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Doctors Lounge - Cardiology Answers
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| RandomName
- Wed Oct 21, 2009 2:30 pm |
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My Grandmother is near 80 with a history of deep vein thrombosis and was on anticoagulants until recently suffering a hemorrhagic stroke.
She lost movement and feeling in most of one side, and has now developed a DVT on that side. Unfortunately the doctor is a close family friend and is being vague about the outcome or possible treatment.
I know anticoagulants are unlikely given the recent stroke, but I don't know what else could be done (if anything). What is the prognosis?
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| John Kenyon, CNA
- Thu Oct 29, 2009 11:35 pm |
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 Anticoagulants would be extremely dangerous, but often are not given for DVT anyway. The ideal would be to implant a filter to keep any moving clots from reaching the lungs. It's sometimes difficult to deal with a doctor who is close to the family or the patient, as they sometimes have difficulty separating personal feelings from what's best for the patient. It's a dilemma for sure, but perhaps he wouldn't mind having a vascular specialist in on a consult, which would be appropriate anyway. The filter is probably the only way to insure no clots will move from the affected leg up to the lungs, and is a fairly simple surgery to install. It can be removed later or left indefinitely in place.
Some doctors feel that beyond a certain age such therapies are not justified, but I would disagree quite vigorously on that point, at least using age alone as criterion for witholding potentially life-saving therapy. Prognosis without the filter would be about 50/50. With the filter your grandmother might well manage well for a good while. Much depends upon weighing the quality of her life. If she's otherwise comfortable and enjoying life and interaction with others then that should be sufficiently high quality to justify the simple filter.
I hope this is helpful. Good luck to you all with this difficult issue. Please stay in touch with us here.
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