The revenge of the DVT

[Català/English post]

Let’s start at the beginning. Summer 2013 I was diagnosed with a Deep Vein Thrombosis (DVT). I wrote about the 6-month experience here (link). Two years later, summer 2015, I suffered a thrombophlebitis or superficial vein thrombosis, which I also blogged about (link). After that the doctors ran a test on me to see if I had a genetic disposition (a mutation of the Factor V Leiden) to thrombosis problems. The results said I had inherited this problem but only from one parent, which isn't so bad. Not good, but not bad. After seeing various experts, the conclusion was the same as back in 2013 – just bad luck, and advice to keep wearing the compression stockings, every day, summer and winter. Which I have done. 

But, a month ago, October 2018, I was diagnosed with another DVT in the same leg! A similar process, extreme pain in my lower leg, swelling, a bit redder and warmer than the other leg... when the GP saw it (30 October), he recommended going to the hospital Emergency department straight away for tests to rule out (or not) the possibility of it being a new DVT. Six hours later, blood tests and an ultrasound scan done on my leg, it turned out I’d got a DVT again (and in more than one vein from what I understand). So we then relived the 2013 moment – serious doctors telling me seriously not to worry, they’d get me through this etc, but for God’s sake, don’t move around! Go straight home, bed rest and don’t move for several days. Plus those anti-coagulant injections and some Sintrom pills (the equivalent of Warfarin in the UK I think). So I spent a couple of panic-stricken weeks at home, lying still except for the need to carry out specific bodily functions or eat something, and just getting up to go back to the hospital to have my blood tested and Sintrom dosage adapted accordingly. I won’t be seeing the ‘expert’ until December when I have an appointment with either the hematologist (blood consultant) or vascular doctor (vein consultant), so until then I don’t really know what’s next. Keep taking the pills of course. 

As to what I should do now, 4 weeks into the problem, I’m combining intuition, experience from 5 years ago, and Google research (I know, I know!). Because one of the main problems or worries now is, what should I be doing. The Emergency Ward doctor told me the first day to stay still, at least a week, maybe two.... but now four weeks have gone by and I still won’t be seeing the specialist until week seven. So, following my research, I think (but I’d love to ask a doctor!) I should be trying for a balance of rest, and not doing anything daft, but gradually moving about a bit as probably the worst moment has passed. As I said in a previous post, the worst moment actually lasts a few weeks and it’s when the blood clot can break free and travel around your veins and block your lungs and cause serious damage or, speaking clearly, kill you. I think/pray that risk is now reduced substantially after 4 weeks on the pills, which is more or less what Google’s telling me. But still, those nights when you lay awake paying attention to every single twinge, ache, pain, even trapped wind, thinking ‘Is this it? Do I need to get off to the hospital NOW? What about the kids? Where are my shoes? etc’ until you eventually drop off to sleep and wake up the next morning realizing you’re fine....

So, I’ve been off work for a month and will probably be off till Christmas I imagine. I can, and have decided it’s best to, move around the house and garden now, going out from time to time (for example, round the supermarket), and just lie down for an hour at a time to ease the pain. When I get up, I do light things around the house, but can only sit down for short periods as that’s the most painful moment. In a couple of weeks I’ll see the consultant and hopefully get a clearer picture of where I am and what I should be doing, and, more importantly, find out if they have any idea why this “one-off” problem has happened again despite my precautions (not sitting down for long periods, feet exercises, liquids galore, expensive stockings, reasonable fit and healthy, anti-coagulant injections before flights).

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Començarem al principi. A l’estiu del 2013 em van diagnosticar un trombosi de vena profunda (TVP), el qual em va tenir patint fins gener 2014, i de la qual vaig escriure aquí (link). Dos anys després, a l’estiu 2015 vaig patir un tromboflebitis a la mateixa cama, probablement a causa de la TVP anterior (link). Vaig tornar a fer la ronda de metges. Em van fer una prova per assegurar que no tenia cap problema genètic (com una mutació del Factor V Leiden). Vaig rebre el OK i un ‘No pateixes’, i em van recomanar portar mitjons de compressió tot l’any, estiu i hivern, dia sí, dia també. Amb això pensava que ja estava tot arreglat...

 però... sorpresa, ara a l’octubre 2018 han tornat a trobar un TVP a la mateixa cama. 

