Transition lovenox coumadinj

I’m in a bit of a complicated scenario as I’m undergoing IVF (scheduled for frozen transfer tomorrow) in Europe, but I live in Canada so my primary care is in Canada.
Two weeks ago I went to the ER at home in Canada because I suspected I had a DVT in my calf. The hospital put me on Xarelto and gave me a referral to a thrombosis clinic the next day. The Dr at the thrombosis clinic did a hand held scan of the area behind my knee and said the arteries/veins are open, so he’s not too worried. (There was no scan of the area that was red/hot/swollen) He gave me a 30 day prescription of 20mg of Xarelto every 24 hours. No follow up scheduled.
I’m now in Europe for my FET, and reading that Xarelto is not safe during pregnancy. Neither my fertility Dr or the thrombosis Dr seems to have a clear answer of what I should do now. (Thrombosis Dr said to ask fertility clinic, fertility clinic said to follow thrombosis Dr’s orders - which were to check with the fertility clinic)
When starting IVF in January I was put on a 4000iu dose of Lovenox by my fertility Dr in Europe, I still have several boxes left, but I’m not sure if that dose is high enough now.
I want to transition back to Lovenox, but can I safely just switch over starting tomorrow? And what should my dose be? It’s clear to me that I am unlikely to find a provider to help support me through this in the short term, so I think my best bet is to ask the fertility clinic to up my Lovenox dose to whatever it should be based on my own research.
Additional context: I have a genetic mutation that causes predisposition to clotting disorders, a family history of DVT, and I’m on a bunch of hormones that increase the risks. I’m also flying monthly for IVF.

My dad was recently diagnosed with Lung cancer back in March. We found out because his right arm was swollen and was found to have multiple DVTs in his Right IJ, subclavian, basilic, and brachial veins so he was on lovenox and then later transition to xaralto. We had our first chemo on April 30 but my dad has to be hospitalized on May 2 for acute respiratory failure due to pneumonia. He’s still hospitalized but his platelets were dropping and when they were 57k, the physician held his xaralto. Now his platelets are coming up but still low; this morning it was 105k. I was not able to be at the hospital today because I worked last night and missed the call from the physician. They called my sister asking if we wanted to restart the xaralto?
I don’t if we should or shouldn’t yet? Due to the risk & benefits. Any input would be greatly appreciated.
Other history for my dad includes diabetes, high cholesterol, hypertension, COPD, former smoker.

Going into THR surgery next Monday. Now noticed the PA wrote the note in my pre-op visit, saying, following our VTE guidelines, I fall into group 1. I would need Lovenox injection daily for 28 days and then transition to aspirin 81mg twice a day for 14 days. Is this serious? I never heard of this injection from other friends who had this THR surgery before. Thank you!

New grad nurse here with a random question — I had a patient with a pulmonary embolism and subdural hematoma on an argatroban drip after experiencing HIT. The doctor ordered the argatroban drip to be discontinued and for the patient to be transitioned to lovenox. The drip was to be discontinued at 4pm, and the lovenox was also ordered to be administered at 4pm. I ended up giving the lovenox immediately after turning off the drip. Thinking back, I’m wondering if I should have clarified with the doctor if we should wait a little longer before administering the lovenox so that the patient would not be too “anticoagulated” at once….
Anyone know the protocol for this?

Hey guys just wanted to give a update on my dvt I’ve actually been doing really good I haven’t had and chest pains or anything like I used to I’ve been switched from my shots(lovenox) to a pill (Eliquis) and the transition has been going pretty well I’m still going smokeless so that’s also been really good I’ve did have a couple days where I missed taking my meds do to sleep schedule but I talked to my doctor and they told me I should be fine but yeah other then that I go in for my 3 month check on February 20th!!! and they said if I’m doing well and my blood work is all good I will be able to stop my meds so yeah that’s my update!!!!

