My name is Alma. When I was 35 and 10 weeks pregnant, I started to experience some lower back and leg pain which got very intense in a short period of time. Over the course of 48 hours I went from having some pain to struggling to walk. My right leg had some discoloration and my right foot was very cold. I called the out of hours GP who called to my house and diagnosed me with sciatica. He recommended exercise, massage and paracetamol.
The pain didn’t improve. I was really struggling to walk. I made an appointment with a physio to get a massage but also rang my GP because I was worried that the pain was something other than sciatica. When I spoke to her I mentioned that my foot was swollen. She asked me to come see her.
By the time I got to the GP, my right calf was very swollen. My GP examined me and was concerned that I had a clot. My right calf was 7cm bigger than the left calf at this point. She referred me to Holles Street emergency department. My biggest concern was our baby, I just wanted to know if he was okay. Holles street did a scan and confirmed that all was well with our baby. However, they were also concerned that I had a clot so administered an injection of blood thinners and transferred me to A&E in St. Vincent’s.
At Vincent’s I needed a wheelchair as I 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 that had travelled from my calf into my vena cava. The vascular team told me 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.
My husband and I consulted with the Vascular and Haematology teams, my obstetrician and also the consultant in the Mater Hospital who specialized 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, I had a mechanical thrombectomy to remove the clot, the first procedure of its kind in Ireland. 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 a lot of time to walk, even short distances. The twice daily blood thinner injections (which my husband administered) and wearing a compression stocking also took some getting used to.
I took blood thinners for the duration of my pregnancy and for 8 weeks post-partum% (after birth). I had an emergency c section so I did worry that another clot would develop in that 8 week period but thankfully it didn’t.
Now, almost three years since I had the clot, I am healthy and well, with a wonderful little two year old to keep me on my toes. I want to share my story in the hope that it can help other pregnant women to recognize the signs and to act quickly. I was not a smoker, I had a healthy BMI and there was no family history of clots so 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 I trusted my gut when I felt that the 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.
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 minimize the risk of another clot.
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