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Advice on DVT risk


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Hi,

My mum had a SAH 6 weeks ago in France. She was in intensive care for 3.5 weeks and then discharged home back to England. She is making a good (but v slow) recovery so far and gaining strength each day. The reason I am writing is that she is v much still bed bound, although she is sitting up in a chair more and more each day and probably spends about 4- 5 hours a day out of bed. She can walk v small distances eg to and from the bathroom. When in hospital she was on heparin to reduce the risk of developing a DVT but since she was discharged home has only been on pain killers for headache and wears flight socks. I just wondered if anyone has any experience/ knowledge of managing the risk of a DVT - were you on drugs such as heparin for a long time if you were still in bed a lot?

She is doing excercises daily now (which a physio gave her) and does wiggle her toes as much as possible when she's in bed.

I am still v nervous about anything happening to her as she has made such a brilliant recovery so far, I would hate anything to happen to her which is preventable.

Thanks,

N x

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Hi Nic.

I used to get in awful trouble for taking off my thigh length support stockings, (I caused a laugh on another thread as they were green, how bad is that? I hope your mum's are a nicer colour).

I can't offer you much advice on the DVT risk Im sure one of the others or maybe your Dad will help there, i didnt have any meds for that i dont think. I had Nimpodopene for three weeks but after that it was pain relief and lots of it.

I do know that it took me an age to be able to walk any distance or stay on my feet. I spent over 5 weeks in hospital initially. That's a lot of lying down and a lot of muscle wasting. Then you have the brain trauma to deal with so sleeping and resting were my lot for a considerable time after. So that meant so were my support stockings.:wink:

When I came home I had a rota of my babysitters as I called them. Friends , their mums , my mum all came and kept me company in the day but I mainly just slept. If I got downstairs for lunch that was my achievement of the day and it was a good one. The healing your mum is going through is immense and it takes up massive energy. Have you asked her whether she feels like doing any more or is she happy with the pace? If she feels wobbly she might need a stick, I still take one with me when I'm out and about , it was hard at the age of 40 , any age to be honest, to need a stick but it gave me reassurance to venture out of the house when I was ready. That was about three months after I walked down the road...

My little book of mindfulness today said...

"and sometimes the most important thing in a whole day is the rest we take between two deep breaths"

It must be hard knowing how to help mum but if you keep her energy levels up with food, help her rest and make her smile then that will be enough. Most important look after yourself and your little one because she will worry about you otherwise.

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Hi Nic,

I would presume that they just used the Heparin whilst your Mum was bed bound and perhaps slightly more at risk .. I'm not a medic, but I believe that Heparin thins the blood to prevent clots, but perhaps it's been stopped now because of the brain haem and because your Mum is more mobile, so less likely to develop a DVT?

It's something that you need to ask your Mum's GP/Consultant to explain, but I was told not to take any pain medication post surgery/leaving hospital that did thin the blood, such as Aspirin etc as it would slow up clotting and not advisable post SAH. Treatment seems to vary from place to place and I have seen on here, some members being prescribed Aspirin as well, so it's probably very much an individual case history/patient type of thing. Not sure if that helps!....but would suggest contacting your GP surgery if you're worried, but haven't seen anybody on here that went on to develop a DVT. xx

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hello nic

i had an SAH in sept 2010 (see my post Tick Tock tick tock). i came out of hospital in december 2010 but returned in feb 2011 firstly with a pulmonary embolism(PE) followed by a DVT. at the time I was moving around the house and more active than at any time since theSAH. The doctors were in a dilemma following the PE and didn't want to risk any blood thinning medication because of the high risk of another bleed. They decided instead to insert a filter in my abdomen to stop any future clots moving to the lungs or brain-its still there. i am surprised your mum was given heparin because of this risk.

The doctors think the PE was the result of the clot moving from my leg and because of the length of time i was in critical care but at that stage I hadn't had the DVT. why they didn't check my leg following the PE i will never know. Eventually my neuro surgeon said I could take warfarin but i have to check my Inr level regularly and it has to be kept quite low.I have bought a monitor to do this at home and so far it has worked. i also wear compression stockings which are a pain to put on and take off.

I think you need to check with your mum's consultant and see what he/she says about the risk of a Dvt against the risk of another bleed.it's not an easy choice but if she has already taken heparin maybe they have already discussed this risk in which case perhaps she could continue with it.

The PE and DVT set me back weeks but equally I couldn't have survived another bleed. The choices aren't good i am afraid but keep her as active as possible and good luck to you both.

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hi nick

lin has had clexane which is heperin in a different guise lin had it first in 2008 and again last week when she had her crainioplasty they can only give it for a short time of seven to ten days because lin was bed bound however this time they only gave one because she is kept active ie excersises

lin no longer wears her compression stockings because she is doing her phyical jerks so to speak karen has offered good words but also talk to mums gp and take guideness from him/her wishing your mum well

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Thanks again everyone - this site really is a great support.

Daffodil - I think at the moment mum is happy with her levels of 'activity'. Yesterday she managed to get downstairs and sit in a chair for a couple of hours, today we had some family over for lunch and she managed to join us - it was brilliant.

She did feel shattered afterwards but we were so pleased she could join us! I think people are surprised at how well she is doing.

She really is taking it all v well and resigned to the fact that she has to take it v v slowly - we thought she would struggle with this as she was so active before. She retired 3 years ago but got bored (!) so started doing loads of things like becoming a magistrate, joining a book club, volunteering at the local national trust house etc. all these things have obviously been put on hold for a while but I guess she is lucky (in many ways :wink: ) because she doesn't have to work and worry about going back to work.

My Dad is relatively relaxed about the DVD risk (compared to me but i am a worrier as you can tell!) but he knows its there and I think he would like to see her a bit more active, but at the moment it's just too much for Mum. I may give her GP a ring in the morning and get some independent advice - I know dad finds it difficult to advise on mum and would prefer we all go to her GP which is understandable. He's not legally allowed to treat her anyway.

My sister is not working at the moment and is looking after her (Dad has to go back to work tomorrow). I am spending every day with her too but my maternity leave runs out next week so I have to go back to work - that will be difficult :-(

Leonard - thanks for your response. You have an incredible story. Did you have an operation to secure the aneurism after the initial bleed? Actually, I will go and read your tick tock post.

Paul and Karen - thanks for your replies, that may be the answer that they only give heparin on a short term basis and she is no longer deemed at high risk. These are all questions we would have asked the consultant in France had we spoken the same language! Roll on the appointment with the neuro surgeon she has been referred to (6 weeks time)

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