|
|
| BODY
Our Bodies, Ourselves: Expect the Unexpected by Robin C. Bonner
Tendonitis. Or, Blood Clots? Dr. Keiser examined my leg and compared it with the right one: a little swelling, but not a lot. “It’s probably tendonitis, but I want you to get a venous Doppler [ultrasound] done right away, to rule out a blood clot.” What? In my mind, blood clots plagued the bedridden or complicated one’s recovery from surgery. I was far from bedridden and hadn’t had surgery in 20 years. Frankly, I was annoyed. I had a major work deadline to meet that afternoon and couldn’t afford to sit around a hospital for a couple of hours. “Listen, if you were a relative of mine, I’d drive you there myself. Now.” Keiser coaxed. “I want you to go this afternoon. Don’t wait until next week.” It was the Friday before Memorial Day, so “next week” would mean Tuesday. “Oh, by the way,” he added. “If they find anything, they are to call me immediately. And they will want to admit you.” Admit me? Geez. Nice way to officially start the summer! I was sure they wouldn’t find anything, but I promised I’d go—in an hour, after I made arrangements for my work project to be finished by a colleague. I’d been seeing the doctors in this practice for 20 years. If they said I should have a test, I should probably have it.
The Unexpected The finding began an odyssey to stabilize the clots and to ensure that no others formed. After an examination by Dr. Slagel in the ER, I agreed to inject myself with Lovenox twice a day for a week to avoid a hospital stay. During that week, I would need to “take it easy” (read: Do absolutely nothing—don’t walk; lie around instead). By then, the clots should be stabilized. I would also begin Coumadin therapy, which would last for six months. If a piece of one of the clots should break off and travel to my lungs, heart, or brain, I could experience a pulmonary embolism, heart attack, or stroke, any of which could be fatal. The situation was certainly nothing to mess with. After the clots were stabilized, I’d have to worry only about the Coumadin itself, an anticoagulant. And this was no small worry. If I should be injured and bleed, I could bleed to death if not treated quickly. Internal injuries could cause hemorrhaging. Oh, and did I mention that estrogen therapy could also pose a problem (because one of the possible side effects is blood clots)? Hence, after more than 20 years, I gave up my birth control pills. All told, it wasn’t a pretty picture for an active woman. This new mind-set would take some getting used to.
Silent Killer The National Institutes of Health (NIH) Web site offers a good layperson’s explanation of DVT. Most at risk are those who sit for long periods, whether at a computer or while traveling by car, bus, train, or plane. I was right about surgical patients and the bedridden being most susceptible, but also I learned that traveling or sitting at my computer for long stretches could jeopardize my health. To me, long stretches at the computer or rides in cars, planes, and other vehicles had always amounted to just the time spent. (And, as a passenger, I was usually working, reading, or sleeping.) However, there’s more to it than that. When traveling, I rarely get up (or stop the car) to walk around, and I needed to change my habits. For working and traveling—activities I always took for granted—if not done carefully, could kill me. According to the NIH, 5% to 27% of first-time clotters will experience a second clot. (The NATT claims that 30% will, over 10 years.) This rate isn’t high enough for doctors to assume a subsequent occurrence and prescribe a lifetime regimen of Coumadin. So, it sounds like Russian roulette. I must take precautions to ensure that clots do not recur. If they do, however, an option is available: A screen can be surgically implanted in a major vein (usually in the groin) that will trap a clot should it break off and travel, thus keeping it from causing problems. The real trick is to avoid getting clots—to build movement into my stationary work day—and to be astute enough to identify the problem, should it happen again. My symptoms were so minor that it was difficult for me to distinguish them from general muscle fatigue. Many times, one’s leg will swell considerably, look red, and be warm to the touch. If those signs had shown up, I would have seen the doctor sooner. I clearly needed to educate myself about blood clots. The important lesson learned is to be on the alert for any change in our body that seems out of the ordinary. Minor symptoms could indicate a major problem—one you will want to catch sooner rather than later. Without becoming hypochondriacs, or spending all of our time at doctors’ offices, we should be vigilant. As we age, then, more and more we need to expect the unexpected. . . .
Links
Robin C. Bonner is editor of Empty Nest. For more about Robin, see About Us |
© 2008 Spring Mount Communications
In early May, after working out at the gym (and getting all my muscles to ache!), I found that my left leg didn’t seem to recover the way my right leg did. We were busy with our daughter’s college graduation, and because my leg wasn’t causing me dreadful pain, I back-burnered the issue for a while. We prepared for the graduation, then spent several exciting but exhausting days running around New York City: up and down hundreds of subway steps, uptown, downtown, standing in line, lugging luggage, and so on. Finally, the last week of May, life seemed to settle down some, and I called my doctor’s office. I would finally get that "tendonitis” taken care of.
My husband drove me up to 
According to the