Coagulation Trepidation!

I did have a bit of a scare last week. As I mentioned in a previous post, last week was really tiring work-wise. Our organization had its annual lobby day at the State Capitol, and it happened to be over 90 degrees that day. Even though I only was assigned to accompany members on two legislative visits (some of my coworkers went to 10 or more), I was on my feet a lot more than usual. That combined with the 90 degree weather really did a number on my legs and feet.

By the time I got to the Newborn Care class, my feet were as puffy and swollen as I've ever seen them. When I woke up the next morning, my feet were just as swollen as before, and I had pain underneath the left side of my right knee, something I definitely hadn't experienced before. It got more painful as I was walking, particularly walking up and down stairs, or other movements that required me to bend my knee. So I called the doctor's office, explained my symptoms to an advice nurse, and they asked that I come in that afternoon.

The OB, a new one I've been assigned to, checked my leg for varicose veins and felt underneath the leg for blood clots. She didn't feel anything unusual, but asked that I get an ultrasound just to be sure. At the same time, she checked my measurement, and saw that I was measuring at 36 weeks (I was exactly 33 that day), so I may have to get an ultrasound after the next appointment to make sure that my baby isn't gigantic.

However, before I could get an ultrasound scheduled, the ultrasound office required that I get a blood test that can rule out your risk for deep vein thrombosis or DVT (i.e. blood clots). I went down to the lab, had my arm stabbed for the fifteenth time this pregnancy, and off I went. As I've mentioned before, Kaiser has a great electronic health record where you get an email when a new test result has come in. The downside to that is that you find out the information (good or not) well before you get a call from your doctor. Needless to say, my blood test for blood clots came out positive. I found this out at about 9PM on Thursday night, just when I was about to watch The Office. Naturally, I panicked and started researching DVT immediately. I read that pregnant women are more susceptible to blood clots because their bodies coagulate their blood more to prevent (wisely) excessive hemorrhaging when they go into labor. If blood clots are found (via an ultrasound or MRI), pregnant women will receive injections of blood thinners to stop the blood clots. The real concern is if the blood clot moves up the leg and into the lung in the form of a pulmonary embolism.

So much of Friday morning, I was just waiting to hear from my doctor about getting an ultrasound scheduled. Finally, after all my meetings were over, I called Kaiser to demand to know what to do next (ignoring the fact that the pain in my leg had already gone away by this point). Long story short, I was connected to the radiology department, and was informed that I could come on in and get looked at between regularly scheduled appointments.

After waiting in the small ultrasound waiting room for over an hour (and having perused every issue of Southern Decor magazine), I finally had my legs examined. Unlike the ultrasound for the baby, the ultrasound for my legs was PAINFUL! The technician (who happened to be the same curt, no-nonsense tech that did the ultrasound for me at 20 weeks) had to press hard all along the vein in my inner thigh and it boy, did it HURT. Once it was over, the tech had my go back to the waiting room while she consulted the doctor in the ultrasound room. Luckily, nothing showed up and I was told I could go home. My OB called me about an hour later and told me essentially the same thing and that if my leg was hurting, I could use a hot compress to ease the swelling.

Big relief. Of course, once I got home, I googled D-Dimer testing (this is the blood test I had) and pregnancy and realized why the OB hadn't wanted me to have the blood test in the first place and instead go straight to the u/s. If your body is already naturally making coagulation of your blood easier, it makes sense that there would be false positives from the blood test! So I probably worried myself needlessly just because the ultrasound department didn't want to see me until after I had a positive on the D-Dimer test.

Oh and yesterday, my feet came back briefly to say hi. I could actually see tendons and bones and some definition to my ankles! Chris exclaimed, once I pointed them out to him: "Wow, they almost look downright dainty right now!" I'm sad to report, however, that they've gone back in hiding for another 6+ weeks...