Jessica Phillips survived a life-threatening PE right after giving birth to her fourth child. Her DVT symptoms were overlooked and a massive PE ensued, so her OB doctor introduced many changes in her practice to prevent DVT and PE after Jessica’s near death.
On October 29 2010, I gave birth by C-section to my fourth beautiful child and second son, William Stone. The nurses quickly encouraged me to walk around, which I did willingly, since I was eager to return home to my husband and three other children. I mentioned that my left leg hurt to several of the nurses. My leg was visibly swollen, hot, and red, in my left inner thigh. The OB suspected superficial thrombophlebitis, and results of a Doppler scan were negative for any deep vein thrombosis (DVT). I was discharged the next day.
The doctor told me I had a superficial thrombophlebitis, and told me to go home and enjoy my baby. She advised me to elevate my leg periodically, get some rest and continue the low molecular weight heparin injections for 2 more weeks. I was on the dosage to prevent clots during my entire pregnancy, as well as my previous pregnancy, because 3 years before, it was found that I have a prothrombin 20210 gene mutation (factor II). I was not given any other special instructions or warnings, even though there was still a hot, red and swollen area in my left thigh.
I went home with my new son, and felt overjoyed and ready to meet a house full of family, my other three children, and friends. I was exhausted post-delivery, but unconcerned about my leg, because I was told it was nothing to worry about. I continued to feel discomfort in my leg, but I didn’t notice any increase in pain or swelling. I continued to take low molecular weight heparin injections as instructed. Life was good. Our family now felt complete and we all smiled about our future; our oldest was soon to turn six years old.
One week after discharge, I climbed back into bed after I finished feeding my 9 day old son. Suddenly I could not breathe. It was as if a ton of bricks was thrown on my chest. I grabbed my husband’s arm and told him to call 911 right away. I thought I was dying. As my husband recalls, my lips, neck, chest, and fingernails were blue and my eyes looked as if they were somewhere else, and my skin was pale and clammy. He said I looked like death.
The ambulance arrived within minutes, put me on oxygen immediately and whisked me to the closest Emergency Room (ER) where a CAT scan revealed massive pulmonary emboli (PE) in both of my lungs. A pulmonary intensive care doctor was called to attend to me. My husband was informed that my PEs were the largest they had ever seen and that I was in a critical life-threatening situation, and I have vivid memories of the nurses rushing me to the intensive care unit (ICU). The CAT scan also revealed my left leg had two completely clotted veins in my left leg, the same area that was hot, red, painful, and swollen since childbirth.
I knew that I was fighting for my life with every breath, and I was told to lie as still as I could as I struggled to find air to breathe. I was given a full therapeutic dose of heparin, and focused on each in breath and out breath, as I silently repeated the names of my husband and four children over and over. I found myself pleading in prayer to give me enough breath to live.
My husband describes the next few hours as one of patience, prayer and petition that something would relieve the clotting. I was too critical for any invasive measures or placement of a filter to prevent more clots from entering my lungs. The last resort for my life was tPA (tissue plasminogen activator) if I went into shock and crashed as a last silver bullet to save me. What started as a ton of bricks on my chest at 6:00 AM turned into full blown pulmonary shock at 2:15 PM, and felt like my life was seeping out of the bottom of my feet. As the last resort to save my life, my doctor administered tPA, even though it carried extremely high risks of internal bleeding due to my C-section nine days prior. My husband, my family, and my friends, waited for hours outside the ICU doors to find out if they would ever see my smile again. Our children were innocently unaware that their Mommy might never kiss them again.
The silver bullet and many prayers worked. I’m a 34 year old proud mother of 4, and thrilled and grateful to be alive.
The doctors at the hospital where I had my baby did not pick up on the classic symptoms of DVT that were apparent right after I gave birth. Instead, they relied strictly on the technology of a single Doppler reading rather than on clinical findings. Simply put, they missed it. I was sent home despite my pre-existing blood clotting disorder known to this OB practice as well as my hematologist. I was also at risk because of the C-section and the fact that it happened during the first six weeks after childbirth, when clotting is more likely. I was a perfect storm for a potentially fatal outcome.
My doctor admitted that she did not pay sufficient attention to my clinical symptoms and relied instead only on the Doppler results. She apologized to me, and I accepted. Her practice has taken my brush with death seriously and she has taken steps to continue promoting awareness and focus on DVT as well as blood clotting disorders as they affect pregnancy, delivery, and recovery.
They now do follow up Doppler scans if the clinical symptoms of DVT persist a day or two after discharge. I believe that my near death experience has affected my OB greatly, and made her more alert to DVT risk associated with pregnancy and C-section, especially in the presence of a clotting disorder. The hospital has begun work to improve doctor and patient awareness of DVT/PE and has now added a section about DVT warning signs to their discharge papers for all new mothers. This is a start. There is hope for the future.
DVT and PE are serious. The doctors and nurses involved in my case still cannot believe that I survived.
I see my survival as a miracle. But we cannot always rely on miracles. Nor do we have to.
I want to help doctors and the public become more aware about risk, treatment and prevention of DVT/PE so that others avoid my experience of being on the brink of death.
This issue is very serious to me. I have participated in a video for the hospital as well as a commercial for it to share my story and to alert people to DVT and PE risk. I am including the www.stoptheclot.org web site so more people can benefit from the important and essential information included in it on risk, prevention, and treatment of blood clots.