So, like, anybody here ever have a blood clot?

[cynyc]

Do they just cut them out or something?

Waiting on whether I have one in my lung or not. The doc I saw last night didn't realize the one blood test sent to the lab isn't processed over the weekend. A "D-Dimer."

Hurts like hell.



I'm going back to bed.

[Earl Snake-Hips Tucker]

Usually clot-busting drugs do the trick.

[Frazzled]

I have a clot in my leg and take Coumadin - also known as rat poison and possibly the drug used to kill Stalin. But once the medicine did its trick I can't tell I have a clot - I do most of the same activities I did before. There are worse things to deal with.

[China Guy]

Hmmm, does the pain feel like a burning hot knitting needle being cranked around in your chest when you breath deep or move more than a 1/4 inch?

I was on fragmin injections for about 2 weeks before the cumadin kicked in.

It takes a few months for your body to naturally dissolve the clots. Then at least a few more months before the anti coagulation folks will take you off of it. I'm gonna go see my doctor now that it's been 6 months to stop the cumadin (I hope).

[Frazzled]

Oh yeah - I forgot about the Lovenox injections in my stomach at the start. Good Times....

[Colibri]

Since the OP is asking about personal experiences, this is best suited to IMHO.

Colibri
General Questions Moderator

[cynyc]

But I take my baby aspirin every night.

Sigh.

Well, at least I don't have to worry about being missed here. ;-)

How about apple cider vinegar? Huh? Huh?

Maybe I'll tell them to take the damn lung. I'm sick of being sick.

And they can't just cut them out like a tumour?

Well the jury is still out but this Oxycodone ain't doing squat. I switched to beer. It's actually better.

[cynyc]

Well I haven't been diagnosed with a blood clot yet. Perhaps I should have asked, what is a blood clot and does it hurt and feel stupid for simply not going to Wiki or something? Why have a factual board when people can just google (I hate that word) the answer?

OK. In my humble opinion does anybody here no anything about blood clots?

Originally Posted by Colibri

Since the OP is asking about personal experiences, this is best suited to IMHO.

Colibri
General Questions Moderator

[cynyc]

In your humble opinion you mean? But why would you get tummy shots? Is that where it was?

(Ducking and weaving.)

Originally Posted by Frazzled

Oh yeah - I forgot about the Lovenox injections in my stomach at the start. Good Times....

[svd678]

I had a DVT (deep vein thrombosis)(blood clot) in my leg some time ago. Everyone was surprised that I had no pain with it - symptoms were swelling of calf and ankle & pinkness. This happened after I had been on aspirin for years. I imagine a clot in the lung would be more difficult. I thought I had a relapse a few weeks ago, and the hospital called in a tech to do an ultrasound at night, no clot. I did the Lovenox myself. There was no pain then, either. The shots are in the abdomen because they must be into fat and not muscle. A retired doctor wondered why they didn't just open the leg and tie a knot in the vein. I think the modern way is better!

[The Vorlon]

Mrs. Vorlon had had clots in her lungs 3 times.

First time might have been BC related, Second was pregnancy related and the third time the rat poison stopped working. If noone had told you, Coumadin is a art, not a science. The correct dose one week will have your eyeballs bleeding the next---and like the Queen Mary, it takes a while (min 72 hours) to turn anything around.

Lovenox is now generic, but as a word to the wise, the pre-filled syringes do NOT fit in drug store sharps containers. If you are on it for a while, hit Amazon or Ebay for a industrial szed one.

Hope you have good insurance--a 90 day supply of the generic Lovenox runs north of $22,000.00

[C K Dexter Haven]

I ain't no doc, but when I had blood clots (following surgery, in my legs and lungs), they basically put me on blood thinners (cumadin and/or lovenox, but I had a horrible allergic reaction to the lovenox) to prevent future from occurring, and let the body heal itself (eroding away the existing clots.)

I was actually hospitalized for a few days while they waited for the cumadin to take effect, but then wound up being re-hospitalized for a week because of the lovenox reaction.

