Advice please

Hello Christopher, when I was first diagnosed with DVT and PE I had extensive pain in my upper leg. Absolutely nothing would sooth the pain until I discovered heat patches. I live by them, even now two months into recovery I use heat jel to help ease any slight pains (I may have become slightly addicted). So I definitely recommend as well as walking and general exercise, but dont over do it listen to your body and take time to relax too.

I was told to walk as much as i felt comfortable with and to keep my leg elevated at all times when sitting, never ever to sit with the leg down, it had to be raised.  Blood thinners will not get rid of the clot, they will stop it worsening or more developing, you have to wait now for your body to break the clot down and absorb it, in the meantime you need to keep the blood flowing.  My vein was almost totally blocked, the clot was huge, from the back of my knee, up my thigh, through my groin and across my abdomen, I had it washed out.  My leg is now about 80% back to normal and I walk 6 to 10 miles daily with virtually no pain.  

Hi Christopher

Sorry to hear about what has happened. The best advice which was ever given

to my daughter was to keep moving and stay as active as you can. It helps with healing. Also to remember that the pain does get better with time so at the start you have to brave it out.  However the exercise can promote healing  and encourage healthy blood flow through your veins.  So swimming or walking loads helped my daughter.  As your job is sedentary, try to take regular breaks and move around and if you can manage it, elevate your leg a little to help with swelling. My daughter found wearing a high grade stocking helped with swelling too. 

Good luck with your recovery  😊

Thanks for the advice guys. I will tough it out and move around as much as I can. Not sure codeine is working as a painkiller and it's making me really tired. Might see gp to look at alternatives.

I'd be definitely getting another scan to determine the blood thinners have dissolved the clot, and because it is still warm and painful, you haven't developed another clot.

When having clots, they are caused by long periods sitting or bed bound, but once a clot is formed, you should be on strict bed rest, with compression stockings, and a special machine that basically automatically moves your calves up and down whilst your bed bound. Also, have they ensured your getting regular pathology? To determine if your warfarin, or clexane or whatever blood thinner they have put you on, is within the therapeutic levels? As if levels too low, your at risk of a reoccurring DVT, so it is VITAL that your levels are checked every second day until you become stable, and once someone is usually stable, you just go to a weekly pathology check, and if your dose needs adjusting, they will contact you, and tell you what dosage they want you to take and tell you when to get your pathology taken again.

But, as a RN, IF I saw a DVT patient walking around, you'd give me a heart attack!!!!! It's recommended you remain bed bound, with use of that machine and the compression stockings, as the more active you are, the clot will slowly continue to travel through your body and then once it hits the lungs, it becomes what is called, a Pulmonary embolism(PE) - which is then extremely dangerous, and life threatening!!!!! and some people, like you, get the burning, warm and red calves that are a classic dvt symptom, and know to seek emergency care immediately, but as many people are asymptomatic (means they do not get those symptoms, until they present to Emergency Dept). But if you become breathless, and have chest or arm pain, then seek immediate Emergency care and remain still.

Also, find out your family history, as some people have a genetic history, so ask if they've given you a factor V blood test and other factors, to ensure your not at risk of this continuing. But smoking, is also a major contributor to developing a dvt as well. But ask your Dr what you can and cannot do. If your in the Acute phase and in hospital, you've probably be receiving a heparin infusion, and if you start to develop clots regularly, they can surgically implant a coil, which is usually implanted in the femoral artery, and IF you happen to get another DVT, this coil will stop the clot from travelling into your lungs, and the anticoagulants will dissolve it. But if your in hospital with IV, ALWAYS check with your nurse and Dr, as some hospitals, countries etc have different ways they manage them, and whilst my advice is relevant to our hospitals, who by law, have to follow evidence based practice guidelines, it may not be what your Hospital and specialists implement as part of your care plan.

Each patient is different. I've seen people with a genetic history of a mother or fathers backgrounds have embolisms and DVT's on a regular basis, and one gentleman in particular, had a massive clot, showed no symptoms, ie: pain, warmth, redness etc,  and we have given a double dosed IV Heparin infusion, and when the Cardiologist has utilised an ultrasound on the calf, legs, have visually seen that particular patient still throw off up to 20 clots!!!!!! Even the Cardiologist has been amazed and shocked, so he was given a coil implant within the hour once a surgical theatre had been prepped and ready. So if there's a family history? I would suggest ONCE DISCGARGED, that you remain as active as possible, but always take any calf pain etc serious and seek medical attention immediately!!!!! no matter how active you are, you may always be at risk of getting another clot, if your a smoker, inactive, have a history of them etc. I would ask for a referral to a hematologist. They issue a massive amount of pathology tests, to check every possible factor to try to understand why you are having regular clots. I mean,  you may never have another Clot again! EVER! Most people get one, and once resolved, live happy, healthy lives and never get another one again, and live to be 100! But there is a very small percentage that are more serious and seem to get them regularly. But again, research family history, ask you dr about anything your not sure of, give up smoking if your a smoker, and just remain active. So, for eg, if you have an office job? Every hour get up and take a 5 minute walk and or stretch. Minimise your risk factors! Basic common sense!

Pain is normal, but should not be as agonising as your describing, so I would definitely alert the nurses and the doctors. Every patient has different pain thresholds, and whilst one pain medication may be adequate for one, does not mean it's adequate for you. So ask and complain to your nurses and Drs about your pain levels, you may need something stronger!!!!!

Pain relief should be given, no matter what form either codeine or morphine based narcotic. Pain can hinder your ability to heal, cause a multitude of symptoms of becoming bed bound because of pain etc, but the golden rule is there is no correct protocol of a dosage for a patient. The dosage is correct, when the patient states they are either pain free, or only have minimal pain, that's not worrying you.

i open this helps....

I am amazed that as an RN you are advising that blood thinners will dissolve a clot, they do not, they thin the blood to stop more clots forming or the clot to worsen, your own body dissolves the clot and absorbs it.  I was in hospital for two weeks with one of the largest clots they had ever seen at Stoke Mandeville hospital and was encouraged to walk from the start. I was not allowed out of hospital until I could walk out of the hospital myself.