Foot injury - advice? {It’s a blood clot}

Done and done!

I was on clopidogrel (Plavix) after my stent. Having a styptic pencil saved me a trip to the ER.

Well, it seems pretty bad just sitting where it is. But yeah, a piece traveling to your heart or lungs or brain would be even worse.

Will recanalization occur in a timely enough manner if there is no medical intervention?

nm plus words for discourse

Complete recanalization occurred in ~ 50% of patients 4-6 months after DVT diagnosis (female > male) in this study:

It is indeed.

But since I thought (from earlier postings) that they weren’t really doing anything about it, I thought that perhaps it was located somewhere where that was not a risk.

Reading more recent postings, I see they do have you on something to prevent nasty problems.

Would it be a bad idea to use my stationary bike (gently)? The pain has been intense today and walking about the house is one of the only things that brings relief.

Aside, I can’t really tell if the calf swelling has changed - I see no obvious change in color to that or my foot, both seem swollen as before. I’m told to watch for a warm patch in the swelling, nothing detectable. The pain seems much worse today than yesterday, but hell it was even worse on Monday, so I don’t see a reason to do an ER or UC trip at this point. Just looking for tips (like the bike) as my options are keep moving and take Tylenol.

Thanks!

The bike would be fine in moderation. What you want to avoid is anything that restricts blood flow to your legs. This is why crossing your legs (for a period of time) is to be avoided. And you don’t want to stay stationary for too long because moving your legs fires your calf muscles to help pump your venous blood back to your heart.

Thanks, good advice and appreciated.

Honestly I can’t stop moving throughout the day, it’s the only thing that brings relief. Good to know this is a good thing, though it’s going to be difficult to attend meetings. I’ll try the bike at short intervals. Thanks for the expertise!!

Are your meetings in person, or via teleconference?

If the latter - get yourself a headset and pace!!

I’ve even attended a teleconference where one participant was on a stationary bike. Admittedly, that was a group of gym teachers, so it was a good look. It wouldn’t be a good look for my primary employer.

But when i was pregnant and my feet swelled, i propped them on my desk, and no one dared to complain. I bet you could get around with taking conference calls on a bike, or certainly pacing around, “for medical reasons”.

Often I don’t have the camera on during Zoom calls.

Total remote. I love living in the future!

Yup, already there, it’s just that I’m in a leadership position so I tend to lead discussions, so appearing on camera is helpful. I’ll have to figure out some strategy to pop on and off camera and not have that be disruptive. I have done this sometimes, but not when it’s my meeting. I’ve got a super important 11am today that I’ve been trying to get decision makers to attend for like two months, no way I can bike around the room or whatever, so it’s going to be a challenge.

Took me about nearly an hour on the phone but I now have an appointment on Sept 9 – at an actual Primary Care doc! Yay! :tada: I can’t say enough good things about the staff at Sutter Health, they’ve been amazing, especially the phone scheduler I spoke with this morning.

Good news! Ask lots of questions at your appointment. The squeeky wheel gets the most worms and gathers no moss…or something like that.

For stuff like this, I like to take a list of discussion topics in with me. I let the discussion go naturally with the doc, but near the end, I check my notes and see if there’s anything we’ve missed.

Internet advice is worth what you pay for it. Nothing below replaces what you are told by your doctor. A lot of it is probably repeated above, I did not read the links. My explanations start off very basic and build on that.

  1. Your leg has veins which carry blood to the heart, and arteries which carry oxygen in the blood from your heart to your leg. There are veins close to the skin (superficial), which cause varicose veins if blocked. These are not dangerous. And there are veins deep in the middle of the leg which you cannot easily see.

  2. Blood clots in the superficial veins are unimportant. Blood clots in the deep veins have the potential to travel to the lung. The fancy word for a blood clot is a thrombus. A blood clot which moves elsewhere is called an embolus. So a blood clot to the lung is called a pulmonary embolus. Strokes are also often caused by emboli, usually in arteries, especially if the heart rhythm is irregular.

  3. How big a deal pulmonary emboli are depends on the amount of lung blood supply which is blocked. The blockage stops blood in these veins from being reoxygenated when you breathe. If the vein is small and does not supply much (microemboli), it may not matter that much but is still important to diagnose. If it is a big clot in a big lung vein, or if there are many clots, it can be life threatening. Blood clots in arteries can be very dangerous, but this is a different subject. Blood clots in the lung can be detected by a CT scan (better with injected contrast to improve the view of the vein) or less well with other tests (such as injected nuclear isotopes).

  4. If there is damage to the wall of a blood vessel, this can increase clot formation. Some people have genetic conditions that increase the chance of a blood clot and your doctor should test you for these. Undetected cancer and pregnancy can increase the risk of a blood clot, as can immobility due to long trips, splints or casts, surgery or other things. Often clots happen without a detectable cause. Blood is designed to clot due to cuts and other things, and this depends on a surprisingly complex series of reactions.

  5. If you develop difficulty breathing, this needs to be seen immediately. It can be equally concerning if the foot changes colour, feels cold or there is extremely severe pain.

  6. The treatment of a blood clot is usually medicine. There are pills you can take by mouth. These take several days to work. So for the initial period, injections are usually used. There may be a need to test “the thinness of the blood” depending on the specific medicines used. Medicine does not work for a small percentage of people who need may need more invasive solutions. Surgery may be done in large centres for very large and dangerous clots. This is rare. If you take any anti-inflammatories, let your doctor know.

  7. Blood clots in the calf are much less likely to travel to the lung than ones in the thigh. Usually blood thinning medicine is given for six months for the first blood clot of unknown cause. Repeated blood clots may require continuous medicine and should prompt more invasive searching for a cause. There are several ways to detect clots but ultrasound is better than blood tests for clot.

  8. These can be very difficult to diagnose. Often there are few signs. There are scoring systems which are not that helpful.

  9. Exercise is good - but get checked out if breathing becomes much more difficult than expected. Lack of movement can sometimes cause clots in susceptible people. Stockings, elevating legs, walking around in an airplane and moving your feet after surgery may help prevent clots, but in the presence of a clot are less useful.

Compression socks are used to PREVENT blood clots. Whether they would help you - yep, ask your doctor.