[Dangerosa]

My brother in law has one which they can't treat with blood thinners. They put filters in so that if it gets loose it won't kill him. He has terminal cancer and the chemo has wrecked his body's ability to do anything well, so he isn't clotting, so they gave him platelets to help clot after three surgeries to get his kidneys to kick back in, and he clotted in his leg.

[WhyNot]

I'm about to summarize what I usually teach over 8 1 hour nursing visits, so yeah, this is going to be a long post.

A blood clot happens when any one of a number of things goes wrong with the clotting system in your blood.

A blot clot is a scab, like when you skin your knee, only it's inside you and usually a lot smaller. We want blood to clot sometimes, like when you get cut. We don't want it to clot other times, like when it's still all inside your blood vessel. We don't want it to clot there because it runs the risk of being pushed along with the flowing blood until it reaches a teeny tiny blood vessel where it won't fit, and it blocks the vessel like a cork in a bottle. Then whatever is downstream of that block doesn't get blood supply, and lacks oxygen and stews in its own waste products.

If the clot is just sitting there stuck to the blood vessel wall, it's called a thrombus. The condition or action of having a body which makes a thrombus is called thrombosis. If it happens in a big vein in your leg (where they often start), it's called deep vein thrombosis.

Once it starts to move, the clot is called an embolus. If it gets stuck somewhere, that's called an embolism. Often people refer to it as a thromboembolism, and I refrain from whacking them with sticks because I love humanity. Thromboembolism is more properly the condition of thrombosis + embolism. Don't worry about it, you don't need to know that part.

If the embolus gets swept along until it gets stuck in a blood vessel going to your brain, you can have a stroke. If it gets swept along until is gets stuck in a blood vessel going to your heart, you can have a heart attack. If it gets swept along until it gets stuck in a blood vessel going to your lungs, you can have a pulmonary embolism. These are all Bad Things. And yes, they can all hurt. They can also all not hurt. Pain is not a good way to diagnose a thrombus or an embolus, but it does often tell us where we need to start looking.

A thrombus/embolus can sometimes be diagnosed by using a kind of ultrasound called a Doppler ultrasound. Painless and non invasive, but it doesn't "see" all of them. Sometimes they use contrast dyes injected into the vein and then x-rays or CT scans - this won't let you see a thrombus/embolus itself, but it will let you see where blood is being blocked and not getting through anymore.

There are a lot of steps involved in making clots, and any one of them can go wonky and create inappropriate clots. If your doctors know which step in the process is acting up, they can choose which drug to give you, because the drugs work on different steps in the process. But most of the time, they don't know exactly which step is broken, and they don't care. There are four common tried-and-true and one new and exciting drugs which work on almost everyone. All of them require some amount of dose fiddling to make sure you're not likely to get a clot you don't want, while still being able to make a clot when you do need one and don't suffer excessive bleeding.

Aspirin. We've all heard about low dose aspirin therapy. Some people get put on full dose aspirin therapy. Aspirin inhibits platelets from sticking together, which is one of the steps in clot formation. There is no antidote to aspirin if you take too much and start bleeding.

Plavix. Plavix also inhibits platelets from sticking together, but it does it slightly differently than aspirin. Plavix has an unfortunate side effect of killing white blood cells, so it can make you more likely to get infections or have trouble fighting off infections. It also interacts with a ton of other drugs. There is no antidote to Plavix if you take too much and start bleeding.

Heparin/low-molecular weight heparin/Lovenox. This is an injection into the subcutaneous tissue (the fat) under the skin. It's usually given in the stomach, but it can also be given in the back of the arm, the thigh, the shoulder...anywhere you can give insulin, you can give heparin. Heparin blocks something called thrombin, another step in clot formation. There is an antidote to heparin if you take too much and start bleeding.

