What do you think of my theory of how I might have generated blood clots?
I’m a 62 year old man who spent 9 days in the hospital (7–8-13 though 7–16-13) for heart surgery. After I was released from the hospital in Indianapolis until I flew back to my home in Seattle (5 hour flight) on 7–22-13 I felt a bit weak but otherwise good. For 5 days in Indianapolis I did a lot of easy walking (as directed by my surgeon) per day. It felt so good to walk so I walked 3 to 4 hours a day very easy while wearing a light backpack (10 to 12 pounds). When I got back to Seattle I felt very good for the first 3 days (7–22-13 to 7–24-13). I started to do my calisthenics, swam twice for 20 minutes, did a very easy 20 mile bike ride, did a lot of yard work and went for a 7 mile hilly walk with my wife all with no problem. My life seemed to be getting back to normal at last. However in the evening of 7–24-13 I experienced very extreme pain in my upper right and left shoulder muscles (where the backpack straps were). Later that evening the pain radiated down to the areas of my heart and lungs. My heart was pounding and it suddenly became difficult and was painful to take a deep breath.
I went the the Emergency Department of a local hospital where they found blood clots in my lungs (Pulmonary Embolism) and was treated in the hospital for the next 5 days and released.
The doctors in the hospital were sure that I initially formed the blood clots in my legs. However I never had any pain, numbness or cramps in my legs. However when I offered to the doctor my thought that the blood clots most likely originated in my shoulders (because of the constant and long term pressure the backpack straps had on veins my shoulders could have facilitated clot formation), she just laughed at me. She explained that blood clots typically form in the legs. I said that’s true but I have had no leg pain and a lot of pain in my shoulders. She just emphasized that the legs is where blood clots form and ordered a doppler ultra sound of my legs which found no clots.
What do you think of my untypical and out of the box theory?
FYI: The very intense shoulder pain is still with me after the second day out of the hospital. Also I’ll be seeing my Family Practice doctor tomorrow.
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6 Answers
Most likely the blood clots started in your legs. Same thing happened to me last year. A massive number of blood clots collected in my legs and migrated to my lungs. No pain in my legs—it was only when I started having trouble breathing that I realized something was very wrong. I too spent 5 days in the hospital and have been on a blood thinner ever since. I never really had pain anywhere so I can’t speak to your shoulder pain.
Well, I seriously thought I had a mini blood clot behind one ear from my sunglasses pressing there. I never got it diagnosed as one, all I mean is I got that same feeling from a similar situation. Usually they start in your legs, but I don’t think it is a rule that can’t be broken. I feel like my blood could ball up at any moment anywhere in my body.
I think most likely you let yourself become dehydrated and coupled with your surgery and long flight you got a blood clot and what you need to know is you get them, and have to do everything to prevent them. Sometimes people have no pain with a DVT in their leg, but usually they have pain. I think your surgery is the main cause. My nonmedical opinion.
It’s very likely the two issues are unrelated: your shoulders hurt from the stress you put on them with the weighted backpack, and your DVT was generated in the the leg veins post-op, quite possibly on the flight (which is very common). Be sure to get some high-quality compression stockings. Walking frequently is important because the calf muscle is the heart’s counterpart in the venous system to eject blood uphill back to the heart. Be aware that not all doppler ultrasounds are 100% accurate. It’s possible to have a false-negative result if the clot didn’t happen to appear on the doppler scan at that moment. You might want to consult with a vein specialist in your area.
You can check the American College of Phlebology website’s physician finder and look for a physician in your area that’s a certified diplomate (that means they’ve taken the phlebology exam). I work for the Richmond Vein Center and while I’m not a doctor, I produce a lot of the material for patient education as well as lecture material for when Dr. Gould gives presentations to other MDs, PAs and NPs. I know enough to point you in the right direction.
Vein specialists will be able to get you fitted properly in a high-quality compression stocking, and usually employ the very best vascular ultrasound technologists in town who can keep an eye on your venous system.
I really don’t know if it’s possible.
I had blood clots found in my lungs. I had not ever had leg pain and no clots were found in my legs.
You’re right that just because it is the currently held medical belief that most clots form in the legs doesn’t mean that they couldn’t have formed elsewhere.
Are you looking for intellectual validation or are you concerned that there are undetected clots elsewhere in your body (like your shoulder)? Perhaps you could consult with a vascular surgeon or interventional radiologist, both of which are familiar with venous and arterial anatomy and can inject dye into vessels and view them under x-ray. For the record, I don’t think this is necessary and don’t think insurance would cover it.
I’m sorry you’ve had to deal with blood clots. I hope the treatment and recovery go well for you.
Thank you all for your input. It looks like my blood clots did likely form in my legs. I thought that when blood clots for in the legs that there would be some sort of indication such as pain, swelling, numbness, discoloration etc.
I suppose that the pain that I feel in my shoulders could actually be coming from my lungs.
Anyway, I’ll try to be a good patient and let that medical experts do their work.
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