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Hey all, Sorry I haven't posted in a while. Its...
Hey all,
Sorry I haven't posted in a while. Its been a whirlwind of a month. I started walking, mostly upright, about a mile a day at 3 weeks post-op. About 4 days into that I started having low back pain, just to the left of my spine/SI joint. Over the next few days the pain started radiating down my left leg and I diagnosed myself with sciatica the day before thanksgiving. Thanksgiving morning my leg was so painful I could barely stand. After struggling to get the turkey in the oven I told my husband I was just going to go sit in the shower for a little bit, maybe the hot water would help loosen up my back. And thats where he found me, 20 minutes later, sitting in the tub and looking at my significantly swollen, painful and purple left leg/thigh. Thanksgiving morning. Of all days. I actually made my h call the PS, to be sure for positive that I had to go in right then. Denial, party of one!! I knew. Fortunately I also knew at least one friend who was going to someones house for thanksgiving and not manically running around her own kitchen. She came over and watched our 3 kids while my h drove me to the local ED, she even basted my turkey. lol. I knew by the ultrasound sonographers face that it wasn't good, he turned the screen so I couldn't peek. I tried to joke with him about the fact that I was pretty screwed if he couldn't even compress the vein at my thigh, no turkey for me. He looked terrified. Within 10 minutes of him leaving I was in CT for a chest scan to rule out a PE (pulmonary embolus).
Doc came in and told me what I already knew, I had a massive blood clot. And a few things I didn't. No PE - Yay!!! And my clot extended from my knee up through my pelvis into the IVC - not so good. One of the biggest clots he has seen - uh, yay me? Then, for my little holiday miracle. An Interventional radiologist at another hospital was willing to accept me in transfer and try and dissolve the clot. This doctor, and his entire team, stayed late on thanksgiving for me. Talk about warm fuzzies. I'm tearing up just thinking of it!
So, I sent my husband home to relieve my friend and finish dinner for the kids. There would be no food for me for the next 3 days, let alone that night. But, my babies deserved Thanksgiving dinner. And there was no way I was going to intrude on anyone else's holiday. I didn't even tell my friends until the next day. So, there I sat, alone, in an ED room for a couple hours waiting until the receiving facility had an ICU room for me. The whole time wondering what the next few days would hold. And thinking heavily of a patient of mine 2 years ago, 42 y/o father who died of a PE in transit from our facility to another. Oh, the things that go through your head when you know enough to be dangerous and are drugged up on dilaudid.
The Interventional Radiologist met me within 15 minutes of arriving at the new hospital. I went almost immediately down to the IR suite. Even with conscious sedation, I could tell that the clot was almost completely occluding my vein. It took some time to weave the catheter, described to me as kind of like a soaker hose, from the back of my knee up the length of the clot. With the cath in place I went to ICU. TPA (clot busting drug) and heparin (anti-clotting drug) were run through the lines placed in the back of my knee.
Then the waiting began. There were a multitude of possible outcomes......again, enough knowledge to be dangerous. The drugs could dissolve the clot, my venous function could return, my leg would return to normal size and color. That was the best case scenario. Of course the TPA doesn't discriminate against new clot and old clot, so the possibility of all of my MM sites starting to hemorrhage existed. Or, I could start to bleed in my head, or stomach - I have a history of a NSAID induced duodenal ulcer. With TPA and heparin I could bleed to death in no time. Then again, the opposite could happen. A bit of that clot could break off and clog my pulmonary vessels, making it so that my oxygen depleted blood couldn't reach my lungs/oxygen. Effectively suffocating me to death. Also, not a pleasant outcome, and unfortunately what took the life of my patient a few years ago.
The TPA and heparin ran through my popliteal lines for about 36 hours. As time progressed my cath insertion sites started to ooze. Not wanting to make things worse the nurses just kept replacing the gauze over the top of the bleeding sites, which I would then promptly bleed through. Oh, what a site! When my thrombin levels dropped to 152, the TPA was turned off and the heparin was turned up.
The next morning I went back to IR. The new venograms showed almost complete resolution of the clot, what remained he obliterated intravascularly. And he found something else. May-Thurner Syndrome, or MTS. A congenital anomaly where the right iliac artery sits on top of, and compresses, the left iliac vein. He placed a stent into my vein in hopes to keep it from being smashed by the overlying artery.
It seems MTS was the cause of my clot. Sure, the MM increased swelling and decreased activity and certainly encouraged clot formation. But without my underlying defect, its likely that none of this would have happened. Even if I did form a clot, it would have started in my calf, like normal people. My clot started in my pelvis, which is why it spread so quickly and was so bad. The IR doc was actually surprised that I had gotten through 3 pregnancies and caesarian deliveries without a previous clot. Certainly that would have been worse. I can't imagine leaving my week old baby and being confined to an ICU. What would my husband have done with that?