Coumadin (brand name)/warfarin (generic). Warfarin blocks Vitamin K, which is needed to make several different clotting factors, another step in clot formation. It's taken by mouth, and takes several days to kick in. While you're on it, you need frequent testing (as much as twice a week for the first month or two, and monthly once your body gets used to it) to test how long it takes your blood to clot when compared to someone not on warfarin. This test is called a PT/INR, or just INR. If your INR is too low, you need more warfarin and you're at risk for a clot. If the INR is too high, you need less warfarin, and you're at risk for a bleed. Vitamin K in your diet can affect the dose you need. They used to tell people to avoid Vitamin K if you're on warfarin, but now they suggest simply keeping your diet consistent in the level of Vitamin K week to week. If you eat leafy greens, eat about the same amount of leafy greens/bananas/other foods high in Vit K every week, and they can match the dose of warfarin to the amount of Vitamin K in your diet. What you don't want to do is eat no leafy greens this week and go on a collards binge next week. The extra Vitamin K won't be blocked by your warfarin dose, and you may develop a clot. There is an antidote to coumadin if you take too much and start bleeding. (I have an 8 week lesson plan just on warfarin therapy, but this will do for now.)

Pradaxa. This is the new and exciting one. It works by inhibiting thrombin directly. It doesn't require frequent blood tests, you can eat all the Vitamin K you want and it's an oral drug. There is no antidote to Pradaxa if you take too much and start bleeding.

Because all of the oral drugs take a few days to reach effective levels in your body, doctors often order heparin/lmw heparin/Lovenox right away while you start taking one of the oral meds, and then take you off of it when the oral medication is working. This is called "Bridge Therapy" or "Bridging" for short. Later on if you need surgery, or even extensive dental work, your doctor will tell you when to stop taking your oral medication a few days before (if possible) and may want to "Bridge you" with heparin until a few days after the surgery when you can resume your oral medication. This provides the best protection against clots, while also providing the best prevention of excessive bleeding during or just after surgery.

So, if you have a clot, you need to be under a doctor's care (which is sounds like you are) and you need to take your medication as directed and make sure you understand the risks (bleeding) and benefits (fewer clots) and when to stop taking it (when your doctor tells you to.) You also need to tell every medical professional you ever see - doctors, nurses, pharmacists, dentists, paramedics - that you're on anticlotting therapy, because it's really, really important that they know that.

Whew! Any questions?

[Voyager]

Originally Posted by WhyNot

Coumadin (brand name)/warfarin (generic). Warfarin blocks Vitamin K, which is needed to make several different clotting factors, another step in clot formation. It's taken by mouth, and takes several days to kick in. While you're on it, you need frequent testing (as much as twice a week for the first month or two, and monthly once your body gets used to it) to test how long it takes your blood to clot when compared to someone not on warfarin. This test is called a PT/INR, or just INR. If your INR is too low, you need more warfarin and you're at risk for a clot. If the INR is too high, you need less warfarin, and you're at risk for a bleed. Vitamin K in your diet can affect the dose you need. They used to tell people to avoid Vitamin K if you're on warfarin, but now they suggest simply keeping your diet consistent in the level of Vitamin K week to week. If you eat leafy greens, eat about the same amount of leafy greens/bananas/other foods high in Vit K every week, and they can match the dose of warfarin to the amount of Vitamin K in your diet. What you don't want to do is eat no leafy greens this week and go on a collards binge next week. The extra Vitamin K won't be blocked by your warfarin dose, and you may develop a clot. There is an antidote to coumadin if you take too much and start bleeding. (I have an 8 week lesson plan just on warfarin therapy, but this will do for now.)

Pradaxa. This is the new and exciting one. It works by inhibiting thrombin directly. It doesn't require frequent blood tests, you can eat all the Vitamin K you want and it's an oral drug. There is no antidote to Pradaxa if you take too much and start bleeding.

The downside of Pradaxa is that it is damn expensive. I'm on warfarin and have my INR checked every month. They asked me if I wanted to change, but warfarin is cheap, I'm very stable, and the clinic is on my way to work. The test only takes a few minutes. I can see Pradaxa being worth it if you lived 100 miles from the nearest doctor or something, but you can buy a machine to check your own INR for not that much.

