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Walking Therapy or Femoral Bypass

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Gate_Keeper
Gate_Keeper

3 weeks ago I was diagnosed with a blood clot behind the left knee, another in the left ankle and an aneurysm filled with the blood cot, also behind the left knee, a popliteal aneurysm. Pulses in the left foot were absent and I was admitted into The Royal Free vascular unit for 24 hours. I was discharged on Clopidogrel 75mg and Rosuvastatin 10mg tablets. Since discharge, I am walking 1 mile per day. The left foot pulses have returned, but are very weak. I have an abdominal aortic aneurysm 3.6 cm which is being monitored. I should have had a scan and consult today, but it was cancelled until 14 October. I am not on any anti-coagulants and have been told by my GP that I am not to wear compression stockings, because of the knee aneurysm. There is a lot of pain at night and day in the legs. Buprenorphine 5mg patch helps . Before all this, I was very active. I do not drink alcohol and I stopped smoking 10 years ago. I am generally positive thinking.

Should I have a femoral bypass? Anti-Coagulants? Or press ahead with the Walking therapy?

I do a lot of long haul flying. Does anyone know when it is safe for me to be able to tackle a long haul flight again?

The hospital says I must go to casualty it my feet go icy cold or white. The GPs have been most supportive, despite being ever so busy.

Thank you for taking the time in reading this. Thank you!

2 likes, 13 replies

13 Replies

  • supercargo
    supercargo Gate_Keeper

    Posted

    Hi Gate Keeper

    I was diagnosed with DVT behind left knee 5 weeks ago.

    Had 3 injections Clexane, now on Warfarin and wearing support stocking.

    Not quite as complicated as yours.

    • Gate_Keeper
      Gate_Keeper supercargo

      Posted

      Thank you supercargo for your reply. It looks as though you were treated in the nick of time. I wish you all the best with your treatment and recovery.

      Initially, I thought I had pulled a muscle in the leg as the pain was cramps and a sharp pain behind the knee. I had been seen by a private vascular surgeon, arranged by private health cover. He sent me to the Royal Free casualty, saying that my case was too complexed for him. I admire him for promoting the NHS in trying to help me in through this emergency, when perhaps the private sector could not.

      At the Royal Free, I was given 3 treatment options: anti-platelets + walking, or thrombolysis, or bypass. The NHS consultant said the bypass might not work and decided to go the medical management route. I do wonder if I should be on warfarin or heparin. Maybe it has been held off in case the knee aneurysm bursts or the knee clot completely blocks off the blood supply to the foot. I do not know.

      It is a nagging worry, that as time goes by, that even with walking therapy, the leg could go onto develop limb ischeamia and need amputation or that another fatty deposit or clot will break off from the abdominal aneurysm and travel up north.

      I guess we all get those worries from time to time.

      Positive thoughts to you....

    • supercargo
      supercargo Gate_Keeper

      Posted

      Hi Gate Keeper

      That's a lot to take in.

      Hopefully you are confident that you are getting the right advice and treatment.

      All I can say is keep positive.

    • Gate_Keeper
      Gate_Keeper supercargo

      Posted

      Thank you supercargo, time will tell. Last year, a relative developed a DVT in her leg and could not work for 6 weeks. She made a complete recovery and a year on, goes running every day. I hope a similar outcome for you.
  • Rebeccarockchic
    Rebeccarockchic Gate_Keeper

    Posted

    Hi gatekeeper, I am sorry to hear of your blood clots and aneurysm problems. How frightening for you. Having just one blood clot for people is worrying so to I cannot imagine how much worry you must have. I was diagnosed with two blood clots in june this year- totally spontaneous. I will be referred to vascual studies for testing to see why I had them. I had cramp in my leg a couple of weeks before then my leg and ankle doubled in size and became excruitiating in pain, this is what made me go to hospital. I was given anticoagulants straight away and compression stockings a week later. How ever your case seems a lot more complex than others and the Doctors must have there reasons and be experienced enough to know why they have not given you the medication or stockings. You sound like your doing the right thing by walking, I pushed my self to walk everyday even tho it was so so painful.The walking helps more than anything as the muscles help pump the blood flow around the legs. The swelling has gone down but I still have some pain and visable veins. If you are not happy maybe another visit to the Doctors to put your mind at rest, do not think you are taking up their time, that is what they are there for and in your case it is more than justified. hope things get just a little easier for you.  As for flying, I had been on a short flight for 3 hours before my blood clots but they said that is really not enough to cause them at all. I am now frightened to get ona plane at all, I am going to be sticking to cruises/boats etc for my form of travel. I know this is not always possible and I am being over cautious as I believe if you wear the compression stockings and move around then it does lower the risk, I think you do have to consult your GP before flying and your insurance company. Hope this helps.
    • Gate_Keeper
      Gate_Keeper Rebeccarockchic

      Posted

      Gosh Rebecca, you have been through it. I am just going out for a walk and will write on my return.
    • Gate_Keeper
      Gate_Keeper

      Posted

      I had a call this evening at 7pm from the GP. She said she had emailed the consultant. The response is that nothing has changed. No heparin, carry on with the tablets. No compression stockings, because of peripheral vascular disease and no flying. I am to wait until 14 Oct for the scan and appointment, in the meantime to go to casualty if I worsen.

