Pulmonary Embolisms !!

[Pat Walter]

Link http://health.groups.yahoo.com/group/surfacehippy/message/94165

...On Nov 25th I woke in the night with shortness of breath and chest
pains, some of them severe. I got through the night and things were
better the next day. Next night was similar but not quite so bad, and
things continued to improve slowly. As a result of Thanksgiving
weekend and a snowstorm it was 29th before I got to the local hospital.

I was given a CT scan and diagnosed with pulmonary embolisms in at
least two lobes of my right lung. I was admitted and put on bed rest,
EKG monitoring and supplementary oxygen.I was kept in for three days,
during which a Doppler Scan showed blood clots in the deep calf veins
of my operated leg.

According to the Mayo Clinic pulmonary embolisms, left untreated, have
a fatality rate of 33%. 10% die within the first hour, which is about
the time it takes to get yourself registered in most hospitals.I am
still short of breath and am trying to find out whether this will lead
to permanent lung damage. I do not know when I can get back to any
sort of strenuous activity.

I was well aware of the possibility of blood clots and paid attention
to what was done to prevent them. In the Salem hospital I had powered
compression devices on my feet and elasticated stockings below the
knee. I was pumping my feet from the moment I came round in recovery.I
was out of bed on day 2 and pounding the corridors soon after. After
discharge I was put on warfarin, and followed the dosages carefully. I
am someone who does not sit still and I drive my wife crazy by moving
around in bed all night. I am fairly fit and have good leg muscles,
which I had kept in shape by biking right up to the surgery. I have no
personal or family history of blood clots. I figured I was at low risk.

So what went wrong?

The hospital did not give me compression stockings on discharge, or
advise me to get them.

More important, I think, my warfarin regime was inadequate. The day
after discharge my INR (measure of blood thinning) was a bit below
man-in-the -street level, i.e. no thinning effect. The technician
pointed this out and raised the warfarin dose a bit but didn't seem
particularly concerned. Six days later I was still virtually at
control level.The dosage was tweaked up once more.Again no one seemed
concerned. Warfarin acts slowly - perhaps if someone had thought to
put me on injectable heparin things might have gone better.

Dr Boyd says this is the third time he has seen this in around 3000
THRs and resurfacings.He agrees that I should have been low risk...