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Old 06-28-2013, 10:58 PM
 
Location: Durham UK
2,031 posts, read 4,499,927 times
Reputation: 1127

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Quote:
Originally Posted by kati1985 View Post
A greenfield cannot stop you from having a heart attack. It actually cannot even stop you from having a clot go to your lungs (a PE). That is the entire point of having the filter placed, but in all reality, it is not completely effective. It really only has a 50% benefit rate. I have had bi lateral dvts with factor V leiden for the last 10 years. I have been on a heparin drip, Lovenox shots, and Coumidin. Because of my clotting factor, I am on coumidin for life. There is so much misinformation out there that you need to be your own advocate. If you have had more than 1 clot in your life, you most likely will be on a blood thinner for life. If you are on a blood thinner and have had no problems with a clot and a doctor tells you to stop taking the meds because you haven't had a problem- he is out of his mind. You haven't had a problem because YOU WERE TAKING THE MEDS! And, just for the record, none of the medicines are actually blood thinners. There is nothing available on the market (anywhere) that actually thin out your blood. Coumidin, Warfarin, Lovenox and Heparin all help to reduce the chances of your platelets sticking together. That's it. Even if you are on a 'blood thinner', you can still clot. Do not listen to the idiot who posted earlier talking about breaking down the clot with heparin and eventually being able to take a baby asprin a day so that you won't clot anymore either. That is the stupidest advice I have ever heard of. You might as well take up drinking because that will be just about as effective as that advice. Believe me when I say that you need to find a good hemotologist, research him/her fully, and then research all of the advice they give to you. Get second and third opinions from doctors outside of that hospital and in different organizations (if possible). This is especially essential if you are having any invasive procedure such as having a filter put in. Also, make sure you fully understand the risks of having anything done. Every procedure has risks and as a patient, you need to be made completely aware of them. There is nothing wrong with asking your doc a question, or 12... that is why they are the doctor and you are the patient. Be your own advocate and take care of your blood.
Heparin and Warfarin do to some degree thin the blood because they extend the time it takes for the blood to clot -this is the prothrombin time and it's measured in seconds. The INR is based on this.
Drugs that break down clots are called thrombolytic agents and are only really used in stroke, although they were trialed in Pulmonary embolus (not sure what they found) and did used to be given to heart attack victims but now not so much.
Agree about a hematologist and not letting people mess with anticoagulation.
And ASK ASK ASK
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Old 07-03-2013, 10:28 PM
 
1 posts, read 2,021 times
Reputation: 10
I believe the greenfield filter is metallic.I was informed that there is a chance that the filter can break into small pieces and cause problems.Is this true?
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Old 07-17-2013, 10:09 PM
 
Location: cuyahoga falls ohio
1 posts, read 1,906 times
Reputation: 10
my girlfriend has blood clots in her legs.Recently she had to go to er for severe pain on her right side and it has slowly gotten worse.What do you think is causing pain.Could a clot be hitting a nerve.Any advice would be helpful...
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Old 07-18-2013, 07:54 AM
 
1 posts, read 1,899 times
Reputation: 15
I'm a 47 year old female. I've always had some kind of trouble with my legs. A superficial vien would rupture, I'd feel the bee sting sensation, then the "burn", then the redness and "hardness of tissue" would set in. One month ago I noticed that my back of my left leg was hurting. It just felt like I had hyperextended it, I was wrapping it in ACE for 2 weeks. Then, while walking up a hill, I lost my breath. My heart pounded, and I could not slow it down. But, being stubborn, I STILL waited two days to go to the ER. They preformed a Doppler on my leg, found nothing. Performed a chest CT and much to my surprise, bi-lateral P E's, multiple, and of moderate size. Scared me for sure. 5 days in the hospital for 5 days on the "belly shots", (lovanox?) and on coumidon (sp) The coumidin (warfarin) only brought my protime up to 1.0 the entire stay in the hospital. I was less than excited about that. Left the hospital at 1.0 and doc put me on Pradaxa, 150 mg 2x's per day. 2 days post hospital departure, I was at 1.5. My doc has recommended that I get a Greenfield, as he thinks that this will be a lifelong problem for me. I DID smoke, but had my last cigarette the night before I went to the ER. Genetic testing came back negative. It's all me, lol.
The main reason I was compelled to write this post is to inform those "Type A" personalities out there, like myself, that if you feel any symptoms, GO TO THE ER! I should have went in the day that I lost my breath. Did not happen.
Now, I'm trying to research this filter as much as possible, because, hopefully, I will have this in my body for the next 30 years. (meaning I will still be alive:-)
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Old 07-23-2013, 07:56 PM
 
