Just dx'd w/possible DVT

  1. I've been feeling lousy for a couple of weeks (okay, probably about 6 or so) with this off/on pain in one calf. I finally asked my Dr. today when I went to see him about a migraine if he thought *maybe* it was a DVT. He didn't think so, since I have no risk factors (I don't think Type 1 diabetes counts, does it??), but agreed to do a D-dimer (?) test to see if there was a possibility.

    He called tonight to tell me it came back positive. So I promptly called into work (I was supposed to work 2 12's this weekend) because he doesn't want me working and on my feet right now. I feel horribly guilty about that! I left them less than 12 hours to find a replacement for me for the weekend (LNA).

    Plus, he wants me to have an ultrasound this weekend, but my local community hospital doesn't have ultrasound coverage on the weekend, so I may end up at the hospital I work at! Then I have no idea if they'll want to start me on blood thinners or what right away.

    Is this test a pretty good indicator of DVT? I'm a nursing student, but haven't dragged out my books yet for next semester to look it up. I feel like it most likely IS a DVT, due to the positive test and the pain. I'm also wondering how soon people that work on their feet are usually back to work. I know that quite a few nurses get them.
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    About RedSox33RN

    Joined: Jan '04; Posts: 1,462; Likes: 104
    ED RN
    Specialty: Emergency Dept, M/S


  3. by   jimthorp
    Do you have accompanying edema in the affected LE?

    DM is a risk factor for vascular problems. Actually, people with DM and no other risk factors have higher incidence of arteriosclerosis and/or atherosclerosis than non-DM people with other risk factors.
  4. by   TheCommuter
    I have also been afflicted with pain in my right calf, but it's been occurring for the past 10 months. I think I might have DVT or intermittent claudication, but the doctors are unwilling to do the appropriate diagnostic procedures since I am a young adult. All my doctors say that DVT and claudication occur most often in the 50+ crowd.
  5. by   button2cute
    Hello, all

    If the ultrasound shows a dvt in the leg. It depends on the philosophy of the physician and if he decides to place you on herparin IV or not. One physician may say we do not treat the small dvts in the legs and another might say he will treat it.
    If you are taking birth controls discontinue them as soon as possible and inform your physician you were on them. That is a very important piece of the puzzle.
    Do not be scare at all the ultrasound is wil show your arteries in a red color and veins in blue color. You can actually watch the test. Sometimes they will explain things to you and if they do not ask them too.
    Depending what they find and the physician you may be on heparin and wean off to coumadin. Then a blood test is require for the PTT level while you on heparin...remember the test is PTT is for heparin and they will want you at a specific level.
    They will determine when to wean you off heparin and give you coumadin for a certain time. You will have to go to the lab for a pt to check your level and your INR. There is a range the doctor would like for you to be in...the PT is four coumadin and it is how many seconds your blood clot and the INR level will keep you above the 2.0 level for theraupetic range to keep your blood thin. You do not want to to be below 2.0 because that is normal. You want to to be thin to prevent any clots to form.
    Now do not jump the gun till you have all the facts first and ask questions about the dvt, the location, how come no chest xrays? and etc. Remember you cannot have a large amount of Vitamin k because it is the antidotic to coumadin. Therefore, if you have salad be consist and not too much dark green and leafy veggies.
    This is premature till you receive the ultra sound and the doctor tells you the findings. Just take one step at a time and do now worry about work. Work will survive believe me. So relax and go to your ultrasound.

    Emm, Thecommuter your physician si not true about the age thing. I received my first dvt at the age of 27. Therefore, you need a physician that will listen to you and take actions.
    You might want to think about it and want to be heard.

    Have a great day,
  6. by   Katnip
    I have seen a lot of DVTs in young people in the ER. Usually we send them home with a Lovenox regimen rather than IV heparin, but it depends on the doc and the DVT.

    Commuter, not sure why your doc doesn't think somebody under 50 can get them.
  7. by   ckh23
    Also want to throw in there that a D-Dimer is not a difinitive test for a DVT, its more of a tool to rule it out or to do imaging studies to determine what is causing the pain. If you went to the ED, they would probably run a d-dimer and if it comes back positive then it would be off to ultrasound to confirm or ruleout a DVT.
  8. by   L&Dnurse2Be
    All my doctors say that DVT and claudication occur most often in the 50+ crowd.

    We have had 2 patients under the age of 30 in the past 2 months with DVT.
  9. by   Fonenurse
    You might find this article on DVT interesting. There are a lot of reasons why you could get a DVT - obviously the older you are the more at risk you become, and being less mobile as you get older doesn't help. Diabetes, Cancer, vascular problems and air travel also are implicated... this article also mentions that D_Dimer can have false positive readings if you are diabetic...

  10. by   NJLPN
    I unfortunately had a DVT at 23. so as far as I'm concerned age really shouldn't be a factor. Is there a family history?
  11. by   TheCommuter
    Quote from NJLPN
    I unfortunately had a DVT at 23. so as far as I'm concerned age really shouldn't be a factor. Is there a family history?
    In my situation there's a family history of vascular problems; however, all of my relatives with vascular issues are also diabetics. I am not a diabetic (yet), but I was immobile much of the time due to long commutes to school. I was sitting in a car for 3 to 3.5 hours while driving 200 miles daily from home to school. I suspect that the long periods of sitting caused my blood to pool in the leg area.....