I was diagnosed with a DVT on Thursday and had a pulmonary embolism Saturday evening.

It was pretty mild and the emergency room doctor thought it was anxiety. But then the radiologist found it on the CAT Scan and they sent me to Amarillo by ambulance.

So ona heparin drip now.

That's good news.

aa4136 said:

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Good luck. Hopefully you were transitioned to Eliquis or Xarelto, both quite effective in management.

Several considerations to think about...

1. Your age at diagnosis and whether it was "provoked" or "unprovoked". Meaning...was there any precipitating events (recent surgery, hospitalizations, infections, trauma) beforehand that could have triggered it? If provoked event, might do confined duration of blood thinner of 3-6 months. Sometimes not having a trigger leads to outpatient workup to assess for underlying clotting disorders especially if you are <50 yrs old at diagnosis OR if you have a family disorder of DVT or PE. Also sometimes doing a longer duration in those settings makes sense. Extended durations of additional 1 year on top of initial 3-6 months of Eliquis might be considered (data is from AMPLIFY-EXT trial).

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I asked about that but didn't get much of an explanation.

The only recent surgery I have had was to remove a cyst on my back. which doesn't seem to be likely. I also had my gall bladder removed last July.

The biggest surgery I had was in July of 1974 (51 years ago) for atrial septal defect.

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2. Think about getting your cancer screenings done - colonoscopy, PSA etc since DVT/PE can be the harbinger of underlying cancer.

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I had a colonoscopy in November and the next is supposed to five years after.

My PSA is not very high.

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3. If you smoke, quit ASAP.

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I used to smoke but quit about 40 years ago.

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4. If you use testosterone, stop immediately

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I haven't used this.

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5. If you are heavy / obese, good motivation to cut down weight.

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I have lost bout 50 pounds in the last few years and could probably do to lose more weight. I currently weigh less than I did about 30 years ago.

If I understand it correctly, blood thinners do not actually dissolve clots! Instead, they act to keep clots from forming or growing while the body eventually acts to break the clots down over time.

That was a big surprise to find out.

Rhodie88 said:

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I had a DVT and Pulmonary Embolism three years ago and spent three days in ICU. Clot covered my left lung and half of my right. I was in excellent shape and 57 years old. Had just had cancer screenings from my annual physical. They think it was caused by Covid which I had three weeks prior. I am now on Xarelto likely for the long term.

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Yikes.

I was really lucky on mine being small. If it hadn't been for the DVT, I wouldn't have just thought it was an allergy.

eric76 said:

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If I understand it correctly, blood thinners do not actually dissolve clots! Instead, they act to keep clots from forming or growing while the body eventually acts to break the clots down over time.

That was a big surprise to find out.

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There are blood clot "dissolvers" out there, but they are very high risk and can potentially make you hemorrhage and bleed to death from too many reasons to count. They are used only in the ER/ICU setting for the highest of risk conditions: major stroke, heart attack when a cath lab is not immediately available, and a PE blood clot in the lungs WHEN the likelihood of dying is high to imminent.

There are procedures right now in clinical study that may be validated in the next 5 years where catheters can be directed to the lungs to "suck" out the clot and relieve burden, but they are still a couple of years from being mainstream or "standard of care".

Blood thinners remain the mainstay of therapy. They don't dissolve the clot but they thin the blood to prevent them from getting larger, they help stabilize them from hopefully spreading, and they aid in the body's own innate mechanisms to reduce them in size, and shrink them to go away.

There are multiple thrombectomy/thrombolysis devices for both PE and DVT that have been approved for over 5 years. Although they aren't quite standard of care, not using those therapies on the right patient is a disservice. It is a rapidly evolving field but unfortunately most places lag behind.

We use the devices in my hospital. I've seen them save lives, but they always quote the caveats.

I dodged the bullet. Diagnosed with DVT in 2023. Left calf was swollen, hard to the touch and ached quite a bit. Long story but went about 10 weeks with this. Saw two different PA's at two different specialists offices. Neither suggests or diagnosed DVT.

Saw my primary physician. He ordered ultrasound which identified the DVT. Xarelto for 6 months. Discontinued after that.

Two weeks later same symptoms. New ultrasound. Same DVT. Back on Xarelto to present day.

