Dvt

[Marvin]

If you have read the thread I started after coming off my bike, you'll know that I have a DVT (deep vein thrombosis), a clot just below the knee in my left leg. I'm now being treated with warfarin after a few days of clexane. Lookng back, I think I had the clot for around four days before treatment started, i.e. before I was discharged from hospital in Bangor.

I've been lucky not to have much discomfort from my injuries, but the DVT is very uncomfortable - an ache that I can only control by elevating the leg. I suspect that it's the DVT that's going limit when I can get mobile again rather than the injuries.

Has anyone else had a DVT? How long did it take to get over it? How long were you on warfarin? Were there any lasting effects?

[Mike T]

Hopefully you are wearing a stocking to reduce the chances of "post-phlebitic leg" - pain/swelling/varicose veins months down the line - though these symptoms are very uncommon with a DVT confined to the calf.

[Marvin]

Hopefully you are wearing a stocking to reduce the chances of "post-phlebitic leg" - pain/swelling/varicose veins months down the line - though these symptoms are very uncommon with a DVT confined to the calf.

Nope, nothing like that advised! How long do you think it will take for the clot to break down? Should I wake up one morning with the blood flowing properly again, or is it a slower process than that?

[Mike T]

I would suggest seeing your GP to get a stocking. This should be "routine". DVT symptoms vary a lot from person to person and there is a poor relationship between the size/position of the clot and the degree of symptoms. Some people have a huge clot and no leg symptoms and are only diagnosed when they get a clot on the lung. Others get quite a bit of pain/swelling, despite the clot only being confined to the veins in the calf. It can take weeks/months for the symptoms to settle, but a stocking and exercise should help. The veins slowly become patent again - recanalize - with time in most cases, though this process is not always 100% successful - in that a small number of people do have ongoing symptoms. Follow up tests are not normally done to see if the clot has gone, it it normally just symptoms that are monitored.

[Marvin]

Thanks again Mike, that's all very helpful.

Exercise should be easier once I have my stitches out and have a bit more mobility. I'm still under the care of Stepping Hill Hospital rather than my GP, but INR monitoring there is a nuisance because of all the travelling and waiting around. I'm going to try to get referred back to my GP, but need to see a doctor at the hospital to do that, and they weren't keen to refer me until I'd had the loading dose of warfarin and got some stability of the INR. So my checklist for tomorrow's visit includes: stocking, referral back to GP and period of treatment on warfarin.

[cyclops]

Mike, could you advise on levels of exercise that can be undertaken with a DVT?

[Mike T]

In general early mobility is felt to be beneficial, but this is ordinary mobility, as opposed to running/cycling etc. There is some good general advice here: http://www.inate.org/en/1/2/6/956/default.aspx Often the cause of the the DVT - injury or surgery or an illness resulting in bed rest - will be what determines when normal training can be resumed. DVTs are such a large spectrum - small clots confined to the calf, up to large clots in the groin/pelvis +/- a pulmonary embolus that it is difficult to give blanket advice. If I had a large clot, I would be taking a few weeks off - if it was small I would be having a couple of easy weeks whilst doing my best to ignore it.

[L.F.F.]

I had a DVT in my left calf in 2007. I found out as I had a very painful/stiff calf and chest pains.

The after-effects have been damage to my veins which has made the blood-flow not as smooth, so it swells up if I don't wear a stocking and feels uncomfortable, although not awful.

I basically have to wear a stocking up to below my knee at all times. Not sure how it's affected my running as I only started after it happened, but it's probably better when running that when stood washing up, for example, so there's a good excuse.

Depressing to hear you have to wear a stocking for ever more, but you get used to it.

And apart from that, it's just a case of being careful on flights.

Hope that helps a bit.

[IanDarkpeak]

Sorry to hear about the extra grief Andy,

[Marvin]

Phew, I've escaped Stepping Hill for INR monitoring after spending all afternoon and early evening there. I'm now referred back to my GP. INR on Saturday and today was 2.9. Dose for the next three days is 2mg. Someone else in the waiting room was on 36mg per day and not achieving target INR!

Stepping Hill advise that stockings are not used for first six weeks, but I'll discuss this again with my GP/practice nurse on Thursday. I'll also take up the period of treatment with them.