Beware of clots. My father had one in 1962 and he was in the hospital for months. This was long before modern treatment though, and he lived for another 49 years. My son-in-law's father had one, undiagnosed, in his leg. It killed him.

I'm on warfarin for AFib - as a preventative measure. No problems so far.

[congodwarf]

Well I'm not gonna try to get scientific since WhyNot did such an awesome job.

When my boyfriend had a pulmonary embolism in October 2010, we thought it was a heart attack. He had all the stereotypical male heart attack symptoms. But, all the tests they ran on his heart were fine. A blood test showed the possibility of clotting. He had a CT scan and another with contrast. I believe he had an ultrasound. They were mostly concerned with checking to see if he had an embolism in his legs, which he didn't.

They started him on Coumadin but it took a long time (over a week) to get to therapeutic levels so they also had him on Lovenox shots (which is how I found out I am incapable of watching someone give themselves a shot in the stomach - I had to be banned from the room whenever he did it). The shots lasted over a week and then he was on warfarin (Coumadin) for 14 months. Last December he finally started showing normal clotting times so they put him on daily 325mg of Aspirin instead of warfarin. He still gets his clotting times checked every few months just to be on the safe side and if he starts having strange pains or abnormal bruising, I'm supposed to rush him to his doctor's office or the ER.


No one has the slightest clue why he suddenly developed a clotting problem. Every tests they ran was totally normal, except the clotting times.

[aruvqan]

Well, I was just chatting via email with Cynyc, and she is convinced it is not a clot, so we can only hope she gets it sorted out. Feeling crappy is no fun.

I get random bone pain in my long bones still from the whole parathyroid thing, and previously the occasional muscle pain until I got off statins. Mystery pains are no fun.

[Antigen]

I'm surprised the lab doesn't run D-dimers over the weekend. It's a pretty straightforward test, run by most coagulation analyzers these days. Where I was working, in a community hospital lab, D-Dimers were done as they came in from the ER or the floors, no waiting to batch them or anything. Where were your labs sent?

The test is looking for a specific molecule that is only present in the blood when your body has begun breaking down a fibrin clot. The way I understand it, a negative result is a pretty clear indication that there's no clotting activity going on and the patient is not likely to be suffering a pulmonary embolism or deep vein thrombosis, the two conditions this test is usually looking for. A positive result doesn't necessarily mean there's a clot, though, because many other conditions (rheumatoid arthritis, cancer, pregnancy) can cause an elevated result. The test is usually for ruling out thrombosis, not for diagnosing it.

[WhyNot]

Originally Posted by Antigen

The test is looking for a specific molecule that is only present in the blood when your body has begun breaking down a fibrin clot. The way I understand it, a negative result is a pretty clear indication that there's no clotting activity going on and the patient is not likely to be suffering a pulmonary embolism or deep vein thrombosis, the two conditions this test is usually looking for. A positive result doesn't necessarily mean there's a clot, though, because many other conditions (rheumatoid arthritis, cancer, pregnancy) can cause an elevated result. The test is usually for ruling out thrombosis, not for diagnosing it.

THAT is awesome! Thank you! I always wondered why the diagnosis was made and treated for sometimes even if they couldn't find a clot by imaging. Dang, science is cool...

[cynyc]

This is interesting. I did have two similar episodes but assumed it was a "superficial phlebitis" since that was a frame of reference when like I was 17. I'm glad, so to speak, that I started this thread.

I thought I've seen it all so subtract 1 from from my sig.

Hm. A hundred years ago I saw a homeopath who gave me something that I had to inject in my belly for the same reason. I didn't love it but it wasn't anything to faint over.

Oh, and that retired doc? I would of jumped at that. It is essentially what they do for cosmetic varicose vein treatment.

