The main target of anticoagulant treatment is to avoid the creation of new thrombi and, at the same time, making sure that the risk of bleeding does not increase much.
The treatment of thrombosis does not differ from that of pulmonary embolism, since both are manifestations of the same disease, VTE. An anticoagulant treatment for a minimum of three months is the rule.
We treat patients with VTE by administering anticoagulant drugs. These are drugs make blood thinner, thus the thrombi stop growing and detaching (if they break loose, pulmonary embolism will occur). With this treatment the thrombi slowly harden, get smaller, retract and become small scars.
Yet the thrombus is not always removed completely. What tends to happen is that it reduces in size and it gradually heals, so the vein where it formed or the pulmonary artery where it was located, eventually recovers nearly to its usual flow.
We treat patients with VTE by administering anticoagulant drugs. These are drugs with which we seek to make blood thinner, thus the thrombi stop growing and breaking (if it breaks, a pulmonary embolism willl occur).With this treatment the thrombi slowly harden, and get smaller, they retract themselves and become small scars.
This is how anticoagulant treatment works
Anticoagulants allow stabilizing the thrombi and preventing the appearance of embolisms in the lung, but at the same token this can also cause bleeding.
When doctors prescribe anticoagulant treatments, we try to minimize the risk of the thrombus increasing or breaking (and going to the lung) but at the same time, making sure that the risk of bleeding does not increase much. This balance sometimes is very difficult to achieve.
Hemorrhage is the weak point of the anticoagulant therapy, reason why in everyday tasks like when shaving or brushing our teeth we bleed, and menstrual bleeding may be heavier if we take anticoagulants.
We can also bleed from small blows or cuts. Therefore we recommend patients to refrain from doing contact sports, such as football, rugby, mountain biking, skiing, while on anticoagulant therapy. A blow, that otherwise would only cause a bruise with no greater consequence, in a patient taking anticoagulants could become a serious hemorrhage. We furthermore advise you to be careful to not cut or prick yourself (in the kitchen, at work…).
In order to get the right dose of anticoagulants, it is necessary to see your the doctor and to follow their recommendations.
Both the diagnosis of TVE and the beginning of the treatment are done in a hospital. At first, the doctor administers heparininjections, but when the patient goes home, these injections are replaced with tablets: which are antivitamin K tablets, the best known being acenocoumarol (commercialized as Sintrom®).
Furthermore, recently we have also prescribed new oral anticoagulants, but only in countries where their use is approved and funded by the public health system.
How important is to take the treatment everytime at the same hour? Until what point should it be the same hour?
You don’t need to set your alarm for taking it at the exact time, but if you do it regularly at the same time, you won’t forget it.
I take my treatment every day at the same time, but today I forgot about it. Can I take twice the dose tomorrow instead?
Not at all. Tomorrow you should take your usual dose. Try not to forget again, but never take more dose than the normal one.
Some mornings, when I brush my teeth, I feel taste of blood in my mouth and when spitting, water is red. Should I tell my doctor?
If you are under anticoagulant treatment it is something completely normal. It shows that it’s being effective. Another different thing is that you were having an abundant bleeding. If this was the case, you should go to Emergencies department.
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