question: Hello doctor, My girlfriend is 26 and was diagnosed with heterozygous factor V Leiden and heterozygous prothrombin 20210. She is very active, runs half marathons, and works out three to five times a week. She had broken her ankle, and we watched TV for two weeks and noticed some swelling. We took her to the doctor, and she had a DVT. She was also on birth control at the time. We have stopped birth control, and she did a regime of Xarelto.  Now since the doctors have found out, she has these two mutations, they want to put her back on Xarelto for life. Is this a viable option? Can she be safe without the blood thinners? We believe the clot was due to the increase factors (birth control, break, and sedentary life). Do you think she needs blood thinners for life or she can take then at times of increased risk breaks, surgery, pregnancy, etc.?