Amsterdam, the Netherlands
In September of 2011, at the age of 29, Emma Peters broke a bone in her foot, requiring her to wear a plaster cast on her leg. After her doctor finished placing the cast, he gave her a preventative dose of heparin, which she was then to administer daily. Her doctor explained that the medication would help to protect her from the possibility of deep vein thrombosis (DVT), a condition which can be triggered by the use of plaster casts.
“Being health conscious, when he told me about DVT, I went to ‘Dr. Google’ to try and learn about the symptoms of DVT just in case,” Emma says.
The plaster cast was removed a week after it was put on, but a couple of days later Emma began feeling advancing cramps in her calf.
“I had read that one of the signs of a DVT was cramps in the calf, so I went straight to the hospital where they did a blood test and an ultrasound, which showed I did have three medium-sized blood clots in my leg where the plaster cast had been,” she says.
To treat the clots, Emma’s doctors prescribed anti-coagulation injections and then warfarin. During the treatment, she was required to have a blood test every few days to evaluate how it was working. One week after the diagnosis of a DVT she started getting pains in her chest, which led to the discovery that she had very small PE.
“It is important that your INR stays within a specific range during treatment – if it is outside you could either get another DVT or you may suffer from internal hemorrhaging. My blood tests were rarely in the normal range which meant I had to keep adjusting my dose of warfarin,” Emma recalls..
Fortunately, after three months of treatment, the blood clots had disappeared. Following her recovery, Emma was advised to get a DNA test for a thrombophilia, which would indicate a genetic predisposition to developing blood clots. As it turned out, Emma did have a thrombophilia that is rather common. This means at the time of her injury, Emma had three risk factors which led to her DVT: genetic thrombophilia, leg in a plaster cast and use of birth control.
“I was taking contraceptive pills, which were linked to developing blood clots, and I didn’t know it,” Emma says.
Yet, Emma’s recovery wasn’t fully complete for several more months after the blood clots disappeared. She began experiencing what is known as post-thrombotic syndrome (PTS), a fairly common long-term complication of DVT.
“Every time I went walking or did any exercise with my legs, I would get exactly the same pain in my leg that I felt when I had the DVT,” Emma explains. “Obviously this set alarm bells ringing, so, on the advice of my GP I would return to the hospital for blood tests and ultrasounds. This happened about three or four times in the first year following the DVT. Luckily after that, the pain started easing, and I began to be able to do normal activities again.”
In retrospect, Emma is glad that her doctors took the preventative measure of injecting her with heparin, but wishes she was also told about the signs and symptoms of a DVT at the time. As a public affairs professional in the health sector, Emma knows the importance of communicating the right message.
“They were pretty sure that because I was receiving prophylactic injections I wouldn’t get a DVT, so they didn’t warn me of the signs and symptoms in case I was one of the unlucky few who do develop clots despite receiving heparin,” she says. “It was only because I educated myself that I recognized the symptoms and could act upon them when they appeared.”
Thanks to her own proactive research, Emma was able to ensure that treatment was started before it was too late. And like other DVT survivors, Emma can appreciate the positives of overcoming the disease. After discovering her thrombophilia, her father also got a DNA test before a knee operation and found out he had the same disease. The diagnosis was able to help doctors plan his recovery more effectively.
Emma has shared her story with friends, hoping that her experience will help others become more aware of the risk factors as well as the signs and symptoms of DVT. She makes a point to emphasize that many risk factors are applicable at all ages.
“When I tell people about it, they are often surprised,” Emma says. “They think of DVT as a condition that affects older people. The problem with DVT is that it can affect people of all ages, and if you are not aware of the symptoms and don’t act on them, it can kill you. There does need to be more awareness about this.”
*Emma Peters is a pseudonym for a patient who wished to remain anonymous.