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Thread: Blood clot in leg and yet another UTI!

  1. #1
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    Blood clot in leg and yet another UTI!

    My poor guy just cannot catch a break! He was in the local hospital for 4 days starting Memorial day with a UTI and small bowel blockage. Went home with Amoxicillin (never heard of Amoxicilin for a UTI!) for 7 days, resulted in diarrhea and skin breakdown plus yeast infection. Condom catheter wouldn't stay on due to yeast infection, so went to ER to have Foley put in. Same day urine was still color of red whiskey so we went back and doctor said urine was "marginal", gave him Bactrim for 7 days. Dealt with diarrhea and skin irritation for another week. Finished Bactrim Saturday, felt pretty good, then started with chills, fever, feeling very tired and weak, legs swollen (despite starting Lasix), so yesterday we went to Pittsburgh to AGH in hopes that they would be better equipped to find out what was wrong and help him! He has a blood clot in the same leg he had one in in 2000. There is a stent in that leg, but one clot is on the wrong side of the stent. He also has yet another UTI. They started him on Heparin IV and Rocephin IV. They will switch to Luvox IM for the clot since he will not take Coumadin - says it almost killed him in 2000 due to internal bleeding they had trouble stopping. What exactly causes blood clots (besides lack of movement)? Is it related to being in the hospital for four days a couple of weeks ago, or is it something else? He is a T9/T10 para so movement hasn't really changed. The only thing I know about blood clots is that they can be deadly. I am trying to learn everything I can about what causes them, how to get rid of them and how to prevent them. As always, any advice, suggestions or comments are very welcome! On a positive note, the Neurontin 600 twice a day and 900 at night is really helping with the "usual" muscle spasm type pain. Could the blood clots, legs swelling, UTI, etc., be at all related to the Neurontin? Thanks!
    Last edited by Nickib; 06-20-2012 at 07:50 AM. Reason: Correct Medication! LOVENOX, not Luvox - ugh!

  2. #2
    Moderator jody's Avatar
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    Sounds like me last summer. It may set you back. read or do something outside at least an hour a day. you will heal and fight the problems faster. honest, the sunshine will help you heal faster. no sunscreen unless you are very light skinned, and then just enough not to burn.

    yes be careful with the blood thinner. They will test your level every few days until it is at a level to dissolve the clot. I had a weird feeling while on the warferin. I felt a feeling of utter dread. a feeling like I was waiting for my dad to get home a beat my ass. not panic, but foreboding. It was weird, but as soon as I was off that for a while, it went away so I know it was connected even if my Dr thought I was a nutcase.
    I got my bloodclot at the philly folk fest. I think a combo of heat, dehydration, and the travel to get there, oh and I was taking birth control pills, caused a uti, and clot.

    It sucked, and set me back a bit, but I think My Dr appreciated that I followed her treatment carefully, and told her all of my symptoms even if they didnt seem important.

    It turns out the awful feeling feeling of dread may be a side effect of warferin. I have spoken to others and some say they had that feeling.

  3. #3
    A second blood clot may result in needing to be on a blood thinner long term. Neither Neurontin nor UTIs make anyone at risk for blood clots. Lower extremity swelling and immobility make anyone at risk for blood clots. Compression stockings help prevent blood clots as they improve the circulation.

    I hope your son feels better soon. He has had several significant set backs that have been unfortunate.

    pbr

  4. #4
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    Thanks for your kind words and information. He won't wear the TED hose during the summer - stubborn one he is! He's my significant other - we have been together 2 years yesterday and yes, since fall 2011 he has had a lot of medical issues. We are hopeful that being at Allegheny General Hospital in Pgh will help get to the bottom of what's going on with him overall and find a treatment plan to get him back on track! I just moved in with him at the end of May so at least I am here every day now and not an hour away!

  5. #5
    My apologies on not reading your initial post correctly. I hope your significant other feels better soon. Please keep us posted.

    pbr

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    Update - multiple - old - clots in both legs!

    Well, now they say he has "multiple" clots in both legs, and they have been there so long there are blood vessels growing around them. How can this be? Apparently he has a Greenfield filter in place from the clot in 2000 - I'm thinking that filter saved his life! We are waiting to see the surgeon tomorrow to find out the options - surgery to insert stents in both legs or some type of "clotbusting" medication. Anyone have any experience with any of this?

