I'll never forget the moment my left leg suddenly went numb — it was a hot day in the summer of 2007. Late morning. The place was my apartment, located in a major city in Southern California. I was in my early 30s and working remotely from home, creating marketing graphics for a major corporation. Most of my working day was spent seated. I found the work excruciatingly dull but kept at it because it paid the rent and gave me time to pursue my real passion, which was writing books on an esoteric subject that interests about .0001% of America's reading public. (Think model trains, only less cool). At the time, I was functioning under the delusion that one of these books would be successful enough for me to leave the job. Anyway, I had just been emailed an especially boring, time-consuming task from a superior I particularly loathed when I felt a strange, cold wave of numbness washing up from my left thigh up into my groin.
"Oh," I thought, "my leg has fallen asleep and I better get up and shake it off." This happened to me frequently, as my job was very sedentary and often required 5-15 hours of overtime per week on top of the standard 40 hours expected of me. The situation was worsened by my futile writing pursuit, which I often did in a semi-recumbent position to reduce chronic back pain, which I'd had for 15 years. My spare tire didn't help matters either, though I was "only" 20 lbs overweight. Mind you, I wasn't a completely immobile blob — I jogged regularly and walked quite a bit, as I had no car of my own and lived in a pleasantly walkable neighborhood full of wild-eyed hoboes and muscular gay gentlemen. I also drank at least a quart of coffee each day and consequently got up to urinate about every thirty minutes. I thought this level of activity was enough to keep me from having a heart attack for at least a few years, but I had no idea of the danger I was putting myself in.
So I got up to shake off my sleeping leg and point Percy at the porcelain only to find the leg refusing to cooperate. "Weird," I thought. I began pacing quickly around the house, then vigorously shaking the leg, elevating it, slapping it, finally flailing it about in a desperate sort of chicken dance routine. No dice. After about 5-10 minutes of this, I knew I was in serious trouble. At that point, I should have called an ambulance and gone straight to the nearest emergency room (and so should you, dear reader, should this awful thing every befall you). Instead, I got back on my computer — first to notify my boss that I was sick and in big trouble, then visiting several medical sites for a self-diagnosis. I had been experiencing unusually severe lower back pain for several days and was convinced I had a herniated disc or sciatica; the latter assumption was based on The Slingshot, a Swedish movie which featured a limping man with this affliction. He was cured by being suspended from the ceiling and having his torso hugged tightly and pulled violently downwards, resulting in a sickening crunching noise, screams of agony, and the eventual ability to walk normally again without a limp. "That's just what I need!" I thought, and called my insurance to find the nearest orthopedist; I scheduled an appointment with one that afternoon. It's always best to make major health decisions based on hazy recollections of obscure foreign films, that's what I say.
You may be wondering why this moron didn't call an ambulance and go straight to the emergency room, as any sane person would. Well, the closest hospital had a bad reputation, with a high rate of medical errors on its record, such as a well-publicized incident in which a surgeon had operated on the wrong leg of a patient. I am a generally unlucky fellow and was convinced that I'd be in next week's paper with both legs accidentally amputated if I went to this hospital. I also wanted to avoid an ambulance ride — my stepfather had recently required one and ended up paying $900 out of pocket for the privilege. I had the money, but I am a colossal cheapskate who would sooner save a few shekels than look out for my own personal health.
Since the orthopedist was only about six blocks from my apartment, I thought I could manage walking there on my own. I limped up our incredibly steep driveway (we had foolishly rented a place that was basically inside of a canyon) and slowly started hobbling my way to the doctor's office, doing my best (involuntary) Igor impression. A walk that should have taken 10 minutes took much, much longer. An injured leg is really quite a heavy dead weight to be dragging along, especially on a hot day under a blazing sun. By the third block, I was having to grab my left thigh in my arms and pull the leg forward to advance; the pain was unbelievable. It was also beginning to swell, with the left pant leg gradually becoming tighter than the right. I was sweating profusely, gasping for air, and cursing under my breath, collapsing under the shade of a tree for a few minutes then dragging myself up to carry on for another half a block. Nobody gave me a passing glance, as the neighborhood was littered with broken human beings in various states of mental and physical dissolution. I desperately did not want to be late for the appointment, and by some miracle I made it on time, arriving as a disheveled, wheezing wreck.