114 posts, read 179,314 times
Reputation: 54
DVT's can be treated and primarily treating them with medicine is old school.
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Old 08-07-2013, 10:13 PM
 
2 posts, read 3,565 times
Reputation: 10
Default Same Boat

Quote:
Originally Posted by lambchop002 View Post
I'm a 47 year old female. I've always had some kind of trouble with my legs. A superficial vien would rupture, I'd feel the bee sting sensation, then the "burn", then the redness and "hardness of tissue" would set in. One month ago I noticed that my back of my left leg was hurting. It just felt like I had hyperextended it, I was wrapping it in ACE for 2 weeks. Then, while walking up a hill, I lost my breath. My heart pounded, and I could not slow it down. But, being stubborn, I STILL waited two days to go to the ER. They preformed a Doppler on my leg, found nothing. Performed a chest CT and much to my surprise, bi-lateral P E's, multiple, and of moderate size. Scared me for sure. 5 days in the hospital for 5 days on the "belly shots", (lovanox?) and on coumidon (sp) The coumidin (warfarin) only brought my protime up to 1.0 the entire stay in the hospital. I was less than excited about that. Left the hospital at 1.0 and doc put me on Pradaxa, 150 mg 2x's per day. 2 days post hospital departure, I was at 1.5. My doc has recommended that I get a Greenfield, as he thinks that this will be a lifelong problem for me. I DID smoke, but had my last cigarette the night before I went to the ER. Genetic testing came back negative. It's all me, lol.
The main reason I was compelled to write this post is to inform those "Type A" personalities out there, like myself, that if you feel any symptoms, GO TO THE ER! I should have went in the day that I lost my breath. Did not happen.
Now, I'm trying to research this filter as much as possible, because, hopefully, I will have this in my body for the next 30 years. (meaning I will still be alive:-)
I am also 47 y/o female. First DVT/saddle PEs were later found to be probably caused by cancer. Last year, ended up back in hospital for 2 PEs but no DVT. Put on Coumadin but a month later, back in hospital with INR of 6.2 and yet another PE. Was scanned for cancer - none, so they switched me to Pradaxa 150 and installed Greenfield filter. No reason found for continuous clots. Worried now because have been having weird "charley horse" feeling in leg for a couple weeks now. Have tried increasing calcium, potassium, Vitamin D, etc. Also having shortness of breath, but not sure if they can do anything for me. Been to the hospital a couple times before this started and basically, they say I am fine. Eat better, exercise, lose weight. I barely eat 1000 calories a day and limit my salt intake. Severe edema in both legs and lymphedema in my arm (parting gift from lumpectomy). My Greenfield IVC has been in for almost a year and as far as i know, working fine. Wish I could say i have not visited ER since it was installed, but I haven't had any further PEs that I am aware of.
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Old 08-19-2013, 06:47 AM
 
2 posts, read 3,565 times
Reputation: 10
Default IVC and Pradaxa

Quote:
Originally Posted by Whatsthenews View Post
I worked in the UK as a Clinical Nurse Specialist in anticoagulation care- ie we managed over 7,000 patients requiring warfarin and/or Low molecular weight heparin for DVT and PE.

Some were life long after having several episodes of DVT, maybe due to inherited thrombophylias, cancer etc.
Others required LMWH during pregnancy, followed by warfarin after delivery for 3-6 months.

