Pulmonary Embolism

[A.Goldberg]

Supa_fly,
The ER doc thought that I may be on Xarelto for life. The second doctor doesn't think so. But, it can still take about six months for the clots to dissolve. I am told that my body calcifies the clot and that is why it takes so long to dissolve.
If I am wrong, I'm sure that Dr. Goldberg or monochromicorn will chime in.

Also to Monochromicorn; I do plan on getting an ID bracelet as soon as I get off the road. The last thing I need is to bleed to death for a dumb reason.

Sorry, I missed out on this thread as I wasn't quoted. The duration of the anticoagulant treatment is variable, but associated with risk. I don't know your full background, but assuming the theory is caused by your frequent periods of stationary sitting (truck driving) and this is part of your usual lifestyle, it would be my opinion that long term treatment would be safer. Short term therapy is often reserved for those who have situations arise that provoke the incident (a single airline flight, surgery, certain drugs, trauma, etc). These clots occurred in your lungs, which is serious (more serious than DVT). Your doctor however will be able to make the best judgements here based off your situation.

Whether its months or years, you're taking the steps necessary to be healthy. I wouldn't worry about it. Whats important is you doing everything you can to live happily and healthily.

As for the medical ID, if you have not purchased one yet, I highly recommend using Apple's HealthKit to enter in your emergency information. Additionally, I'd suggest slipping a piece of paper in your wallet in a fairly conspicuous place (near your license if possible) indicating you're talking Xarelto, just in case.

Also, FYI, The New England Journal of Medicine (most prestigious medical journal in the world) just published Pradaxa's antitode's Phase III trial results days ago. I haven't read it the article, but supposedly things look promising. The name of the product is Andexanet Alfa developed by Portola Pharmaceuticals. I would expect to see this coming to market in the near future. Like I said, Xarelto is a pretty safe drug, but it's nice to have the peace of mind and antidote should be available soon.

 

[Les Kern]

No experience with that drug, but after I shattered my hip and the bad doctor put in pins I was given Lovenox injectable due to DVT's caused by non-use on my leg. Had a blog clot from my groin to my ankle. The first two weeks was scary as the doctor said to basically not move and by no means, even a little, should I rub my leg as it could cause what you have. Had to get rid of the clot which took months before I could have surgery. I was given the surgery even before resolution as I was losing the ability to walk and the longer it took the less chance I had. I still have issues with my ankle swelling but happy to report my new hip (put in by the good doctor) is incredible and I am back to normal. (Had Mako robotic surgery)
I had zero side effects except for injection site pain, but only on occasion. Warning: It' costs $2,500 for 20 days.

 

[Les Kern]

It does, indeed, take several months for most of the clots to dissolve but the upshot is my brother in law now feels much fitter than he has in years.

I learned from my own adventures that clots don't actually dissolve. It's not like blood thinners break them up. What they do is make the blood flow better so new clots don't form. Meanwhile the clots in your veins simply absorb back into the wall over time. And it takes a LOT of time. Up to a few years as I understand. And the most important time is when they first form as they are unstable. That instability could result in part of it breaking off causing embolisms.

 

[Crwmlw]

I feel ya brother. I myself had a PE back in March of 2011. Woke up at 4AM feeling like I had heartburn, drank some milk, did nothing. Fell back asleep and woke up a few hours later with a shooting pain in my arm and what I thought was heartburn, took some pepcid ac and that did nothing. Another hour passes and I couldnt breathe at all, felt like I got stabbed in the side with a knife. Call 911 and go to the hospital, they draw blood and look me over and say " looks like you pulled a chest muscle" I said I know my body and I didnt pull anything. They stuck with their decision and gave me pain meds and sent me home. Later that night I felt ok because of the morphine given to me earlier so I decided to take the wife and daughter to eat, I start walking to the backdoor and I collapsed, couldnt breathe at all, rush me back to the hospital, do an emergency cat scan and there it was, a huge clot in my lung between heart and lung. They admit me to critical care and on the way to that unit I remember plain as day the Nurse telling me im a very luck man to be alive, that didnt really hit home because I was so drugged up. Spent 8 Days in critical care. I was on lovenox and coumadin for another 6 months after I was released. Lot of bruising and fatigue on those meds but I feel they saved my life. Everyday I am grateful for what I have after that episode. Sorry this doesnt answer your question but I am happy your still around.

 

[A.Goldberg]

I learned from my own adventures that clots don't actually dissolve. It's not like blood thinners break them up. What they do is make the blood flow better so new clots don't form. Meanwhile the clots in your veins simply absorb back into the wall over time. And it takes a LOT of time. Up to a few years as I understand. And the most important time is when they first form as they are unstable. That instability could result in part of it breaking off causing embolisms.

You're right, oftentimes they don't dissolve and become part of the vein's wall as the tissue grows over it. In some cases, the body can degrade the clot. In many others, the clot remains, but is protected from detaching or growing bigger though complications can still exist. There are a class of drugs called thrombolytics that can break up clots, but you only have a finite period of time to use them as they are absorbed into the vessels relatively quickly. Thrombolytics are also pretty dangerous and normally only used in life threatening acute situations.

