Bob Slydell
DIS Legend
- Joined
- Mar 25, 2004
- Messages
- 11,086
http://www.surgery.medsch.ucla.edu/...et Syndrome - Paget Schroetter Syndrome.shtml
Its been a very long 5 days, but let me try to give a summary of the first real health scare that Ive ever faced
Last Wednesday morning, I woke up with a sore and tingly right arm that just didnt look right. It was a different color than my left arm and didnt seem like it was getting good blood flow. I gave it a day, figuring it might get better, plus we were running around with Ryan to his doctors appointments, since he was sick as well. By Thursday morning, it hadnt gotten better, so I called my primary care doctor (and godfather to DS2) and he asked to see me at 1pm.
As soon as he saw my arm, he didnt look happy. Quite the opposite he looked concerned. He checked me out, asked me a ton of questions. These were questions I was going to end up hearing dozens of times in the upcoming days questions like had I had any traumas recently, hurt my arm, etc. Unfortunately, the answers to every question was either No or I dont think so. So after drawing some blood, he came back and told me he had talked to a vascular surgeon and he wanted me to go see him right from his office. They were going to do some ultrasounds and see if they can find a blood clot.
Across town I headed to the surgeon. His ultrasound tech got me in right away and spent about 30 minutes scanning every part of my arm and shoulder. Sure enough, there was a clot.
A subclavian vein clot to be specific (beneath the clavical bone). And to make things worse, it looked like my shoulder was pinching the vein anytime I lifted my arm. This becomes an important thing in a day or so when they start giving me more details as to my treatment.
So, I was told that they were admitting me to the hospital right then and there (there office was at the hospital, so I was already there). Actually, I had to wait an hour or so before I registered because the bed I was being assigned had just literally been discharged (it was the only open bed in the hospital). So, as odd as this sounds, I went and got a sandwich at the cafeteria (and made a couple phone calls) while I waited. It was weird with the exception of my arm feeling stiff, I felt fine. I had to have been one of the healthier looking people at admissions that day.
They got me registered and I got wheeled up to my room (another weird feeling, being pushed in a wheelchair when you can walk fine).
Once I got settled in, they got my IV started. Well, no, they didnt get it started; as it turned out two different nurses were 0 for 4 trying to get an IV started.
Finally, the house doctor had to start one for me, at 10:30pm (keep in mind, I was admitted at 6pm). They started giving me Heparin and let me know that at 7am Friday, I was heading down for surgery to insert a catheter to administer TPA to the blood clot.
Friday morning, I headed down for my surgery. It wasnt so bad kind of a weird feeling having a wire poked in your arm (they entered around my triceps muscle) and literally pushed up to my shoulder so they could get the TPA up there. Then they tried to send me to ICU for observation. One problem the same problem as the night before, no beds, this time in ICU. So I got sent to patient surgery recovery, which is normally is meant for brief recovery before patients get either discharged or sent back to their regular room. I was there for the long haul, though. Fortunately they had one bed there which had a TV, or I might have died from boredom. I was basically one-armed now as well, since I had my right arm strapped to a board so I didnt accidentally bend my arm. I wasnt allowed any food or water since midnight, so that kind of stunk too.
Later in the afternoon, they brought me back down to see how the TPA was working on breaking up the clot. I was pretty hopeful the clot was gone and I was going to be headed back to my room for more Heparin and eventually to be released. No such luck. It was starting to work, but nowhere near gone, which confirmed to them that this was Paget-Schroetter, because that tends to be a clotting that occurs over a long period of time, as it appeared that my clot had been. It was also then confirmed that because of my condition (e.g. the pinching of the vein), that in a few months, I was also looking at surgery to remove my first rib plus some of the muscle around that area, to avoid future pinching and problems.
I was sent back yet again to patient recovery, this time for the rest of the night. They basically kept the area open just for me (which made for a quiet night ) because normally once all the surgery patients are recovered and moved to rooms, the area is closed for the night. But since there were no ICU beds, that became home for the night. I was pretty uncomfortable most of the night, with occasional doses of morphine to help out, but I was lucky to be able to get some decent sleep (oh, and around 6pm, they allowed me to eat, so DW went and got me some dinner
).
Saturday morning, around 8am, I was back once again to get checked out. It didnt look encouraging when they looked at my swollen arm and hand and frowned, but as it turns out, that was because nobody told anyone to elevate my arm. The clot was gone!!