Vaig començar a notar un dolor agut, vaig anar al metge de capçalera, i em va dir que donat els precedents, millor anar a urgències a fer les proves per descartar que fos un TVP. Sis hores d’urgències desprès, i, sorpresa, les proves (una de sang, i l’ecografia de la cama) donaven positiu. Llavors va passar el mateix que el 2013, cares serioses dels metges, paraules recomfortants, i consells de sobretot no moure’s en absolut durant uns dies o setmanes, donat que (com vaig explicar el primer cop) el coàgul que està tapant la vena pot començar a ‘flotar’ dins de la vena fins arribar a tapar l’entrada al pulmó i l’historia acabaria molt malament. Et donen les típiques injeccions per fer la sang menys coaguladora (¿), i les pastilles famoses Sintrom. Llavors, quieto a casa, menys els dies que has d’anar a l’hospital per fer el control del Sintrom – que és el dia quan decideixen si tenen la dosi ben calculada o no, i t’ho van ajustant. De moment fa 4 setmanes que estic de baixa i crec que arribarà fins nadal. D’aquí uns dies toca visita amb l’especialista, o l’hematòleg o el vascular.

Crec que ja ho he explicat en posts anteriors, per mi el pitjor d’això és no saber que passa, no saber fins a quan hi ha perill, fins a quin punt no t’has de moure, o sí que has de moure. Surts de l’hospital amb instruccions de no moure’s en absolut. Però llavors no veuré el metge fins que hagin passat 6 setmanes. Mentrestant, que? He d’estar 6 setmanes enganxat al llit tremolant de temor? O pots fer alguna cosa? I aquest perill de tapar-te un pulmó, com ho notaria, que passarà? Si em moc la cama és possible que jo mateix posi en moviment el coàgul?

Amb una mica d’intuició, i els records de fa 5 anys, i una buscada per Google, he deduït que a partir d’un parell de setmanes has de buscar un equilibri i començar a moure una mica però evitar segons quines accions o postures... diuen que hi ha perill de que el coàgul es mou durant unes 4 setmanes. Faig molt de llit/sofa encara, però ara, a 4 setmanes, m’aixeco cada horeta, em moc dins de casa o al jardí, i minimitzo les estones de cadira que és quan em fa més mal. Però clar, això que diuen de que tens aquesta cosa a dins i es pot moure i et pot matar, pos, cada nit quan no pots dormir (o sigui, cada nit!) comences a analitzar cada sensació, cada petita molèstia o punxada... he estat molt a prop de sortir corrents cap a urgències diverses nits, però al final he esperat i ha passat, ja que evidentment són les petites sensacions ‘normals’ d’un cos. Però com que no sé com se sent tenir un coàgul tapant-me el pulmó fins que passi, pos, jo, a la deriva. En fi, ja tinc moltes ganes de parlar en l’expert per fer-li mil preguntes, saber que puc (no) fer ara, i sobretot si tenen alguna explicació del perquè m’ha tornat a passar.

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August

And then after July came August as usual. August started well - exceptionally well in fact; the very first day we had our annual Big Day Out on the beach. We "camp out" all day once a year on one of the huge deserted beaches on the arms of the Ebro Delta, with a fantastic knee-deep bay of water on one side of the beach, and  the wilder sea of the open Mediterranean on the other. See satellite photo below. Cousins, grannies, uncles, friends, we all hit the beach with cars loaded up with sun shades (essential), kites, buckets and spades, canoes, picnics, drinks... and spend the full day there till dusk. A great time was had by all.

Two days later I flew to England with our oldest son (12 today) to drop him off at my parents' in South Yorkshire for a week's break from us and a chance to practise his English. And then I flew back to Catalonia. The rest of us spent another week here, finishing off translation work and coping with the heatwave before joining Andreu in England for a 3-week holiday.

However the day before we flew I felt a sharp pain in my leg which brought back unhappy memories of my DVT 2 years ago and so went to the hospital to have it checked. I was given the all-clear, and a couple of blood-thinning injections "just in case" and told to fly.

For our first week in England we'd decided to go to the Lake District and a grand time was had by all - lake cruises, treks up and down hills, bathing in tarns and lakes, eating Grasmere gingerbread, visiting the Pencil Museum and so on. See photos.

However, again, by mid-week that pain was starting to come back. I managed to finish the week in the Lakes but as soon as we got back to my parents' we went to Barnsley Hospital A&E to check it wasn't a DVT again.... and it wasn't, it was a SVT! I'll explain: instead of a potentially life-threatening deep vein thrombosis which could mean the clot moving into the delicate parts of your body, it was (is) a "superificial vein thrombosis" or "thrombophlebitis" which is nowhere near as bad ... unless it develops into a DVT if the clots start to move from one vein system to another... which shouldn't happen but.... lots of should/might/but/not usually vocabulary used by the doctors who gave me a very thorough looking over in the hospital (long live the NHS!) meant that I spent the next 2 weeks scared out of my brains once again. They were right, though, so far: the pain was intense and unbearable for a few days but has gradually faded, and is now just annoying. They say in 7-14 days more I should be OK again as the SVT is just running its course. It all meant I did hardly anything for the other 2 weeks in England but I did manage to check out a new second-hand record shop in Elsecar, The Vinyl Tap! With a few more blood-thinning injections "just in case" we flew back to Catalonia on 31 August and now the next step is seeing more doctors to see why this has happened and if there's anything I can do about it - and, looking at my history repeating itself, whether these incidents are related to flying.

