### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My father n law had a surgery about 10 years ago, replacing all veins from top of leg to foot. Although that surgery has done well the doctors have had him on blood thinner ever since. Just recently he has gone to hospital with severe headache and they found a subarachnoid hemorrhage in the brain. They took him off the blood thinner, kept in icu a week, and now say just go to regular doctor. We asked what would happen now to the original vein surgery (since stopping Coumadin) and basically was told its a catch 22 . So by that advice it will either be the aneurysm or something else that kills him. I understand that none of us will escape death, I would just appreciate knowing the options. I will gladly appreciate your professional ADVICE and experience with this matter.

### output:

Hi, I am Chat Doctor.  I have read your question with care and understand your concerns. Let me try to help you Question : I would just appreciate knowing the options. Answer : The way forward is to maintain his blood in such a level that it has enough anti coagulants to prevent thrombosis in the veins, but not enough anti coagulants to cause a bleeding in the brain There are few tests that will help us find about Blood Clotting These are called PT, apt, Into have to do Consult your doctor, do these tests, and titrate (increase or decrease the dose of his anti coagulant medications (blood thinner) so that the medications are enough to prevent his veins from clotting, but do not increase in the blood to such a level as to lead to bleeding in a brain This looks tricky, but there are lots of people who are in the same situation, and they are maintaining good quality of life by meticulous testing and adjustments of the doses Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Let me know if I can assist you further. Take care.