Saturday, October 30, 2010

Happy Halloween!

I can't wait to carve pumpkins and hand out candy to the kids tomorrow! I enjoy Halloween immensely. It's nice to be able to look like whomever (or whatever) you want for at least one night.

Besides starting warfarin on Monday, not much has changed with me condition-wise. I had the time my blood takes to clot (INR) taken on Thursday and it's not within therapeutic range yet. Mine is at 1.3 and therapeutic is between 2-3 (normal is around 1). I'm on 6mg of warfarin and 0.80ml of heparin until the INR is over 2 and then I'll be taken off heparin. I've been having intermittent chest pain and heart palpitations, but I freak out at every little leg twinge so I think I'm bringing it upon myself.

This morning I woke up with what feels like a muscle cramp on the back of my thigh that's pretty mild. It very well could be another clot but there's nothing more that be done about it now that I'm on blood thinners, so I'm trying not to worry but it's difficult.

I hope everyone has a fantastic Halloween night!

Sihing Karissa Martin
Silent River Kung Fu
Stony Plain, AB

Monday, October 25, 2010

Finally! Some direction!

My appointment with the hematologist went very well. The blood tests so far have turned up normal, but I still have to get the blood drawn for a lupus anticoagulation test. I'm not in the clear just yet for any diseases, but it looks like I'll be on anticoagulants for only a year.

At the moment the only cause of my blood clot is oral contraceptive use. The chances of developing a blood clot while on the pill is very small. Here is a article on thromboembolism and oral contraceptive use (it's a bit of a tough read if you're not into statistics but it's not too bad):http://www.medscape.com/viewarticle/421027_4

I also received the results of the V/Q scan and ultrasound of my leg. According to the report my right lung was almost completely blocked, as well as having multiple large clots in my left. I am basically running on a quarter of the lung capacity I usually have... I'm surprised that I don't have any chest pain. Or I just have a crazy pain tolerance. On a good note, there is no evidence of acute or chronic clots in my leg and all veins look normal. Yay!

Today I'm going to attempt a few push ups and sits ups just to see how my body reacts to them. Wish me luck!

Sihing Karissa Martin
Silent River Kung Fu
Stony Plain, AB

Sunday, October 24, 2010

Many thank you's and a little medical speak.

First of all, I want to say thank you to those of you who took the time to read about my experience and to say some kind words. Not only do you now know what the deal is with me but hopefully you learned something too. Thanks again.

Second, I'm going to list off the symptoms I had as they are kind of scattered throughout my last post. Remember that these were my specific symptoms and sometimes people don't have any symptoms at all.

Symptoms of a blood clot (deep vein thrombosis):

-localized pain (in my case in my left hip) that made walking painful. I would describe it as being similar to when you pull a muscle, expect that the pain doesn't subside over time.
-mild swelling in my thigh and feet
-my whole leg felt heavy and just funny in general

Besides the pain, my other symptoms were very general and mild. I honestly thought I had just pulled something while working out at the gym. It was when the pain didn't improve after a week that I had considered going to a doctor, but then I had the pulmonary embolism that day. Go figure.

Symptoms of pulmonary embolism:

-sudden cramp of my entire leg. It was unlike any other cramp I have had before as it encompassed my WHOLE leg. Very odd feeling.
-almost immediate shortness of breath and pleuritic chest and upper back pain (pain that worsens when taking a deep breath.)
-weakness
-anxiety
-tachycardia (fast pulse). This is what I found most disturbing. My normal resting pulse rate is around 60 bpm. My heart rate during and for around 5 days after the embolism was 140 bpm, sometimes going up to 160.
-abnormal heart beat

Remember that pulmonary embolism is a complication of deep vein thrombosis, so it doesn't occur without the presence of a clot. Also remember that these are the symptoms that I had, and others may present with different ones, though mine are pretty much textbook.

If you experience any of these symptoms, call an ambulance. Most people who do die of pulmonary embolism do so within the first hour, and a quick diagnosis cuts down the mortality rate substantially.

I want to stress that my case is very unusual. In fact, my family doctor has never seen a pulmonary embolism in a 19 year old in his 10 years of practice. Blood clots are way more likely to happen to elderly people who are sedentary, after surgery and to people with genetic predispositions to blood clots. There is a good chance that I have a genetic clotting disorder but that's another post altogether.