The orthopedist turned out to be useless. He examined both my leg and spine, had some x-rays done, but came to no definite conclusion. He ordered some additional tests, but the results wouldn't be available till the following day. He gave me a prescription for Vicodin and sent me on my way. I should have called a taxi, but instead I slowly shambled first to the nearest pharmacy and then back to my apartment; the Vicodin did little to relieve the throbbing pain of my increasingly bloated, discolored limb. The journey home was less stressful than the one to the doctor's office, as I could take my time and sit down to rest more frequently. However, it was still an ordeal.
My wife, who was a couple months pregnant with our daughter, got home from work to find me sprawled out on the couch with my leg elevated and an ice pack on my thigh. I thought she took me to the emergency room at that point, but she tells me that we didn't go till the next day, probably because I wanted to wait for the results of the tests. In addition to having a dead leg, I was dead from the neck up as well. I must have slept on my back with my leg elevated, as that was the only position I could tolerate, but I doubt that I got more than a couple hours of rest. I'm sure I woke up to find my left foot even more purplish and puffy than the day before; at that point, common sense prevailed and I finally asked my wife, who had a car, to drive me to the emergency room, though at a different hospital with a better reputation some 25 miles away.
I recall getting in fairly quickly; the attending physician swiftly ordered an ultrasound done on my leg, which involved smearing a cold gel on my thigh and having it scanned by a handheld device. Normally I would have enjoyed a cheap thrill like this, but at that point I just wanted some sort of relief and an answer: what the heck was wrong with my leg?
"You've had a severe deep vein thrombosis (DVT), Mr. Hamhock" she told me. "A blood clot in your leg."
Deep Vein Thrombosis and Pulmonary Embolism
According to the CDC, a deep vein thrombosis (DVT) is a medical condition that occurs when a blood clot forms in a deep vein, usually developing in the lower leg, thigh, or pelvis, though it can also occur in the arm. While it generally happens to people over 60, it can occur at any age and cause serious illness, disability, and even death. Symptoms of DVT can include swelling and pain in the affected leg (occasionally both legs); the pain often starts in the calf and can feel like cramping or a soreness. However, a DVT may sometimes occur without any noticeable symptoms.
My DVT was probably caused by slow blood flow resulting from prolonged periods of sitting. It was also attributable to some unique physiological issues which weren't discovered till later. Additional causal factors include long periods of sedentary travel; pressure from pregnancy or obesity; certain inherited conditions; damage to the vein from surgery or injury; reactions to certain medications; hormone replacement or birth control pills; specific cancer treatments; and smoking, among others.
A DVT is often accompanied by a pulmonary embolism (PE), in which a blood clot travels from the legs and blocks one or more pulmonary arteries in the lungs, blocking the flow of oxygenated blood to the heart. This can be life threatening, as a severe PE can lead to a collapsed lung, abnormally low blood pressure, or even sudden death. I was very fortunate not to suffer a PE considering that I did not seek appropriate treatment for 24 hours.
Warning signs of a pulmonary embolism include an unexplained sudden onset or shortness of breath; chest pain or discomfort that worsens when you take a deep breath or cough; feeling lightheaded or dizzy, or fainting; rapid pulse; and coughing up blood. If you are experiencing one or more of these symptoms, you probably need to seek medical attention as soon as possible.
Three hundred thousand to six hundred thousand Americans are affected by DVT/PE each year. Of those, 60,000 to 100,000 are estimated to die, with 10-30% of them expiring within one month of diagnosis. One quarter of people who suffer a PE die almost instantly.
There have been several well-publicized cases of DVT/PE in recent years. NBC correspondent David Bloom died in 2003 from a DVT/PE after having ridden for days in a cramped military vehicle during the opening invasion of Iraq. In March 2007, Vice President Dick Cheney suffered a DVT after a 25,000 mile trip to Asia aboard Air Force Two. Tennis star Serena Williams was struck down with a PE in March 2011 that nearly put her on her deathbed; it may have been precipitated by a severe cut to her foot the summer before. If a young, world class athlete can come down with a life-threatening clot, it can potentially hit anyone. I only wish I had been more aware of these cases when I suffered my DVT; I might have recognized what had actually happened to me and sought proper treatment sooner.