They took out the catheter and left in a sheath and sent me off to a regular room! The plan was to keep administering Heparin to me until my blood levels got to a therapeutic stage, so that they could start giving me Coumadin and be able to send me home.
That was the boring part. I got to my room by Saturday morning. I was allowed to eat and drink and all that, but still not allowed out of my hospital bed until my blood levels were good. So, I sat, and sat and sat. I had some guests which was nice as it broke up the boredom. My BIL (DW's brother) brought me a portable DVD player and some movies, so that helped as well. Unfortunately, it was Sunday afternoon before I was allowed out of bed. Too bad, because if they would have allowed me to, I would have gone running down the hall Sunday morning when my roommate started playing gospel music and sermons on his boombox and singing and praising right along to the stereo.
Once I was able to get out of bed, I was feeling much better (and not just because I could go to the bathroom without a bedpan
). My sister and BIL came to visit and went out and got some good bar food for lunch and thats when they told me that they were going to move me to a different room. Turns out my roommate had been there because he had surgery to remove tumors from his colon and liver and wasnt allowed to eat anything, so the smell of food in general both upset him and made him nauseous. So DW and I went down the hall with my sister and BIL to eat in an empty room and when we were done, they had moved everything a couple doors down to a different room. We watched the Daytona 500, and then everyone said goodnight and I watched some TV and got some rest.
Monday, I pushed and pushed to get discharged I did not want to spend another day in the hospital if I could help it. Problem was, my doctors were in surgery all day. Finally, around lunchtime, one of the nurses from surgery came to visit and said my doctors orders were Go Home (the exact quote)
. So, the nurse came down to teach me how to give myself shots of Lovinox (another form of Heparin), took out my IV and discharged me. Nicole and I went and got my Lovinox and Coumadin prescriptions from the pharmacy and then went and picked up the boys from school.
So now, I have a check-up this afternoon with my primary doctor, a follow-up with the surgeon sometime next week and have to give myself shots of Lovinox in my stomach for 5 days (twice a day). The Coumadin I will likely be on for around 6-8 months and Ill likely be looking at surgery to remove my rib and muscle in about 2 months or so. But other than making some adjustments in my life, Ill be fine.
Its been a very long 5 days, but let me try to give a summary of the first real health scare that Ive ever faced
Last Wednesday morning, I woke up with a sore and tingly right arm that just didnt look right. It was a different color than my left arm and didnt seem like it was getting good blood flow. I gave it a day, figuring it might get better, plus we were running around with Ryan to his doctors appointments, since he was sick as well. By Thursday morning, it hadnt gotten better, so I called my primary care doctor (and godfather to DS2) and he asked to see me at 1pm.
As soon as he saw my arm, he didnt look happy. Quite the opposite he looked concerned. He checked me out, asked me a ton of questions. These were questions I was going to end up hearing dozens of times in the upcoming days questions like had I had any traumas recently, hurt my arm, etc. Unfortunately, the answers to every question was either No or I dont think so. So after drawing some blood, he came back and told me he had talked to a vascular surgeon and he wanted me to go see him right from his office. They were going to do some ultrasounds and see if they can find a blood clot.
Across town I headed to the surgeon. His ultrasound tech got me in right away and spent about 30 minutes scanning every part of my arm and shoulder. Sure enough, there was a clot.
A subclavian vein clot to be specific (beneath the clavical bone). And to make things worse, it looked like my shoulder was pinching the vein anytime I lifted my arm. This becomes an important thing in a day or so when they start giving me more details as to my treatment.So, I was told that they were admitting me to the hospital right then and there (there office was at the hospital, so I was already there). Actually, I had to wait an hour or so before I registered because the bed I was being assigned had just literally been discharged (it was the only open bed in the hospital). So, as odd as this sounds, I went and got a sandwich at the cafeteria (and made a couple phone calls) while I waited. It was weird with the exception of my arm feeling stiff, I felt fine. I had to have been one of the healthier looking people at admissions that day.
They got me registered and I got wheeled up to my room (another weird feeling, being pushed in a wheelchair when you can walk fine).Once I got settled in, they got my IV started. Well, no, they didnt get it started; as it turned out two different nurses were 0 for 4 trying to get an IV started.
