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.

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Calf pain / not sure

rytheguy71
rytheguy71
Hi everyone, its been a while since I have been on the group. I am seeking advice on some recent pains. So I had my DVT / PE back in February 2014, "massive" saddle PE with DVT in my right leg from just below the knee up my thigh to my groin. The DVT really was several months in the making, starting in late November 2014 with what seemed like a charley horse. In the hospital for 11 days, on warfarin for 1 year. Have been doing better, still wear my compression stockings daily when sitting in desk at work, staying hydrated,etc.

I just started working out again in October after a long hiatus. About 2 weeks ago I started feeling pain in my left calf, although there was not an "aha" moment like a sharp pain or cramp At first, the pain was on the inside of the left calf, and I could feel a discernible knot in my calf... almost felt like I could feel a blood vessel. I took off from the workouts for 5 days or so, and it began to feel better. I started again and worked out twice and now the same calf has what feels like a large knot in the middle of the back of the calf about halfway between the knee and the foot, and some soreness up in the back of the knee when you press on it. It is hard to walk and it is especially bad in the morning, but seems to get better as you have more movement. The pain is worse if I lift my toes and my heel back. There doesnt seem to be near as much swelling as when i had the DVT in my right leg. When I had the DVT I could barely put my shoes on, this time there is no swelling near the ankle or foot.

Should I get a d-dimer done? Would that have any value, or should they just do a doppler ultrasound? Should I really be concerned that this is another DVT? I dont want to head back down that dark road of worry that I thought I was past, but here I am again. Any advice is welcomed and I am grateful for everyone's wisdom in this group

Thanks

Ryan
msuspartax
msuspartax
I would say yes. A have popletial and tibial veins DVT, and no swelling; but I had one before with swelling, and it felt like the aftereffects of a Charlie horse. Soreness and cramping.

I would ask the doc for a d-dimer to be safe.
TossNTurn
TossNTurn
I'd get it checked out, especially because I know you have a tendency to worry about these things. Better to spend an afternoon getting an ultrasound and then move on, then obsess about it on and off for weeks.

When in doubt, I'm always in favor of getting checked out. A few false alarms just add to your store of knowledge for what is "normal" or OK and what might be more important. None of this is wasted time.

Let us know how you're doing!
danh2015
danh2015
I wouldn't rely on lack of of swelling to indicate that there is no dvt. I had 3 dvt's in my right leg after an ankle surgery that cause massive bilateral PE's. I didn't have any swelling other than where I had surgery. I went for an ultrasound to check for a blood clot due to pain on Oct 23rd and nothing was found, Nov 6th I was in the hospital with dvt/pe.

Hope you have gotten that pain checked out.
rmb
rmb
I would let your doc figure out if an ultra sound or d dimer is called for. The main thing is to get it checked out. I don't know if it's a DVT or not but it's unexplained calf pain so you probably want to get it checked out. You know I'm not an alarmist but I think if your calf hurts or feels like it's pulling when you flex your toes toward you, that can (not always) be one of the signs for DVT.
rytheguy71
rytheguy71
Thanks for your thoughts everyone. I decided this morning to go see my ortho. When I got to the office he did an exam he said that based on my history that I pretty much need to get a ultrasound done whenever pain in the calf occurs, and if this happens again for me to call and he'll send me straight to imaging without having to go for the office visit. He sent me straight over to the imaging department (his office is in the pro building of a hospital) on a "stat" order. They let me go home and told me the doctor will call me with the results which I have interpreted are probably negative.
rmb
rmb
Yeah it's probably not a clot if they let you go home or didn't contact your doctor while you were there. When I had a clot in my arm, it presented itself only as pain, no swelling or redness, like I had with my calf. It's hard to know what to do when the symptoms aren't identical to what you previously experienced. So it's good that you got it checked out, regardless if it's a clot or not.
ShilosMommy
ShilosMommy
If I had read this yesterday I would have also recommended getting it checked out, and I'm glad for you that it seems like it's probably not a clot. I know how frustrating it can feel to go get checked out for a 'false alarm', but do try to think of it as Toss described earlier, it adds to your store of knowledge as to what is normal. Unfortunately with a clotting history, there really isn't much you can do other than get suspicious pains checked out, as your doctor said, and I tend to think the pain should be addressed with or without swelling. I mean, if you have swelling, then sure that's all the more reason to suspect a clot. But most of my clots didn't present in the early stages with any swelling, in fact my first clot was largely discounted as being a clot because my leg wasn't swollen - when in fact once I had really serious clots that ultimately led to PE. Over time, I think you do gain more confidence in determining yourself what needs to be looked at and what doesn't, but at the end of the day, we all know what's at stake if you guess wrong in favor of not having an ultrasound. I'm glad you got it checked out, even just for the peace of mind.
rytheguy71
rytheguy71
Thanks everyone, Toss, RMB, ShilohsMommy, etc. I got a call this morning from my ortho doc. It turns out there is a clot, but it is in a superficial vein. He wants me to go see my family doc or hematologist to determine if I should go back on anti-coagulation. That being said, does anyone have experience with "superficial" vein clots? Can they in fact move to the deep vein somehow?....Should they need to go in and do another CT to see if there are other clots in there? ... Could my exercise routine have caused this?... So many questions
rmb
rmb
I don't think you probably need a CT scan. I had two superficial clots, years before my DVT. T. If there was concern it was going to travel or go deep, they'd have put you on anticoagulants right away and not sent you home to wait.

I don't know what could have caused it. I would just see what the doc says.
TossNTurn
TossNTurn
I haven't personally dealt with superficicial clotting, but from what I've seen on these boards, doctors aren't generally too concerned about them. For the most part, I think docs consider a superficial clot as a sign that your body is working properly. Every scab or bruise you've ever had is a superficial clot... and docs don't worry about those.

I mean, obviously, you have other concerns, since you have a past clotting history and it seems odd that this clot has formed and is causing as much pain as it is causing. It's definitely time for a conversation with your doc or hematologist, but I don't think you need to be in crisis mode or that you need a CT.
msuspartax
msuspartax
I've had lots (at least 6 times) of superficial clots (thrombophlebitis). They generally aren't dangerous. If you have any varicose veins, they'll be more prone to them. They hurt, and you can feel them from the surface.

From what I understand, it's possible, but unlikely, for them to spawn emboli; but they can't become DVT.
rytheguy71
rytheguy71
Just got back from hematologist with my prescription for xarelto. Doc said the thrombus is in the lesser saphenous vein and is rarely known to cause an embolus, but they don't want to take any chances with this so we are going to do 6 weeks of xarelto and then take another ultrasound
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