Wednesday, November 7, 2012

Deep Vein Thrombosis

About 3 and a half weeks post partum I started to ache in my hip.  Not really that big of a deal, initially, considering I had just given birth to over 10 pounds of babies, I knew my body had just gone through quite a lot of change.  I had a similar pain while pregnant, which Kevin and I both knew was my hips beginning to stretch out for labor.  So, 3 weeks after having the girls, I assumed it was my hips going back in to place.  Plus, a quick google search let me know that post-partum hip pain is pretty common.

The problem with this pain is that it didn't get any better.  After a week of stretching and walking it slowly started to get worse.  On the day my parents flew in to town it continued to get worse, in fact, after a quick trip to the grocery store I started limping.  That evening, as I sat down to pump, I propped my feet up on the ottoman and noticed that my right leg, the leg with the pain, was noticeably swollen compared to my left leg.  This immediately set off an alarm in my head... this wasn't typical post-partum hip pain.  A quick google search later and Kevin and I were off to the ER.  Every symptom led us to believe that I had a blood clot in my leg.

I've had many trips to the ER in my lifetime, nothing ever life-threatening, but I've always hated how long the wait is.  Well, when you walk into an ER in the middle of the night and tell them you think you have a blood clot in your leg, you get special treatment.  I was called back almost immediately to get me into a room, and within an hour was sent to Radiology to have an ultrasound done on my leg.  Ultrasounds to look at a baby are fun and cute, ultrasounds to look for a blood clot are not fun and very painful.  The results were back, I had a 75% occluding blood clot in my right leg.  I was discharged and placed on a high dose of Lovenox (a blood thinning shot) twice a day and had to follow up with the Coumadin clinic.

A few days passed, the pain got worse.  I was doubled over if I had to walk anywhere.  I winced if I ever had to move my right leg, and trying to fall asleep was torture.  I never imagined that a blood clot could be so painful.  For a week I was taking blood thinning shots, pain medications AND nursing newborn twins (luckily none of the medications kept me from breastfeeding).  In the middle of the night about 4 days later I started to notice a slight pain in my chest, which is something they told me to be on the lookout for.  So, in the middle of the night we headed out for yet another trip to the ER.  This time I had to have a chest CT which required a contrast dye.  Because of the dye, I wasn't able to breastfeed for 24 hours (thank heavens I had a good supply of frozen expressed milk).

On top of a blood clot in my leg, I also had two blood clots in my right lung.  I was given an option to be admitted, but the only additional care they'd provide if I were inpatient would be to handle my pain.  I decided to stay home, and had my husband and parents asking me questions around the clock to make sure things weren't getting any worse.  I now had to worry about myself on top of caring for newborns. I had appointments with family practitioners to help deal with my pain, and I had to meet with the Coumadin clinic weekly to monitor my INR level.

A few things about DVT's and blood clotting... There aren't any medications they will give me that will break up the clots.  I was given Lovenox, which is a short acting injection to thin my blood and prevent any more clots from forming.  I had to take these shots twice a day until my INR from the Coumadin was in a therapeutic level.  Again, Coumadin is only a blood thinner, it doesn't actually break up the clot, just prevents any more clots from forming.  I have to wait for my body to produce enzymes that will break up the clots.  Every week I have to go in, have my finger pricked, and have a consultation about how to take Coumadin.  It's a trial and error game... take 5mg ever day and my INR is a little high, so the following week I'll take 5mg every day except Friday and Monday, and those days I'll take 1/2 tablet.  Then I go in the next week and see if that regiment keeps my INR where it should be.  If my INR level is too low I'm at risk for developing more clots.  If my INR level is too high I'm at risk for excessive bleeding.

The two weeks since I found out about the DVT's and were the toughest two weeks of my life. Between the pain, the exhaustion of newborns and trying to balance everything on my plate right now, I feel completely drained.  I can't thank my parents enough for being here during the whole ordeal.  If it weren't for them, we would have had to take two newborns to the ER on multiple occasions in the middle of the night.  They were also generous enough to feed the girls some of my frozen milk so I could get some extra hours of sleep.  They cooked dinner and did laundry and let me sit and rest while Kevin was at work.  I am forever grateful to them.

I'll have to be on Coumadin for 6 months and I'll have to take extra precautions for the rest of my life.  Any time I'm sitting for a long period of time (like a plane ride or a long car ride) I have to make sure I get up and move periodically.  Any time I have a pain in my leg there's a good chance it's a blood clot.  If I ever get pregnant again, I'll be on the Lovenox shots for the entire pregnancy and probably two months post partum.  Although it's been extremely tough, I'm thankful the clot happened AFTER the girls arrived, there's no telling what could have happened if I had a clot while still carrying them!

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