Possible blood clot in kidney...increase in Eliquis now?

I was hit with the flu and then "walking pneumonia" in March, which also seemed to affect my digestive tract. So after dealing with nausea and excessive burping, I decided to go to the Dr. and get checked out. They sent me for a Cat Scan of my stomach area and determined that all was fine there, but noticed a "wedge shaped" area on my kidney - so suggested a follow up with a kidney doctor...Dr. Kramer.

Dr. Kramer reassured me that this was not cancer, but he thinks it is from a blood clot that went to my kidney. He also asked me if I remember having any injury in that area or pain, which I don't remember...unless it was from a long time ago when I fell. He seems to think it was more recent. SO...he got in touch with my cardiologist, who says she wants me to increase the Eliquis to 5 mg BID, versus the 2.5 mg. I had titrated down to awhile ago, after my 2nd ablation with Dr. Natale (per his instructions). By the way, my Cardiologist was interviewing a new doctor about a year or more ago, who just happened to be the one who did/oversaw my TEE after my 1st ablation, at St. Luke's hospital. She recalled him saying that I had "a lot of "smoke" in my atrium, which shows a higher likelihood of having a stroke. I went back and looked at that TEE report, and it says nothing about that. It also said there was no evidence of "smoke" on my 2nd TEE done about a year ago. at Montefiore hospital.

I'm surprised that I might have a blood clot while on Eliquis, but also wondering if that's definitely what it is....and if it's really necessary for me to increase the dose. The Cardio. says "I don't' want you having a stroke" and would feel better if you were on the 5 mg BID now. I suppose I should increase it just to be safe, although I sure wish they knew for sure if this is what caused the "wedge".

I have a phone call into Dr. Natale's office...as well as an email.

Any thoughts on this, my Afib comrades?

~ Barb

Check with Dr Natale's office, sounds like the docs in NY are more or less fishing with an educated guess and based on little more than that at this time. Of course, it's easy enough for the Cardio to say increase the OAC which is the easy option, but would be better for you to see if you can investigate further and thus move beyond a hunch as to what that wedge-shaped image on the CT truly is. It it's clearly from a blood clot an effort to track the origin down could be worthwhile, it's doubtful it's highly doubtful it's related to AFIB or Flutter since you haven't had either in a good while now and have been on the 2.5mg dose of Eliquis.

Explain the issue to Dr Natale and let him make the call, he might want further work up. If you feel more comfortable fir the time being in 5mg since you tolerate it well that's fine too, but I'd want to go deeper and see if clarity can be uncovered confirming if indeed thou really need the extra dose of Eliquis, of if this is just a prescriptions of convenience for the doctors who ate taking a stab in the dark on this.

Take care,
Shannon

I am going to increase the dose for now, Shannon, as Dr. Natale isn't due back in the office until Monday, per Shirley. I'm not sure how anyone can figure out where the clot may have come from..if indeed that's what it is.I already had a CT scan..which is where this showed up. I did have a severe pull on my left side about a year ago, which I felt deep within my body and hurt for weeks afterwards, but I don't know if that could have affected my kidney in some way....
I am feeling like I don't know who to talk to now.....which doctor? The kidney and Cardio docs both feel I should increase the OAC (they work for the same health care system in the same town)...so were talking about this together.

Feeling a bit concerned...oh boy....Barb

Hi Barb,

As I suggested above it is fine to increase back to 5mg of Eliquis for now, but take to Dr Natale too about the situation and get his input. Long term you may not need to stay on 5 mg and from your last few TEE scans collectively it was clear your risk of any LAA thromboembolism is not high at all, hence Dr Natale's comfort in letting you drop to 2.5mg.

Didn't one of the radiologist looking at your CT say the image in your kidney could have been from an older or even childhood injury? I would also consider doing the blood viscosity test at Meridian Valley labs to see if systemically you might have thicker more turgid blood that you can definitely do something about either with certain herbal supplements plus regular rehydration steps each day, a doc in more severe cases adding in periodic hypovolemic phlebotomy blood draws.

In any event talk to Dr Natale and get his input and in the meantime you can stay on 5mg of Eliquis BID just for peace of mind, I just don't want you to assume you have to stay on the higher dose indefinitely just from the rather preliminary diagnoses it appears you've had so far. Look deeper for possible reasons for such a clot if it's possible to find, and check to see how your systematic blood viscosity looks now so you can be sure you are doing everything you can to improve a possible high blood viscosity if indeed you have that.

You'll should be well protected in the meantime that way but not necessarily subject to larger dose of OAC long term if it can be determined you are not at elevated risk of clotting going forward.

Take care and don't worry too much Barb, at 5mg you won't be at any real risk of an embolic clot while you look into this further and get Natale's input too.

Shannon

Thank you, Shannon, for this and your earlier phone call. I am looking into getting the blood viscosity testing done -apparently it's a bigger deal here in New York...rules...argh. I have to stop at the Quest Diagnostics lab as there is no option to talk to a live human being to find out if they will draw the blood for me to be sent for analysis at another lab (Meridian labs)....so I will try to do that shortly.

In the meantime, I have a phone call in to talk to Dr. Natale when he returns to his office, and have also increased the Eliquis to 5mg bid. Now I know why getting tests done can be a real pain in the _____, as they always seem to fine SOMEthing wrong that needs more tests, more angst, etc. I still think there's a good chance I had a little blood clot from the injury I had on that side last year...but we'll see what they have to say.

Stay tuned. And thanks again for your support. I consider you my guru ~ Barb