Medical Advice Needed

[mightsurvive]

Hiya
I have a few questions regarding a medical matter which is completely off topic as it isn't PTSD related. It is something I am very worried about and I have done some on-line research and come up with nothing.

I got a call the day before yesterday to say my dad was going into hospital as he had a blood clot in his leg. I realised that this could be serious as it can dislodge and move to the heart or brain causing a stroke / pulmonary embolism. He went into hospital yesterday to have a clot removed from his leg however, when they opened his leg up they found that he had too many clots to remove by surgery and so they closed him up again. He is now back at home. I will be calling him tomorrow to find out what the situation is but in the mean time I am very worried. I spoke to his wife this morning and there was no news as to alternative treatments.

Can anyone tell me if there are any alternative treatments or if surgery was likely to be the last option for him? Basically I would like to know what I am dealing with here and if it means finding out that he doesn't have long left at all then, although it would be upsetting, I would rather know sooner rather than later. I would appreciate ANY replies from anyone who knows about this sort of stuff but please don't not reply for fear of upsetting me or for fear that you may give me the wrong information because I haven't told you enough of his medical history. Regardless what you tell me I will not be upset with anyone for getting it wrong. Knowing something is better than knowing nothing.

Many thanks in advance
:s

 

[amethist]

If you google DVT, you will find a lot of information and treatments.

The usual medication in the UK for this is a 3 to 6 month course of Wafrin, via tablets, with maybe an injection of this to kick start it all. This thins the blood to help disperse the clots safely. But with multiple clots, I am not sure how it would work, and weekly blood checks are done to help regulate the dose needed.

Hope this helps.

Amethist

 

[mightsurvive]

Thanks for your response Amethist. It is very much appreciated. My mother in law also had a blood clot a few years ago and it was treated with injections and then Warfrin. She wasn't offered surgery so I presumed that surgery was the next step after Warfrin. There doesn't seem to be any information on the internet on what the next step after surgery is.

 

[deer_in_headlights]

Dear Mightsurvive,

(I hope this posts ok, I'm away from my computer, on a mobile, so please forgive me if the formatting is poor.)

I'm sorry you're facing this worry!

There are a number of things that can be done, all based on how extensive the clots are, your father's medical history, etc...

They can put your dad on anticoagulants (watching him carefully), and hoping the clots stabilize and the blood circulation re-routes around the stabilized clotting. (That is a very common form of treatment.)

They might decide to put in a stent, and/ or a type of filter in the blood vessel to keep clots from moving to a vital area. They might decide to strip out the blood vessel, and or do a bypass. If the leg is ulcerated, there are a lot of wound care options available. If the leg is badly infected and it's threatening his life, they might need to remove it in an extreme case.

This is a common problem, and while serious, it's wonderful that the doctors know about it, now.

You can google the Cleveland Clinic. This is a magnifient resource for information, guidance, treatment. It's one of the top cardiovascular/vascular centers in the USA. If you can get your Dad there for treatment, even better! The Clinic has contact numbers that you can call.

I would recommend that whatever is done, that your Dad works with a top medical center that specializes in vascular diseases, rather than relying on a local hospital. His recovery options are much better.

Good luck! My heart, thoughts and prayers are with you and your Dad!

 

[mightsurvive]

They might decide to put in a stent, and/ or a type of filter in the blood vessel to keep clots from moving to a vital area. They might decide to strip out the blood vessel, and or do a bypass. If the leg is ulcerated, there are a lot of wound care options available. If the leg is badly infected and it's threatening his life, they might need to remove it in an extreme case.
...
You can google the Cleveland Clinic. This is a magnifient resource for information, guidance, treatment. It's one of the top cardiovascular/vascular centers in the USA. If you can get your Dad there for treatment, even better! The Clinic has contact numbers that you can call.

Many thanks for your post deer_in_headlights and for the effort you have gone to to post. I know what a pain it can be on a phone. It really IS a comfort to know that there are other options even if it does mean amputation of his leg. I got the impression that there was more than one blood vessel with numerous clots in it but that may not be the case. I will have to check with him tomorrow. The phrase that was used was "his leg was riddled with clots" but we will see. It may just be a matter of my interpretation of what was said. If I have misinterpreted it wrongly then perhaps a stent / filter / stripping of the vessel / bypass will be options. I am just GREATLY relieved (to say the least) that there may be other options for him rather than just waiting to die.

