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.
In terms of your surgery question I can't help, but in terms of S.O.B, fatigue, dizziness and pains, it is all part of the healing process for almost all of us. I was warned by the hospital, that as the clots cleared I would feel pain from the sites, most likely.
You, just like me and many others who this has happened to, need to remember your body...lungs more precisely have taken a real battering and it takes time for them to recover from what has happened. I am about 7 months out from my diagnosis now and I still get the symptoms you describe, just less often and usually not as bad, things do get better, believe me there =).
As for your CT result, that speaks for itself, it is a great result to have and shows you are recovering.
Best of luck and keep plugging away, Stu.
I did two repeat trips to the ER after my diagnosis with similar symptoms. Both times, they totally worked me over, didn't blow me off, and both times it wound up being anxiety. It really took me a while to work through it and I required both therapy and some anti-depressants to really get my feet under me again. Of course, those are personal choices and they don't work for everyone.
I felt much worse at four weeks out than I did at diagnosis. I only had severe SOB when diagnosed. Four weeks out, I added extreme fatigue and some pain. I was just pushing myself too hard! My lungs were still healing ... really my whole body was still healing ... and they just couldn't handle the level of activity.
For a long time, it can seem like one step forward and two back, but eventually you start moving forward and little bit more and more. It really does get better, but it takes SO much longer than we are expecting.
It sounds like there are several solid causes for your clots, but if you are worried about genetic factors, I would check with a hemo. I'm skeptical that they do those kinds of tests before surgery ... genetic testing usually requires about ten tubes of blood and a wait time of 8-10 weeks. I've never had that kind of testing before surgery.
Also, I find their comment that a .9 INR is low to be a little weird. Normal people range between .9 and 1.1. (Wikipedia says between .8 and 1.2, but they aren't totally reliable.) I have no idea what a .9 INR would have given them in terms of diagnosis. The d-dimer would be much more helpful.
I have done some guided relaxation. I used the "Deep Relaxation" tape from Effective Learning Solutions (http://www.effectivelearning.com/shop/deep-relaxation/) and that definitely helped, although it took a while for me to feel the effects. When I was really, really freaking out, the tape couldn't calm me down, but it was helpful when I was calmer at letting me relax and really get in touch with my body. Something to consider.
Best wishes! Keep us posted!
Best of Luck
HUGS Ferr
Mayo Clinic states:
"Medications that are commonly called blood thinners such as aspirin, warfarin (Coumadin, Jantoven), dabigatran (Pradaxa), rivaroxaban (Xarelto) and heparin significantly decrease your risk of blood clotting, but will not decrease the risk to zero."
"Interactions with other medications, food and alcohol are common with blood-thinning medications, especially warfarin. These interactions may decrease the effectiveness of your blood thinner, making you more likely to develop blood clots. If you take a blood thinner, be sure to follow your doctor's advice on dosing and ask about foods and other medications including over-the-counter drugs and herbal supplements that may interfere with the blood thinner."
Although a clot may form while still on warfarin and they do, according to most thrombophila sites) it's possible also that an old clot broke free and landed in the lungs. But the danger will still be the same to the patient.
Then there's the interactions of herbs, foods and other drugs that interfere with or enhance warfarin.
Also:
http://www.dailystrength.org/c/Pulmonary_Embolism/forum/1274088-blood-clot-while-coumadin
http://www.dailystrength.org/c/Pulmonary_Embolism/advice/9491993-pes-whilst-using-warfarin