Sammy Sue & Her Clot

I figured I should blog about my niece, Samantha (aka Sam, Sammy Sue- I will probably refer to her like this throughout this post). Some of you are already aware of what happened to her, but like anything else, this is important and I blog about the important things (sometimes even the not so important)! :)

A couple of weeks ago, I was visiting my sister, Becky and she was telling me that she was awaiting a phone call from Sam telling her what was wrong with her leg. Sam was supposed to go to the doctor and let Becky know the update. Apparently Sam's leg was very swollen and sore. It had been bothering her for a little while, but she didn't think too much of it because she thought that she had just pulled a muscle while exercising.

I decided to leave to go home and I told Becky to call and let me know what was happening and if she needed anything to let me know. No sooner than I walked in the door with the kids, Becky was calling me to let me know what the doctor said. Sam had a blood clot in her leg and the doctor sent her to the emergency room to get an ultrasound. Becky was driving up to Sherman (north of Dallas) and wanted me to go along for support and company. I packed in a matter of minutes and made plans with my parents to drop off the kids with them since Gabe had to work. We left about 5:30 that evening, dropped off the kids with Grandma & Papa, and made it to the hospital at about 11pm.

When we arrived, Sam had already been a room for a little while. It was confirmed by the ultrasound that she definitely had a blood clot in her leg. And she was on bed rest so that the clot would not travel to her lungs. The doctor was already concerned that she might have had a small clot in her lungs because Sam said she had been short of breath at work. They also took an x-ray and an EKG in the ER. Other than that, that is all that we knew. The nurse on duty really couldn't tell us a whole lot. A lot of the paperwork hadn't made it from the ER yet and the doctor wouldn't be in until morning. So, Becky and I decided to leave for the night and go to the hotel.

I think we maybe got 5 hours of sleep that night. We were up by 6am so that we could be at the hospital in time to see the doctor. It was unknown what time he would make his rounds, but we didn't want to take the chance of missing him. Becky obviously had a lot of questions, but she also needed to know if she could leave the country the following day. Her and Dan were planning on leaving for Rome for a full week.

We sat with Sam all morning trying to keep her entertained and comfortable. She was hooked up to an IV which was a blood thinner medicine. Her leg was really swollen- all the way down to her ankle. And that didn't seem to be getting any better. One of the nurses had a good idea- let's measure it so that we can track it. Her good leg measured at 17 inches and her swollen leg measured at 21 (if I remember correctly). The doctor came in finally at 2:15! He was very thorough and answered all of our questions before we could even ask them. According to him, the clot was most likely caused from her birth control since there was not a family history of clots and that she was so young. He suggested that she stay in the hospital till Friday (this was Wednesday), stay on the blood thinner medication, and on bed rest. Over the weekend however, she would have to stay in bed and give herself injections of another blood thinner medication. Luckily, Sam has a really good friend whose mom offered for her to stay at their house until she got better. This made Becky feel a little more comfortable with leaving. The doctor also ordered another ultrasound to track the progress of the clot. The nurse was to call Becky once she got the results back.

So, we decided to leave. It was hard to leave though, knowing that Sam didn't have any family there to take care of her - I can only imagine how Becky felt. It was still 'up in the air' as to what her and Dan were going to do about their trip. They decided to make a final decision once they got the test results back that night.

We met my parents again to pick up the kiddos. As usual, they had a good time at the lake with Grandma & Papa. We then continued on our way home. The nurse called while we were driving through The Woodlands. They did confirm that a small piece of the clot had traveled to Sam's lung, but the doctor felt confident in his original plan. Most likely she would still be discharged on Friday. Becky dropped me and the kids off at about 8pm that night (what a long day) and she said she would be in touch with their decision on what they were going to do.

Overnight, they decided to cancel their trip. They figured if anything should happen... well, you know how that goes. I think we have all been there before. When I called Becky that morning, they were already on their way back up to Sherman.

Day 2 in the hospital: A new doctor comes in and decides that a specialist should see Sam. Her leg and ankle were still really swollen and at times getting bigger! The specialist decides to run tests to definitely make sure what caused the clot. They also have to watch her INR level. Not sure what that stands for, but the target number to be discharged is to be between a 2-3. Hers was at a 1.6. To check her INR, she has blood drawn 1-2 times a day!

Day 5: The nurse had trouble finding a pulse in Sam's foot. They gave her an EKG and hooked her up to a heart rate monitor which they watch constantly. She also had a MRI to look at the clot to rule out a few things. Left untreated, Sam would have a lifetime of problems with this leg. It could even result in loss of a limb. But the procedure that they were recommending would be to prevent future problems. The results from the MRI came in. She was diagnosed with May Thurner Syndrome. Here is Wikipedia's definition:

May-Thurner syndrome in medicine is the name given to the situation in which deep vein thrombosis (DVT) of the iliofemoral vein is caused by compression of the left common iliac vein by the overlying right common iliac artery.^[1][2]

This was something that she was born with. So the clot was not caused by the birth control.

Day 6: Sam has the procedure done. The doctor went in and used a stent to 'prop' open the vein, he also inserted a filter so that none of the clot would travel while he was doing the procedure, and he cleaned out the clot (100 cm) which went from her belly button to the top/mid of her thigh. She would have to stay in recovery for 24 hours.

Day 7: Sam got out of ICU and everything looked good. She was cleared to be discharged for Wednesday morning! Only a week later!!

Day 8: Sam was discharged from the hospital and they packed up and drove home.

She is still taking blood thinner injections (I think only once a day) and she still has to have her blood tested every few days to make sure the medicine is working. Other than that, the swelling has gone down and she is feeling fine. She has been home for about two weeks to recuperate. And she has a follow up appointment tomorrow in Sherman. I will be sure to leave an update when I know something. I know she is anxious she get back to work and her friends!