Unfortunately, a DVT/PE is often difficult to diagnose, which may have been why the orthopedist didn't recognize mine. According to
Ineffective Treatment
Once I was diagnosed, the treatment was straightforward — I was placed on anticoagulant medications, specifically heparin and then Lovenox. I believe I took the heparin in pill form and had to inject the Lovenox in my gut several times per day in an effort to thin my blood and break down the clot. Being no fan of needles, the initial injection gave me pause, but I soon got used to treating my stomach as a pincushion. I received another prescription for painkillers, and at one point I think I was on both hydrocodone and Vicodin to manage the pain. I did not become an addict, though I was quick to take one in the months after the incident to treat my chronic back pain. They also gave me a set of crutches to hobble around on and advised me to get a compression stocking for the leg, a single chic black pantyhose for the Glen or Glenda set. I left the ER relieved to know what was wrong with me but still in extreme discomfort.
Thankfully, my employer was sympathetic to my situation and let me take several weeks of combined sick and vacation time to heal up. My recovery proved to be frustratingly slow, however; the anticoagulants hardly seemed to be working and the painkillers did little to numb the excruciating pulses of pain from my thigh whenever I had to stand upright and limp to the bathroom or kitchen. The leg pain was compounded by the pain caused by the crutches to my armpits and shoulders; in retrospect, I don't think they were adjusted correctly, but it was the first time I'd ever used them, so what did I know. I only found relief when laying down on my back with my leg propped up under a stack of pillows.
I expressed my frustration to a physician during a follow-up exam a few days later; he was surprised that my recovery was progressing so slowly. I asked if surgery was an option, and he initially said no, though he would look into it. My memory is hazy, but I think I saw him at least one more time before I got a call requesting me to fast in preparation for check-in at the hospital at the end of the week. Someone had decided that my situation was serious enough to warrant going under the knife. The first thing I asked was: will my insurance cover this? "Yes," I was told. I had never undergone surgery before but whatever trepidation I had was thoroughly offset by my fervent desire to end this chronic leg pain. "I'll be there," I replied.
Undergoing a Venous Thrombectomy
My case had made its way to the desk of the area's top vascular surgeon. The irony was that he worked out of the very hospital near my apartment I had so desperately tried to avoid; if I had just gone to the emergency room there the day the DVT occurred, I could have possibly come under his care much sooner and minimized the damage to my leg. This was karma rubbing my face in my own stubborn stupidity.
My wife drove me to the hospital Friday evening; they checked me in, had me strip down and change into the usual embarrassing hospital gown designed by an exhibitionist with a sense of humor. I found it almost impossible to sleep and developed a fever; the stress of combating the clot had finally caught up with my body. I sweated profusely, shivered like a beaten dog, hallucinated, heard voices, the whole works. For some reason, I don't think I called the nurse though, probably because I thought she was one of Satan's minions. I may have also caught some bug during my frequent visits to the doctor, as hospitals are ideal places for exposure to a cornucopia of bacteria and viruses. When the nurse came to prep me for surgery in the morning I was in worse shape than when I had checked in.
Prior to surgery, the doctors had me do an MRI. I remember one of them telling me that a healthy person should not have one done, as it often reveals internal anomalies that could drive a hypochondriac crazy with anxiety. In my case, they made an important discovery—I was missing myinferior vena cava (IVC), the large vein that carries deoxygenated blood from the lower half of the body into the right atrium of the heart. Instead, I had a complicated spiderweb of veins that somehow fulfilled the same function. The doctor explained that while my lack of a normal IVC likely was a causal factor in developing the clot, it may have also saved my life, preventing the clot from breaking off and traveling to my lungs, where it could have caused a PE with potentially fatal consequences. I asked the doctor if the abnormal IVC was unusual enough to make the medical journals, and he responded in the affirmative with some enthusiasm. I felt an absurd sense of pride that my mutant vascular system was worthy of publication. My subsequent research has shown that lacking an IVC is a very rare condition, with only 62 cases having being described in medical literature as of December 2010.