      It was most unexpected of my Doctor to ring me at home, a nice surprise given how stretched everyone is.

      Rebecca, it took me about a year to accept that I had an aortic aneurysm. In that time I had a second opinion at Christian Barnard in ZA. There was no change, except they offered to do a repair if I was really worried. So I decided to step back and not worry myself into an early grave smile

      I have come to believe that all of us who are diagnosed in time, with either a clot or an aneurysm have been given a second chance at life in one way or another. I sincerely hope that the vascular studies scientists and Doctors are able to pin point the cause of your clots. There is a lot of common sense and wisdom in what you had to say to me about the hospital consultant's advice and how I could deal with it.

      Thank you so much for writing. I really do wish you well.

  • Rebeccarockchic
    Rebeccarockchic Gate_Keeper

    Posted

    Thank you for your reply and update. That is good of the Doctors to keep you informed and information and confirmation is good for the mind. You sound like you have been on quite a journey and it is good of you to take the time to share your story so that others can feel they are not alone and I like your statement 'given a second chance' a very postive and good way to look at things. I know it is fighting a battle not to worry our selves into early graves, it takes will power and strength to overcome our fears. Your doing all the right things and have a good medical team around you so this will help you lots and it is amazing what medical advances they have now and what they can do to help people with medical conditions.  I am no stranger to medical diagnosis and the blood clots probably being the worse of them- so I think that the blood clots may have been caused by some other medical condition I have but its all very complex and I am not a Doctor so I cannot self diagnose (although still guilty of it!). I have been diagnosed officially with 23 medical conditons/ailments/illnesses in 12 months. One of the main ones being Ehlers-danlos syndrome which is a connective tissue disorder. I have been diagnsed with type 3, however I could be diagnosed in the future with the vascular type (that is my worry now I have blood clots) and aneurysms are the main cause of illness and danger with that type.  But like you said we cannot worry our selves into early graves. I hope that your treatment works well, the walking helps and in the long term things get easier for you. I am sure you will fly again just not now-good advice I think from the doctor.  Let us all know how you get on, it does help those in similar situations and others may read and find it helpful.smile
    • Gate_Keeper
      Gate_Keeper Rebeccarockchic

      Posted

      Dear Rebecca

      I have not stopped thinking about your 23 conditions that you have. What a blight, something which puts mine into perspective. We are lucky that we are able to tell our story, as there are some people who do not want to share or who can't, either because illness is something never to be discussed or people do not know how to express themselves or some are illiterate. Last September, I was driving down a mountain road in South Africa and was bitten in the testicles by a poisonous spider. It was very painful and gave me problems for about 3 months. Looking back it could have been much worse, somehow that condition managed to bring a smile and lighten things up with others who were having difficulties.

      Tonight, the pain has been really bad in the legs and reluctantly, I will have to go to the GP to ask for more pain relief. This is my 3rd week of being on the Buprenorphine 5 mcg patch.

      I was thinking of asking to be referred to a pain management clinic.

      I hope these boards keep going, as they are a lifeline, a gold mine of support and information. Thank you for helping.

  • Gate_Keeper
    Gate_Keeper

    Posted

    The GP sent me to casualty last week again, as the foot was icy cold. Seen by the on-call vascular consultant who said I needed a femero-distal bypass plus vein, but not straight away. Sent home.

    A couple of days ago the abdominal aneurysm was scanned and it is okay at 3.6 cms. The leg and foot was not scanned, even I asked for it to be done.

    After the scan I saw another vascular consultant who told me to carry on with the tablets, carry on walking making new collateral veins and that she would see me in 3 months time.

    She told me that I do not have a DVT, that I have blood clots in the leg.

    How confusing, this and 2 conflicting proffessional opinions.

    To cut a long story short, I have arranged to see another vascular surgeon (private) next week. Hopefully he will know what to do and explain the difference between a DVT and blood clot. I hope the leg does not get so bad that it becomes too late to save from amputation. Thanks for reading.

    • Gate_Keeper
      Gate_Keeper

      Posted

      Update: Sorry to bore everyone, but it helps me to gather thoughts and might help someone else facing similar.

      I saw the private surgeon in the week. I forgot to ask him what the difference is between a clot in the leg and a DVT. We discussed my options for treatment and he did not sway or pressure me into deciding. If I carry on with the walking and not have surgery, he anticipates that I will get back to about 50-60% mobility max of my former self and will not be able to get up the mountain. If I have surgery, it will be an 'open' op and he pointed out the risks. I had a CT angiogram with iodine contrast yesterday of pelvis, abdomen and outflow. Results next week to be discusssed with the surgeon, then decide what to do. Apparently the pictures were beautiful and the radiographer kindly gave me a DVD of the scan for my travels. I wont look, as I am not qualified to read it and would only frighten myself. The pain continues to be bad at night in both legs, despite the Bupronorphine Patch and the ZaPain tablets (Paracetemol 500mg + Codeine 30mg). I remain motivated smile 

      Thank you for reading. 

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