Bridget Schaap thought she was having simple foot surgery, and was surprised to find that she developed a blood clot after it.
When I look back, it’s hard to believe all that happened to me. As I prepared to quit my job and move from Chicago to Michigan to begin graduate school in December 2010, I decided to have surgery to correct bunions, hammer toes and corns that caused foot pain and irritation for years. The podiatrist assured me it would be a simple procedure and that I would be back to work after a few days of recovery. Unbeknownst to me this decision would change my life forever.
My recovery from my surgery was brutal. The doctor corrected more than he anticipated, including placement of temporary pins in six toes, cutting of a tendon on the top of my right foot, removal of bone from four toes, and shaving bunions from both of my feet. I spent the first few days after surgery in agony, hating any time I had to walk to the bathroom and sobbing each time I had to put weight on my throbbing, swollen feet. I had to stop taking the medication that relieved my pain after a few days, because it made me nauseated and dizzy. Its replacement was less effective.
I began to notice a slight pain in my right calf three days after surgery. Because I was walking stiffly and spent so much time with my legs straight and propped up, I assumed I may have just pulled or strained my muscle. At my one week post-op checkup at my podiatrist, I mentioned my leg pain to the nurse, who did not think I should be concerned, and sent me on my way. The pain continued to worsen daily.
The medication for pain did nothing to ease my pain, and I iced my leg even though I was supposed to be icing my feet. I went back to work about 10 days or so after the surgery, and had to use a walker to walk, and wore special shoes to protect my feet, minimize the pain, and keep me steady. I even attended the company holiday party, and continued to ignore the intensifying burning sensation in my right calf.
Two weeks after my surgery, I finally realized something was very wrong. I got up for work in the morning and sat in the bathtub rubbing my leg and noticed how swollen and red my calf looked. Because I missed so many days of work already with my recovery, I went into the office, only to hide while I cried in my cubicle for two hours. I e-mailed my mom to tell her that the pain in my leg was so horrific that I could no longer feel any pain in my feet. I left the office to work from home.
I made it home and lied down on the couch, and continued to sob from my agonizing pain. I decided to call the podiatrist. The nurse who took my call became alarmed as soon as I mentioned the pain in my leg and quickly said, “I don’t want to scare you, but you need to go to the Emergency Room (ER) right away, because it could be a blood clot.” I was absolutely terrified. Thankfully, my good friend Samantha was staying at my apartment, so she and I took a cab to the nearest hospital, just a few blocks away.
I did not have to wait long in the ER before a series of doctors and nurses asked questions and examined my leg. They all assumed I had a deep vein thrombosis (DVT) in my right calf which was confirmed by an ultrasound. Even though this diagnosis frightened me, I was very relieved to know the reason for my pain, and hoped that it would be alleviated soon. Unfortunately, a few days went by before I felt any relief, but it was like a dark cloud lifted from my body. I was given my first dose of injectable low molecular weight heparin, and injected it for a month or so until warfarin became effective. My doctor and I had a difficult time keeping my warfarin dose at a level that kept my INR in range (2.0-3.0) in the beginning, and I eventually took 10 mg of Warfarin a day for 6 months. I had some of the side effects of blood thinners, lost a ton of hair, and had no appetite or energy. I was never advised to wear compression hose.
I took 4th generation birth control pills for over a month and a half prior to my surgery, and had taken other types of birth control pills for a few years. I cannot take birth control pills ever again. My podiatrist never asked me whether I was taking birth control pills, so did not mention the risk they might pose in combination with my foot surgery. I was instructed to move my feet around every half hour, but the pain in my feet after surgery stopped me from doing so consistently.
I was an active, healthy 23 year old woman before this surgery. I never imagined I could be at risk for a blood clot and that is why I waited almost two weeks before going to the hospital to have my leg pain checked. I am so thankful that the clot did not move from my leg to my lungs as a pulmonary embolism (PE). After extensive testing for blood clotting disorders, I did not test positive for any. My hematologist determined that my blood clot was caused by my use of birth control and extensive airplane travel prior to the surgery. I worked for an airline and flew most weekends to various places, including a trip one month before surgery to Dubai… and my inactivity after surgery. There is no history of blood clots in any member of my birth family.
I hope that my story can make other people aware that even young and healthy people can get blood clots. It is so important to listen to your body. I ignored the pain in my leg for longer than I should have, and it could have cost me my life.
I am now doing graduate certificates in Gerontology and Dementia, and work for an interior design firm that specializes in senior living, and my life is moving forward. I am happy to be here!
Take Home Messages
Note the messages from this patient in her story.
- It is always wisest to call an ambulance to go to the ER when a blood clot is suspected.
- Sometimes it takes trial and error to get the dose of warfarin in the right range.
- Hair loss and fatigue are potential side effects of warfarin.
- Compression hose help prevent complications of DVT.
- Birth control pills and surgery are risk factors for DVT.