Seeking Guidance for My Partner's Health Challenges (DVT, PE, Blood Thinning Therapy, Fibroids, Severe Menstrual Bleeding)
Hello, I’m reaching out on behalf of my partner who is currently facing significant health issues, and we’re feeling quite overwhelmed. We hope to hear from anyone who may have experienced similar situations: My partner is 32 years old and has a complicated medical history. She experienced deep vein thrombosis (DVT) a few years ago, which occurred after receiving the COVID-19 vaccine. To manage this, she was placed on blood thinners temporarily. Unfortunately, after completing that course, she encountered another DVT and had to undergo further treatment. Eventually, she became pregnant and suffered another DVT, leading to her receiving daily blood thinner injections. After one more DVT, her dosage increased to two injections a day. Despite the struggle, she successfully managed her condition and now we have a wonderful, nearly two-year-old son. During her pregnancy, healthcare providers discovered a fibroid, which we believe measures around 8 centimeters. This situation necessitated a cesarean section as the fibroid was likely obstructing the delivery. After giving birth, my partner continued taking blood thinners while nursing. Once she stopped breastfeeding, she discontinued the medication. However, she developed chest pain, which we initially attributed to muscle strain from holding our baby. When the discomfort persisted, we sought medical attention and learned she had a pulmonary embolism. Following a hospital stay, she was advised to maintain a high dosage of blood thinners, specifically 5mg daily. Simultaneously, she sought help from a gynecologist regarding her heavy menstrual bleeding, which involved large clots and lasted up to two weeks at a time. The gynecologist recommended a Mirena coil in hopes of alleviating her symptoms. During a trip to Australia, she experienced severe headaches and increased bleeding, resulting in her hospitalization for several days where the Mirena coil dislodged, likely contributing to her complications. Due to persistent bleeding, we returned to Ireland for further care. Both the gynecologist and the hematologist suggested she try a progesterone-only pill. The first month yielded some positive results, but the second month brought relentless bleeding—lasting an entire month with an overwhelming amount of blood loss, requiring frequent changes of feminine products. After a two-week reprieve from bleeding, her blood specialist permitted a reduction in blood thinner dosage to 2.5mg administered twice a day, believing that it might help regulate her bleeding. A subsequent CT scan indicated that the pulmonary embolism had resolved, which prompted the decrease in medication. Regrettably, the heavy bleeding returned, accompanied by significant clotting. Over the past nine months, she has undergone three iron infusions due to her condition, which typically leaves her feeling flu-like for several days afterwards. We are actively seeking advice on her situation. Recently, we consulted with her gynecologist regarding the potential removal of the fibroids, as we suspect they may be a contributing factor to her bleeding issues. Many doctors we’ve spoken to from other countries advocated for fibroid removal as a standard procedure. However, our gynecologist expressed concerns due to her current blood-thinning regimen and the risk of increased clot formation. He advised that surgery could lead to severe bleeding and possibly necessitate a hysterectomy. He suggested that she might consider having another child, which would perhaps be a way to alleviate her bleeding issues before tackling surgery. While she is fully committed to expanding our family, I find myself more hesitant given our current circumstances and the pressures of financial stability, including saving for a home. I recognize that this situation is complicated, but I would sincerely appreciate any insights or recommendations on possible paths forward. It feels frustrating to be advised to have another child now, as I see it as an inadequate solution, yet it might indeed be the only option left. Thank you for any guidance you can offer!
Answers (1)
3/26/2025, 12:11:01 PM
OpenHealth AI
I'm truly sorry to hear about the health challenges your partner is facing. It sounds like both of you have been navigating difficult situations, and it’s understandable to feel overwhelmed. Here’s a summary of key points and some actionable steps that may help your partner:
Main Points:
- DVT and PE History: Ongoing management of blood thinners is crucial, but it also complicates other medical decisions, particularly regarding surgery.
- Heavy Menstrual Bleeding & Fibroids: Fibroids may be contributing to her heavy bleeding, with the potential consideration of surgical intervention complicated by her blood-thinning therapy.
- Balancing Family Planning: Discussing family expansion while managing these health issues is understandably a source of stress.
Explanation:
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Current Management: It’s essential for your partner to continue monitoring her health with her doctors. The history of DVT and pulmonary embolism makes any surgical intervention risky, especially in the current context of blood thinners and heavy menstrual bleeding.
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Fibroids & Heavy Bleeding: Fibroids can cause heavy periods, and it’s understood that surgical options such as myomectomy (removal of fibroids) may help. However, her doctors are rightly cautious about the risk of severe bleeding during surgery while she is on blood thinners.
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Progesterone-Only Pill: Since the first month on the pill showed some promise in reducing bleeding but the second month resulted in significant issues, it might be worth discussing alternative hormonal treatments or different formulations with her gynecologist.
Next Steps:
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In-depth Consultation: Schedule a comprehensive consultation with both a hematologist and gynecologist. Discuss the risks and benefits of surgery with a thorough focus on managing both her fibroids and DVT/PE history.
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Alternative Treatments for Bleeding: Ask about non-surgical options that may include:
- Other Medications: Such as tranexamic acid (which can help decrease menstrual bleeding) or hormonal options that might stabilize her cycle.
- Lifestyle Adjustments: Dietary changes or supplements that may help manage bleeding and promote iron levels.
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Family Planning Discussion: Have an open conversation about family planning with both her healthcare providers and you. Weighing the biological desire for another child against the current health risks is crucial. It can be beneficial to explore fertility in a controlled medical environment considering her medical history.
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Emotional Support: Given the stress of medical issues, consider seeking support from mental health professionals who have experience with chronic health issues. This can provide both of you with tools to manage emotional strain.
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Regular Monitoring: Encourage keeping a symptom diary that records bleeding patterns, medication effects, and overall well-being. This can help provide useful information to her healthcare team.
Please take this advice as a supportive guide, and always remember that each decision should involve careful consideration with healthcare providers who are familiar with her unique circumstances. Your partnership and understanding throughout this journey are invaluable.
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