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Poycythemia vera and portal vein thrombosis

Resolved Question:

my problom is about coagulation or the blood ability to clot. and a blockage in the portal vien that cause (Gastric varices and Esophageal varices.
Inr : 2.3 I use warfarine 3mg
Hemoglobin : 10


Category: Hematologist

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Category: Hematologist
Dr. Prasad Eswaran is online now

Expert:  Dr. Prasad Eswaran replied 4 Days.

Hello,

Thank you for your consult at DoctorSpring.com.

I hope your query is about the use of warfarin 3 mg and INR of 2.3. Is this right ?? Kindly mention your exact concern.

I see that you are diagnosed with multiple problems. You have Polycythemia vera / Pulmonary embolism / recovered from intraabdominal hematoma / multiple venous thrombsis (due to PV). More recently newer drug is introduced (Ruxolitinib) but I am not sure if this can be tried in you in clinical trial basis for Polycythemia vera.

I would advise you to be considering a Bone marrow transplant physician opinion too. Meanwhie you can ask your doctor if you need more appropriate blood thinning agent since you have additional problems. Instead of warfarin you can switch over to LMWH or Fondaparinaux too based on your physicians opinion since you have already experience many complications of the disease and warfarin probably.

Hope I could answer your query. Kindly let me know your specific concern if any.

Regards


Patient replied :

thank you doctor for your responce...
But I also want to know if there is a specific cure or treatment for my blood problem, originally?
or it is only that I have to take the warfrin for the rest of my life..
last note:
my hemaglobin before surgery was up of 18
after surgery it's low to 8 but now it's become 10 after i used Feromin Ferrous Sulphate 190mg
I had the surgery before 2 years ago...you have a copy of its report..


Expert:  Dr. Prasad Eswaran replied 3 Days.

Hello,

Thanks for the follow-up.

Right now we don't have a cure, but few centers do bone marrow transplant. But I am not sure if this would of really helping you. You need not use iron supplements as you will be already having good iron stores in your body. Instead of warfarin, you can switch over to LMWH which is easier to manage in case of bleeding, but I am sure this may be costly compared to warfarin tablets.

I suggest to consult a bone marrow transplant physician to discuss your options.

Regards


Dr. Prasad Eswaran
Category: Hematologist
Experience: 
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
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