Hi, Dr P (medicus capsicum annuum 
) thanks for the lengthy reply and advice.
So what do the thinners actually do for the problem? I started taking Xarelto 15mg 2/day 4 days ago. My leg (well, calf+foot) is still very swollen and I’m in a lot of pain. Should I expect relief in a few days? Weeks? Months?
Getting at this from another angle: I have a clot in my calf. My blood is now thinner, yay!! 
Um, how does that help? Why does that help? Thanks in advance.
PS I cut myself shaving this morning, and it bled like hell. Styptic pencil needed repeated applications. Blood thinness achieved! 
Blood clots, like other parts of a living body, are dynamic. They can grow, they can shrink. Thinner (less clotty) blood can tip the balance towards the clot shrinking. If it shrinks enough, the blood flow in your calf will stop being impeded and your pain should improve. If everything works perfectly, the blood clot can completely disappear and whatever damage it caused can heal.
Thanks, PG. Shouldn’t thinner blood also help blood flow past the clot point more easily, reducing swelling (and pain 
) ?
I don’t think the blood is actually thinner (that is, less viscous). I think that “blood thinners” really just make blood less likely to clot. But maybe a doctor will chime in.
I think it might be. I was in the hospital a couple of months ago and was told my blood was “thick” - I’m not sure exactly what was meant, but I do know it wasn’t flowing into the tube the way it normally does. After a couple hours on heparin ( which I’m pretty sure was done for other reasons) it was flowing fine.
Correct. Rivaroxaban (brand name Xarelto) is a direct Factor Xa inhibitor (it prevents progression of the coagulation cascade [a series of steps causing blood to clot] and prevents the generation of thrombin [a plasma enzyme that converts fibrinogen into fibrin]). IOW, it’s called a blood thinner, but it doesn’t actually thin the blood, it prevents the clotting of blood.
Blood clots through a complex series of chemical reactions. Medicines given usually interfere with several of these reactions. This stops the clot from getting bigger. The medicines also usually contain chemicals which break up clots directly, as well as help change the direction of chemical equilibrium which make the clots more likely to break up for indirect reasons (time, pressure, increased bloodflow, changes in adhesion).
Well I did hear a thrombone when I got the diagnosis.
Dumb question, but does “don’t cross your legs” mean don’t do this?
Or this?
I find myself doing (and stopping myself from doing) the latter when elevating my leg.
I rarely do the former except when putting my shoes.
Another dumb question: I’m told I shouldn’t fly, the clot could travel 
. Is that purely because you’re immobile for long periods, or something about the nature of air travel and changes in air pressure? If I wanted to take a 1 hour plane flight, is that as risky as my canceled trip to Thailand from SFO?
I have a friend an hour by plane away – is that an impossible situation?
The first photo leg cross is worse because it puts pressure on the vessel (s) affected by the clot thereby squeezing the lumen.
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Not always easy to walk around while flying.
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Not able to easily deal with problems while flying. Even medium problems a major annoyance, emergency landing, dump the patient at random hospital mid flight at your expense, flight may be delayed by hours, customers unhappy about this. Been called four times to assist fellow travellers - minimal medicines and equipment on board. Worse if no health care people on board, one presumes.
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Probably potential problems more to do with lung pressures and not risk of embolism? Might depend on if able to walk and stretch. Not always easy if crowded, seats close, luggage stowed near seat.
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No one wants the liability. Insurance may not cover known conditions.
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May not be easy to deal with problems once at many destinations. Medical care in preferred language, hospital location or quality, available medicines and imaging abilities may differ.
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Side effects of treatment include bleeding and dosing concerns. May be at increased risk of side effects due to balance issues and pressures.
The main problem is no way to get immediate medical care in the event the clot dislodges and travels to the lungs, an emergency situation.
OK, but -
- The clot is in my calf, so considerably (stated upthread) less risk
- I’m on thinners now, a week in so…
If I travel 1 hour 3 weeks from now, isn’t the risk considerably less?
You know what? That’s all a question for my doc when I get one on 9/9. Thanks large for the responses!!!
Different risks. You fall and bang your head while taking a blood thinner, may or may not be a very big deal. The airlines hate dealing with health issues and insurance companies might be unhelpful given the circumstances. There are usually other means of getting to places not far away by air. However, I agree it is annoying for you. Your doctor is, of course, best equipped to deal with your personal situation.
If you are worried about “hitting your head” risks, surely driving 200 miles is riskier than flying?
I don’t know about that. I know I’m more likely to get into a car accident than for the plane to crash - but I’m not at all sure that I’m more likely to trip and hit my head when I get out of the car at a rest area that when I’m walking down the aisle of the plane to the rest room.
Huh. I’ve never come close to hitting my head on an airplane, even on very bumpy flights. You are always so close to something you can grab. It’s hard for me to even imagine falling to the floor of an airplane. I’d think the risk of slipping on a recently-washed floor at a rest area would be far higher.
And even a minor car crash can lead to banging your head up.
I know that sitting still on an airplane for long periods can cause clots. I assumed that was the relevant risk of flying.