Patient Profiles : Cathy’s Profile
Cathy’s Profile
One Wisconsin winter evening after returning home from an outing, Cathy experienced a sudden sharp pain in her left calf. She remembers reaching down, rubbing her calf, and telling a friend that it hurt and felt like a vessel spasm.
The next morning at work she continued to experience the discomfort in her calf. Cathy is a 48-year-old surgical nurse who works in a busy hospital, so the thought of a deep vein thrombosis, or DVT, crossed her mind. She knew many of the symptoms of a DVT— a warm and tender area, redness or swelling — but she had none of these. She experienced a slight discomfort in her calf, which would sometimes intensify if she tried to stretch her calf by pointing her toes toward her head. Plus, Cathy is active and young and didn’t think she had the other risk factors for developing a DVT.
Although her discomfort was mild, it did not go away and she also noticed swelling of her ankle. Around noon, she discussed it with a colleague in the emergency department. It was recommended that a Vascular Lab technician conduct a duplex ultrasound to be sure Cathy didn’t have blood clots in her leg veins.
Cathy was soon given the news that she indeed did have a DVT in her knee and calf veins. She was kept overnight in the hospital to start heparin treatment and was discharged the next day as further treatment could be done as an outpatient. She was given subcutaneous heparin for five days and was also started on a blood thinner pill, warfarin. She was advised to elevate the leg frequently during the day and wear elastic stockings. Cathy needed regular blood tests to manage the dose of warfarin she was taking and was kept on blood thinners for six months. After that time, her doctor prescribed a daily baby aspirin.
Cathy was able to return to work after just three weeks since she "caught" the DVT early. She continues to have mild swelling in the left leg and some pain from time to time. Lately, she has noticed many superficial "spider veins." She also wears compression stockings. Since her initial DVT, she has had two more ultrasounds to rule out another DVT. Although a small "remnant clot" remains, it is scar tissue within the vein from her original clot and poses no additional danger.
Cathy is still baffled that she had a DVT. "I had no previous injury or surgery. My doctor thought that since I am on estrogen replacement therapy, this might be a contributing factor."
Cathy was fortunate that she knew enough about DVTs to seek early diagnosis and treatment and to avoid life-threatening complications.
