The Personal Health Navigator is available to all Canadian patients. Questions about your doctor, hospital or how to navigate the health care system can be sent to AskLisa@Sunnybrook.ca
The Question: I am a 66-year-old male in good physical condition with great annual check-up results and not on any medication. Yet, 7 months ago, I was hospitalized after blacking out twice and was diagnosed with a DVT in the left arm. Following 6 months of anticoagulation with warfarin, my hematologist recommended I stop taking it. Since no cause for my arm DVT was established, my risk of another DVT remains a great concern to me. How does one find and consult medical professionals who are experts in Thrombosis? My GP has had difficulty even finding such an expert to refer me to.
The Answer: You ask two important questions: Why do people sometimes develop thrombosis or abnormal blood clots in arm veins? And how does one find a doctor who specializes in thrombosis?
With respect to your specific circumstances, Dr. Geerts, a thrombosis specialist at Sunnybrook Health Sciences Centre, stated that arm DVT and blacking out spells are almost never directly related. These are nearly always related to separate causes.
Arm DVT is usually not a dangerous condition and the symptoms are usually not severe. Arm DVT results in swelling and discomfort of the arm sometimes with a dusky skin color. The cause of arm DVTs can usually be determined, according to Dr. Geerts, with the overwhelming majority being due to the use of a central venous line or a pacemaker inserted into an arm vein. The second relatively common cause of arm DVT is called thoracic outlet syndrome which occurs because of compression of the arm vein near the shoulder as it passes through the thoracic outlet, the space between the upper ribs and the collarbone.
An arm DVT is treated with anticoagulants given anywhere from a few weeks to indefinitely depending on the specific patient’s circumstances. “There is no evidence that aspirin provides any protection against recurrent arm DVT,” according to Dr. Geerts “and I do not use aspirin for this purpose.” “Although there are no tests that can be done to predict your risk of another arm clot,” stated Dr. Geerts, “it is important to try to determine the cause of the arm clot since this may influence the treatment duration.”
In response to your second question, there are only 30-50 physicians in Canada who specialize in Thrombosis. There are one or more thrombosis specialists associated with most of the medical schools in the country. If you are living in Ontario, your family doctor can FAX a referral to the Sunnybrook Thrombosis Clinic at 416-480-5153.
There are also a number of web sites related to thrombosis, including Lifeblood, the UK thrombosis web site, National Blood Clot Alliance and Vascular Disease Foundation. Web site links on all these organizations are at the bottom of this email.
Thrombosis Canada is an organization of Canadian health professionals dedicated to the prevention and treatment of thrombotic disorders as well as to providing education to other health professionals, patients and the public. A completely revised Thrombosis Canada website will be launched in the spring of 2013.
The National Blod Clot Alliance
Lisa Priest is Sunnybrook’s Manager of Community Engagement & Patient Navigation. Her blog Personal Health Navigator provides advice and answers questions from patients and their families, relying heavily on medical and health experts. Her blog is reprinted on healthydebate.ca with the kind permission of Sunnybrook Health Sciences Centre. Send questions to AskLisa@sunnybrook.ca.
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Hello Lisa. I m a 36 yr old male patient. I was diagnosed with dvt on my leg last month. I was prescribed xarelto 20 mg once daily. Since I started the medication I m seeing a lot of blood in my urine. Severe to moderated pain in my lower side back pain where my kidney is. Also unusual tiredness. Unfortunately my specialist is on vacation. I have been to trillium many times and no answers whether to stop taking or change my medication. Any help would be greatly appreciated .
Hello , I am writing in regards to my daughters health issues with thrombosis that she ended up with after she gave birth to her baby . she ended up hemorrhaging for days after she gave birth and started getting clots . the doctor told her she had 1 in her pelvis 1 in her leg and 1 in her lung . she has been to many doctor and through surgery to stop the bleeding but not one doctor seams to know what to do, they won’t tell her if the clots will ever go away or if the bleeding will stop or if they will do any more test. she is still bleeding and its been over 2 months since she had the baby. she is now at the stage of depression and doesn’t know where to turn or who to turn too . some much appreciated advise would really help . thank you for your time
Barbara,
I am so sorry to hear about your daughter’s health issues, especially after what is usually one of the happiest times of a woman’s life – becoming a new mother. It sounds like a very anxiety-provoking time. It is difficult to tell from your letter what type of doctor – or how many doctors – she is seeing. I’m guessing an obstetrician and a family doctor are in the mix. I suggest that your daughter return with you to see the doctor she has dealt with most on this medical issue. She should describe the symptoms and then discuss the need to know what the plan is for treating them. I would also suggest that she ask that same physician about the merits of being referred to a thrombosis specialist. I hope this helps.