(Left: A vintage illustration of the inferior vena cava courtesy of Wikipedia; mine apparently looks nothing like this.)
In addition to the MRI, the doctors had a lot of blood work done to see what else might have caused such a severe DVT. Various members of the vascular surgeon's entourage came in and out of my room to update me on the results. One young doctor with a terrible bedside manner informed me that I could have cancer, then proceeded to walk out the room and leave me alone to contemplate this dire possibility. Luckily, the cancer theory later proved to be incorrect.
I eventually tested positive for lupus anticoagulant, which is an antibody against substances in the lining of cells. Persons with these antibodies may have an abnormally high risk of blood clotting. Lupus anticoagulant is most often found in persons with lupus, the autoimmune disease that compels the body's immune system to mistakenly attack healthy tissue. However, I did not have lupus and the doctors thought the lupus anticoagulant might be hereditary. Upon getting this news, I immediately worried about my future daughter and the implications it would have for her when she reached childbearing age, as lupus anticoagulant can cause recurrent miscarriages.
The procedure I was to undergo was called a venous thrombectomy, which is the surgical removal of a vein clot. The procedure is rarely performed in the United States and is most commonly used to treat phlegmasia cerulea dolens (literally: painful blue edema), which is characterized by severe pain, swelling, cyanosis and edema of the affected limb. Though the doctors did not use this term to describe my leg, I believe it's the condition I had, as the symptoms were quite similar and a Google image search (not safe if you just ate your lunch) shows photos of affected legs similar to mine.
Prior to the big show, they made small incisions in several parts of my body to insert filters, which were supposed to prevent a piece of the clot from breaking off and causing a PE. I was on local anesthetic. I recall incisions being made in the back of my thigh and the side of my neck, though there may have been others. The attempt to insert a filter in my neck vein was unsuccessful, possibly because there were clots there as well. I think the doctor told me that I had several clots in my system, the one in the leg being the most severe. They placed me on my stomach for the surgery. I first felt a light prick on the back of my thigh, which deadened the area for the big horse needles to go in; they didn't hurt as much as you would think. It helped that I could not see what was going on. They then cut a small hole in the back of my thigh and inserted a catheter sheath (short plastic tube), which stayed in my leg for a couple days. It reminded me of tapping a maple tree. A contrast dye was injected through the sheath and a venography was performed, allowing the surgeon to see the area of the vein being treated on an x-ray screen. I believe he performed a percutaneous mechanical thrombectomy, in which a guide wire is inserted through the sheath in the femoral vein, the wire advanced past the clot, and a catheter is passed over the wire to the blocked area. A device at the tip of the catheter, either a mechanical tool or a high-velocity liquid jet, broke up the clot.
I recall the first procedure lasting about 45 minutes; I never saw the clotted blood they removed, though I imagine it probably resembled the filling of Blutwurst (German blood sausage) — just not as tasty. I didn't feel much pain as they dug around in there, but I did feel the weird sensation of a foreign object probing inside the back of my leg. They finished and cleaned me up, tearing off a lot of leg hair during the removal of tape from around the incision; this was actually the most painful aspect of the procedure. I was then rolled over onto my back, the nurses taking care not to straighten out my leg, as the catheter sheath was still in there. Off to the ICU I went to recover and prepare for the second procedure.
They kept me on my back in the ICU with my leg elevated; despite a steady stream of painkillers, I could feel the plastic tube sticking uncomfortably out the back of my thigh. The following morning I underwent a second surgery that was basically a replay of the first, though I assume they concentrated on removing clotted blood from a different part of the leg. I received no indication of how well it was progressing or if things were going according to plan; I felt basically helpless and at the mercy of the doctors throughout my stay. They finished up, finally removing the uncomfortable catheter sheath from the back of the thigh, and tearing out another big patch of leg hair as a parting gift. If I recall correctly, they did not completely sew up the incision in my thigh, leaving it partially open to heal on its own. The open wound forced me to be careful while showering, as I sure didn't want to accidentally jam my finger in there.
