Friday, January 30, 2015

I'll Be a Few Hours Late

Where to begin?

I'm finally home after my longest stay ever (4 nights) in a hospital and it's so nice to be back. I've been having more clotting issues related to my Factor V Leiden condition and once again they nearly got the best of me.

I had noticed some cramping in my feet for the past several weeks as well as some pain in my lower left leg when I'd try and workout. It became so debilitating Sunday morning that I couldn't even walk on the treadmill for two minutes at a speed of 1 mph. There was a sharp pain in my shin that was now radiating to my calf which felt exactly like a lactic acid burn when muscles are overworked and starved for oxygen. Because the pain had been more toward the front of my leg I put off any thoughts that it was clot-related but now that it was migrating toward my calf, I was reconsidering.

I went up to talk with Tammy about what I was experiencing and she insisted I head over to Ridges ER in Burnsville to have it looked at. She'd have come with me but she was just beginning her workday and I assured her I was fine to get there on my own. I called my work to tell them, "I'll be a few hours late".

It was a quiet morning in the ER and I was seen within a few minutes. The doctor asked me a few questions while a blood-draw was performed and from what I described he made a cursory diagnosis of Claudication, a circulation problem usually associated with atherosclerosis. He said that what I was describing was classic for this condition but his evaluation made no sense to me. Whatever was happening to me came on much too quickly for it to be related to a hardening of my arteries but if he was right, what did that say about the condition of the arteries in and around my heart? I didn't like what I was hearing.

He sent me back to radiology where they performed an ultrasound looking for clots because of my history with them. The D-dimer test from the blood-draw must've also been positive for clotting because I was no sooner brought back to my room when the doctor had me taken back once more for another scan. They would eventually find a large clot in the popliteal artery behind my left knee. It was literally shutting down nearly all of the blood flow to the lower half of my leg. He drew a diagram for me on the whiteboard and said if we didn't act fast I could lose my left leg at the knee.

He told me of a Dr. Foley at Southdale Fairview and said he's the guy I have to see for this. If he could choose to hand me off to anyone it would be him. He made arrangements to have me taken by ambulance to the emergency room at Southdale Fairview Hospital in Bloomington. Tammy was now by my side and I needed that.

Thankfully, Dr. Foley was there when we arrived and he met us in our room while quickly going over what they had found so far. I expressed to him that I was feeling what may be a pulmonary embolism in my left lung when I breathed deep. I knew that feeling from before. He ordered a CT-scan of my chest to go along with whatever other scans he would need. He didn't like the look of my leg and reiterated what the previous doctor had told me about the distinct possibility that I may lose my leg at the knee. There was virtually no pulse to be found. The only blood flow getting through was from the extraneous system of veins that worked their way through the tissue. The main lines had been cut off. My mind kept going back to the thought of losing part of my leg and what my new normal would be like.

I was wheeled down to Interventional Radiology where their team wasted little time preparing me for what would be maybe a 30 minute procedure to thread a catheter through my right groin at the external iliac artery then up and over through the common iliac artery then back down the left side through the femoral artery to the popliteal artery behind my left knee. Here's a diagram to help.

The vascular surgery team found two clots: one in my left femoral vein and one in my left popliteal artery. The CT-scan would find another in the form of a pulmonary embolism in my right lung. I had no clue how sick I was when I walked into Burnsville Ridges ER a few hours earlier.

The fix for my clots would be to place a very slow drip of TPA (a clot-busting drug) at the site of the clots in my leg and allow it to work over the next couple of days with a vascular surgeon and his team going in on subsequent days to reassess the progress.

I would have lots of downtime in between but Tammy and Rachel were there throughout much of it to keep me company. Having Rachel come up from Rochester to be there meant a lot to me. She's a busy person and I would've understood if she couldn't be there but she was. What a sweetheart!

The IV rack next to my bed was impressive, reminding me of a Christmas tree. Blood-draws were performed sometimes several times a day from a single vial at a time to a dozen. Medical science is amazing as are the people who make up the field.

On Tuesday morning they would spend more than two hours using a combination of methods including angioplasty to try and open up the vascular system of my lower left leg. It's delicate, tedious work as the arteries become tinier and tinier the further down my leg they went but they were successful!

Dr. Foley was described to us as someone who looks at cases such as mine as riddles to be solved and that's exactly how he came across to us. He was in search of clues and an answer as to why my blood was clotting as it was and where the clots were originating from. It isn't enough for him to simply rest on the fact that I have Factor V Leiden and leave it at that.

To be continued...


John A Hill said...

I've been praying that all would have a good outcome (still am) but had no idea so much was going on or how serious things were.
Keep us posted.
Blessings, brother!

Kevin Gilmore said...

Thanks so much, John.

I will!

steve c said...

Amazing Kevin. When I talked with you the other evening, you said nothing about losing your leg. I am so pleased you are ok. Thank you for the amazing, but frightening update.

annmcpt said...

Not only am I amazed at your acurate medical accounting, it's the tone of surrender and being very present and accepting. I'm sending prayers for solutions and healing.

Kevin Gilmore said...

I think I may have been in a drug-induced fog when we were talking, Steve and some of the details were left out of our conversation.

Thanks, Ann.