I am still resting up at home now but hope to get into school for some preparation this week, and aim to be 100% for working when classes start on the 14th. Our kids also go back to school that day, with our son moving up to the Big Boys' School - i.e. secondary school. Time flies.

Let's get physical

Aixi que, com deia ahir, estic recuperat. Però no del tot fisicament. Els mesos de inacció, i uns altres mesos de poca acció, m'han deixat bastant fora de forma - quan abans podia caminar 4 o 5 hores sense descansar, ara justet arribo a una hora (a més dels 5kg que he guanyat). Afegit a aixo està al fet que els metges m'han dit que si reforçi la musculatura de la cama, potser les molesties que noto no seràn tantes. Per tant, he fet allò que sempre sabia que no s'ha de fer. Comprar una maquina de fer exercicis. És ben conegut qua aquelles maquines s'usen el primer dia i despres es guarden a l'habitació de trastos .... però,en fi, he decidit posar una mica de disciplina en la vida. Crec que si marco objectius amb una data final - de fer-ho regularment durant un any, per exemple - encara puc fer-ho sabent que aixo no serà per a sempre. De moment, lo de "regular" varia entre 1 i 2 cops per setmana!

...

So, as I was saying t'other day, I'm back to my usual fit and healthy self. Well, not quite. The months of inactivity, followed by months of little activity, have taken their toll. Apart from the extra 5kg of weight, I can no longer do a 5-hour walk without breaking into a sweat. Lucky if I manage one hour. On top of this problem, the doctors all insist that maybe strengthening the leg muscles will relieve the pain I often feel in my leg, maybe. So, I've gone out and done the one thing I know you should never do - buy an exercise machine. It's a well-known fact that they just get used once and then merely serve to collect dust, but I'm hoping my fame for self-discipline will come to the fore-front here. Surely, if I set a schedule and end-date, I'll stick to it, knowing that this torture will one day come to an end? So, I'm hoping to use it "virtually every day" for one year, then see where I'm at. This regularity has demonstrated itself as one or two goes a week so far....

Leg (s). Mine and others.

No és que sigui hipocondriac o paranoic, però aquest estiu passat vaig viure unes experiencies que encara ara recordo...

... recordareu (o no) que fa un any, vaig patir un trombosisa la cama. Vaig estar de baixa des de l’estiu 2013 fins al gener d’aquest any, i no vaig rebre el OK dels metges fins al febrer quan em van fer les ultimes proves i va acabar el tractament. Pos, a l’agost(2014) vam anar de vacances al mateix lloc on vaig notar per primer cop els dolors del trombosis, un any abans, a l’agost 2013. Pujant les escales empinades i de cargol en una casa que lloguem per passar les vacances de l’estiu – per més inri, en un poble empinat que no fas res més que pujar i baixar tot el dia.

Des de febrer fins l’estiu, jo havia tornat a treballar pero tampoc havia fet gairé cosa més d’exercici per falta de temps. Per tant, les vacances també van coincidir amb les primeres caminades (de mitja  o 3 /4 d’hora només) des del trombosi. En fi, a cada pujada, notava dolor – coses que els metges em van dir que seria normal, però jo no podia evitar de recordar els dolors del trombosi. A les escales de la casa, cada dia, pujant-les a pas de tortuga i encara així tremolava. I a la nit, ja “descansant” al llit, notava cada dolor, cada punxada, cada cansament de l’exercici del dia com si fos un nou atac, fins al punt que passava hores sense dormir, o em despertava a meitat nit suant i tremolant!

Per sort, i per suppost, no va passa res. Vam acabar les vacances i vam tornar a casa. Suposo que era necessarir trepitjar l’escenari del “crimen” per passar pagina, però el meu cap no pot controlar aquesta mena de sensacions i realment va ser un calvari!

En fi, al setembre, em va tocar la revisió d’un any, i em van confirmar que estic curat del tot –algunes venes m’han quedat fetes malbé i això em pot causar (i causa) moltesties per a ves a saber quant de temps, però no genera perill. Un altre de passat...

