"For the benefit of others:
- Paley gives blood thinners for precice patients for 5-6 months which is well after distraction
- Blood thinners are not the only way of preventing blood clots. Mobility also is. For fracture patients, they use weight bearing nails so they start walking very early. Same with knee replacement patients. Precice LL is very different.
- Blood clots can happen to even healthy people who sit a lot. It is just that after a surgery like this, the risks are much higher for the first 3 months. So even with a weight bearing nail if after 3 months you start sitting on a chair all day then you are at a risk of blood clots.
Everybody needs to choose a doctor they trust 100% and do as they say."
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This is the more accurate response altough it is not complete and Paley isn't God (altough he starts to think so, if it's true that he claims never having or will (!) have cases of infection. So I would add only the followig:
-I take anticoagulants daily and never had any surgery, fracture or LL yet. My condition is just that, my blood is "thick", a general practitioner sees that in routine analysis easily (time of prothrombin, etc).
So Dr. Paley should add: "special care is needed with patients that are already taking anti coagulation medication prior to LL surgery"", "special care and further medication is needed for these patients if undergoing LL" and (ethically, "safety first" Paley's slogan, but something no LL candidate wants to ear: "a candidate to LL may be excluded from the procedure if blood analisys, other cardiovascular condition, or any history of DVT, any embolism, etc , advise so."
-From the above one must conclude that it may be beneficial to take those medicines for more than 6 months not only in these situations but specially if for any reason the patient has low mobility for whatsoever reason. In fact, the only problem is not only a person that stays too much time seated but with little movement in whatsoever position. There's even at least one case of a plane stewardess coming from a transcontinental flight that fall flat dead while waiting for luggage due to some kind of thrombosis. And surely she must have walked some distance inside the plane. But she may have been also a longtime seated, a longtime standing and/or walking in a very limited space. The cloth formed surely while in the plane and reached the brain or cardiac artheries later on. In some countries healthy patients are already advised, since a certain age, to take 100 or 150 mg of aspirin, a natural, light, anti coagulatnt, daily, because of this risk (the benefit of such measure has however been challenged recently).