My mom is 50 yo Caucasian female, ~250lbs, 5’4, ~35 year cigarette smoking history (transitioned to vape within last few years), mostly sedentary. Medical history includes gallbladder removal, 1 childbirth, cervical cancer with chemotherapy and radiation approximately 8 years ago. She took no prescription medications prior to this. She’s is not current with a PCP.
She presented to ER with her entire left-leg dark red/purple in color, 1.5-2x larger than normal from swelling, and pain.
She was recently discharged from the hospital after she was in the icu for a week. She had left sided occlusive thrombi from her popliteal to iliac veins possibly due to May-Thurner syndrome. They did heparin drip to EKOS to thrombectomy with stent placement and lovenox. Finally, she was discharged with eliquis, baby aspirin, and a three day supply of pain medication. She has been home two days and is still in a great deal of pain. She is walking to the bathroom and getting up to feed her dogs with a walker. My question is, is this pain during recovery normal after a week of being unable to move? After the surgical interventions and EKOS? Or should I be concerned she could be clotting again?
Affected side is cooler, still swollen ( but improved from hospital) with palpable pulses. Color is very close to color of her unaffected leg. Maybe a shade a darker when dependent/ standing. Capillary refill is around 4-5 seconds. Also, how long should I keep her leg wrapped? We received no instruction on that

I'm reaching out on behalf of my wife and am hoping to hear from anyone who has gone through a similar experience:
My wife is 31 weeks pregnant and had been experiencing intense pain in her upper left inner thigh for several days. One evening, the pain suddenly intensified, and she couldn't bear weight on that leg. Additionally, the area began turning purple and she had reduced mobility.
In urgency, I carried her into the car and we rushed to the ER. An ultrasound revealed a clot extending from her left thigh to her calf. They immediately elevated her leg and administered an IV blood thinner, heparin, upon confirming the clot. After being closely monitored for a few days and transitioning to lovenox injections, we were discharged.
However, her leg remains extremely painful and quickly turns purple unless kept flat or elevated. This was known to the doctors as we left the hospital. Currently, she's relying on a walker and needs to move swiftly and with caution to prevent her leg from turning purple. If she's walking or sitting normally, her foot turns purple within roughly 10 minutes.
Has anyone faced a similar issue? How long did it persist? Does it improve over time? We deeply appreciate any insights or advice. Thank you.

I'm reaching out on behalf of my wife and am hoping to hear from anyone who has gone through a similar experience: My wife is 31 weeks pregnant and had been experiencing intense pain in her upper left inner thigh for several days. One evening, the pain suddenly intensified, and she couldn't bear weight on that leg. Additionally, the area began turning purple and she had reduced mobility.
In urgency, I carried her into the car and we rushed to the ER. An ultrasound revealed a clot extending from her left thigh to her calf. They immediately elevated her leg and administered an IV blood thinner, heparin, upon confirming the clot. After being closely monitored for a few days and transitioning to lovenox injections, we were discharged.
However, her leg remains extremely painful and quickly turns purple unless kept flat or elevated. This was known to the doctors as we left the hospital. Currently, she's relying on a walker and needs to move swiftly and with caution to prevent her leg from turning purple. If she's walking or sitting normally, her foot turns purple within roughly 10 minutes.
Has anyone faced a similar issue? How long did it persist? Does it improve over time? We deeply appreciate any insights or advice. Thank you.
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Hi I had a question regarding loading eliquis for PE. So the patient received 10mg bid for 2 days then were transitioned to Lovenox 1mg/kg BID for 3 days then transitioned back to eliquis. The question is as follows,
A. Would the patient require a full 7 day loading dose of eliquis
B. Load the remaining days of 7 days with eliquis (10mg BID for remaining 2 days)
C. Load the remaining days of eliquis loading dose (5 days of 10mg BID)
D. Begin 5mg BID
Thank you!

28F. So I had my first appointment with my OB yesterday, first ultrasound (transvaginal) This is my fourth pregnancy (second one was a SAB/loss) My LMP was 7/15/2023 so my due date was 4/20/24. So that would have made me 10W & 6D yesterday. My periods are always regular, starting on the 15th of every month. So in August when I didn’t have one, I took an at home early detection test. It was negative, so I waited until the 18th of August to test again and it was a faint positive. During the ultrasound, my OB said everything looked great, nothing of concern. HR was 168 and yolk sac was intact. He said at this point in my pregnancy, it’s typical to see arms at this stage but the arms didn’t look as developed and baby was consistently measuring about 8W & 4D. I’ve never had any of my babies measuring behind on ultrasound based on my LMP, they’ve all been spot on. So they did end up changing my due date to 5/02/24. Like I said, my doctor wasn’t concerned about anything. But that hasn’t stopped my anxious brain from thinking of all kinds of possibilities. I have been awful about taking my prenatals because I’ve been nauseated 24/7. I also was on Warfarin (blood clot in leg) for the first probably 3-4 weeks of my pregnancy until I learned that I was in fact pregnant, then my OB transitioned me to Lovenox injections. I don’t know if any of that info helps. Based on all of this information, does it sound like my due date was just off? Or should I be concerned about possible birth defects? Just looking for advice from people with similar experiences and any medical professionals who have any input, thank you all in advance! I know I should’ve asked my OB yesterday this, but like I said, he said, nothing looked concerning to him and honestly my husband and I were just so happy to see a heartbeat after experiencing a loss.

28F. So I had my first appointment with my OB yesterday, first ultrasound (transvaginal) This is my fourth pregnancy (second one was a SAB/loss) My LMP was 7/15/2023 so my due date was 4/20/24. So that would have made me 10W & 6D yesterday. My periods are always regular, starting on the 15th of every month. So in August when I didn’t have one, I took an at home early detection test. It was negative, so I waited until the 18th of August to test again and it was a faint positive. During the ultrasound, my OB said everything looked great, nothing of concern. HR was 168 and yolk sac was intact. He said at this point in my pregnancy, it’s typical to see arms at this stage but the arms didn’t look as developed and baby was consistently measuring about 8W & 4D. I’ve never had any of my babies measuring behind on ultrasound based on my LMP, they’ve all been spot on. So they did end up changing my due date to 5/02/24. Like I said, my doctor wasn’t concerned about anything. But that hasn’t stopped my anxious brain from thinking of all kinds of possibilities. I have been awful about taking my prenatals because I’ve been nauseated 24/7. I also was on Warfarin (blood clot in leg) for the first probably 3-4 weeks of my pregnancy until I learned that I was in fact pregnant, then my OB transitioned me to Lovenox injections. I don’t know if any of that info helps. Based on all of this information, does it sound like my due date was just off? Or should I be concerned about possible birth defects? Just looking for advice from people with similar experiences and any medical professionals who have any input, thank you all in advance! I know I should’ve asked my OB yesterday this, but like I said, he said, nothing looked concerning to him and honestly my husband and I were just so happy to see a heartbeat after experiencing a loss.

Can anyone here guide me to info that can explain the risk of stroke, heart attack or other embolic event for someone with AFIB who is on anticoagulants?
My 93 year old aunt was diagnosed with AFIB when she was in her 80s. Refused to take Xarelto and would only take baby aspirin. In other words, she played Russian Roulette and her time came a calling in July when AFIB threw an embolism to her femoral artery. Luckily, I visited her that day and was helping change her footwear and noticed that one foot was very cold and the lower leg was discolored. Pulse in the foot was weak and she went off to the emergency room. Fortunately, time was on her side and it was caught before any tissue died.
Medical record earlier in July noted acute hypoxia due to AFIB and again yesterday during a doctor exam, AFIB was apparent.
She is currently on Lovenox injections twice per day with hopes to transition to a DOAC when seen by a cardiologist in mid September.
I can't find any articles that discuss her risk of a major AFIB event while on anticoagulants. Any guidance would be appreciated.

Today makes the 9th day since my surgery and recovery is going pretty well.
The earliest available PT session near me was 6 days following surgery, so I was doing the recommended exercise at home while awaiting my first PT session.
The day after surgery the therapist had me walk with a walker the entire length of the hospital corridor and back. I estimate the corridor length to have been at least 300 feet long and my room was on the far west end. Then he had me go into the stairwell and walk up and down a flight of stairs. And that's after telling him I did not have stairs at our home. When I returned to my room, he had me do 4 more exercises. I thought I was going to pass out or vomit but did neither.
I have had very little pain for several days now and yesterday, the 8th day post-surgery, I started transitioning from walker to cane. I can take a few steps without assistance but I kind of look like a newborn colt taking its first steps.
The surgeon prescribed Eliquis blood thinner but all the pharmacies in my area (Apopka, Florida) were surprisingly out of stock. But a neighbor, who is a cancer patient, had plenty of extra Eliquis to give me while I waited to fill my prescription. On Wednesday someone from my surgeon's office called and told me there was an error with my prescription and that I should have been prescribed Lovenox. I told her I would stay on the Eliquis and am not doing the Lovenox injections. She said she would consult the doctor and get back to me. Well, she hasn't called back yet.
While awaiting her return call I did some research and learned that aspirin is commonly used as the only pharmacological agent for the prevention on VTE post joint replacement surgery in the Untied Staes. So, this past Monday I stopped the Eliquis and started with aspirin. The Eliquis gave me a hard to describe weird feeling that I did not like at all. Aspirin is great because it's a blood thinner and pain killer.

Trying to wrap my head around what is going on with my provider.
Had two uncomplicated pregnancies (shoulder distocia in first, scheduled c section second). I am currently 17W and this pregnancy is going well thanks to some info/changed approach.
Unfortunately, my husband and I suffered 5 consecutive losses after these pregnancies before this one. OB was not supportive when I kept asking and saying I was concerned. Went to specialist after not getting answers/support.
It was discovered I have Factor V Leiden clotting disorder and 2 other borderline clothing disorders. Met with hematology who had me start lovenox in current pregnancy. Lab reults showing clotting disorder as well as notes CC to OB.
OB is not supportive of me staying on lovenox (despite being currently managed by HEM)
Additionally, she is arguing about my due date. Despite myself, MFM and other radiology imaging aligning (actually even measuring ahead of my calculations) whereas the uktrasounds she has performed are substantially off. Like over a week behind. I brought this up to my MFM and said it’s either user or equipment issue. And that they would speak with OB about correcting due date.
This is important because I need to stop lovenox and transition to heparin before I go into spontaneous delivery.
Again, she is refusing to acknowledge the MFM and change my due date to the correct due date.
I don’t even know what to say - I know people change physicians all the time but I have built what h thought was a good relationship with this provider and I’m literally bothered by the contentious nature of this.
Why short of ego would this provider not want to listen to MFM and HEM?
I am in the northeast fyi

Short Backstory: 26M, relatively healthy + active, family history of hetero FVL, no health issues in adult life
I end up in the ER after ~4 days of calf pain and acute chest pain, thought to initially be a pulled calf muscle and some heartburn, ends up being DVT in left calf + bilateral PE after CT scan and Ultrasound. Immediately started on Heparin over 24 hours then transitioned to Xeralto after being discharged 2 days later (one shot of lovenox in-between).
Pain was at a 2/3 over the course of this happening and I even debated going into the ER as I stood outside of it, contemplating if it was just my anxiety or if there was actually something wrong. I went to Reddit the night before my ER visit, after my symptoms still persisted, and read all of the posts listing the importance of going to the ER, describing the same issues I was having.
I was kind of taken aback by how many people around my age, who are healthy, and then suddenly are hit with blood clots seemingly out of nowhere. I am very thankful of all the people's stories I came across that made me realize this was an issue I needed to take seriously, so I went to the ER.
For my symptoms, I had what felt like a lingering pain in my calf like I had a charlie-horse or dehydration, and what almost felt like indigestion when lying down and drawing a full breath. Otherwise, there really wasn't any additional indication that I had something seriously wrong. I had been on a health kick over the last month: lifting weights, biking and eating clean, getting in better shape, etc. Can't outrun your genetics I suppose.
I just want to reinforce that all the doctor's told me I was smart to come in, and I wanted to express my gratitude to all who have shared their stories here, otherwise I likely would have stayed in pain and tried to suffer through which could have been fatal.
Sidenote: My dad, my grandma, my uncle, and cousin all have tested positive for FVL, I just had never had any major health concerns/outcomes that I thought I needed to be tested yet (plus my sister tested negative 5 years ago). It was the first thing I mentioned to the ER doctor was that my family has the blood-clotting disorder, and my dad has been on warfarin for the last 20 years. In hindsight, I should have been more adamant about being tested previously.
I am feeling better now, no more leg pain - but some lingering chest pain still. If anyone has any questions about the treatment I received, or any advice moving forward - I would be more than welcome to it.
TL;DR: Went to ER, diagnosed with DVT in left calf and bilateral PE. Have unlucky genetics, but thankful for all the info shared here.

Hi I hope this post is ok to put here but wanted to get feedback from those who have had success. TW: mention of losses.
I couldn’t find much info on IUI protocols so hoped I could get some help from this amazing group! I’m 43 SMBC using a known donoex for IVF. I’ve done a bunch of ERs for banking and had two embryo transfers (untested high grade) end in MC from age 42, two additional failed to implant (age 42-43). I’m moving to Philadelphia in July and changing REs (RMA or Mainline—whoever will accept my remaining embryos).
Ok well my main question is for those who used a kitchen sink protocol—but specifically lovenox and prednisone for IUI, when did you start those meds? I don’t have a known diagnosis and only a history of low +ANA 1:80 and superficial blood clots while on stims last year. I know there aren’t a lot of people who go from IVF to IUI but I’m just doing it this month and maybe next because I expect my move/transition to be intense and I don’t want to “waste” my “younger” embryos until things settle a bit for another FET. I know the chances are super low at my age with IUI but I’m determined to try with my own eggs until I’m at least 44. I don’t feel that old but my ovaries apparently say otherwise. Even if you didn’t do IVF and only did an IUI that would still be immensely helpful! TIA
Side note: I did try PGT but the results were lackluster so I only have 1 mosaic and 4 untested embryos left.

Not pregnant yet, but I needed to transition from my oral blood thinning medication to Lovenox in order to start trying. I’ve been doing injections twice a day since mid-January.
Mostly it has been fine. But lately every injection I give myself leaves me with these hard lumps under the skin. I know that you are supposed to rotate injection sites to avoid this and I am. I have… a lot of real estate to inject in lol. So I really don’t think that’s the issue. Also, it’s immediate. There is nothing, I inject, hard and gross lump now in that spot.
Anyone else dealing with this? Any ideas of why they are occurring or how to prevent them?
Edit: I have asked my hematologist about it and the response was- that’s just something that happens with frequent injections, even other meds like insulin. Just make sure you are rotating injection sites.

If a patient has DVT, has been getting lovenox treatment dose for 5-6 days, transitioning to eliquis. Do you load eliquis or start at 5mg BID ?

I went in on Tuesday for an ultrasound and they said he felt big but was probably about 7lb 14oz. They were guessing 8-9 lbs. Went in on Thursday to get heparin after stopping lovenox the night before. They decided not to do it and start with with cervadil. I was so excited and hopeful it would work that I would not need pitocin. 11 hours later and no change to my cervix at all. So we decided to start the pitocin around 9-10. It wasn’t as bad as I thought I just kept moving and trying to make my body work. I was still having stomach virus diarrhea (I had a bad stomach virus at 38 weeks). I was feeling drained. I walked and bounced and moved for four hours straight focusing on my breathing and the three p’s. After 4 hours I was only at a two. I was discouraged but not letting it get to me. The doctor discussed breaking my water to speed things up as time was of essence due to not having any blood thinner and getting bad leg pain in my clot leg during the night (worst one yet). So I agreed and we did it and amped up the pitocin. Bad idea it was almost immediately unbearable. There was so much fluid everywhere. I was hugging My husband and wanted to cry but they kept coming harder and faster. Pretty soon I felt like transition so they checked me and I was only at a 3. I felt like how I felt when I was a 10 with my second. I felt like I needed to push and get out of this. I knew the pain and the water breaking was stalling my labor so i gave in and asked for an epidural and some pain meds while I wait. That was weird because I hurt from contractions but could relax slightly in between 1.5 minutes of contractions. The contractions were now basically on top of each other. I felt like my uterus was going to explode and kept saying these aren’t my contractions. I was terrified of the epidural not working or wearing off or them turning it off like what happened in Germany. The anesthesist was so good! She got me in the first try and was careful in between the contractions. I got still feel my feet and slightly move my legs. After I got the epidural I felt so much better and happier. I tried to rest and my nurse changed my positions. I went from 3-10 in 3 hours. Pretty soon it was time to push. I did a few practice pushes and 2-3 real ones. I felt one last kick on the top of my belly and out came the tiniest little baby boy. He was so small and skinny. Not at all like my belly or ultrasound measured. He looked like a tiny version of our middle child. I cried a little tear when she said he had hair before I got him out and I was so excited i just grabbed him and held him immediately and kissed his little head. I was so happy and emotional. I’ve never cried after birth or before. It was crazy to have a birth that I was excited and smiled I didn’t scream get him out I just pushed him out. I didn’t worry about having him in the car or any miscommunication from foreign language. I didn’t tear but she gave me a stitch anyway. I also didn’t hemorrhage and they dc’d the epidural and got me on heparin by midnight. Would I do an induction again? No not if it wasn’t medically necessary like this one. Did I have a great birth? Yes. I’m so happy with how everything turned out. Baby was the mvp and tolerated pitocin and the epidural just fine.

