[Ann W (OP)]

I had a DVT 9 years ago following surgery, i was treated with Clexane for a week or two and then for 12 months with Warfarin.    Five years later i was to have another operation and had a doppler of that leg to check it, the radiographer said he could see where the clot had been so i had more of the above treatment.

Recently (and for some time) my leg has been painful so I approached my doctor and thankfully he didn't laugh at me but I had a doppler.    Good Grief, two clots measuring 20 centemetres each!   One vein was totally occulded and the other partially.    I have had Clexane for 10 days and now am having Warfarin for life.

I have read a lot of stuff I really don't understand and would like to know the difference between Clexane and Warfarin.    I really don't like having Warfarin for all the blood tests it requires.   

Can you give me any advice at all?   Please.

[Jen Timo]

Dear Ann, I am so sorry to read about your ongoing DVTs, I had a DVT about a year ago- similarily I was treated for a few weeks with clexane and the 6 months on warfarin. 

The big difference between the two are their half lives (drug activity) and the route of administration- heparin is approximately 30 minutes thus needing a continuous infusion to maintain its therapeutic levels and it needs to be injected as when taken orally it is inactivated.  Whereas warfarin which has evolved into being the medication of choice to maintain anticoagulation therapy in humans is easily absorbed in the gastrointestinal tract and retains its effect for 2 to 5 days. 

The coagulation pathway has several clotting factors that can be mediated, heparin directly inhibits the formation of thrombin, which can activate the formation of a fibrin clot. Warfarin inhibits the actions of vitamin K (and therefore affects the liver- so  the reason why no drinking, or green vegetables that are high in vitamin K) thus interfering in the activation of certain clotting factors through to inhibit the clotting mechanism.   

I have read recently the availabilty of a machine that allows you to do your INR tests at home, if you are going to be on warfarin I would certainly look into that.


I am assuming you are not on the pill - as a link exists between oestrogen and clot formation.
I wish you better heath, take care, Jen

[Ann W (OP)]

Thank you Jen, you have given me a clearer view of the medications.    Due to other problems, (Yes, I have a heap of them), I eat mainly steamed vegetables including broccoli.    The nurse said that would be OK provided it was a regular part of my diet and therefore the doseage would be adjusted around that.   Do you agree, or do you think it will be akin to me getting on the turps?   

And I am not on the pill, I am a bit old for that.