The lines were removed from my knee that morning, thank goodness. I was eventually transitioned to lovenox injections twice a day and coumadin. 5 days after initial presentation I was allowed to go home, even though they would have liked me to stay another 3-5 day. My babies were starting to miss me. My 7 y/o was crying, asking me to please come home. My babies win. They trained my h to give me injections, I promised to find a GP, and I got to go home.
Its been a bit over a week since my discharge. I am still on coumadin, but had my (hopefully) last lovenox injection yesterday morning. I have near daily blood draws to check my INR (indicator of clotting function) I'm doing ok. I am still swollen. I have to wear medical grade compression hose, thank goodness its winter! I am only taking tylenol during the day, but still need narcotic pain medication at night in order to sleep. About 5 pm the pain starts creeping from my low back to the left side of my pelvis, down my inner thigh to the back side of my left knee. Improvement has been slow, but steady.
Coumadin is a difficult medicine. In order for it to work properly you need to minimize the amount of vitamin K you take in, or at least keep it a consistent amount. Unfortunately prior to diagnosis a great deal of my diet was high-mod vitamin K containing foods. Salads/leafy greens, spinach, broccoli, snap peas, garden peas, avocado, celery, parsley/herbs, kiwi..... I have been trying to minimize my vitamin K, but I think that figuring out a consistent amount may be a better option for me.
I saw my PS last week, just after discharge. I was afraid that the tension caused by the rapid swelling caused by the clot might have compromised my incisions, but he assured me they looked good. Also, ultrasound prior to discharge showed evidence of hemorrhage in my left thigh, which they think was from the inner thigh lipo which re-hemorrhaged in the presence of the TPA. He said it may take a little longer for the swelling should go down, but shouldn't effect overall results. I am spitting a stitch in my left breast. Thats annoying, isn't it? But, I guess in light of all that I have to be thankful for, thats a little thing.
I'll try and get some pics up in the next 7-10 days. Overall I'm very happy with the results. I am down about 10 pounds from pre-op. Of course I didn't eat anything for 3 days in ICU and really very little the following days.
One last note on Dr. Vath. He was amazing during all of this. He talked with my husband while he was on vacation with his family, on Thanksgiving. And then, proceeded to call him everyday for updates and to check on us. This degree of caring, compassion and empathy is not found in every PS. He is not only a great surgeon but a good man.
Lots of love to you chicas! Thanks for all the support.
Sorry I haven't posted in a while. Its been a whirlwind of a month. I started walking, mostly upright, about a mile a day at 3 weeks post-op. About 4 days into that I started having low back pain, just to the left of my spine/SI joint. Over the next few days the pain started radiating down my left leg and I diagnosed myself with sciatica the day before thanksgiving. Thanksgiving morning my leg was so painful I could barely stand. After struggling to get the turkey in the oven I told my husband I was just going to go sit in the shower for a little bit, maybe the hot water would help loosen up my back. And thats where he found me, 20 minutes later, sitting in the tub and looking at my significantly swollen, painful and purple left leg/thigh. Thanksgiving morning. Of all days. I actually made my h call the PS, to be sure for positive that I had to go in right then. Denial, party of one!! I knew. Fortunately I also knew at least one friend who was going to someones house for thanksgiving and not manically running around her own kitchen. She came over and watched our 3 kids while my h drove me to the local ED, she even basted my turkey. lol. I knew by the ultrasound sonographers face that it wasn't good, he turned the screen so I couldn't peek. I tried to joke with him about the fact that I was pretty screwed if he couldn't even compress the vein at my thigh, no turkey for me. He looked terrified. Within 10 minutes of him leaving I was in CT for a chest scan to rule out a PE (pulmonary embolus).
Doc came in and told me what I already knew, I had a massive blood clot. And a few things I didn't. No PE - Yay!!! And my clot extended from my knee up through my pelvis into the IVC - not so good. One of the biggest clots he has seen - uh, yay me? Then, for my little holiday miracle. An Interventional radiologist at another hospital was willing to accept me in transfer and try and dissolve the clot. This doctor, and his entire team, stayed late on thanksgiving for me. Talk about warm fuzzies. I'm tearing up just thinking of it!
So, I sent my husband home to relieve my friend and finish dinner for the kids. There would be no food for me for the next 3 days, let alone that night. But, my babies deserved Thanksgiving dinner. And there was no way I was going to intrude on anyone else's holiday. I didn't even tell my friends until the next day. So, there I sat, alone, in an ED room for a couple hours waiting until the receiving facility had an ICU room for me. The whole time wondering what the next few days would hold. And thinking heavily of a patient of mine 2 years ago, 42 y/o father who died of a PE in transit from our facility to another. Oh, the things that go through your head when you know enough to be dangerous and are drugged up on dilaudid.