Ultrasound a month ago. DVT still there. Referred to hematologist who referred me to vascular surgeon. Vascular surgeon says I have chronic DVT. It's small. Behind my knee. It's not going to go away. Probably get off of Xarelto. Told to wear compression socks from now on. I'm 70 so can deal with that.

Hematologist orders several blood test. I don't have the hereditary blood clot gene. Received test results today:

I IG# is high at .04,
EO% is high at 3.3, MCH high at 31.9, IG% high at .06 Calcium high at 10.4, BUN high at 21, Bilirubin high at 1.4.

Protein S and C are normal. Antithrobin normal.

I don't know what all of that means. Will meet with hematologist next week to review and plan accordingly.

I'm 10 pounds overweight. Very active but eat too much. Feel fine.

Vascular surgeon said I was lucky.

I'd go see a second vascular surgeon. If you're in Houston, Alan Lumsden and his group at Methodist is excellent.

My DVT has barely been noticeable the last few days, but I haven't pushed it very much.

I've wondered about DVT's and exercise. Is it best to take it easy or to push it? Or somewhere inbetween?

TRD-Ferguson said:

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I dodged the bullet. Diagnosed with DVT in 2023. Left calf was swollen, hard to the touch and ached quite a bit.

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What clued me in that my leg ache was unusual was that it was appearing on both calf and the thigh.

The soreness began Sunday afternoon and when I went to the doctor on Wednesday, I pointed that out and asked if it might be a blood clot since I couldn't think of any other reason to have the soreness start out in two different muscles at the same time. (I'm sure there are other reasons that I am ignorant of.) I felt like a hypochondriac when I said it.

Also, in my case, after a few minutes rest the soreness subsided. I assume that means that the blockage in mine is not real substantial -- either the clot does not completely block the veins or there are enough other veins to do the job with a little rest.

I had strained my Achilles tendon in that same leg several months before. Had PT for that and was much improved. The pain that returned a few months later (DVT) felt similar. I figured I had aggravated the AT again.

FWIW I kept up my exercise routine before the DVT diagnosis. Exercise routine was daily 3 mile walk, 3X/week Peloton stationary bike and 2X/week strength training. Felt fine.

After the diagnosis I was told I could continue normal activities because the Xarelto was dealing with the DVT.

TRD-Ferguson said:

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I had strained my Achilles tendon in that same leg several months before. Had PT for that and was much improved. The pain that returned a few months later (DVT) felt similar. I figured I had aggravated the AT again.

FWIW I kept up my exercise routine before the DVT diagnosis. Exercise routine was daily 3 mile walk, 3X/week Peloton stationary bike and 2X/week strength training. Felt fine.

After the diagnosis I was told I could continue normal activities because the Xarelto was dealing with the DVT.

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My normal activities include climbing ladders. The doctor very explicitly told me not to climb any ladders. Also, no motorcycle riding.

The obvious problem is that if I fell and injured myself, they might not be able to stop the bleeding.

I don't know what they are worried about -- the last time I fell off a ladder was in June 2024. That time, it was more like the ladder fell and I rode it down.

At 40, during my annual physical, my doctor told me no more ladders. What???? Told me I'd be stunned the number of folks 40 or over who fall off ladders every year and do some serious damage to themselves. It's been a useful excuse for 30 years!

Since the DVT and Xarelto I've been cautioned to avoid activities that could cause bleeding. I still shave with a DE razor though. No issues with that.

TRD-Ferguson said:

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Since the DVT and Xarelto I've been cautioned to avoid activities that could cause bleeding. I still shave with a DE razor though. No issues with that.

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Me, too. I keep my styptic pencil ready to go, though.

It surprises me how many people have never heard of styptic pencils, much less used one. I said something about them to the doctor at the emergency room the night that the clot hit my lungs a couple of weeks ago. He not only had no idea what they were, but his first question was something like "Why would you ever put something like that on your face?"

On those occasions where I had minor cuts and had no styptic pencil handy, it could sometimes take ten to fifteen minutes for the blood to clot. On the other hand, I can use a styptic pencil on a cut and it stops the bleeding so fast that I can immediately get back into the shower and rinse my face and the cuts do not start bleeding again.