Finally, the house doctor had to start one for me, at 10:30pm (keep in mind, I was admitted at 6pm). They started giving me Heparin and let me know that at 7am Friday, I was heading down for surgery to insert a catheter to administer TPA to the blood clot.Friday morning, I headed down for my surgery. It wasnt so bad kind of a weird feeling having a wire poked in your arm (they entered around my triceps muscle) and literally pushed up to my shoulder so they could get the TPA up there. Then they tried to send me to ICU for observation. One problem the same problem as the night before, no beds, this time in ICU. So I got sent to patient surgery recovery, which is normally is meant for brief recovery before patients get either discharged or sent back to their regular room. I was there for the long haul, though. Fortunately they had one bed there which had a TV, or I might have died from boredom. I was basically one-armed now as well, since I had my right arm strapped to a board so I didnt accidentally bend my arm. I wasnt allowed any food or water since midnight, so that kind of stunk too.
Later in the afternoon, they brought me back down to see how the TPA was working on breaking up the clot. I was pretty hopeful the clot was gone and I was going to be headed back to my room for more Heparin and eventually to be released. No such luck.
It was starting to work, but nowhere near gone, which confirmed to them that this was Paget-Schroetter, because that tends to be a clotting that occurs over a long period of time, as it appeared that my clot had been. It was also then confirmed that because of my condition (e.g. the pinching of the vein), that in a few months, I was also looking at surgery to remove my first rib plus some of the muscle around that area, to avoid future pinching and problems. I was sent back yet again to patient recovery, this time for the rest of the night. They basically kept the area open just for me (which made for a quiet night ) because normally once all the surgery patients are recovered and moved to rooms, the area is closed for the night. But since there were no ICU beds, that became home for the night. I was pretty uncomfortable most of the night, with occasional doses of morphine to help out, but I was lucky to be able to get some decent sleep (oh, and around 6pm, they allowed me to eat, so DW went and got me some dinner
).Saturday morning, around 8am, I was back once again to get checked out. It didnt look encouraging when they looked at my swollen arm and hand and frowned, but as it turns out, that was because nobody told anyone to elevate my arm. The clot was gone!!
They took out the catheter and left in a sheath and sent me off to a regular room! The plan was to keep administering Heparin to me until my blood levels got to a therapeutic stage, so that they could start giving me Coumadin and be able to send me home. That was the boring part. I got to my room by Saturday morning. I was allowed to eat and drink and all that, but still not allowed out of my hospital bed until my blood levels were good. So, I sat, and sat and sat. I had some guests which was nice as it broke up the boredom. My BIL (DW's brother) brought me a portable DVD player and some movies, so that helped as well. Unfortunately, it was Sunday afternoon before I was allowed out of bed. Too bad, because if they would have allowed me to, I would have gone running down the hall Sunday morning when my roommate started playing gospel music and sermons on his boombox and singing and praising right along to the stereo.
Once I was able to get out of bed, I was feeling much better (and not just because I could go to the bathroom without a bedpan
). My sister and BIL came to visit and went out and got some good bar food for lunch and thats when they told me that they were going to move me to a different room. Turns out my roommate had been there because he had surgery to remove tumors from his colon and liver and wasnt allowed to eat anything, so the smell of food in general both upset him and made him nauseous. So DW and I went down the hall with my sister and BIL to eat in an empty room and when we were done, they had moved everything a couple doors down to a different room. We watched the Daytona 500, and then everyone said goodnight and I watched some TV and got some rest.Monday, I pushed and pushed to get discharged I did not want to spend another day in the hospital if I could help it. Problem was, my doctors were in surgery all day. Finally, around lunchtime, one of the nurses from surgery came to visit and said my doctors orders were Go Home (the exact quote)
. So, the nurse came down to teach me how to give myself shots of Lovinox (another form of Heparin), took out my IV and discharged me. Nicole and I went and got my Lovinox and Coumadin prescriptions from the pharmacy and then went and picked up the boys from school.So now, I have a check-up this afternoon with my primary doctor, a follow-up with the surgeon sometime next week and have to give myself shots of Lovinox in my stomach for 5 days (twice a day). The Coumadin I will likely be on for around 6-8 months and Ill likely be looking at surgery to remove my rib and muscle in about 2 months or so. But other than making some adjustments in my life, Ill be fine.
.
