Vascular Surgery/dvt

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Question
Hi Lauri

Thanks so much for your help.  For the past three or four weeks, I have had a pain deep in the back of my left leg, behind and just above my knee.  It has gotten progressively more painful.  There is a pretty good sized lump which is not on the surface- it is deeper, but it isn't hot or red.  I put it off to a muscle pull, but now my entire leg is sort of swollen and it is becoming more and more difficult to bend the knee joint or for simply get moving once I get up from a seated or even supine position.  I am hesitant to see a doctor for a couple of reasons - it is expensive for me - I have insurance, but the copay is really a lot, and any extra tests also carry a hefty copay.  I'm hoping it's just a muscle pull, though I must admit I've never had one that lasted this long or swelled this far from the original site - from the ankle and up to the thigh.  Are there any symptoms that are hallmarks of dvt that I could check out, so I can rule it out?   Any advice would be greatly appreciated.

thanks!!

andey

Answer
deep vein thrombosis symptoms can include:
Swelling in the leg, including swelling in your ankle and foot.
Pain in your leg; this can include pain in your ankle and foot. The pain often starts in your calf and can feel like cramping or a charley horse.
Warmth over the affected area.
Changes in your skin color, such as turning pale, red or blue.
unfortunately, the only way to tell if it is a dvt is to get an ultrasound
and yes, it is an expensive test, a few hundred dollars, but if it is a dvt

risk factors for dvt according to the Mayo Clinic are
"Many factors can increase your risk of developing deep vein thrombosis (DVT), including:
Sitting for long periods of time, such as when driving or flying. When your legs remain still for long periods, your calf muscles don't contract, which normally helps blood circulate. Blood clots can form in the calves of your legs if your calf muscles aren't moving. Although sitting for long periods is a risk factor, your chance of developing deep vein thrombosis while flying or driving is relatively low.
Inheriting a blood-clotting disorder. Some people inherit a disorder that makes their blood clot more easily. This inherited condition may not cause problems unless combined with one or more other risk factors.
Prolonged bed rest, such as during a long hospital stay, or paralysis. When your legs remain still for long periods, your calf muscles don't contract to help blood circulate, which can make blood clots develop.
Injury or surgery. Injury to your veins or surgery can slow blood flow, increasing the risk of blood clots. General anesthetics used during surgery can make your veins wider (dilate), which can increase the risk of blood pooling and then clotting.
Pregnancy. Pregnancy increases the pressure in the veins in your pelvis and legs. Women with an inherited clotting disorder are especially at risk. The risk of blood clots from pregnancy can continue for up to six weeks after you have your baby.
Cancer. Some forms of cancer increase the amount of substances in your blood that cause your blood to clot. Some forms of cancer treatment also increase the risk of blood clots.
Inflammatory bowel disease. Bowel disease, such as ulcerative colitis, increases your risk of DVT.
Heart failure. People with heart failure are at risk of DVT because a damaged heart doesn't pump blood as effectively as a normal heart does. This increases the chance that blood will pool and clot.
Birth control pills or hormone replacement therapy. Birth control pills (oral contraceptives) and hormone replacement therapy both can increase your blood's ability to clot.
A pacemaker or a thin, flexible tube (catheter) in a vein. These medical treatments can irritate the blood vessel wall and decrease blood flow.
A history of deep vein thrombosis or pulmonary embolism. If you've had DVT before, you're more likely to have DVT in the future.
A family history of deep vein thrombosis or pulmonary embolism. If someone in your family has had DVT or a pulmonary embolism, your risk of developing DVT is increased.
Being overweight or obese. Being overweight increases the pressure in the veins in your pelvis and legs.
Smoking. Smoking affects blood clotting and circulation, which can increase your risk of DVT.
Age. Being over age 60 increases your risk of DVT, though it can occur at any age.
Being tall. Taller men may be more likely to have blood clots. Taller women do not appear to have an increased risk, perhaps because most women do not typically get as tall."

a life-threatening complication is embolism in your lungs
the symptoms of which are:
sudden, unexplained shortness of breath
chest pain that gets worse with deep breath or cough
lightheaded or dizzy, or fainting
fast pulse
sweats
coughing blood
anxiety, nervousness
if you get any of these symptoms you DO have to get to a hospital

not treating a dvt can lead to a life long complication called postphlebetic syndrome with swelling, pain and discoloration of the skin (in your legs) and eventually wounds that are difficult to heal

i hope this helps
lauri

Vascular Surgery

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Lauri Ordway

Expertise

I can answer your questions related to your circulation, your peripheral vascular system. This includes all arteries and veins except those inside the head and inside the heart. For example, neck (carotid), arms (carotid subclavian bypasses to Thoracic Outlet) belly (aortic aneurysm & occlusive disorders, renal artery stenosis), legs (iliac, femoral, popliteal, peroneal, dorasalis pedis, posterior and anterior tibial) arteries. Aneurysm & occlusive disease, atherosclerosis, leg pain, arterial wounds and gangrene, amputation prevention. Arterial Bypass, Reynaud’s, Buerger's disease (thromboangiitis obliterans), Thoracic Outlet and other circulation disorders. Vein disorders: Blood Clots (DVT), post-phlebetic syndrome, varicose veins, venous stasis ulcers. I can help with vascular wounds from diagnosis to treatments. I have worked extensively with VNUS Closure and EVLT (Laser) for varicose veins and can describe pre and post procedure expectations and describe the procedures themselves. I can't help with spider veins or cosmetic vein treatment, we don't do it. I have 15 years of wound care experience, arterial, venous, trauma and diabetic wounds for example. **I CANNOT answer questions about STENTS or STENTING, heart disease, blood pressure, brain aneurysm although I can help with questions about the arteries that go to and from those organs.

Experience

I am a nurse, I worked for 15 years with two terrific peripheral vascular surgeons, and one of them is also the inventor of very innovative wound care products and surgical instruments to make vascular surgery procedures better and faster. I wrote and manage the clinic website and field questions from patients all over the world. I am now working with another vascular surgeon and wound care expert, which has given me an opportunity to widen my horizons as I learn another excellent physician's preferences and benefit from his experiences in this amazing specialty.

Education/Credentials
I am an LPN, licensed in Minnesota

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