I am now off to have a look at the website you recommended. Unfortunately we are in the UK so we wont be able to get him over to the US but I will look into what specialist centres (if any) there are over here.

Many many many thanks for you advice
x

 

[mightsurvive]

And many thanks for all of your kind thoughts and prayers :)

 

[mightsurvive]

Dear Mightsurvive,
You can google the Cleveland Clinic. This is a magnifient resource for information, guidance, treatment. It's one of the top cardiovascular/vascular centers in the USA.

WOW what a fab site. I might be in the UK but I will definitely use it again. Thank you EVER so much. It seems he does other options which has cheered me up a little. He isn't out of the woods but I can have some hope that he may recover from this. :D

 

[deer_in_headlights]

Please keep us updated! Sending hugs, and hoping doors open for you and you find a fantastic medical team for your Dad!
With love, concern and prayers!
Deer

 

[ISupportHer]

I agree with most of this. The stent mentioned would most likely be a Greenfield Filter, also referred to a posterior vena cava filter and some other names. I think of a stent as a sevice that springs open within a vessel or ureter from the kidney to allow passage of blood or urine, depending on the purpose of the stent. In this case I am relatively certain that they would be wanting to stop the clots from getting to the heart and then to the lungs or brain. My Dad had one.

I am guessing that, given the extent of of the clots in the leg, the empasis changed from simply a removal, to the risk of dislodging some clots and, as previously mentioned, a very probable risk of Pulmonary Embolim or occlusive stroke. Yes, I would be relatively certain that your Dad will be on Warfarin/coumadin. Was a venous duplex (ultrasound) done first? Would have thought that one would have been done and shown the extent of the clot(s).

I am just guessing but once a filter is in place, clot removal may or may not be an option. You can google the filters. Kind of a remarkable thing really. They access the inferior vena cava by a "stick" in the groin, advance the filter. Think of it as a little umbrella that goes in before being opened. When in place it is opened like an umbrella and secured and this opened "umbrella" catches the clots!

Hope this helps.

ISH

 

[mightsurvive]

It does, thank you ISH. I don't know if he had an ultrasound done as he lives five hundred miles away. He has also been keeping this very quiet so the first I knew about the problem was 2 days ago. I will be calling him this afternoon to see how he is. Hopefully he will have some idea of what they are going to do to help him but I get the feeling that he wont. He didn't know yesterday when they had sent him home from hospital but we will see.

 

[mightsurvive]

Update: I spoke to my dad and apparently it isn't blood clots!!! He has a blockage in his leg of what they thought was between 4 and 6 inches caused by calcification of one artery in his leg. When they opened his leg the blockage was MUCH larger and so they were unable to remove it. the doctors at the hospital he went to do not intend to do anything else to help him:mad:. He has been told that it may get worse but it may not. Either way, it will not end up with his leg needing amputated. They have sent him home but have not advised him as to how he needs to change his lifestyle / diet / exercise regime to avoid it getting worse. I have suggested that he now contacts the Cleveland Clinic for an online second opinion as well as looking into being referred to a specialist hospital elsewhere in the UK (there is one about 2 hours from where he lives). As far as I am aware this blockage is not as serious as having (numerous) blood clots so that is a relief but the matter is still a serious issue so hopefully we will find him some decent help soon.

 

[ISupportHer]

OK so we are talking an arterial blockage (flow away from heart) as opposed to venous blockage (flow to the heart). Totally diofferent thing, of course.

Sometimes stents ARE used for that. In an emergency, here at least, they try to restore blood flow with a Fem-Pop bypass. Some are done on an urgent basis if flow is dramatically less but not totally occluded.

Again, I don't know details but there must be some sort of blood flow, directly or via peripheral circulation. Otherwise they would be talking surgery. That is good. So, yes, he still needs followed as far as anticoagulation with Warfarin and also watching the blood levels to make sure the dose is therapeutic. You may know this already but he would need to go to the Emergency Room if there is signs of an acute blockage. Intense, new pain, and, assuming there is not an issue with the other leg, a visual difference in color (pale or blue) and a noticable change in temperature. Affected leg cool to touch. Difficulty feeling a pulse in the foot, etc.

I trust all will go well, just telling you the bad stuff to look for, not that it WILL happen.