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Dr  S.A.Alam
Dr S.A.Alam, Doctor
Category: Medical
Satisfied Customers: 4469
Experience:  MBBS/FCPS(R)/MRCP(R) U.K
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Had a PE in July, no previous history of Dvt. Took clexane

Resolved Question:

Had a PE in July, no previous history of Dvt.
Took clexane injections for 3 weeks and currently on warfarin 12/13mg alternating daily. My INR is rarely in range (2-3). I am advised by INR nurse I will come off warfarin after 6 months and there will be no screening/testing to see what caused it as was 'unprovoked'. I have never seen a haematologist or specialist of any kind.
I also have Multiple sclerosis and iron deficency anemia I am 30 years old.
Should I be fighting to be screened for clotting disorders or once I come off warfarin will all be ok? Thank you for any insight you can offer.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr S.A.Alam replied 3 years ago.
Dr S.A.Alam :

Hello, Welcome to JustAnswer and thank you for your question.

Dr S.A.Alam :

In case of PE in a young person we have to check legs for clots with use of doppler ultrasound

Dr S.A.Alam :

and then we have to screen to clotting factor disorders like

Dr S.A.Alam :

factor V laeden, protein C and S deficiency.

Dr S.A.Alam :

These are mandatory test to make sure this does not happen again.

Customer: My nurse and gp have both told me I won't be screened unless I have another?
Dr S.A.Alam :

No this is not true,,, We do not screen if a person has a DVT and it is only a single episode but we need screening in case of PE

Dr S.A.Alam :

whether first episode of second

Dr S.A.Alam :

because it is a life threatening problem and needs clotting tests

Dr S.A.Alam :

You should consult a hematologist

Dr S.A.Alam :

he will tell you exactly what i have told.

Dr S.A.Alam :

You have questions ?

Customer: How do I get to see a haematologist?
Dr S.A.Alam :

Your GP or medical specialist can refer you

Customer: Gp refused a referral as it only happend once?
Dr S.A.Alam :

In UK is is very difficult to see a hematologist directly

Dr S.A.Alam :

Then only option is a private visit

Dr S.A.Alam :

For PE embolism it is clas 1 recommendation to check for clotting problem.

Customer: So either pay up or risk it??!
Dr S.A.Alam :

I am afraid so..

Dr S.A.Alam :

You have questions ?

Customer: Not much more I can say. Thank you for your help.
Dr S.A.Alam :

You are welcome....

Dr S.A.Alam :

Have a nice day.

Dr S.A.Alam :

Do rate my answer as positive to credit the reply.

Dr S.A.Alam :

Thank you.

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