A Mother's Journey with DVT

On November 17, 2003 when seven-pound newborn Caitlyn Lei' Lana Ruffin was placed in her mother's arms, 31-year-old Le Keisha Ruffin was overcome with an instant feeling of gratitude and love at becoming a mother. She had no idea that her harrowing experiences over the next several weeks would overshadow her feelings of joy.

Le Keisha was home from the hospital only a short time when she started to feel extremely ill. Her husband Craig made several trips to the emergency room with her, only for her to be sent home after being told she was having pain as a complication from her Cesarean section. As her pain increased, she began to experience stabbing sensations in her chest and side. Her husband took her back to the emergency room, but once again, Le Keisha was sent home.

On January 9th, her pain intensified to the point where she was having difficulty walking. In an attempt to console her, Craig ran a bath for her. As soon as she got in the bathtub, Le Keisha was overcome by dizziness and wanted to get out immediately. Craig tried to convince her to stay in the water, but Le Keisha insisted that she get out; once she did, she passed out in his arms. It was then that Craig noticed that his wife's leg had swelled to over three or four times its normal size and she was in excruciating pain.

Once she was examined at the hospital, the ER doctor suspected what had taken place and ordered several tests, including an x-ray of her chest, EKG, CT-scan, venous Doppler ultrasound, and others. Her results showed that she had a blood clot or deep vein thrombosis (DVT) in her lower right leg that stretched from her calf to her abdomen. The reason Le Keisha was experiencing so much pain was because the clot had broken loose and had traveled through her heart into her lungs, causing a pulmonary embolism (PE).

"The ER doctor then informed me that, if I had not come into the hospital when I did, I would not have lived through the rest of the night," said Le Keisha. "She said I was the miracle patient because this clot had probably been parading around in my lungs for weeks!"

Le Keisha was admitted to the hospital, where she was confined to her bed because she was too weak to walk; she was placed on a heparin drip, which is an intravenous blood thinner. When the pain increased, she was rushed back to ICU. The DVT in her right leg was continuing to break off in pieces, so the doctors inserted a Greenfield filter to trap the clots before they reached her heart and lungs. *A Greenfield filter is an IVC filter, a device that is placed in the inferior vena cava (IVC), which is the main vein in the abdomen.

After the filter was inserted, Le Keisha remained in the hospital for a short time because the doctors were having a hard time regulating her blood thinners. She consulted hematologist Howard Terebelo, MD, who discovered that her resistance to warfarin or Coumadin® (see sidebar for information about warfarin resistance) was causing the difficulty with her blood. Dr. Terebelo prescribed enoxaparin (Lovenox®), or low-molecular-weight heparin that she self-administered at home by subcutaneous injection, which resulted in clot resolution and relieved her pain and symptoms.

"Women with no underlying risk factors for blood clots have a 1.2% chance of having a blood clot while pregnant, while women at risk for DVT (such as those with an inherited predisposition) will have a 7.7% chance of having clots during pregnancy," said Dr. Terebelo. "Le Keisha did have a family history of DVT, but she had no other risk factors. In women who have blood clots during pregnancy, the majority of the clots appear in the left leg because of the position of the uterus, although an underlying May-Thurner Syndrome must be considered as well. Le Keisha's clot occurred on her right side, which was odd."

Le Keisha was finally released from the hospital without medication with the exception of a prescription for a four-six month course of enoxaparin (Lovenox®). Now clot-free, Le Keisha says that she's getting stronger every day and feels very grateful to be alive and able to walk.

"I am so blessed that I'm doing as well as I am," said Le Keisha. "Recently my father, who is only 55 years old, was also admitted to the hospital with a PE in both of his lungs. Initially he didn't want to go to the hospital, but thankfully my mother called the ambulance. I cannot stress the importance of making sure you go to the doctor right away if something isn't right; it can make all the difference."

Today Le Keisha hopes more people will learn about DVT and PE and learn to recognize the warning signs and symptoms; from her past experience, she now realizes how important it is to get immediate care and hopes that others will do the same.