Originally Posted by svd678

I had a DVT (deep vein thrombosis)(blood clot) in my leg some time ago. Everyone was surprised that I had no pain with it - symptoms were swelling of calf and ankle & pinkness. This happened after I had been on aspirin for years. I imagine a clot in the lung would be more difficult. I thought I had a relapse a few weeks ago, and the hospital called in a tech to do an ultrasound at night, no clot. I did the Lovenox myself. There was no pain then, either. The shots are in the abdomen because they must be into fat and not muscle. A retired doctor wondered why they didn't just open the leg and tie a knot in the vein. I think the modern way is better!

[cynyc]

Ever try tonic water--that weird tasting seltzer-like stuff? Supposed to be loaded with quinine or something. I'm going to drink some tonight except I'm going to sex it up and make it a 'gin and tonic.' ANyway I get these weird leg pains too and some rheumatologist told me to try that.

Originally Posted by aruvqan

Well, I was just chatting via email with Cynyc, and she is convinced it is not a clot, so we can only hope she gets it sorted out. Feeling crappy is no fun.

I get random bone pain in my long bones still from the whole parathyroid thing, and previously the occasional muscle pain until I got off statins. Mystery pains are no fun.

[cynyc]

To WHYNOT:

Thank you for the time and consideration you put into that. It is very generous of you.

Meanwhile I can't sit here any longer but I will revisit this.

Meanwhile my tentative dx is--well I call it Tse Tse Fly Disease. But that's not fair so I'll look again; it's hard to remember:

TIETZE'S DISEASE.

Maybe I 9-11 coughed my way into this on top of my chronic pain syndrome.

I'm miserable.

Thanks for listening.

[WhyNot]

Originally Posted by cynyc

To WHYNOT:

Thank you for the time and consideration you put into that. It is very generous of you.

You're very welcome. I hope you never need it. Chances are someone will, sooner or later, so I don't regret doing it, even though your diagnosis turned out to be something else.

TIETZE'S DISEASE.

Ooh. The bad news is, I hear that hurts like hell. The good news is, it's usually self limiting and after 3 months or so of hurts like hell it goes away as mysteriously as it appeared. Here's hoping yours goes away more quickly than that.

I'm miserable.

I bet you are. That sucks.

[luv2draw]

WHYNOT: excellent post!

My story--as short as possible:

You didn't mention a vena cava filter. I had one inserted after the back of my knee had been hurting on and off for a couple of days and then my leg swelled up. Went to ER and was admitted. Leg elevated. (I had just come off of a severe trauma brain injury a few weeks before so the doc didn't want to give me Heparin).

After the filter insert and a few days later I was supposed to go home. Took a deep breath and couldn't catch my breath. Gave me oxygen and rushed me for X-rays and then stuck me in this machine where they could see my lungs as they clamped a breathing mask over my face. Yup, LOADED with clots, or rather PEs (pulmonary embolisms) which probably were there before they put the filter in. Lucky I was still in the hospital.

Then they gave me Heparin (fortunately, didn't affect my brain). Week later went home and did Lovenox for 6 weeks. 16 years ago. I'm good. Oh pretty sure the clots were caused by the previous 18 mos. I had been taking Loestril for heavy menstrual bleeding. Never took it again.

Whew! Yeah, I'm a lucky lady.

Oh yeah, and the hematologist told me that the clots don't actually leave the lungs, but they flatten out and are not so dangerous.

[The Vorlon]

Originally Posted by luv2draw

Oh yeah, and the hematologist told me that the clots don't actually leave the lungs, but they flatten out and are not so dangerous.

Mrs. Vorlon had problems the second time she tossed clots---she formed scar tissue over them, thus severely restricting blood flow in the lungs. We realized we were in deep do-do when the head of the lung department at Mass General Hospital told her she was going to San Diego to get her lungs roto-rootered because "we don't do that surgery on the East Coast"


She came back with a tshirt with her number on it--436.

I had to get trained on handling LOX for breathing until she healed.

