DVT Start to Present

After having a few questions about when things happened and how I feel each day since having a DVT on May 18, 2012, I'm starting this blog.

May 18th I came down with a DVT. Early in the morning at work, around 9 AM, my right leg started making it hard to walk. I had a limp and my right leg was in some pain, but not unbearable. I also had a cough and it didn't seem all that bad. I had been getting sick Wednesday night (16th) and on Thursday (17th) stayed home from work with what seemed like a sinus infection. Friday I felt well enough and went to work. Shortly after an early meeting my leg started acting up. I had a cough that was developing during the day as well.

I got home from work and did a search on the Internet for my symptoms and they suggested to see a doctor soon. So, I went to an Instacare clinic and got a blood test done to see if clotting was high in my blood and checking for a possible DVT. I got home from the Instacare and my mom was visiting and suggested that since my grandpa had phlebitis (DVT) that I should go and have it checked out at the ER. I went to the ER. They did an ultrasound of the leg to check for clotting and a CT scan of the chest to make sure that I didn't have any pulmonary embolism. The CT scan revealed I had pneumonia and the ultrasound showed that I had clotting from my mid-thigh down into my calf.

I was discharged from the hospital later that night. I was given a prescription for an injectable blood thinner called Lovenox and started on Warfarin (Coumadin). The next few days I spent in bed mostly. I went to see my primary care physician (PCP) on Monday and continued taking Lovenox for a few days and then stopped as the Warfarin was up to the correct INR (International Normalized Ratio). I checked back in with my PCP about once a week to see how the INR was doing. My second or third time back I had an INR of about 7.6. A therapeutic INR is 2-3 so this was a bit high. I was given a new dose and took that along with frequent tests to verify that the INR was coming down to a better level. I think it ended up being somewhere around 5 and then 4 or so over the next few tests.

As far as I can recall the INR went from around 3 to around 2 and dropped below 2 at about 1.7 for a few days when I had it readjusted to bring me back up, since 1.7 is low. It was 1.7 on June 26th if memory serves. I had an INR in the therapeutic range after that hovering around 2.8-2.2 over the next period.

As a family we celebrated July 4th with fireworks and fun and I was fairly mobile. Over the next few days I developed what seemed to be another, or progressing DVT. This was confirmed later in July with another ultrasound and new clotting had gone from mid-thigh up to my groin. An MRI was done of my pelvis area to see if veins were situated in a way that might contribute to me having this clotting. Nothing was found.

The week after July 4th I had a CT scan performed of the Brain to make sure that I was't bleeding because of headaches that had started and just weren't going away. The CT scan came back negative for bleeding.

I visited a neurologist to discuss options for my headaches. He thought it was probably related to my thrombosis and had an MRI Brain and MRA Brain scheduled to see if there was any clotting. He suggested and prescribed a Lupus clotting test and gave me a prescription for some hydrocodone (Lortab). My mom had concerns about me using this drug and developing a habit, so I stopped taking it. It seemed like it made the pain a little more bearable but I couldn't tell if it helped my headaches go away so I figured suffering was all I could do.

The MRI Brain Without Contrast and the MRA Brain without and with contrast came back clean except for a spot that might have a nonocclusive thrombus within the sigmoid sinus. The therapy for this would be blood anti-coagulants so even if there was something to be done, I was already doing it.

I was able to talk to Dr. Mark Kringlen, an interventional radiologist who is able to perform a procedure that can clean clots from a leg using a catheter injected into the vein and then deliver thrombolytics directly to the clot to break it up. This procedure was scheduled and the procedure attempted. However, my clotting was such that the veins were totally occluded in parts that made the catheter unable to get to the thrombis and so the procedure didn't work for my situation. An attempt was made from both behind my right knee and one to go up and over the femoral vein from the left groin going over what I think is called the iliac bridge.

After the failed procedure, I visited a new thrombosis specialist a couple days later and have changed medications to dalteparin (Fragmin). I have been on that drug for around 20 days. I have been having headaches for the last week and they are pretty painful. I feel pretty bad at times especially after exertion. I feel a constant pulsing that sometimes is lessened, but everything pulses for me. I feel pressure on my ears and behind or near my eyes. I can sometimes sleep but sometimes the pain is so great that I am wakened from sleep. I have talked to my PCP about the headaches and he prescribed somatriptan to take when a headache is coming on (although they seem constant so I don't know when to take it really). He also prescribed cyclobenzaprine to help with muscles that are really tense in my neck and shoulders. I think that might have helped me sleep through the night last night.

Tomorrow I'm scheduled for a CT scan to see if there is any bleeding on the brain and also to have a better look at the possible thrombus in the sigmoid sinus.

My goal is to post daily how the day went and my level of function. This should help keep a log of how things are progressing or getting better and possibly help future doctors in diagnoses.