DVT

I returned home from work at 8am on April 26th, after working two nights in a row, and was exhausted. My first night working I got sick from the frozen dinner I had eaten and ended up vomiting in a patient's room. Nurse of the Year - right here! When I returned home, I fell asleep on the couch and at 7pm Brett woke me and asked if I wanted to go grab some dinner with the Newmans. Andy knew I had been craving breadsticks so he and Leisl invited us to join them at Olive Garden! 

When I rolled off of the couch I noticed my left leg felt a little numb and heavy, but I wasn't too concerned. I thought maybe it was just "asleep" or maybe it was sciatica. I had been having to wear heating pads at night when I worked because of low back pain and thought maybe it had traveled down my leg. My leg continued to bother me throughout dinner. By the time we left the restaurant I was having difficulty walking. 

I got home and took off my pants to get a good look at my leg and was a bit surprised to see it was about 1.5x larger than the right leg and was discolored. My first thought was DVT (deep vein thrombosis), but worried maybe I was being a paranoid nurse. Why would I have a DVT? I had just been on my feet for the past two nights at work and I was wearing compression stockings. I became more concerned and sent pictures (below) to my brother-in-law, Dr. Stevenson, to see what he thought. I knew it would be difficult for him to diagnose based on a picture, but I needed someone to bounce ideas off of before I decided what my next move would be. My sister, Brooke, said she and Brad were talking when he received the pictures. He looked down at his phone and then mid-conversation said, "I need to call Allie." He and I chatted for a while about my symptoms and he felt fairly certain I had a DVT. I agreed, but didn't want to go to the ER and felt I'd be okay waiting until the next day - I had an appt with my OBGYN at 2pm. I really freaked Brett out before bed when I said, "If I seem to be having difficulty breathing tonight, call 911." He said, "Oh great. Now I'm going to be up all night watching you breathe." 

The quality of the photo is poor, but my left leg (right side of photo) is swollen and discolored.
This was after elevating my leg for over an hour.

By 2:30 am I was in such intense pain that I decided it was time to go to the ER. I hadn't showered since returning home from work, and I refused to go in before cleaning up, so I asked Brett to carry me into the bathroom so I could bathe. The hot water soothed the pain and I again decided to wait until the morning to call my OBGYN. At 8am I called the office and asked for the triage nurse. She was on another call so I left a message, but didn't hear from her. Two hours passed and at this point I was feeling a bit anxious so I called the office again and asked if there was an earlier appt available to see my OBGYN. Luckily, there was an appt available for 10:30am. I called Brett, who was at school, and asked him to come pick me so we could go to my appt. 

I limped into the office and the MA said, "This doesn't look good." Dr. Onstad came into the room with a big smile on her face and asked how I was feeling. She must have assumed I was there for a routine OB appt. My eyes started watering and I said, "I'm concerned" and continued on explaining my symptoms. She said that it wasn't unusual for women to have swelling during pregnancy, especially in the left leg, but she agreed that we should rule out a possible DVT. 

Brett wheeled me down to the lab to get a doppler test on my leg. I explained to the tech that the pain was primarily in my groin. She put the wand on my leg and said, "There it is." Brett said, "There what is?" She said, "The clot." She then traced the clot from my upper-calf to my abdomen. She wasn't sure where it stopped because Evy's head got in the way of the doppler in my abdomen. We told her Dr. Onstad had instructed us to go home after the test and that she would call us with the results. The tech said, "Stay here. I'm going to go call your doctor RIGHT NOW."

When she left the room, I looked at Brett who was tearful. He expressed concern for me and for Evy. I assured him everything would be okay. I don't think reality had hit me yet.

The tech returned and said she had been instructed to take us to the 3rd floor of the hospital immediately. I was admitted to Ante-partum. Brett was scheduled to has lasik eye surgery that afternoon, so hesitantly, he left me in the well-trained hands of the nurses. 

I was immediately started on Lovenox injections. I'm such a baby when it comes to needles, ironic, I know. I had doctors, nurses, med students, pharmacy students, etc. in and out of my hospital room all afternoon. Many had never heard of a clot so long and mine was palpable in my left groin - which added interest. 

Brett returned to the hospital a bit drugged up from his surgery and we sat in room 373 watching TV and relaxing. Later, the Newmans brought Cafe Rio for dinner. Brett painted my toe nails. Bright and early the next morning lab came in to draw 10 vials of blood. 

I was offered pain meds several times, but I refused, worried it might hurt Evy (even though I knew I would not be prescribed anything that would be harmful). On the second night, my nurse walked in to find me curled in a ball on the bed, rocking back and forth trying to take my mind off of the pain. She insisted that I take at least half a tablet of my pain med. I agreed, but it only took the edge off of the pain. The day nurse finally said, "Listen. You need to stop being a stubborn nurse and let me take care of you. I'm bringing in an entire tablet of your pain med and you're going to take it." There wasn't much fight left in me at this point, so I did as she said. Thirty minutes later I was laughing to the point of tears. My nurse and a doctor came into the room to check on me and I said, "I'm as high as a kite. You're my new best friend." 

The original plan was to keep me hospitalized for up to a week, but I was getting a bit stir crazy and since I already knew how to give myself injections, I was discharged on April 29th. Brett stayed home on April 30th to take care of me, but the next day he had to get back to school. He was in the middle of finals - of course! I had to crawl around the apartment because it was too painful to walk. When I stood, my leg would immediately swell and turn purple! Luckily, meals were brought in by friends and ward members and I had several visitors.

Flowers from my friend, Rachel Johnston, who visited while I was in the hospital.

A couple weeks later I had an appt with my specialist, Dr. Wilk, who told me I have a genetic blood-clotting disorder called MTHFR C677T that caused the DVT. I told my nephews, Luke and Tate, that I was a superhero with special blood powers and Luke promised he'd help me learn to use my powers. It was nice to know what had caused the clot, but it was also concerning to learn the potential risks to Evy such as low birth weight, placental abruption, neural tube defects, still birth, etc. My OBGYN, Dr. Onstad, said I was pretty lucky to have gotten pregnant so easily and to sustain the pregnancy into my third trimester with no complications. She said often women with this disorder figure it out after multiple miscarriages - which is another risk associated with the mutation. 

For a while I was numb. When the reality of my situation hit  - it was emotionally difficult - but I felt blessed the clot had not traveled to my lungs which could have potentially caused, well, death. I also felt blessed Evy was healthy and developing normally. I had to continue giving myself Lovenox injections twice a day which was difficult at times and caused large hematomas at the injection sites. The only reason I was able to poke myself sometimes was the thought that I was protecting my baby. We also scheduled several ultrasounds to chart Evy's growth through the remainder of my pregnancy.