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Suggest Remedy For Pain Under The Right Knee
Question: I am a lifetime coumadin patient due to multiple hypercoaguable disorders (Factor V Leyden and Protein S Deficiency) and an incident involving a dvt with bilateral pulmonary emboli about 5 years ago. Since the PE's, I've kept a pulse oximeter in my house.
A little background, I have been having pain under my right knee that is reminiscent of my dvt in 2010. I am getting more concerned. I have a PT/INR machine because I test at home. I am in therapeutic range (2.2) but the pain is getting worse. I just took my pulse ox reading and the oxygen was normal at 97% but the pulse was 44! Should I be concerned? What do I do if I get a clot while I'm in range?
A little background, I have been having pain under my right knee that is reminiscent of my dvt in 2010. I am getting more concerned. I have a PT/INR machine because I test at home. I am in therapeutic range (2.2) but the pain is getting worse. I just took my pulse ox reading and the oxygen was normal at 97% but the pulse was 44! Should I be concerned? What do I do if I get a clot while I'm in range?
Brief Answer:
you should do an ultrasound scan just in case
Detailed Answer:
Hello,
the oxymeter reading and your pulse are very much against pulmonary embolism. The DVT cannot be evaluated with either of the findings. DVT may cause pain, swelling and increased temperature locally (on the site of thrombosis).
Although taking anticoagulants is very protective, thrombosis cannot be excluded. The low pulse rate is a concern. 44 is not normal. Do you take beta blockers? A cardiological assessment would be appropriate for your low pulse rate.
Also, while 2.2 is OK for most cases, I would have targeted a value around 3.0 just be more safe regarding thrombotic complications, since you're very young and you've already had a very serious event in the past. This is also the answer to your last question. You can intensify (under the guidance of your doctor) anticoagulant treatment.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
you should do an ultrasound scan just in case
Detailed Answer:
Hello,
the oxymeter reading and your pulse are very much against pulmonary embolism. The DVT cannot be evaluated with either of the findings. DVT may cause pain, swelling and increased temperature locally (on the site of thrombosis).
Although taking anticoagulants is very protective, thrombosis cannot be excluded. The low pulse rate is a concern. 44 is not normal. Do you take beta blockers? A cardiological assessment would be appropriate for your low pulse rate.
Also, while 2.2 is OK for most cases, I would have targeted a value around 3.0 just be more safe regarding thrombotic complications, since you're very young and you've already had a very serious event in the past. This is also the answer to your last question. You can intensify (under the guidance of your doctor) anticoagulant treatment.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
do you think this is an emergency type of situation or should I wait until the morning and contact my hematologist?
Brief Answer:
doesn't sound like an emergency but you'd better find out ASAP
Detailed Answer:
It doesn't sound like an emergency and you're also under treatment which also protects you against DVT (provided your INR remains within targets). You should clarify this issue though, as soon as possible because if you did have thrombosis under treatment then the treatment has to be intensified and perhaps other options considered.
Patients who had a serious event in the past (like acute myocardial infarction, stroke, DVT, etc) may sometimes recognize the symptoms in a second event, so if you feel like the first time, you'd better do an ultrasound scan (triplex) to find out.
Kind Regards!
doesn't sound like an emergency but you'd better find out ASAP
Detailed Answer:
It doesn't sound like an emergency and you're also under treatment which also protects you against DVT (provided your INR remains within targets). You should clarify this issue though, as soon as possible because if you did have thrombosis under treatment then the treatment has to be intensified and perhaps other options considered.
Patients who had a serious event in the past (like acute myocardial infarction, stroke, DVT, etc) may sometimes recognize the symptoms in a second event, so if you feel like the first time, you'd better do an ultrasound scan (triplex) to find out.
Kind Regards!
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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