I feel ya brother. I myself had a PE back in March of 2011. Woke up at 4AM feeling like I had heartburn, drank some milk, did nothing. Fell back asleep and woke up a few hours later with a shooting pain in my arm and what I thought was heartburn, took some pepcid ac and that did nothing. Another hour passes and I couldnt breathe at all, felt like I got stabbed in the side with a knife. Call 911 and go to the hospital, they draw blood and look me over and say " looks like you pulled a chest muscle" I said I know my body and I didnt pull anything. They stuck with their decision and gave me pain meds and sent me home. Later that night I felt ok because of the morphine given to me earlier so I decided to take the wife and daughter to eat, I start walking to the backdoor and I collapsed, couldnt breathe at all, rush me back to the hospital, do an emergency cat scan and there it was, a huge clot in my lung between heart and lung. They admit me to critical care and on the way to that unit I remember plain as day the Nurse telling me im a very luck man to be alive, that didnt really hit home because I was so drugged up. Spent 8 Days in critical care. I was on lovenox and coumadin for another 6 months after I was released. Lot of bruising and fatigue on those meds but I feel they saved my life. Everyday I am grateful for what I have after that episode. Sorry this doesnt answer your question but I am happy your still around.

Remarkable story. I always hate these stories of hospitals turning people away when they have serious issues. Morphine and shortness of breath... that's not a very good combination (opiates can reduce your ability to breath deeply). Regardless, very lucky to be alive indeed. Glad to hear you're okay and doing well.

@Foggydog , you said Xaralto is the only drug you're taking. How's your blood pressure, cholesterol, etc?

 

[Foggydog]

Good A. Goldberg,
I haven't had my blood pressure checked since my stay in the ER, but whenIi left is was around 110/80 I think.
Even upon admittance it was my normal of about 118/86. As for my cholesterol , I currently have no idea. I really need to have that checked. As a quick update taking Xaralto, I am on 20mg daily with no side effects. I am feeling pretty darn good these days.

 

[Stella Martin]

I followed this thread and I am glad that you have gotten better. But still, a long way to go for your full recovery.

 

[Foggydog]

Thank you Stella. I am happy to still be among the living.

 

[.Andy]

Morphine and shortness of breath... that's not a very good combination (opiates can reduce your ability to breath deeply).

Morphine and shortness of breath is actually a great combination in the right circumstances. Low doses in the palliative setting for COAD and even for pulmonary oedema can really take away the feeling of SOB and associated spiral of anxiety. The issue with opiates is not really that it reduces your ability to breath deeply, rather it reduces your respiratory drive. http://bja.oxfordjournals.org/content/100/6/747.full

 

[A.Goldberg]

Morphine and shortness of breath is actually a great combination in the right circumstances. Low doses in the palliative setting for COAD and even for pulmonary oedema can really take away the feeling of SOB and associated spiral of anxiety. The issue with opiates is not really that it reduces your ability to breath deeply, rather it reduces your respiratory drive. http://bja.oxfordjournals.org/content/100/6/747.full

I'm looking at this in the context of the situation. The responding member here went to the hospital and was shortly released with the painkillers with reportedly little work up, according to the information he provided. Given the possibility of a cardiac issue, opiates can be a poor choice imo and create complications further treatment. Also factor in the safety profile of morphine and potential side effects. The member was informed he probably had a "pulled chest muscle" which evidently sounds like why they dispensed the morphine, not to treat SOB in at home for which there are much better options. This was not a palliative care case or even an acute, monitored, situation.

 

[5105973]

Get well soon. I'm so glad you made it through. I am high risk for PE's myself. I have no idea what I can do to prevent one, short of going off the prescription I'm on--the rest is genetics. I guess I'll leave that to my new doc to sort out.

My husband has had horrible shortness of breath and edema since being put on blood pressure medication. I'm worried, but he insists its because of his BP pills and brushes my concerns aside. I'm going to bug him to mention the shortness of breath to his doc. The doc already knows about the edema.

 

[Snoopy4]

Good evening forum members;

First off to the mods, I seldom start a new thread so if this is in the wrong place, please feel free to move.

Last Wednesday, I started having a shortness of breath. On Thursday my breathing was so difficult that I started breathing quit hard after walking say 100 feet or so. It also took almost an hour to take a shower that morning at the truck stop. I was concerned, but being the male that I am, I just thought that I had eaten to much the day before and it wasn't digesting very quick. Boy was I wrong. By Friday morning, I couldn't walk but about 15 feet without having to gasp for air, and I felt like I was going to feint. I am a truck driver and I was luckily at our home city and our senior driver took me to the urgent care. Within one hour I couldn't walk at all without gasping for breath and the doctor called the ambulance to have me taken the 4 blocks to the ER. After the initial questions and simple checks, they brought in a portable x-ray and sent me for a CT scan. The result of that scan was that I had three clots on my lungs. Two on the left and one on the right. I should have died long before I even got to the urgent care. The doctor said that I was a very special patient (having three clots) and a very lucky one at that, and that my body compensated remarkably.

So, I am very interested in asking others here for any personal experience, and if anybody in these forums has taken the blood thinning drug XARELTO?

I have a condition were my bone marrow produces extra platelets. I'm very familiar with thinners having been out on several medications before they finally figured out what was going on. Xarelto was an option in the event of a clot, but never had to take it. I have heard it can have complications so you need a good hematologist and constant monitoring to ensure you Van Widebrand factor is in range or you could literally bleed out. Mine started to actually break down under a daily aspirin regiment so they put me on a medication. I'll PM you with some other stuff.

 

[PattyMc]

Just wanted to say that I'm glad you are feeling better! Take good care of yourself and remember to follow up regularly with your physician.