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What Is The Treatment For Superficial Clots And Phlebitis In Left Leg And Deep Vein Thrombosis In Right Leg?

Posted on Sat, 25 Jan 2014

Question: ihave been diagnosed w/homozygous and have been living w/it for 25 years.all tbe hematologists that I have seen do not inform me of the aggressiveness of this disease.my left leg has had over 30 superficial clots & phlebitis.i now have dvt in rht. calf & knumbness in left toes,then foot only after standing/walking for more than 2-3 minutes before I have to sit w/legs elevated.i currently am taking warfarin 5mg and 2 folbic tablets.current hematologist treats me & other people like crap and when questions are asked answers are ignored or subject changed .can someone help me or am dead soon.muscles in both lower extremities cramp constantly including front that control foot & ankle flexibility.

Answered by Dr. Shafi Ullah Khan (1 hour later)

Brief Answer: Diagnosis? Homozygous what? Detailed Answer: Good day Mr XXXX! My name is Dr S Khan. I would like to answer your worries bout your genetic condition which has predisposed you to your hypercoagulation resulting in DVT and phlebitises. Mr XXXXXXX to get answer you need to provide a good question. Rest of your question is good presented, i wonder why your doctor would not explain things to you. so let me get this straight. Homozygous is a trait not a disease. For example homozygous recessive or homozygous dominant trait for any features. so what have you been diagnosed homozygous for? which hypercoagulation issue it is? Are you talking about familial hypercholestrolemia, Leiden 5 mutation or some other genetic hematologis issue. Please provide the name of diagnosis and we will talk about it until you want us to talk about it. and i wont treat you like your doctor. My patient is my family. SO tell me some thing more about your disease and we will discuss what to do. Waiting for your answer Dr. S Khan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shafi Ullah Khan (16 hours later)

thank you for wanting to help.1;blood report only shows diagnosis as homozygous,or homozygous.mutated blood from both parents.that will be ny question w/him when I see him.this is exactly what I am talking about.he doesn't tell me anything.also the referral you sent me are all in nj.i live in Illinois. hello dr.shafi XXXXXXX i will ask for diagnosis report on the homozygous trait tomorrow when I go in for my pt/inr.but I'm still need a trusting and very good expert/specialist in my area near plainfield or joiet in Illinois.not new jersey.thank you & have a nice new year.please reply.

Answered by Dr. Shafi Ullah Khan (36 hours later)

Brief Answer: Sorry for the inconvenience Detailed Answer: Thank you Mr XXXXXXX I am sorry for the inconvenience. Let me know of the diagnosis, And i provided you the doctors from the mentioned places. Please let me know if you need further assistance i will always be here to help. And regarding the thics of the doctor you visit i believe you have the right to have a second opinion and the doctor who understands your needs. Keep me posted please. Regards S Khan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shafi Ullah Khan (14 hours later)

hello dr XXXXXXX i just got back from my pt/inr appointment & it was low because dr.keeps changing dosage.i still have no definite answer from them.i don't think they know.so I got copy of lab results.here it is.shows that I have homozygous w/these notes.mthrf c677t gene mutation dcc.then under that says this.mthfr dna anal.then "patient is homozygous for mthfr gene mutation and may be at increased risk for spontaneous thrombosis.family studies may be of interest." also report shows this.factor v leiden not detected.also this.factor II {prothrombin}gene mutation dc,procedure dgm not detected.

Answered by Dr. Shafi Ullah Khan (6 hours later)

Brief Answer: Hyperhomocystenemia Detailed Answer: Thank you Mr XXXX! MTHFR = methylenetetrahydrofolate reductase.) is an enzyme and used for the maintenance of a complex pathway which keeps the folic acid levels and vitamin b levels and keep the levels of a Thrombotic factor Homocysteine under check . so in nut shell your homozygosity of MTHFR gene is called Hyperhomocysteneimia which has predisposed you to clotting and thrombosis and that is why you PT APTT INR values are low and you are very much prone to thrombosis spontaneously and you need a good control and monitoring of the bleeding clotting homeostasis. To avoid complications like DVTs and strokes etc you need a prophylactic diet and medicines and vitamin supplements to keep out of woods. it will help the prognosis. You will need Pyridoxine, at a dose of 100-500 mg/d at a constant pace with full compliance. in combination with folic acid, and vitamin B-12 . . Aspirin, clopidogrel, and aspirin-dipyridamole are to be taken for prophylaxis to avoid complications, Take Low methionine diet continuously , Seek dietitian help for diet plan and consult your Hematologist for blood profile monitoring and avoid triggers and risk factors like smoking , high cholesterol diets etc and you will be fine. Take some very good care of yourself and keep me posted. I would love to be of some help in future too. Kindly close the discussion and rate the answer as per your experience. Regards Dr S Khan

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar