Persistent swelling post DVT

Patient

Q: I was diagnosed w/ a DVT in my right leg on the 16th of feb...i have been on coumadin (5mg/day) since that time. i was also on lovenox till the 26th of feb. i have been working for a week and a half. im on my feet all day. everyday my leg swells but there is no longer any pain, just swelling. i had blood work done on fri the 26th of feb. my protime was 33.9 and my inr was 2.8..will the swelling receed or is this something that will continue? and should i b worried about this? i also chew.

Doctor

A:   Deep venous thrombosis is a clot in the deep veins of the leg. This clot/blockage prevents the flow of blood back to the heart and causes blood and fluid to leak into the surrounding tissues, leading to pain and swelling of the affected leg. This is often how the problem presents. Your INR is now within the therapeutic range. This treatment prevents the clot from becoming larger and pieces of the clot from breaking off and travelling to the lungs, which can be fatal. Unfortunately it often does not break down the entire clot but just results in partial clearance, Permanent damage may occur to the valves in the leg veins leading to valve incompetence (reflux). Post-thrombotic syndrome may occur in as many as 50% of patients with DVT, which includes persisting pain, swelling, heaviness and itching in the affected leg. I would advise the use of elastic compression stockings and elevating the leg as much as possible to reduce the swelling.

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