The one positive side effect of my surgery was dramatic weight loss. The stress of the procedure and the medication I was on effectively ruined my appetite; I lost 19 pounds in less than a month. For a while, all I could stand to eat was broth; anything else revolted me. It was the first time I had been slim since college. In my experience, there has been no more effective weight loss method than becoming deathly ill; if only there was a pill that could produce that same sense of nausea and revulsion when solid food is placed in front of you. Unfortunately, my appetite for breakfast burritos and Irish stout returned, and I eventually ballooned up and beyond the weight I was at when the DVT originally put me out of commission.
A Painfully Slow Recovery
After a couple days, I was able to get out of bed and walk to the bathroom. At that point, I requested to be discharged, as I knew the longer I stayed, the more massive my potential hospital bill would be. They gave me a wheelchair rental and out the door I went. The wheelchair was a welcome improvement over the crutches, as I could raise the bad leg up to reduce the pain of getting around. I certainly needed it, as the immediate relief I thought would come after surgery did not materialize; the level of pain was only slightly less than what it was before entering the hospital. I was both surprised and deeply depressed about this; there were moments where I thought that I would never be able to walk normally again without extreme discomfort.
A few weeks after surgery, I finished up the book I'd been working on and sent it off to the publisher. I recall the wheelchair making it difficult to do simple things like making copies of the manuscript and getting the package mailed. The book was published about 6 months later and so far it has earned me the princely sum of $3,500. I would gladly give it all up to have a normal leg again.
Slowly my condition began to improve; I was able to spend more and more time upright and limping around. I would push myself each day to take increasingly longer walks around the neighborhood, making more progress each week. At about six months after the DVT, I could walk normally again without a noticeable limp. However, there were definite limitations to my mobility, as I'll discuss below.
Living with the Consequences
My Gammy Leg
My leg never returned to 100% health; I would say it's at about 66%. Thankfully, I can walk without a limp, though I cannot run for more than 45 seconds before it starts to burn and gradually give out on me. According to the doctor, this is due to the damage done to the valves in the main leg veins, preventing blood from circulating fast enough to replenish oxygen to the leg muscles. The smaller auxiliary veins have to do most of the work, and consequently they are much more visible under the skin of the left leg than on the right, though they are not as unsightly as your typical varicose vein. The left leg is also puffier, about 15% larger in volume, and darker in color. There are strange patches of hard flesh along my left shin, and I wonder if there is dead tissue under there; indeed, I wonder how much there is distributed throughout the leg. When I crouch to grab something from down low, there is an uncomfortable tightness and stiffness to the flesh of the left leg; it cannot compress as much as the right. It feels as if a mass of spoiled muscle tissue is ready to burst out the sides of my calf in this position, so I try to avoid it.
My left foot looks like it's been hobbled by Kathy Bates' sledge hammer, with ugly dark red blotches of scar tissue around the inner ankle and lighter discoloration on the outside one. The poor thing bore the brunt of the damage caused by the DVT and it shows; out of courtesy to others, I try to avoid being barefoot outside of the house, though I make an exception for walking in the surf along the beach, as it seems to have a therapeutic quality. I hope I haven't spoiled the evenings of too many young couples strolling past me as I lumber the other direction.
Having done a fair amount of research for this article, I am now fairly certain that I have a mild to medium case of post-thrombotic syndrome, which includes swelling, pain, discoloration and scaling in the affected limb. I am not alone, as half the people who have had a DVT suffer these long-term complications, an estimated 330,000 people in the US alone. In general, the more extensive the DVT, the more severe the symptoms of the syndrome will be.
I attempted biking a few months after my DVT but my left leg rapidly gave out on me, becoming a heavy dead weight and forcing my right leg to do all the work. I've attempted biking a few more times since then with the same result. I'd like to try a recumbent bike, as I think the leg might work better at a horizontal attitude, but they are quite expensive and currently outside my budget. It's probably not a good idea for me to be biking anyway, as it's one of the more dangerous forms of transport. One good smack by a car I'd probably die of an internal hemorrhage within a few minutes. It's unfortunate though, as I used to bike frequently and it helped keep my weight down.
