Hey all,
I was hoping you all might have some information about blood clots in the legs. I had written and said I found out I have a blood clot in my leg, I have a bruise the size of a silver dollar, maybe a little larger, and a large hard lump on my leg a little above about 1/2 way between my knee and ankle on the left side of my left leg. It just showed up, I didn't hit my leg on anything. Anyway the doctor said it is a blood clot and told me it was probably close enough to the surface to heal on it's own. The problem is that it is possible that when you have a Superficial clot, it could mean you have a DVT (Deep Vein Thrombosis) elsewhere, that may not have any signs or symptoms, those can break loose and travel to the lungs, to the heart or to the brain, which can be fatal. The doctor told me to keep my leg elevated, take asprin (regular strength), use ice and heat, and wear support hose (those are sooooo sexy right?) I am doing all of those things (well I'm trying to anyway) The doctor didn't say I had any restrictions and I was too tired to ask (I had been up 24 hours when I went in and had worked all night the night before.) Does anyone know if there are things I shouldn't be doing, or things I should be doing? I wanted to go play with the horses today, but I don't know if that is a problem, I work tomorrow (daytime) I'll probably be on my feet. I was planning on going to Stillwater on Sunday to see the horses. I don't see my doctor until Tuesday, he was on vacation this week. Some internet sites say not to sit for long periods, so is working and going to the farm a good thing? Some of them say to stay off of it, I don't know what to do, if any of you know the answer to any of this I'd love to hear them. I'm also concerned that the doctor will tell me I can't drive to Florida, but I hope not. Thanks for all of your help.
Michele
Here's some info I found on Web MD about my kind of clot. It's very scary sometimes.
Superficial vein thrombophlebitis may occur spontaneously or as a complication of medical or surgical interventions. Sterile thrombophlebitis limited to the superficial veins rarely is life threatening, but a thorough diagnostic evaluation is mandatory because many patients with superficial phlebitis also have occult deep vein thrombosis (DVT), which carries very high rates of morbidity and mortality.
Phlebitis should be assumed to involve the deep veins until proven otherwise, because superficial vein thrombophlebitis and deep vein thrombophlebitis share the same pathophysiology, pathogenesis, and risk factors.
Superficial thrombophlebitis often progresses through perforating veins to involve the adjacent deep veins. In the case of spontaneous thrombophlebitis, a superficial phlebitis at one location may be accompanied by occult deep vein thrombosis in noncontiguous veins in the same leg or even in the contralateral leg. This occurs because hypercoagulable states tend to produce thrombosis simultaneously at multiple sites in both the superficial and deep venous systems. A surprising number of patients with clinically apparent superficial phlebitis subsequently die from a pulmonary embolism (PE). Autopsy studies in these patients have demonstrated that the site of deep vein thrombosis often is not contiguous with the site of superficial phlebitis.
Clinical examination alone cannot distinguish purely superficial thrombophlebitis from phlebitis that has both superficial and deep vein components. When superficial and deep vein thrombosis coexist, the superficial veins usually are tender and inflamed, while the deep component most often is clinically silent. Duplex ultrasound identifies deep vein thrombosis in approximately 30% of patients with obvious superficial thrombophlebitis who have no clinical evidence of deep system involvement, and continued surveillance reveals occult deep vein extension in 45% of cases. In hospitalized patients with superficial phlebitis, 10% eventually have a recognized diagnosis of PE, and 20% of those PEs are fatal.
Every effort should be made to prevent superficial phlebitis from progressing to involve the deep veins, because damage to deep vein valves leads to chronic deep venous insufficiency (often referred to as postphlebitic syndrome) as well as to recurrent PE and a risk of death.