The Interventional Radiologist met me within 15 minutes of arriving at the new hospital. I went almost immediately down to the IR suite. Even with conscious sedation, I could tell that the clot was almost completely occluding my vein. It took some time to weave the catheter, described to me as kind of like a soaker hose, from the back of my knee up the length of the clot. With the cath in place I went to ICU. TPA (clot busting drug) and heparin (anti-clotting drug) were run through the lines placed in the back of my knee.
Then the waiting began. There were a multitude of possible outcomes......again, enough knowledge to be dangerous. The drugs could dissolve the clot, my venous function could return, my leg would return to normal size and color. That was the best case scenario. Of course the TPA doesn't discriminate against new clot and old clot, so the possibility of all of my MM sites starting to hemorrhage existed. Or, I could start to bleed in my head, or stomach - I have a history of a NSAID induced duodenal ulcer. With TPA and heparin I could bleed to death in no time. Then again, the opposite could happen. A bit of that clot could break off and clog my pulmonary vessels, making it so that my oxygen depleted blood couldn't reach my lungs/oxygen. Effectively suffocating me to death. Also, not a pleasant outcome, and unfortunately what took the life of my patient a few years ago.
The TPA and heparin ran through my popliteal lines for about 36 hours. As time progressed my cath insertion sites started to ooze. Not wanting to make things worse the nurses just kept replacing the gauze over the top of the bleeding sites, which I would then promptly bleed through. Oh, what a site! When my thrombin levels dropped to 152, the TPA was turned off and the heparin was turned up.
The next morning I went back to IR. The new venograms showed almost complete resolution of the clot, what remained he obliterated intravascularly. And he found something else. May-Thurner Syndrome, or MTS. A congenital anomaly where the right iliac artery sits on top of, and compresses, the left iliac vein. He placed a stent into my vein in hopes to keep it from being smashed by the overlying artery.
It seems MTS was the cause of my clot. Sure, the MM increased swelling and decreased activity and certainly encouraged clot formation. But without my underlying defect, its likely that none of this would have happened. Even if I did form a clot, it would have started in my calf, like normal people. My clot started in my pelvis, which is why it spread so quickly and was so bad. The IR doc was actually surprised that I had gotten through 3 pregnancies and caesarian deliveries without a previous clot. Certainly that would have been worse. I can't imagine leaving my week old baby and being confined to an ICU. What would my husband have done with that?
The lines were removed from my knee that morning, thank goodness. I was eventually transitioned to lovenox injections twice a day and coumadin. 5 days after initial presentation I was allowed to go home, even though they would have liked me to stay another 3-5 day. My babies were starting to miss me. My 7 y/o was crying, asking me to please come home. My babies win. They trained my h to give me injections, I promised to find a GP, and I got to go home.
Its been a bit over a week since my discharge. I am still on coumadin, but had my (hopefully) last lovenox injection yesterday morning. I have near daily blood draws to check my INR (indicator of clotting function) I'm doing ok. I am still swollen. I have to wear medical grade compression hose, thank goodness its winter! I am only taking tylenol during the day, but still need narcotic pain medication at night in order to sleep. About 5 pm the pain starts creeping from my low back to the left side of my pelvis, down my inner thigh to the back side of my left knee. Improvement has been slow, but steady.
Coumadin is a difficult medicine. In order for it to work properly you need to minimize the amount of vitamin K you take in, or at least keep it a consistent amount. Unfortunately prior to diagnosis a great deal of my diet was high-mod vitamin K containing foods. Salads/leafy greens, spinach, broccoli, snap peas, garden peas, avocado, celery, parsley/herbs, kiwi..... I have been trying to minimize my vitamin K, but I think that figuring out a consistent amount may be a better option for me.
I saw my PS last week, just after discharge. I was afraid that the tension caused by the rapid swelling caused by the clot might have compromised my incisions, but he assured me they looked good. Also, ultrasound prior to discharge showed evidence of hemorrhage in my left thigh, which they think was from the inner thigh lipo which re-hemorrhaged in the presence of the TPA. He said it may take a little longer for the swelling should go down, but shouldn't effect overall results. I am spitting a stitch in my left breast. Thats annoying, isn't it? But, I guess in light of all that I have to be thankful for, thats a little thing.
I'll try and get some pics up in the next 7-10 days. Overall I'm very happy with the results. I am down about 10 pounds from pre-op. Of course I didn't eat anything for 3 days in ICU and really very little the following days.
One last note on Dr. Vath. He was amazing during all of this. He talked with my husband while he was on vacation with his family, on Thanksgiving. And then, proceeded to call him everyday for updates and to check on us. This degree of caring, compassion and empathy is not found in every PS. He is not only a great surgeon but a good man.
Lots of love to you chicas! Thanks for all the support.
I know, I know. Don't weigh yourself post-op. ...
