DEAR DR. ROACH: I would like your opinion about staying on blood thinners for the rest of my life. In July 2017, a CT scan showed a small blood clot in my lower-left lung. This was an indirect the result of a grade 3 hamstring pull suffered while jogging. I am now on 20 mg Xarelto daily. My doctor said that I would need to stay on blood thinners for the rest of my life because in 2010, I had a DVT and blood clots in both lungs as a side effect of birth control pills. (At that time, I took Coumadin for six months.) I am 63, exercise daily, maintain a 1,200-calorie diet and take no other medications. After the current blood clot is reabsorbed into my bloodstream, I want to stop taking Xarelto. Is that advisable, or do I really need to be on this medication for life? - E.D.
ANSWER: There is not a clear right or wrong answer to your question. My guess is that if you saw 10 hematologists with expertise in managing people with blood-clotting issues, eight of them would tell you to stay on some kind of anticoagulant - both warfarin (Coumadin) and rivaroxaban (Xarelto) reduce your body's ability to make clots - but two would not. There is much room for judgment in medical decision-making, and the patient's desires need to be factored in.