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There's no "right" answer to this question. Don't massage your leg. That could knock a piece of the clot loose. Continue to wear the support hose, as they prevent venous stasis which could make the clot bigger. Don't sit with the back of knees or calves against a chair while sitting. That can reduce blood flow and cause the clot to grow. Some Doctors order strict bed rest because walking and movement could throw the clot. Some doctors say, "get up and walk" because just lying around can cause DVTs and venous stasis. Some say elevate the legs, but some say don't because of gravity. Gravity could advance the clot further with elevation. Some doctors say only apply ice or only heat. Heat dilates the veins and allows blood to move more freely around the clot. Ice constricts the vein and lessens the chance of the clot being knocked loose, but could allow more platelet and RBC build-up. Unfortunately, there's no clear cut treatment. There's both disadvantages and advantages to each treatment. If you've never had a history of a DVT in the past, I'd say..continue on with normal activity. That's what I would do. The clot will dissolve on it's own eventually. I have however seen venous scans show old clots. In some people with a history of a DVT, the clot never went completely away. It dissolved down to a small enough size that the person was no longer symptomatic and they assumed it went away...but in fact, they carried the DVT around for 20+ years and never knew it. Sometimes this is seen when the person is receiving a scan for a different problem.
Thanks, I have had clotting problems in the past, but I had blood clots in the placenta during pregnancy, they ruptured I almost bled to death. I have Lupus which I was told increases my risk of clotting. All of the info I have found says that if you have a Superficial clot you can also have a DVT you don't know about. The doctor felt this was related to the Sinus Tach I have had. My biggest fear is the symptoms I was told to look out for, rapid heartbeat, chest pain, shortness of breath, headache, dizziness, fainting, etc. I have all of those already, the chest pain is typically pluerisy, sinus tach, the sinus tach causes shortness of breath, migraines, and blackouts with no idea of the cause. It's concerning, I don't know if I would know. At least I now know why I wasn't given more specific instructions, it doesn't sound like there is a right and wrong answer. Do I need to worry about activities that could result in a bruise, like being around the horses? Today I took it easy and have it elevated, tomorrow I will go to work and will be off and on my feet all day. Most of my work is on the computer, so I do sit a lot, but there are times when I am running to the patient too. I guess all of that is ok? Thanks for all your help.
Michele
Honey that's probably why the Doc took that approach. It's kinda a damned if you do, damned if you don't situation. If he told you to lay in the bed all day, and the clot only got worse, or you developed more clots, you would have gotten all over his tale. Yunno? Still, he should have been more upfront. The pain hasn't changed, or gotten better/worse? I know you feel like the clot could be a ticking time bomb. It is scary. I say continue on. Aspirin works great. If the clot traveled to your lung, you'd know it. You'd be really short of breath. Also, the clot would MORE THAN LIKELY get lodged in one lung. You have two! That's a good thing. You'd have time to get to an ER where a chest xray would show the clot. Just make loved ones and people you are around aware that you may have a DVT. If you start acting funny or strange, you could be experiencing a stroke. You may not realize it though, but the ones around you will notice the change. Just give people a heads up so if you start acting strangely, they can get you help pronto and will have no reservation when trying to explain to a medical team what's going on with you. I'd walk in with you and say give her TPA stat because she has a clot! Same goes for a Heart Attack as well. But seriously, it probably won't result to anything more than a sore and swollen leg. That scenario is the majority.
Thanks for all your help, my doctor was on vacation this week so I don't know much about the doctor I saw, and she doesn't know much about me, that hasn't helped my fear level, I'm sure once I see my doctor I will feel much better about the whole thing. Thanks so much for all of your help!
Michele
Michele,
So sorry to hear about the blood clot problem. I don't know a whole lot about it other than I knew a person that got them often. She was told to sit with her leg propped up.
I wish you the best and I hope you get to go see your horses, I understand about that totally. Take care and keep us posted.
Hugs,
Cindy
Anyone know anything about Sagittal Sinus Thrombosis? My symptoms include: I get constant headaches, nausea, and just a feeling of being not well. Most doctors have told me it is rare and that they are treating it like any other blood clot.
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