My physician advises me to wear a compression stocking throughout the day, but I only do so when standing for prolonged periods in front of my standing desk. I work out of my home office with the blinds open; passersby must think I'm some sort of absent-minded cross dresser, as I usually have on shorts and one black stocking. I don't enjoy wearing the thing and once worked standing without it for several hours, resulting in a cartoonishly swollen balloon foot that could have been drawn by Tex Avery. It made my kids laugh, but it rattled me, so I always wear it now when standing for long periods.
Mmmmmm….Rat Poison!
I am permanently on warfarin (generic Coumadin), consuming 15 mg a day to maintain an international normalized ratio (INR) between 2 and 3. I have to go to the Coumadin clinic of my local health care provider to have my INR tested every four weeks; the test is for the doctor to know whether the anti-clotting drug is on target or if I need a change in my dosage. The biggest risk of warfarin is developing internal bleeding; every time I have a serious headache, the possibility of a brain hemorrhage begins to worry me.
In addition to headaches, I am very sensitive to any unusual pains or muscle spasms, which are not uncommon among middle-aged persons who are not in the best of shape. Whenever they occur in my legs, especially around the left ankle, I immediately start considering the possibility of another DVT. Though I wouldn't call myself a hypochondriac, I definitely have a sense of paranoia about this issue. For me, the side effects of warfarin include a tendency to bruise very easily; bleeding like a stuck pig after a minor cut; and heightened sensitivity to swings in temperature. These are nothing compared to some of the more serious documented side effects, such as hair loss; bleeding from the rectum; bleeding in the urine; hives and various other skin conditions; fever and flu-like symptoms; vomiting; diarrhea; joint pain; priapism; skin necrosis; and gangrene, among others.
Every morning I toss a handful of water in my mouth followed by three pills of warfarin, praying I don't mess up in swallowing and accidentally get one of them lodged on my tongue, as they taste absolutely horrid. There are elderly stroke survivors who consume less warfarin than me, and that's who I see when I come in for my monthly blood test — a room full of very seasoned citizens. Warfarin was initially introduced in 1948 as a pesticide against rats and mice, and is still used for this purpose. It was approved in the US for use as a medication in 1954. After 5 years of being on the stuff, I asked my hematologist if I could get off of it, as it just can't be good for your longevity to be ingesting a thimble full of rat poison each day. Indeed, it isn't — a recent study shows that being on anticoagulants significantly increases your chance of death if you are involved in a major physical trauma, such as a serious car accident. Given the annual carnage on America's roads, which typically numbers between 30,000 to 40,000 fatalities per year, I believe I have an above average chance of it happening to me.
After running some tests, the hematologist decided that I should stay on the medication. She explained that once you have suffered a major blood clot, you are much more likely to suffer a second one. She was absolutely right, as about one-third of people who've experienced a DVT/PE will have a recurrence within 10 years. She was also concerned that my abnormal IVC put me at a higher risk for another clot. Recalling the lengthy, excruciating pain of my last DVT, along with the possibility that a second one would be my last, I reluctantly decided to stay on it. One curious test result was the absence of lupus anticoagulant antibody that had shown up in tests five years earlier. I don't understand how something like this could just disappear, so I'm guessing the original test was a false positive.
Being on warfarin has forced me to change my diet quite a bit; I have to avoid eating excessive amounts of food high in vitamin K, which decreases the effect of the drug and increases the possibility of a clot. Foods high in vitamin K include kale, spinach, turnip greens, collards, swiss chard, parsley, and mustard greens. I also have to watch out for foods moderately high in vitamin K, such as brussels sprouts, green, broccoli, and various types of lettuce. Beverages to avoid include alcohol, cranberry juice, and green tea. Except for booze, many of these foods and beverages are actually healthy for the normal individual, and several were among the few vegetables I liked eating, such as spinach. It has made maintaining a healthy weight a challenge, especially since I have minimal willpower/self-discipline to begin with.
