circulation problems?

I am 47 years old and was in excellent health before December 2002.  I had abdominal surgery and afterwards had a stroke. I also developed a thrombosis in the SVC, which included an occluded IJVT. I was started on Coumadin therapy for the thrombosis. Recently, I have been told that collaterals have formed and the jugular vein is clear. It is unknown what caused the stroke nor the thrombosis. How is it possible to know when the thrombosis has turned to scar tissue? Once the scar tissue is formed, what is it then called? Is there a chance the scar will be a point of future clotting formation?
I may have abnormal Protein C level, as a coag test was run after the stroke was diagnosed. Are there blood tests that should be run to verify if it is safe before I am taken off Coumadin? What are the risks of being taken off Coumadin if I have 'thick blood'?
When I lean over any amount, my face turns red and I get dizzy.  Recently, I leaned over while doing some sweeping (about 5 minutes) after I stood up, my lips and earlobes were blue. The blue lips are common..but the earlobes? The past few days has started a new symptom, after getting out of bed, my face is red and it feels puffy. I constantly feel tired during the day. My fatigue has been ongoing since December but have been told that this is because of the stroke and surgery recovery. Is there a circulation problem going on? Could the thrombosis (vein stenosis) cause poor sleep and my fatigue level? If the thrombosis has now turned to scar, will there be a time come when I don't get dizzy when bending over?

[CCF-M.D.-RCJ]

Wflint,

Sorry to hear of your ordeal.

Unfortunately, your questions would be more appropriately posed to a hematologist.  The details of the thrombotic episode are very important in determining the future therapy, and so your questions should really be addressed in person.

In regards to "when does thrombosis turn to scar?", this question does not usually concern doctors.  What we do is treat for a minimum of 6 months and assume that by then the "scar" has formed.  This practice is justified because most patients do well with this treatment regimen.  The few patients that don't do well with this type of therapy may include those with protein C deficiency.  This condition requires care from an expert, such as a hematologist.

Your face puffiness and redness could be from many things, but poor circulation from the head veins to the great veins should be investigated.  Poor circulation in this area could be caused by the SVC clot/scar.

Hope that helps.