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Not that I’m a hypochondriac or obsessive paranoic type person but... you may (or not) remember I suffered from a DVT last year, from summer 2013 to the end of the year. I got back to work in January this year but didn’t get the 100% OK from the doctors until February when the 6-month treatment came to an end. Well, this summer we returned to the “scene of the crime”, the holiday cottage in Staithes where it all started in August 2013. A house noted for its steep narrow, and spiral, staircase – which is where I first noticed the pain. In a town noted for its steep narrow and winding streets. The 2014 holiday also coincided with my first real walks (even though only ½ or ¾ hour ones) since I’d got back to work. Anyway, every walk or climb threw up strange sensations in my legs - and every slight twinge of pain was automatically converted in my brain into “here we go again, get a doctor”. I couldn’t get the bloody idea out of mind for the week we were there. Worst of all was in bed at night as I could feel everything, a twinge here, a sharp pain there, needles and pins, hot, cold, you name it I laid in bed awake for hours on end worrying about it – or woke up in the middle of the night trembling and sweating through some nightmarish thoughts I couldn’t get under control.

I suppose I had to do it, go back there as soon as possible, and close that chapter in my life, but, my God, it was hard – and strange. Hopefully, that’s it now, I can move on.

Anyway, in September I had to go back for my “one year later, check up” and my clean bill of health was confirmed. The scan did show, though, that some of the minor veins in my leg have been damaged which is what’s to blame for this constant niggling pain I feel. Not a danger to my health, apparently, but annoying.

Back on the chain-gang - The Pretenders #BackToWork

No sóc massa d’explicar els meus problemes personals aquí al blog, suposo perquè ja sé que tots en tenim i si vinc aquí a l’internet una estona, no és per explicar les meves misèries. Però, avui fem una mitja-excepció, bàsicament perquè he tingut alguna (relativament) bona noticia. Malgrat ser jove, fort i guapo, al final de l’estiu passat em vam diagnosticar un trombosi de vena profunda (TVP) a la cama esquerra. Un mal que te c**** va ser el primer símptoma, seguit per una gradual inflor de la cama. Finalment van descobrir que era un TVP i em van posar el tractament adequat. Com que soc molt, però molt, anti-voler-saber-res-del-cos-humà, no en sabia res d’aquesta malaltia ni les complicacions que podria causar. Per tant, les primeres setmanes quan em van explicar els perills de tenir un trombo a la cama i que podria afectar seriosament altres òrgans del cos, em vaig quedar de pedra i em va costar molt reaccionar! Degut a tot plegat i el mal que em feia, he passat tot un trimestre de baixa de la feina.

Però la noticia avui és que ja hi he tornat aquesta setmana i em trobo (relativament) bé. Encara em fa mal la cama, però es veu que els perills han passat. De fet, em diuen que el dolor pot quedar-se una llarga temporada, però si només és això, cap problema! En fi, ja he fet tres dies de classe, però només unes hores soltes cada dia per anar agafant el ritme poc a poc, i no tornar a necessitar la baixa a la primera de canvi! Però, bé, almenys ara tinc problemes nous en que pensar i puc tornar a cobrar el sou normal :)

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I’m not one for normally moaning, or even explaining, my personal problems on this blogpage. I suppose it’s because we’ve all got our own issues to deal with and it’s not for me to inundate the internet with more worries and moans – if/when I come on here, I’d much rather forget about my troubles (and look at someone else’s!).

But we’ll make a sort of exception today as this problem is coming to an end, and it’s a (relatively) Good News Week – turns out that at the end of the summer I was diagnosed with a Deep Vein Thrombosis (DVT) in my left leg. First symptoms were an incredible pain, and in following days a gradual swelling in my leg until I eventually got a decent diagnosis (it’s a long story which I won’t go into) and was able to start the correct treatment. Being afraid of anything related to doctors and hospitals, I always avoid anything to do with human health issues and as such had never heard of DVTs or the possible consequences of having one. When doctors explained, with a serious expression, what could happen – the blood clots can apparently travel round your veins and get to your important internal organs causing serious damage or something worse .... – I was shocked to say the least. Between my brain going into overdrive and the pain in the leg, it took a few weeks to even come back down to earth. 
Anyway, months of treatment and a never-ending list of doctor appointments and tests later, I’ve now got the OK to go back to work. I started back on Wednesday – yeah!! And am feeling relatively OK. The first few days, I only did 3 classes a day so as to get back into the swing of things without overdoing it and ending up off work again! The fact is the danger has passed, but the pain remains – but apparently this could be here for some time, or even forever! But anyway, I’m back at work, so my brain’s got other things than internet and illnesses to think about and I’m getting my full pay once more, so all’s well that ends well – although it hasn’t ended yet, as I have more tests and doctors coming soon!