[Cub Mistress]

One other bit of information others might find useful: before I became a nurse and learned abot bloot clots, I thought of them a roundish things in a small area of a vein. The truth is they can be and often are, very long, almost entirely filling up a blood vessel in the leg from toes to hip, for instance. Blood clotting is a very complex process, involving many steps and something can go wrong at any one of the steps.

There is also the perfect storm of coagulation, known as Disseminated intravascular coagulation aka DIC

[Deegeea]

When I was eight years old, I had a bump on the chin in dance class that caused a tiny spot under my jaw just to the right of my chin to start bleeding. A reddish spot had been visible there before the bump. I bled, from the reddish spot, a small but steady stream for more than three days, soaking dozens of bandaids. I was told this was caused by a blood clot, but I can't find anything substantiating that sort of symptom from a blood clot on the internet.

[pravnik]

About two years ago I went to the ER for extreme leg pain and was told I had a heart murmur, much to my surprise. An ultrasound and CT scan showed I had blood clots all throught my veins and lungs, multiple DVT's in my legs and multiple PE's in my lungs just threatening the hell out of my life. I even started a thread about it:

So, I just spent about a week in the hospital.

I'm fine now. I even look back on that week in the hospital fondly as the closest thing I've had to a vacation in three years.

[cynyc]

I am slowly and tentatively circling this thread. I'm doing that because it is too scary. And medical insurance being what it is... dang I may have had thrombosis for years and not know it.

The Hello-I'm The Urgent Care Doctor Who takes your insurance and is open on Saturday Nights guy may have dropped the ball.

A couple of months ago I had to take my kid via ambulance to the ER two blocks away. Price? 1200 bucks.

So I'm going to tippy-toe around this. For now.

[cynyc]

OMG! I feel the same way. Things suck so bad that a vinyl mattress, flourescent lights, and a room outside the noisy nurses station looks like a 5-star vacation.

I so ID with you. Thanks. I'm not alone after all.

Wanna be best friends?

Originally Posted by pravnik

About two years ago I went to the ER for extreme leg pain and was told I had a heart murmur, much to my surprise. An ultrasound and CT scan showed I had blood clots all throught my veins and lungs, multiple DVT's in my legs and multiple PE's in my lungs just threatening the hell out of my life. I even started a thread about it:

So, I just spent about a week in the hospital.

I'm fine now. I even look back on that week in the hospital fondly as the closest thing I've had to a vacation in three years.

[cynyc]

So, anybody been through the gallbladder thing?

Copy of mail to neighbor last night for my convenience. Sorry about that.

Was 5.5 hours at 9-11 clinic today. Went to urgent care guy om 23rd St. the other night. So ten hours in house and 30 hours wondering.

But of course 9-11 doesn't do gallbladders (they suggested a couple of hours ago that maybe it's that) and urgent care could give a flying fuck after initial visit (rib chondritis sounds like Tse Tse fly) so here it is Fri holiday wkend Fri night as usual and at 6 pm i find out it maybe is gall bladder ("not my job, we appreciate you being involved in our study of monkeys at ground zero,)

I am bloating like mad. I really need a diuretic to figure out if I should drop everything and go BACK to a fucking ER because of course nobody calls back fridays jewish docs plus holiday weekend Maybe bloating from pain meds.

Ferchrissake if you are home let me know and give me a diuretic because I have 87 other crisis going on without going and sitting in an ER without good cause.

Or just kill me.

SOS. Please advise.

[kittenblue]

Gosh, I hope you went to the ER instead of waiting for a neighbor to buy you a diuretic. And what is a 9-11 clinic? Is that for victims of 9-11?

[cynyc]

Yes ma'am I was a 9-11 WTC initial responder and was there a few months thereafter. All I want to say about that is that if anybody in the world wants to write the story of what it's like for female "heroes"... Well I have a hair curler of a story. It's different for women. Way. I think it should be told for history.

As we were.

Originally Posted by kittenblue

Gosh, I hope you went to the ER instead of waiting for a neighbor to buy you a diuretic. And what is a 9-11 clinic? Is that for victims of 9-11?