I know, I know. Don't weigh yourself post-op. But, I did. Everyday. And, for the first time I am under my pre-op weight, on day 8. Whooohooo!! 138 pre-op, 143 post op (yikes!), and 137 today. My implants weighed 1.5lbs, so really that puts me at 135.5. Yipeeee!!! I expect to be around 130 when all the swelling/bruising subsides. And I do plan on dropping several more after I am healed. A friend has asked me to start doing Crossfit with her, which I am considering. I was doing insanity and the elliptical prior to surgery. And I really want to do a 5k, 10k, half marathon progression by next summer. I want to do the half marathon in my home town the summer of my 20th high school reunion.
The swelling is finally starting to come down. The pain is starting to subside in the incision sites. It feels like my TT incision and my breast incisions are healing well. They are kind of itchy, but thats a good sign! I have cut way back on pain meds. The sides of my breasts are sore. My low back still hurts, more than that the skin and muscles hurt. My back has to be the worst pain. Is it from the lipo, the restricted positions I've been in? The lack of exercise? idk, but ouch! That and my inner thighs.
OK ladies, does anyone else have a problem getting up and out of bed in the night and in the morning? It is my worst time of day. I'm usually in tears when I wake up. My muscles hurt, my skin hurts, I can't move without lots of pain. Once I am up and moving it gets a ton better, but that first 15-20 minutes is hell. Any tips?
I really think I need to start moving more. I've been trying to take it easy because I need to be back up to running my family at that 2 week post-op mark. But, I think the not moving is making me worse! So, I am going to start walking tomorrow.
I updated a boob pic. They are a lot bigger than I expected, honestly. But, they are growing on me. ha! And I think h likes them too.
The swelling is finally starting to come down. The pain is starting to subside in the incision sites. It feels like my TT incision and my breast incisions are healing well. They are kind of itchy, but thats a good sign! I have cut way back on pain meds. The sides of my breasts are sore. My low back still hurts, more than that the skin and muscles hurt. My back has to be the worst pain. Is it from the lipo, the restricted positions I've been in? The lack of exercise? idk, but ouch! That and my inner thighs.
OK ladies, does anyone else have a problem getting up and out of bed in the night and in the morning? It is my worst time of day. I'm usually in tears when I wake up. My muscles hurt, my skin hurts, I can't move without lots of pain. Once I am up and moving it gets a ton better, but that first 15-20 minutes is hell. Any tips?
I really think I need to start moving more. I've been trying to take it easy because I need to be back up to running my family at that 2 week post-op mark. But, I think the not moving is making me worse! So, I am going to start walking tomorrow.
I updated a boob pic. They are a lot bigger than I expected, honestly. But, they are growing on me. ha! And I think h likes them too.
Last night was rough. I think probably because I...
Last night was rough. I think probably because I switched pain meds and I didn't set a timer. So I woke up half hour after my meds were due and was miserable. It took me 15 minutes to get up out of the recliner to go pee, and I groaned the whole time. Its mostly my lipo sites that are hurting - inner thighs, back, hips. My back is bad, and the muscles spasm something fierce. But, last night I also noticed my breasts felt really tight and sore too, especially towards my armpits and sternum. And my ab muscles were not happy either. I think the muscle relaxants really help a lot too. Guess I am not going to be one of those girls who is just on tylenol during week one.
My inner thighs/hips/a$$ are HUGE. The swelling is insane. I left the surgicenter with just an abdominal binder, but no compression to my lower body, and I wonder if thats why its so bad. I ordered a CG suit, and when I get it I will put that on and put the binder over the top if I feel like I need some extra mid abdominal compression.
Also, I have to admit that I have stepped on the scale. I know that is a big no-no. But, I figured he took about 10 pounds off during surgery between TT and lipo so I should at least come off even. I was not expecting to be 5 pounds over my pre-op weigh in at almost 7 days out. :( My lack of patience is once again rearing its ugly head.
Feeling much better right now after taking 2 pain pills and a muscle relaxant. But, at a week out I wasn't expecting to need so much medication. :/ Eventually I need to get back to my non-medicated life!!
My inner thighs/hips/a$$ are HUGE. The swelling is insane. I left the surgicenter with just an abdominal binder, but no compression to my lower body, and I wonder if thats why its so bad. I ordered a CG suit, and when I get it I will put that on and put the binder over the top if I feel like I need some extra mid abdominal compression.
Also, I have to admit that I have stepped on the scale. I know that is a big no-no. But, I figured he took about 10 pounds off during surgery between TT and lipo so I should at least come off even. I was not expecting to be 5 pounds over my pre-op weigh in at almost 7 days out. :( My lack of patience is once again rearing its ugly head.
Feeling much better right now after taking 2 pain pills and a muscle relaxant. But, at a week out I wasn't expecting to need so much medication. :/ Eventually I need to get back to my non-medicated life!!
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