Early DVT Diagnosis Gives Nurse "A Leg Up"

One Wisconsin winter evening after returning home from an outing, Cathy experienced a sudden sharp pain in her left calf. She remembers reaching down, rubbing her calf, and telling a friend that it hurt and felt like a vessel spasm.

The next morning at work she continued to experience the discomfort in her calf. Cathy is 48 years old and works as a surgical nurse in an operating room of a busy hospital. The idea of a deep vein thrombosis, or DVT, crossed her mind. She knew many of the symptoms of a DVTÑa warm and tender area, redness or swelling, but she had none of these. She experienced a slight discomfort in her calf, which sometimes would intensify if she tried to stretch her calf by pointing her toes toward her head. Plus, she's active, young and she didn't think she had the other risk factors for developing a DVT.

Although her discomfort was mild, it did not go away and she also noticed swelling of her ankle. Around noon, she discussed it with a colleague in the emergency department. It was recommended that the Vascular Lab technician conduct a duplex ultrasound to be sure she didn't have blood clots in her leg veins.

Cathy was soon given the news that she had a DVT in her knee and calf veins. She was kept overnight in the hospital to start heparin treatment and was discharged the next day as her further treatment could be done as an out-patient. She was given subcutaneous heparin for five days and was also started on a blood thinner pill, warfarin. She was advised to elevate the leg frequently during the day and wear elastic stockings. She needed regular blood tests to manage the dose of warfarin she was taking and was kept on blood thinners for 6 months. After six months, her doctor prescribed a daily baby aspirin.

Cathy was able to return to work after just three weeks since she "caught" the DVT early. She continues to have mild swelling in the left leg and some pain from time to time. She has noticed lots of superficial "spider veins". She also wears compression stockings.

Since her initial DVT, she has had two more ultrasounds to rule out another DVT. Although a "small remnant clot" remains, it is the scar tissue within the vein from her original clot and poses no additional danger. Cathy is still baffled that she had a DVT. "I had no previous injury or surgery. My doctor thought that since I am on estrogen replacement therapy, this might be a contributing factor." Cathy was fortunate that she knew enough about DVT's to seek early diagnosis and treatment and to avoid life threatening complications.