  7. #7

    Greenfield Filter

    When they first started putting in Greenfield filters they were for acute blood clot prevention. They did not think about the long term effect of keeping them in patients. Now Greenfield filters are being removed following the completion of the acute care phase. If patients have Greenfield filters that are in place long term then patients are to be on blood thinners life long.

    It is not unusual to get new clots on top of old clots and that sounds like what has happened. He sounds like he will need to be on blood thinners life long and compression stockings will help preventative lifelong.

    pbr

  8. #8
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    Blood Clots & TPA - How does that work exactly?

    UPDATE - Danny was in from Mon-Fri during which time they cultured his urine and put him on a specific antibiotic for whatever bacteria he had. One good thing at this point is that after two rounds of broad-spectrum antibiotics and a ton of unpleasant side effects from both he is finally on the road to recovery from the UTI. I haven't been able to be there for all of the doctor's visits and discussion so I am really in the dark and frustrated as to what exactly is happening with regard to the "multiple" blood clots that are supposedly in his legs. I am hoping that once again the plethora of knowledge that resides on this forum might be able to educate me. Here is what Danny relates to me. They went in last Thursday to administer TPA. First, Danny told me that when the doc got in there and started, the clots were so thick and numerous that he could only inject a small amount of the TPA and had to stop, let Danny go home for a few days and then he was to return to continue the procedure. He was discharged on Friday and they called yesterday at 7:00 a.m. to tell him to come. The plan was he was to be admitted right to the procedure (angio?) and then taken to surgical ICU for observation for 3-5 days. When I got there last night (just started a new job - ugh!) he tells me that the doc on Thursday actually "punctured" the vein and wanted him to heal for a few days before proceeding. I don't understand all of that, but okay. So apparently they put the catheter in behind his right leg and the medication is running up to his groin and down the left leg. They are taking him back in today to make sure there is no internal bleeding. They will do this again tomorrow. Providing everything is okay, he expects to be released Thursday. Does anyone here understand this process better than I do? All I know is that TPA is used to treat stroke victims and that it is referred to as the "clot-buster." I do not understand what this process is with regard to an SCI patient with "multiple" clots in his legs and supposedly in his right lower abdomen (where he has all of the dang pain we are trying to resolve!). I also do not understand what our hopeful outcome is after all of this is done (besides of course to not have clots any longer!). What happens to the clots once they are broken up? He tells me that they "stick to the sides of the veins" - how can this be good long-term? If the filter that has been in his body since 2000 catches them, doesn't it eventually get clogged? Then what? Sorry, but I have no other educational resource to turn to. Oh, and just for fun, the Lovenox was $231 for four days' supply - he is in the donuthole and while his insurance doesn't cover much, he doesn't qualify for any of the government programs that help subsidize prescription co-pays and he doesn't spend enough in medication to qualify for the manufacturer assistance program. Again, any thoughts on this? He is terrified to go on Coumadin because of his near-death experience in 2000 due to internal bleeding. As always, thanks for any information, suggestions or advice! God Bless!

  9. #9
    He really should be maintained long term on Coumadin. Yes, there are risks related to this, but for most people, those are less than the risks of not being on it. Yes, his filter is probably clogged with clots by now. The clots will eventually calcify if they don't dislodge. It is common to develop phlebotic syndrome with a lot of leg edema for anyone who has had several DVT, and esp. a clogged Greenfield filter left in place.

    tPA is a drug that dissolves clots that have not yet calcified. It is sometimes used in embolic or thrombotic stroke (never hemorrhagic stroke), and also by nurses to open up clotted off IV and central lines in the hospital. It is unusual that it is being used for DVT treatment. There is some risks involved in its use as it can also cause bleeding if giving in large amounts, but it does not stay around long in the body (unlike Coumadin).

    If you are his SO, then I would recommend that you go to a an appointment with him, or get his permission to discuss his management with his physician for more information.

    (KLD)

  10. #10
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    Wow, this has me so confused. Yesterday they took him down to check things (bleeding, etc.) and said that he was doing great, reduced the TPA in half. They said they would check again today and tomorrow and hopefully he could go home tomorrow. This morning they took him down to check and "removed" the catheter in his right leg but left the sheath. They are taking him back down this afternoon to check the left leg. What I don't understand is this. I thought the catheter/TPA was going in BOTH legs simulatneously? It sounds as though they are doing one leg at a time. Does this mean anything? SCI-Nurse - thank you for your insight. Yes, I am definately going with him to his follow up visit. It's frustrating that I have to be at work while all of this is happening, but it's not possible for me to be at the hospital all day hoping to catch a doctor right now (sigh).

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