Friday, May 2, 2014

My Deep Vein Thrombosis Experience

Few days ago I read a news article about a former actor whose young wife died after giving birth, the symptoms were exactly the same to what happened to me about 5 years ago, she clearly died of Pulmonary Embolism but the actor was still at lost, he doesn't understand what happened to her 26 years old wife. I asked myself why I haven't blogged about it, oh yeah I did write a diary while I was in the hospital but it was in Multiply. I should have wrote it in a blog. I'm pretty sure she tried to google when she's experiencing pain in her leg, but just like me I'm sure she only got 'pregnancy cramps' or common back pain during pregnancy because there's only very few resources that talk about DVT during pregnancy.

I couldn't help but think, if only I knew her,  or if I have at least wrote about it and found me through googling, I could have saved her life. :(

I can't anymore recall the details but I can still remember how painful it was, the leg, the back pain, the 7 month injections, the bruises from the injections. Until now Iphone's default alarm sound still gives me a sad feeling whenever I hear it because I used it as an alarm for my 2x a day injection time. 

I was 8th weeks pregnant then, I never had a problem, no morning sickness in fact, my energy was up than usual. I was still working then in Tokyo and I ran from the house to the train station, to stairs going to the next station until the office on heels! It started as a little pain on my left leg whenever I walk, the pain stops when I sit or just stand because I was a software engineer who sits in front of the computer the whole day that doesn't require too much walking, the pain was manageable.

After three days, the pain creeped from the leg to the lower back, it's that top part of the buttocks but below the hips. I thought it was kidney stones so I went to see my doctor but he said it's not kidney stones because when he pound my back it's not painful, and if it were kidney stones I would have had fever. He said I was fine and it might be caused by my pelvis adjusting to my pregnancy.

Days have passed and the pain on my leg and back has gotten more painful, especially when I walk. It stops when I sit, it was weird because it's so painful when I walk but I don't feel any tinge of pain when I don't move. If it's rayuma, it should be painful every time. Still I managed because I was sitting the whole day, I thought it helped that I was super busy with work that I didn't even had time for a toilet break. (I told you my mental and physical energy when I was pregnant was off the charts! I couldn't be sick right?)

The the fateful day came, I guess it was about two weeks after since the first sign of pain, at 9 pm I logged out, took the elevator with a japanese coworker, told him to go ahead since I felt I needed to walk slower and then just like that, in snap the pain became so unbearable that I couldn't make one step anymore. I was not paralyzed but the pain in my left leg and lower back made it impossible for me to walk. I felt like I will die from pain if I make one step more. I dragged my leg a few steps more so I can sit on a bench outside the NTT Yokohama Building and called my husband who was working 45 minutes away from me. I waited for him while sitting on the bench, in a snowy night but freezing is better than walking. I could have died from freezing or hunger (because it's already 10 pm with no dinner yet!) or if I tried to walk I can die from the pain too. So that pain trumps everything, that's how I can describe it.

The emergency doctors couldn't figure out where the pain was coming from because they couldn't perform an x-ray so they ruled out it's just a common pregnancy cramps and advised me to take bed rest for two days. That night I had to piggy back on my husband to reach the house from our train station. At home, husband had to piggy back me every time I needed to go to the toilet even if we lived in a 30 sqm studio. That's how unbearable the pain is. The next day when I took a bath, I noticed my left leg turning red and hot. My friend messaged me online and told me she has read about DVT and she strongly suggest I go to my OB right away. It's weird because almost all the websites say that pregnancy DVT commonly happens in the 30th weeks but I was still on my first trimester at that time. Another friend suggested I go to the Chiropractor which I thought was more sensible since the I thought pain=bone=chiropractor. Four hours after I took a bath, I went to the chiro doctor who freaked out when he saw my left leg turned purple, he strongly advised us to go to my OB at once who looked more freaked out when my left leg turned dark purple and called the bigger hospital for an emergency referral.

The doctors at Tokyo Medical Center were quick to respond, they looked so scared but I was clueless on what was happening. They kept saying I can die, they put all the injections(heparin, antibiotics, dextrose) on me as fast as they could, and they never allowed me to move from my bed and told me if I move, I can die. And I was so desperate to pee.

The actor said they already performed CT scan on her wife but they didn't see anything, that's because DVT is very difficult to diagnose, blood clots can't be seen thru MRI or CT Scan. In my case, they only did MRI and CT Scan on me in the later part of my pregnancy just to check my blood flow and check any sign of stroke. During that time of emergency they performed 2D (or was it 4D) Echo on my left leg which is the only way to see blood clots. I remember they had to STAT in the best 2D/4D Echo doctor in the hospital who had previous experience in detecting blood clots. At that time, my blood clots were already in my stomach meaning, it's just a matter of hours before it reaches my lungs which could cause the fatal Pulmonary Embolism. I arrived at the hospital at the nick of time, that is why until now, I am deeply indebted to my friend who found out about DVT and told me to get up and see my doctor at once, instead of following the doctor's order of bed rest.

DVT just simply means formation of blood clots on your deep vein which is on your left leg that's directly connected to your heart. It is serious and rare for us filipinos and japanese too that is why it becomes more difficult to diagnose in the Philippines. It's common in America because of their mostly sedentary lifestyle. For the preggies, it usually happens on the 30th weeks or 8th month because that's why the tummy becomes heavy and the mother moves less from exhaustion. But it can be fixed by injecting blood thinners until giving birth. 

My case was rare because it happened in the earliest part of pregnancy and the Japanese doctors had to contact their american counterparts to confirm if it's safe to be on blood thinners for 8 months. They said they've never done it before, and take note, I was already at the best hospital in Japan and the government put me under the care of the best OB gyne in the country who was so popular he could only attend to complicated cases. 

DVT during pregnancy is serious and expensive, the daily injections alone costs P500/day and the cost of the laboratory tests needed is not for the faint of heart. During birth at least three doctors have to be present in the delivery room, namely the OB Gyne, the Immunologist and the pulmonary or heart doctor.

I just had the same blood works done on me few days ago, and I have normal results, protein S, protein C, etc... all normal. I just turn abnormal when I'm pregnant. 

To prevent it from happening to you, keep on moving and exercising. If you have to sit all day, one exercise you can do is stretch your heels up and down to keep the blood flowing on your legs. 

If you are pregnant and you think your left leg pain is caused by DVT, go see a cardiologist who can perform 2D Echo. That's the only way blood clot can be detected, not CT Scan or MRI.