Doug's Sounding Board


30
Dec

Cancel that calf strain and make it a deep vein thrombosis

My calf hasn’t hurt for a little over a week and the swelling has been steading going down, so when I woke up on the 25th to more swelling than ever I thought it would be wise to see a doctor. After all the morning Christmas stuff I mentioned that I would like to go to urgent care for my swollen leg. I didn’t have to wait too long to be seen. My pulse was strong and the rate was good. My blood pressure was excellent. The doctor came in and listened to my story and then asked for my diagnosis. I wasn’t sure I heard him right so I asked “My diagnosis?”

“What do you think it might be?”

“I think it might be a blood clot.”

He agreed, but wasn’t certain because despite my leg being swollen and red I had no pain which usually goes along with it. He went through some more possibilities before deciding that it was definitely a clot and sent me to Dominican for an ultrasound.

Dominican wasn’t crowded in radiology but there was only one radiologist on duty that day and that included covering the emergency room which was apparently crowded. The ultrasound tech. found the clot but couldn’t tell me because she’s not a doctor. She also said that I couldn’t get a CD of the images. It was cool to listen to my blood rushing when the probe was kept in one place. After that they sent the results to the urgent care and the doctor there called me back and teld me it was a large clot and that he was trying to get me some Lovenox from Dominican. Apparently the only pharmacy open at that point was in Watsonville and they didn’t have much. Domican had plenty but they didn’t want to give it up unless I was admitted to the emergency room so off to the emergency room we went.

Dominican was fast at getting me checked in and all the results were sent over to the one doctor on duty there. Unfortunately I seemed to arrive during a shift change so while I was put in a room and hooked up to the monitor I wasn’t added to the list. I was able to listen to the patients around me liek the woman across the hall whose husband died ten years ago that day. Forty-five minutes and still no doctor later Nicole flagged a nurse down to get some attention. The nurse then got the current doctor who knew nothing about my situation so the story got told again and they wanted to draw their own blood. For whatever reason they decided the side of my forearm was a good target (ow!) and we got to see my pulse jump to 92. The doctor decided I had a large clot and should have Lovenox and get started on Coumadin. He also ordered more blood tests to determine whether I’m a hyper-clotter or not so they needed another poke for that one. Luckily they decided to go for the crook on my left arm. I also got my first Lovenox shot (actually two because I’m big) subcutaneously on the sides of my stomach. We finally got out of there and went home where I put up my leg and we watched tv until I fell asleep.

I transferred to the bed and this morning the swelling was greatly reduced. I went to the doctor they set up for me to see as a followup and she said my leg was looking good and prescribed the rest of my Lovenox supply which Nicole or Julie will be lucky enough to inject me with later. The doctor saw no reason for or against using a thrombosis stocking so that’s up to me. For now I’m going to go without one I think.

How did it happen? No one is sure. One generally has to be a hyper-clotter, have some trauma or surgery recently, or be sitting or laying in one position for about 20 hours. I wasn’t sitting around that long and there isn’t any recent trauma so I have to wait for the results on the hyper-clotting. My aunt recently had problems with clots that the doctors believe are left over from a car accident four-years ago so if that’s the case this could be related to my long ago scooter accident. The doctor says that’s not likely though.

So now it’s drugs and rest for the rest of the weekend.

2 Responses to “Cancel that calf strain and make it a deep vein thrombosis”

  1. 1
    Kevin Fulthorpe Says:

    Hi

    Had a burning sensation in my right calf, like yourself thought it may be a clot, went to the Doctors here in Wales. not too much swelling, about a quarter inch larger than normal. Blood Pressure good with a resting Heart rate of about 44. always thought it was the lazy and unfit buggers who this affected. I usualy spend about 4 one hour sessions a week with weight training and about 4 to six aerobic sessions usually running. Now this is where I believe the problem may have started. Over the last five or more years I have had lots of calf strain and achilles problems also went to the florida in August which as well as the long haul flight it invoved lost of driving. Orlando to Naples to Tampa. then back to the UK all over three week period.

    The proble in the UK is they tell you what you have (DVT in the right calf in fact one on both sides)and nothing else. My first thought was have they made a mistake did they pick up scar tissue, not sure. then one week op Heparin amd Warfaren for three months. six weeks off the warferen then check it out again. I was diagnosed with the DVT on the 2nd of march 2009, so about half way through the treatment.

    What I want to know and no one at the Hospital can tell me is can I train if so what can I do. not trained for six weeks getting really fed up with it.

    Having looked at the various bits of information there does seem to be some good evedence to link DVT with calf strain and a low heart rate.

    All the best, hope we both make a full recovery with no further problems. Back to Naples Sf this year hope I can get rid of the little bugger by then, May already be gone, as I said they tell you very little here. Get you in and out as quick as they can

  2. 2
    Douglas Says:

    My doctors have told me to be active. Extra blood flow while on blood thinners helps reduce the clot size. That said, you don’t want to jump right back to full training because the increased blood pressure from exercise can break the clot free where it will do some real damage. It all depends on how the clot is anchored and that’s something they don’t know, they can just look at blood flow.

    My aunt had one and the doctors said to be active and that she could exercise so she immediately jumped back to her normal swimming routine and soon threw the clot. I think you can work up slowly to some level of exercise but I have no idea how fast or what level is good.

    I’m on my way to 6 months of Warfarin then another ultrasound.

    Good luck!

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