I will be meeting with a hematologist tomorrow morning so expect a new post tomorrow.

See how I didn't use Wikipedia? I'm a good university student.

Sihing Karissa Martin
Silent River Kung Fu
Stony Plain, AB




Friday, October 22, 2010

It's been an interesting few weeks...

Two weeks ago I suffered a potentially life-threatening condition called a pulmonary embolism. It is a complication of a condition called deep vein thrombosis in which a blood clot forms in the large veins of the legs or pelvis. When a part of the clot breaks off, it travels to the pulmonary artery and blocks blood flow to the lung(s). This puts great strain on the heart as it's trying to pump blood through narrowed passages while not receiving adequate oxygen itself.

The week before it happened I had moderate pain in my left hip that spread down to the back of my knee that made walking difficult. Since it felt like muscle pain I thought that I'd wait it out and never suspected anything serious. By the day before my embolism I noticed some very mild swelling and redness on my thigh and foot. Again, it was mild but I was becoming slightly concerned that the pain was not improving.

While I was walking back from class I felt my whole left leg tighten and cramp up. About 15 seconds later the cramp let up and I immediately began hyperventilating. My heart began to beat fast and abnormally. I began to feel an sense of impending doom that really, really frightened me. I made it to a chair to sit down as I began to feel weak and lightheaded. It took me a couple minutes to realize that this was not going to go away, so I called my mom. In retrospect, I should have just called 911 but I was panicking and couldn't really think straight.

While waiting for my mom to arrive to take me to the hospital, I began to calm down a little. About 2 hours later we arrive at the University hospital. I could barely walk 20 feet without having to sit down. At the emergency triage, the nurse took a look at my vitals and immediately took me to get checked out. The nurses hooked me up to an EKG and a machine that monitors heart rate and respiration. The machine showed a heart rate of 140 b/m, which is more than double the normal rate of someone my age. A medical student asked me a battery of questions, and then I was taken to be given a chest x-ray. Afterwards I was admitted to the emergency department.

There the resident asked me more questions about my symptoms and family history. She suspected a pulmonary embolism but needed a V/Q scan (ventillation/perfusion scan) to be sure. (I thought the idea of inhaling radioactive isotopes and having gamma rays emitted from my lungs was soooo cool, which cracked the nuclear tech up. Even when I'm sick I don't stop being the nerdy science student.) A ultrasound of my leg was done to check for any clots, which there were none, so either the clot came from somewhere else or the whole thing made its way to my lungs. The V/Q scan showed two large clots in both of my lungs. The nurses started me on anticoagulant injections that will hopefully prevent any new clots from forming.

I was lucky to have been stable enough to be released from the hospital and subsequently be treated as an outpatient. A ton of bloodwork is being done to test for any clotting disorders or autoimmune diseases, as pulmonary embolism is not common in young people. I am going to have to be on anticoagulants for at least 6 months, and if any clotting disorders are found I'll be on them for a lifetime.

Nothing can be done for the clots already in my lungs. They will be reabsorbed by my body in time. How long it will take me to recover, I really don't know. For now being active is really tiring and I become short of breath very easily, which means my training is on hold for a while. How long I'm not sure, as it depends on how I feel in time. Remaining, at least, relatively active during my recovery is important as it will help prevent another clot from forming.

Please be aware that this condition can happen to anyone of any age. I was previously healthy before it happened to me. I want anyone who reads this to be aware of the symptoms of not only pulmonary embolism, but of deep vein thrombosis. When you are injured or sick, try to get moving as soon as possible (within reason) in order to reduce the risk of clots. If you experience any sudden shortness of breath and chest pain, call an ambulance. Don't wait for a ride to the hospital like I did.

If you made it through this post, thanks for reading as I know it's really long. This was mostly just for me as a way to "let go" of that experience and a way to lift a weight off my back. Writing experiences down definately releases any leftover emotions and also allows you reflect on the significance of that experience.

I'm feeling much better than I did last week, so hopefully I'll continue that trend. I will still be hanging around the kwoon during my recovery so I'm not disappearing entirely.

Sihing Karissa Martin
Silent River Kung Fu
Stony Plain, AB
www.silentriverkungfu.com