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While I may or may not have had any clots in my leg on November 2 when they failed to detect the superficial thrombophlebitis in my foot–the technician did actually do the ultrasound on my leg, although she failed to check the part of my body that I had indicated was red and swollen–there definitely WAS a clot in my leg when I had to go into the ER for another ultrasound on Friday, after about 18 hours of ever-worsening calf pain.

It’s a big clot. Apparently it extends into two different veins behind my knee–before you ask, I can only assume that it’s at a point where the veins branch off from some larger single vein. My ER nurse was very nice, but the rest of the staff were pretty much devoted entirely to getting me the hell out of there as fast as possible once they had assured themselves that I was not going to have a pulmonary embolism.

It’s funny; in the past couple of weeks I’ve done numerous course readings on medical technology and patient interventions, all centered around patient knowledge and the involvement of patients with their own medical care. I’ll try to write on those in more detail when I am not stoned on Vicodin–I’m giving myself daily injections of Lovenox, a blood thinner, for the clot, but my calf still hurts like a bastard. Fortunately I anticipated this from my previous DVT experience, and did not leave the ER without a prescription for a narcotic.

Assuming that it wasn’t a technical fuck-up and I really didn’t have a clot in my leg on November 2, then, what happened? I strongly suspect that being largely immobilized for two weeks trying to resolve the superficial clot actually caused this DVT. I didn’t actually think of it in those terms when I was calling my hematologist trying to find out if not anti-coagulating was really such a great idea; I was mostly thinking, If I had a superficial clot for NO REASON while taking a daily dose of aspirin, what exactly makes us think I’m not about to throw a big one?

In retrospect, however, I realized that the very course of action prescribed for the treatment of an existing clot creates risk for developing one if you don’t have it already: inactivity is a DVT risk factor. Given that I have a history of DVT and a known genetic factor, was not anti-coagulating me following an unexplained superficial clot** really a great idea? In hindsight, of course, I am inclined to say NO, and I didn’t really think so even before I had a giant DVT in my knee as supporting evidence–that’s why I consulted with my hematologist rather than taking my primary care’s word for it.

But he said it wasn’t a big deal, and I went along with it because although I generally think I am right about everything, I do not have any specialized medical training. Maybe I should have gone with my instinct. I’m pretty mad. I’m trying to cordone that, because being mad is not the best way to encourage someone to give you high-quality continuing medical care, and I’m reminding myself that my hematologist DID listen to me when coumadin was making me break out in hives and everyone else in the hematology clinic basically insisted that I was imagining things.

But my calf hurts like hell and I have to give myself injections in my stomach and I might not be safe to travel by Wednesday which means missing Thanksgiving with my family before one of my sisters goes off to Costa Rica for a YEAR and there’s a possibility at this point that I might now have to take anti-coagulants FOREVER and I can’t move and what I want more than anything in the world right now is meat loaf, which no one delivers.

I’m feeling cranky.

I have an appointment with my hematologist tomorrow. I am hoping that he’ll clear me for Thanksgiving travel, although I’m not terribly optimistic. I’m also hoping he has a reasonable explanation for why not anti-coagulating me really, really seemed like a good idea at the time.

On the bright side, I am a) high on Vicodin*** and b) extremely fetching in my new gumdrop pajamas, which are probably not what my friends Anne and Nathan were imagining when they told me to “call [them] if [I] need anything at all,” but not only is my apartment filthy, all my warm pajamas are dirty, too, and new pajamas are almost as cheering as Vicodin. Almost.

—

*But not very often.

***And not trying to write any Christmas cards this time.

This entry was posted on Sunday, November 18th, 2007 at 6:18 pm and is filed under media content, medical drama, photos. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.