course, neither of these things is going to happen. Either way, anticoagulated or not, there are risks – and it is on me to weigh these risks and decide which ones I’m more willing to take.
My risk of a spontaneous bleed if I stay on the anticoagulants is relatively low, so long as I keep my INR in the appropriate range. My risk of a major bleed if I say, crash my bike, is a little higher than that of the average person, but this is a risk I’ve been taking for the past two years. I suppose it just means I'll never be racing any crits and my chances of making le Tour are a little less, haha ;)
If I come off the meds, my risk of another clot is definitely there. I’ve tested positive for the genetic clotting disorder Factor V Leiden. However, many people live with Factor V mutations, never knowing it, and never having any clotting issues. I’ve stopped taking oral contraceptives, so have decreased my risk of clotting in that regard.
In all honesty, as much as I would hate to have another pulmonary embolism or DVT, I am not as scared of that as I am of a clot going to my brain. I did experience a minor stroke in February 2009 (one that was never properly diagnosed, but much the same as with my leg, I know it was a stroke) and the fear of something like that messing with my brain again is paralyzing. To lose control of your vision, your ability to process your own thoughts, to not know if the words that are coming out of your mouth are making sense – it’s (excuse my language) fucking terrifying.
And so, for now, I continue with my anticoagulants. No closer now than I was before my meeting with Dr. Smith to making a decision.
To Anticoagulate or Not To Anticoagulate?
No comments:
Post a Comment