After eading this thread I was slightly puzzled as to why people who had had a single episode of DVT/PE, maybe due to factors such as surgery or pregnancy were sitting around with lifelong VCFs in, and appeared never to have been anticoagulated with warfarin.

I did some research and found that the evidence from clinical trials for the use of Vena Caval filters is very limited, but what evidence there is shows that

1. Unless there is a HUGE contraindication to anticoagulation, in most cases VCF insertion should only be considered if anticoagulation has failed ie pt has a repeated episode of DVT/PE whilst therapeutically anticoagulated ie INR within therapeutic range of 2-3 (usually)

2. There is some evidence to suggest that VCFs without the addition of warfarin can lead to clot formation (around the filter) compared to patients treated with VCF and warfarin therapy or with warfarin alone.

3. The VCF isn't going to protect against DVT -which is where the majority of PEs originate. Warfarin will do that.
In those that really do require a lifelong VCF (and this is where there really is lack of evidence) the addition of warfarin should be considered.

4studies showed an increased number of DVTs (almost twice as many) in VCF alone, compared to pts who were anticoagulated, however the incidence of PE may be lower in the VCF group.(different studies had different results, presumably due to recruitment of pts with different case scenarios)Most importantly, there was no difference in mortality between the 2 groups.

5. VCFs require periodic monitoring (pref' by the person who inserted it). They can move! For some removable devices there is a limit to how long after insertion they can be removed

Seems to me that sticking the VCF in may be a convenience/cost choice, which may or may not have been discussed with the patient.
Warfarin, however costs pennys, but the monitoring costs need to be considered.
Also, warfarin can be a dangerous drug if it's not monitored and dosed correctly, and patients don't follow the do's and don'ts, but if it's done well, it works well!
Maybe it's easier to stick a VCF in and forget about it, even though it may not be required or useful anymore.


Here's a link to the most up to date guidelines from the British Clinical Standards in Haematology (the guidelines we followed as CNS as haematologists manage DVT/PE patients longterm in the UK)
Lots of medical jargon-sorry, but at least it's backed by evidence from the limited research there is.
Happy to try and answer any questions if I can!
http://www.bcshguidelines.com/docume...s_bjh_2006.pdf


Also from the (US) Society of Interventional Radiology
http://www.sirweb.org/misc/Guidelines_filters.pdf
[SIZE=1][SIZE=1] [/SIZE]
[SIZE=1][SIZE=3]1. The primary means of therapy and prophylaxis of VTE are pharmacologic[/SIZE]
Moderator cut: too long a quote, 1-2 sentences and link please
Sounds like you are quite familiar with this. Several years ago had massive DVT and saddle PEs in both lungs. They put me on Coumadin, but not filter. Three months later, found cancer and said probable cause of clots. Last June hospitalized again, no DVT but 2 large PE in lungs, no cancer. In July, hospitalized again, another DVT. Taken off Coumadin and switch to Pradaxa. Also inserted Greenfield. Head to thigh PET scan, no cancer. Still having health issues, but do not want to go back to hospital. They say nothing is wrong with me even though I have intense leg pain, swelling, and trouble breathing. Should I really worry about another clot if i have filter and Pradaxa? Tried researching, but hitting alot of brick walls. BTW, had nuclear stress test, told heart is ok.
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Old 08-19-2013, 05:57 PM
 
Location: Florida
725 posts, read 1,320,922 times
Reputation: 1146
Research Serrapeptase.
Serrapeptase Information
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Old 08-19-2013, 06:23 PM
 
Location: Bella Vista, Ark
69,238 posts, read 79,427,308 times
Reputation: 38606
Quote:
Originally Posted by SeaNile31 View Post
DVT's can be treated and primarily treating them with medicine is old school.
We know 3 people with DVT and 2 are being treated with meds only, one is my husband. The one that had the filter has had 3 clots and has only one leg, due to an injury in Nam.
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Old 08-21-2013, 10:45 PM
 
Location: Tennessee/Michigan
27,994 posts, read 46,352,092 times
Reputation: 19398
Never did get the greenfield filter and I hope never will.
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