I recommend working at a standing desk to avoid having a serious DVT/PE like me. This one is cobbled out of various Ikea components and is similar to the one I have. Image courtesy of Spacekat.me.
Some Advice
I am not a medical professional and you should talk to your physician if you feel that you are at risk of suffering a DVT/PE and want to take steps to avoid one. The following advice is based on a combination of my own experience and tips from official medical sites; you should do your own research before substantially modifying your diet or work habits:
- If you are in a sedentary job, get a standing desk. It doesn't have to be expensive — you can hack one together out of Ikea furniture for just a couple hundred dollars. Make sure you purchase a soft anti-fatigue mat to stand on as well. My DVT occurred before the studies about the dangers of excessive sitting had been publicized, and I wish I had known about them earlier.
- Even if you are fitness freak outside of your sedentary day job, it probably will not undo the harm of sitting all day, according to a recentstudy. Get a standing desk.
- Standing stationary for long periods can also be dangerous; you just can't win in this modern life. My weak bladder forces me to take breaks periodically, which helps. I also do exercises like standing on my toes, scrunching them repeatedly, rocking left to right on my feet, etc. If you do this while working in a cubicle farm, you will probably look like a mental patient, so be forewarned.
- If traveling on a long-haul flight, take steps to avoid a DVT, which is often called the "economy-class syndrome" for a reason. You could wear compression stockings; curl your toes regularly; move periodically and stretch your legs; and drink plenty of fluids, among otherprecautions.
- Think twice before accepting a lot of overtime. I know it's crazy to say this in such a depressed economy, but the benefit of extra money may be more than offset by the negative effects on your health. Do you really want to have a bum leg the rest of your life for a couple grand extra per year?
- If you have a sedentary day job, try not to have a sedentary hobby as well. It just compounds the damage you are doing to your body. Join a hiking club, do yoga, play pick-up basketball, swim, etc.
- Go radical and get retrained for a job that doesn't require you to sit in front of a computer all day — become a mountain tour guide, an aerobics instructor, a physical therapist, an auto mechanic, etc. Your reduced income may be offset by a longer, healthier life.
- Though it goes against the advice of one of my doctors, maybe you should get an MRI even if you are healthy. If I had known about my lack of a normal IVC I might have taken greater precautions with my health. An insurer may not cover it here in the US, but consider medical tourism as an option; an MRI only costs $280 in France, for instance.
- Maybe you should also consider a personal genome test to see what time bombs may be ticking in your DNA; I would recommend23andMe, but the FDA prohibited them from offering health assessments to consumers in November 2013. You could try one of their overseas competitors though, which do not face these restrictions.
Postscript
My beautiful baby daughter was born about 2 months after I recovered from my DVT, weighing a healthy 8 lbs and exhibiting no obvious physical problems. Not waiting around, we had a second child 14 months later, a handsome baby boy weighing the exact same amount, again outwardly healthy. Of course, I worry they may both have an abnormal IVC and/or the lupus anticoagulant antibody, but we won't be able to test them for these issues until they are closer to adulthood. It has been 7 years since my DVT and I've yet to suffer a second one (fingers crossed), though the thought is constantly in the back of my mind. I've also never suffered any severe side effects (that I know of) from warfarin, such as an internal hemorrhage. That being said, my gut feeling is that that I probably will not have a long life (my father died at 61), so I try to appreciate each day I have with my family. It's hard some days when the children spill spaghetti sauce on the carpet, but overall I feel fortunate to be here with them. Every day spent above ground is a good day, as the old saying goes.
Oh, and you might have figured out early on that "Gammy Hamhock" is not my real name; I decided on a nom de plume to hide my true identity out of fear that a future employer would do an online search, find this article, and elect not to have a potential insurance liability on staff. I've also left out the names of specific hospitals and doctors to avoid potential legal trouble. Ain't America wonderful?
This is an abridged version of The Charley Horse from Hell—Surviving a Massive Deep Vein Thrombosis (DVT), an eBook available on Kindle, theiBookstore, Kobo, and numerous other eBook platforms. It explores the subjects covered in this article in greater depth and offers more useful information and darkly humorous personal anecdotes than you can shake a gammy leg at.