Previous update: https://www.reddit.com/stroke/comments/r7f3ba/update_3_months/?utm_source=share&utm_medium=ios_app&utm_name=iossmf
Well, my last update wasn’t really much of an update. Let’s see how this one goes.
I haven’t seen a lot of progress over the past month, tbh. I can close my left eye by itself now, and I noticed i can reach over my shoulder with my affected hand to pull my shirt over my head, so that’s something I guess. Still exercising 5-6 hrs per day, which can be a real grind some days, and going to OT/PT twice per week. Oh, I transitioned from Lovenox to Warfarin, so no more twice-daily shots! Some days I feel almost normal and can do some impressive things with my affected hand and arm, some days the pain in my wrist, shoulder and foot (that’s a new one) make things difficult and can really bum me out. If I’m being honest with myself, I’d say I’m about 75% of my pre-stroke self at this point. Hopefully that will continue to trend up and the muscle pain and stiffness I have will trend down over the next few months. I’m know I’m lucky to have as much movement as I do, but I don’t want to get satisfied or complacent with where I am. Couple questions:
Anybody have some good /interesting suggestions for fine motor exercises for my hand? I play with LEGO’s, do a lot of pick and place exercises and move golf tees back and forth from a foam block, but it gets a little redundant after a while. Appreciate any suggestions.
Anybody have experience dealing with daily muscle pain and soreness? What helped you? Did it get better over time?

Original post here: https://www.reddit.com/stroke/comments/px8o83/ischemic_stroke_three_weeks_ago/?utm_source=share&utm_medium=ios_app&utm_name=iossmf
So, I was in the ICU for the first two weeks, mostly so the could get me stabilized on heparin then transitioned to Lovenox ( both anticoagulants). Been in an acute rehab facility the last three weeks. I initially had basically zero use of my left arm and was very unstable on my feet. I’ve since learned to walk without any aid and have nearly 100% movement in my arm, though finer motor control is still a major issue and the arm is still very, very weak. I’m scheduled to be discharged to home this week, though I’ve been lobbying for a one week extension as I know I’m not going to get nearly the level of therapy at home that I’m getting here (4 hours per day). Focusing on staying positive (not easy sometimes) and seeing this as a challenge. I’ve come a long way, but still have much work to do. I feel like I have a 90% chance of getting back to 90% of my pre-stroke self within 9 months, at least that’s my goal.
EDIT: After reading this again, I felt I should clarify something. When I say I have 100% movement in my arm, what I mean is that I can actively and voluntarily move each muscle group. Which is good. It does not mean I have fully restored movement ( not even close at this point).

51M, no known risk factors, went to get out of bed , slumped to the floor and didn’t have the strength to get back up. Been in the hospital since then. They’ve been getting me to a stable”therapeutic” state on heparin before transitioning me to Lovenox and transferring me to a rehab facility (hopefully happening today). Lost some movement in left leg, significant movement in left arm. Sucks big time. Gonna buckle down and work hard in PT to get back as much a I can as soon as possible. So much for eating healthy and staying in shape!