Thrombosis prognosis and course
January 6, 2016 | 20,00 EUR | answered by Dr. med. Ive Dr. Schaaf
Hello Dr. Schaaf,
First of all, I wish you a healthy and happy new year.
I had written to you in mid-November under "Thrombosis Prognosis" and I am now happy to seek your help again.
My thrombosis is now about 3 months ago and the progress is very good. This week on Monday, I had an ultrasound check and a valve function test. According to my doctor, everything looks good. The remnants are almost gone. Only a minimal residue at one point in the back of the knee still remains. My thrombosis extended to the back of the knee and the vein in the back of the knee was only affected for a short distance. The valve function is good, so the likelihood of suffering from PTS is very low and also the likelihood that wearing the stocking long-term will not be necessary is low as well, since I do not have any varicose veins. A reflux was found in the tibialis posterior, which should not be too serious, as it is a small vein. As long as the main vein is fine, I should not worry. I am now supposed to take Xarelto for another 3 months and wear the groin stocking. These are the statements of my specialist.
Now, my questions for you.
How do you assess the situation and what is your prognosis now?
I have also noticed that the stocking I wear often feels tight and uncomfortable. Is this normal, as I often hear from others that they find it comfortable to wear? For me, it is rather torture. I have had the measurements checked at the medical supply store and they are correct.
Should I be concerned about developing PTS or something similar?
Can I look forward to a life without stockings hopefully?
My lower legs tingle and are often restless when I am resting. How should I interpret this?
Is the reflux in the tibialis posterior harmless?
Could there still be a worsening now?
Thank you for your help and I look forward to your feedback.
Warm regards
The answers are in the text below:
+++ How do you assess the situation and what is your prognosis now?
I would fully agree with your doctor. Everything sounds very good and the prognosis should be very good as well.
+++ I have also noticed that the stocking I wear is very tight and uncomfortable. Is this normal, as I often hear from others that they find it comfortable to wear? For me, it's more like torture. I have had this checked at the medical supply store multiple times. The measurements are correct.
A stocking should really be comfortable, so I would say that something is not quite right. A common mistake is incorrect putting on. It may sound silly, but it's true. You have to put on the stocking in a way that it is least stretched in the ankle area. Often the stocking is pulled up with a lot of force and not "modeled" on the lower leg, so it has too little force on the lower shin, but too much higher up, making it (very) uncomfortable.
+++ Do I need to worry about PTS or something similar?
No, probably not, at least not now. If there should ever be complaints later, you are already well informed and can recognize signs (swelling tendency, spider veins on the inner ankle, skin discoloration) and then just get in touch again.
+++ Can I look forward to a life without a stocking hopefully?
Yes, at least a life with 90% stocking-free time. I would also recommend the stockings for long trips etc., so-called risk situations.
+++ My lower legs tingle and are often restless when resting lying down. How should I assess this?
Both? Or just the thrombosis side? Such complaints are usually "functional", meaning there is no real reason found, they are not dangerous, but annoying. Helpful are usually just small tricks like different positioning or similar.
+++ Is the reflux in the tibialis posterior harmless?
Yes, that is to be assumed.
+++ Could there still be a worsening now?
It could always happen, but it is not to be assumed.
Best regards... any more questions? Follow-up questions are free...
Dr. Schaaf
