Topic: Coumadin, blood clots and chemo...Help?

Has anyone out there who has had blood clots, been put on Coumadin and had chemo while on Coumadin.  My new oncologist here locally, mentioned that it will probably become difficult to manage the Coumadin while on chemo...esp as I get further into the chemo.  Well, it's been almost one week since I was dismissed from the hospital after the blood clots....with an INR of 2.6.  By the following Monday (this week) the INR was 2.8 (the target range is 2-3).  Now, today's blood test has it at 3.9.  ACK...huge uptick...and I'm not even ON chemo yet.  I know it can take a while to regulate this stuff, but it sure is concerning to me after all the other crap.  My oncologist mentioned possibly having to move me to some stomach shots....not sure what it was...but I told her that it was no problem for me to give myself shots.....as I do multiple shots every day for diabetes...and would gladly do that if it simplified things.  However, my GP was the one who treated me for the blood clots....because I lost any trust in the previous oncologist and wasn't on board with this new one yet.

"Just for today, I can get through anything."  Hey....I'm a cancer survivor, not a doctor.  The opinions I state are my own, based on my personal experiences or knowledge.  As always, talk to your doctor about your concerns and treatment.

Re: Coumadin, blood clots and chemo...Help?

Julie,

I do not have any experience with blood clots, but I remember reading that "Patty in Illinois" had to deal with blood clots initially.  There might be some relevant information on her blog:

http://pattysjourneyoffaith.blogspot.co … chive.html


Here is her forum profile if you would like to reach out to her:

http://www.cholangiocarcinoma.org/punbb … hp?id=7845

Jason

Re: Coumadin, blood clots and chemo...Help?

Thanks Jason.  I'll try to get in touch with Patty.  I forgot that she dealt with blood clots...far worse than my situation I think. 

Julie

"Just for today, I can get through anything."  Hey....I'm a cancer survivor, not a doctor.  The opinions I state are my own, based on my personal experiences or knowledge.  As always, talk to your doctor about your concerns and treatment.

Re: Coumadin, blood clots and chemo...Help?

Hi Iowagirl.  Sorry to hear about your problems with blood clots.  My wife was diagnosed with CC due to blood clots.  The tumors were causing the clots in both legs and she wound up in the hospital with PE's in her lungs.  She was on Coumadin to start but that didn't work for her at all.  Didn't even slow them down.  The Drs put her on Lovenox which is administered by shot once or twice a day in the stomache.  She did two shots a day for the first 4 months but has been on one a day since then.  She was diagnosed in September of 2013.  She also had a filter implaced in Vena Cava to trap any clots that formed in her legs before they were able to travel to her lungs.  Since starting the Lovenox she hasn't had any more issues with clots but it looks like she's on Lovenox for the long haul.

Hope that helps and I hope you're feeling much better soon.

Re: Coumadin, blood clots and chemo...Help?

Iowa Girl,
I have Patty's contact info. If you need it. My number is 330-903-6868. I met Patty last week and she loves to help others.
Peace
Lisa

This Information Is Not Intended Nor Implied To Be A Substitute For Professional Medical Advice. You Should Always Seek The Advice Of Your Physician Or Other Qualified Health Care Provider

Re: Coumadin, blood clots and chemo...Help?

Hi Iowa Girl!!
I am on Lovenox injections twice daily 12 hours apart. I have blood drawn every two weeks called an Anti XA (pronounced Anti Ten A) and I try to keep it around .50 to .75. At first they did not monitor it and I had a brain bleed. Coumadin is harder to regulate as it stays in the bloodstream longer. My heart dr who sucked out all of my clots (hundreds) said my blood doesn't like the cancer so it wants to clot...I was told no PICC lines, no port (I had it removed while in the hospital) no filters (and who needs them if you are on Lovenox). I hope you have good drug coverage...it's about $1000 a month but due to my husbands insurance, we pay $12. Feel free to call me if you have more questions at 618-392-2239.  God Bless!!

Re: Coumadin, blood clots and chemo...Help?

Patty,  I'm so glad you saw the post and replied.  I think Lovenox is probably the drug that my new oncologist mentioned.  I don't know how long the effects of the cancer last in the body.....my tumors were removed completely with no mets, etc.   I've wondered if 9 weeks post surgery with blood clots showing up, indicates the cancer is still active somewhere,,,microscopically?????  I do have a port...which has been problematic....difficult to access and sometimes hurts unexpectedly.  Nothing has been mentioned by the new oncologist about taking it out....I'm a difficult "stick" for IV's.  Don't know how hard it would be to move from Coumadin to the Lovenox ....getting off of one and onto the other.....but $$$ are not an issue.  Our insurance  through husband's workplace has been excellent.....we're very fortunate.  We have a high out of pocket...($12K) but after surgery at Mayo and the pre-diagnosis tests here, and a surgery followup at Mayo at 6 weeks post op....plus one chemo IV .....we're far beyond having to put out any more cash this year.  Everything at this point is paid 100%.  Some things are subject to approval, as with most all insurance, ...even the chemo treatment, but nothing has ben refused or even questioned thus far.  I'm going to talk to the new oncologist on Wednesday at my pre-chemo chat time about switching to the Lovonox.  She mentioned how difficult the Coumadin was to manage during chemo and it doesn't sound like she was really happy about the fact that I was on Coumadin.  My GP....who was the doctor who admitted me to the hospital was the one to move me from Heparin to Coumadin.  I'm very concerned about the INR for Coumadin not staying in range.  I understand that it can take a while to regulate it, but if it's going to get to be more of a problem as I get deeper into chemo, I think the change being sooner than later makes more sense.  Right now, I"m more than a bit scared about doing chemo again with the Coumadin not stable yet.   I'm going to try to give you a call in the next few days....just to chat about this more a little.  We actually don't live all THAT far away.....I'm just over in Marion/Cedar Rapids, IA. about an hour and a half from the Quad Cities.  Sometime when I get through some of this chemo mess, maybe we can get over to Illinois to meet up in person.

"Just for today, I can get through anything."  Hey....I'm a cancer survivor, not a doctor.  The opinions I state are my own, based on my personal experiences or knowledge.  As always, talk to your doctor about your concerns and treatment.