Pulmonary Embolism Support Group
By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.
cjmenjou
Previous PE was diagnosed 5 weeks after symptoms, so ultrasound found no DVT, both of the legs and the arms. Also did a cancer screening and saw a hematologist. The tests that were run were:
the following were done at time of diagnosis with blood taken pre anti - coagulation
G20210A
Protein S
Protein C
Antithrombonin III antigen
homocysteine
About a month later, with a UCLA hematologist, did:
Factor V Leiden
antithrombonin III activity
Factor VIII
corrected PTT with no inhibitor (APS)
DRVVT
cardiolipin and beta 2GP1 antibodies.
All were negative except for Factor VIII, which the doc says was alone insufficient to warrant indefinite anti coagulation. I've done some research and am aware that excess Factor VIII is an issue.
In November a CT showed no clots, had dissolved.
Stopped warfarin in December. D dimers were normal 2, 4 and 6 weeks after stopping warfarin. About a month later I had bilateral PEs. I had a recurring pain in my left leg, so they only did a left leg ultrasound (wondering if they should have done both)
Questions:
Anyone have any recommendations for a blood clot specialist in Los Angeles? I intend to hunt this down even though I know it doesn't really mean anything for treatment at this point. I just think I would like to know. I was lukewarm on the prior hematologist.
Any ideas for any other rocks to look under? Other tests? I've done a ton of research and haven't come across any others, and of course I'll listen to the doc's recommendations, but my experience is that docs that are not specialists in thrombophilia don't really know that much.
Thanks
Chris
the following were done at time of diagnosis with blood taken pre anti - coagulation
G20210A
Protein S
Protein C
Antithrombonin III antigen
homocysteine
About a month later, with a UCLA hematologist, did:
Factor V Leiden
antithrombonin III activity
Factor VIII
corrected PTT with no inhibitor (APS)
DRVVT
cardiolipin and beta 2GP1 antibodies.
All were negative except for Factor VIII, which the doc says was alone insufficient to warrant indefinite anti coagulation. I've done some research and am aware that excess Factor VIII is an issue.
In November a CT showed no clots, had dissolved.
Stopped warfarin in December. D dimers were normal 2, 4 and 6 weeks after stopping warfarin. About a month later I had bilateral PEs. I had a recurring pain in my left leg, so they only did a left leg ultrasound (wondering if they should have done both)
Questions:
Anyone have any recommendations for a blood clot specialist in Los Angeles? I intend to hunt this down even though I know it doesn't really mean anything for treatment at this point. I just think I would like to know. I was lukewarm on the prior hematologist.
Any ideas for any other rocks to look under? Other tests? I've done a ton of research and haven't come across any others, and of course I'll listen to the doc's recommendations, but my experience is that docs that are not specialists in thrombophilia don't really know that much.
Thanks
Chris
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Not all clot causing conditions are known. What's your family history? You may be a clotter from a condition that has not yet been discovered.
I am in your situation. One cause of clotting is cancer. I have gone through many cancer screenings: thyroid, prostate, colon, etc.
I relied on my primary care doctor to get the bottom of this. She put the information from all the specialists together.
Good Luck
I've had two complete sets of blood/genetic tests with the hematologist plus a thyroid test (some thyroid problems can increase the risk of clotting) and a chest/abdomen/pelvis scan double-checking the clots and also looking for any possible cancers.
So far, zilch.
They told me in the hospital that I may just have something that they can't test for yet. This makes sense, but it is frustrating. I'm like you in that I would like to have a CAUSE for all the mayhem. But, if I have to wait another ten years for them to discover another genetic test or whatever, I guess I'll just have to do that.
Good luck with your hunt!
My hematologist also ordered a FANA to check for autoimmune issues that could have been the catalyst (I am also FVL homozygous, but something still had to set it off) as well as thyroid tests.
It couldn't be more clear that something is going on with you and YOU SHOULD KNOW what that something is - it's more than a matter of curiosity- look at it as a gift to your family medical history to get these things answered. Future cjmenjou's will appreciate your efforts.
http://emedicine.medscape.com/article/158712-overview
From your previous posts I recognize you as another one amongst us who once had total control of all health matters. I miss it just as you do. Knowing the "why" part was indeed a blessing. Keep turning the rocks and I hope you get there. What was lost, can be regained to some extent or another.
Got a reference to a USC hematologist, Howard Liebman, trying to see if anyone knows him, although he does specialize in thrombophilia.
Yes, more2be, somehow feel as if learning the why might get me back on the road to the fitness I had, in some form or another. It's just so strange to me that I can go from completely healthy to clotting, with no "traditional" causes, and then clot almost immediately when off anticoagulants. I originally thought my first clots came from a long race, drinking, and then a longish drive the next day. But these latest clots don't make sense under that theory, unless something was just triggered in me.....
Feels so out of control.
Brian
They have never been able to give me a definitive reason for my clots. They think they may be related to ulcerative colitis, but it could be a multitude of things happening in my body for which they can't identify.
There's gotta be a balance between researching and acceptance. That's a hard one. I spent a lot of time fretting over why I was clotting, agnoizing over it, wondering how I would move forward without that knowledge, how freakin' scarey it was that this was happening in my body. In hindsight, that time could have been better spent living and doing.
I'm not trying to tell you what to think or what to do. I'm just saying there can be a point where there are no concrete answers, that it can be a perfect storm of events that specifically happen in your body for which there is no test, no diagnosis, etc.
Good luck!
There is a control element too. Used to be, I could make my self faster by training more, or thinner by eating less, or less tired by sleeping more. Now, there's this part of me that I can't control, for the first time in my life. And I don't like it
Just making sure no stone is unturned. The reality is that no matter what they find, pretty sure they don't have a cure for it, so whether they find anything or not, the reality is I'm on the thinners indefinitely.
I guess the good news, for what it's worth is that I know the thinners work, and I am not clotting while anti-coagulated. The Nov. 09 CT scan proved that to me.
Now it is on to figuring out how to live my life based on reality. I guess everyone's got limitations. I just have some new ones
Chris
I understand the control thing. I think what I have come to terms with myself is that we have a great deal of control, over how we treat our bodies, how we treat other people but the thing I never understood fully until the PE was that I also have control over how I respond to life's situations, adversity, pressure, stress, sadness, anger, etc. In a way, it has given me insight into how I view things and react to things. So, when it comes to that, I have COMPLETE control. I guess I take it where I can get it!
I think you are a perfect example of the process you go through when you have a PE and when you learn that you have to be on wawrfarin for life. We just keep adjusting our thinking until we find a way to make some kind of sense out of it, even if it's not perfect sense.
I do not regret having a PE, DVT,any of it because I've learned more in the last 2.5 years than I've learned in the last 40 years. I think at the end of the day, the changes I experienced have been positive. There were times where I didn't feel that way, that it made me more edgey and inpatient, but the edges smoothed over with time. I've learned about what I can really handle and I've learned about what I need to work on and I've learned that there is not much to fear that I haven't already experienced. While the PE doesn't define me as a person, it shapes my thinking when it comes to certain aspects of my life. I really do think I'm better for the experience.
It's a long strange trip for sure.