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Over the course of 48 hours, she went from having some pain to struggling to walk. “My right leg had some discoloration, and my right foot was very cold”. She was initially diagnosed with sciatica and was recommended to exercise, massage and take paracetamol.
The pain didn’t improve and she was really struggling to walk. Alma made an appointment with a physio to get a massage but also rang her own GP as she was worried that the pain was something other than sciatica. She mentioned that her foot was swollen and her GP asked her to come see her.
By the time she got to her appointment her right calf was very swollen. On examination Almas GP was concerned that she had a clot.
My right calf was 7cm bigger than the left calf at this point and she referred me to Holles Street emergency department
Almas biggest concern was her baby, “I just wanted to know if he was okay”. Holles Street did a scan and confirmed that all was well with her baby. However, they were also concerned that she had a clot so administered an injection of blood thinners and transferred her to A&E in St. Vincent’s Hospital.
By the time she got to St Vincent’s Hospital Alma needed a wheelchair as she could no longer walk.
"The pain was excruciating. I was sent for a chest x ray and ultrasound on my leg. The ultrasound was very difficult as the pain was unbearable. The consultant confirmed that I had a significant DVT (deep vein thrombosis) that had travelled from my calf into my vena cava” which is is one of the body's largest veins.
Deep vein thrombosis is a condition that occurs when blood clots form in deep veins, usually in the leg or arm. Sometimes there are no symptoms and a DVT is only diagnosed if a complication occurs. Symptoms may include swelling of one leg or arm (usually the full leg in pregnancy), pain in one leg or arm (which may be worse when standing, walking or using your arm), warmth or redness in one leg or arm. If you think you are experiencing the symptoms of a DVT, it is very important that you call your doctor immediately or present to the nearest Emergency Department
The vascular team told her that there were two treatment options. “The first was thrombolysis which involved administering higher doses of blood thinner to break down the clot. There were risks associated with this – it might not be effective; I could be left with long term mobility issues and there was also a risk to the pregnancy. The second option was a mechanical thrombectomy. This was an option in scenarios when the clot was significant”.
Alma and her husband consulted with the vascular and haematology teams, her obstetrician and the consultant in the Mater Hospital who specialised in mechanical thrombectomies. “Whilst there were risks associated with the mechanical thrombectomy, it would not risk the pregnancy which was the most important thing to me”.
A week after the clot diagnosis, Alma had a mechanical thrombectomy to remove the clot. “The procedure was incredibly painful as the pain relief that they could administer was limited due to my pregnancy. Two kind nurses held my hands throughout the procedure and helped me to stay calm”.
The procedure was successful with a large percentage of the clot being removed. Recovery was slow “but ABC was my moto – activity, blood thinners and compression”. The weeks following the procedure were tough, it took Alma a lot of time to walk, even short distances. The twice daily blood thinner injections (which Almas husband administered) and wearing a compression stocking also took some getting used to.
Alma took blood thinners for the duration of her pregnancy and for 8 weeks post-partum (after birth). She had an emergency C section and did “worry that another clot would develop in that 8-week period but thankfully it didn’t”.
Now, almost five years since the clot, Alma is healthy and well, with a “wonderful four-year-old” to keep her on her toes. Alma wants to share her story in the hope that it can help other pregnant women to recognise the signs of a blood clot and to act quickly. Alma was not a smoker, had a healthy BMI and no family history of clots.
I did not meet some of the typical markers of someone at risk of clots. However, I also did not know that I was at a higher risk of developing a clot due to pregnancy
Thankfully Alma “trusted my gut when I felt that the initial sciatica diagnosis just wasn’t right and I owe a huge thank you to my GP for acting quickly, the haematology and vascular teams in Vincent’s and the consultant and his team in the Mater Hospital.”
“I will continue to wear a compression stocking for life as my vein is damaged. In time I may need a stent but for now I ensure that I keep active, taking exercise more seriously than ever to minimise the risk of another clot”.