Possible Blood Clot for DH

[paranoidmother]

So for the last couple of weeks DH (36) has been breathless in the mornings when he goes to the gym and can't do as much as normal. Then last sunday after a large bowl of pasta he also had trouble catching his breath. It was always about 30 minutes after eating and was after eating wheat/gluten.
So I booked a dr appointment for today and he went. Dr has sent him to hospital tomorrow morning for an x-ray and Wednesday morning for a blood test as he thinks it might be a clot/ pulmonary embolism.

Now I know this is serious and he's been told not to fly (we drive to France on Wednesday afternoon). I need more info.
Like what happens next? We're away for two weeks and if he needs tablets because it is a clot do we come back or can we buy the drugs at a dr in France?
He has no other side effects, isn't over weight, is fit, doesn't smoke, hardly drinks ( 1 or 2 beers a week max, none if he's on call which is twice a month for 7 days). He goes to the gym - cycles, rows, cross trainer etc 4 -5 times a week as he use to cycle 40 miles a day but now has changed job so can't.
Is there anything else it could be? Is this worst case scenario?

I just want him to be ok.

Sorry for the ramble but needed to let it out!

Oh is there anything I should be asking or checking with the dr?

TIA

[InSpaceNooneCanHearYouScream]

Well, your best bet is just wait and see what the test results show. Obviously breathlessness can be a sign of serious things, but not always. So try not to panic. The only thing I would say though is if he gets any other symptoms, ie chest pain, dizziness, fainting etc then he should go straight to a and e. Good luck!

[PurpleWithRed]

Does your doctor know you are planning the trip to France?

[paranoidmother]

yes he told the dr we were going away for 12 days and dr said as long as you're not flying. Getting answers is like blood out of a stone!

[InSpaceNooneCanHearYouScream]

Can't you delay the trip for a couple of days to get the X-ray results back?

[UnleashTheBaby]

Sorry your DH isn't well.

Just to warn you that if your hospital is anything like the average NHS hospital though, you may well not have much more information before you go. The chest X-day may well not have been looked at or reported, unless the radiographer who takes it spots something and flags it up. Blood clots in the lungs (pulmonary emboli, PE) do not usually show on an ordinary X-ray. If he has something like pneumonia or infection it would, but again, the film won't necessarily be looked at before you go.

The blood test, if that is all it is, is likely to be a test called D-Dimer. It's an indicator, albeit non-specific, of blood clots in the lungs or the legs. If it's normal, he is very very unlikely to have a blood clot. If it's raised, he might do.

Sitting for long periods driving in a car is also a risk for blood clots.

However if your GP was really worried that it could be a PE, I would have expected them to have him admitted as an emergency under the medical team, and have proper scans to test for it.

Hope things go ok, keep us posted

[GinIceAndASlice]

I had a pulmonary embolism and had injections to "bust" up the clot. I then went on warfarin which is a blood thinner/anticoagulant. However it took daily blood tests for a week to get the dosage right as everyone reacts differently. I was hospitalised as I had just had a c-section and also had pneumonia and cardio myopathy.(didn't do things by halves) so I was in for a month.

I had to go twice a week until it stabilised for testing.


Typically the test would be at 10 in the morning the hospital would call and tell me to adjust my dosage in the afternoon. Tablets were taken at 6pm everyday.

You are right that it can be serious, but once I got treated I was amazed how much better I felt.wait and see what the tests show, but be prepared for the fact that you may need to have more tests in the days after to get the treatment right.

Good luck!

[Musicaltheatremum]

I am very surprised, if he thinks it is a clot then he should have been referred as an emergency that day.

[Cocolepew]

I agree that he should have been referred straight away . Twice I was at my gps with breathing problems, and both times the dr phoned an ambulance. As soon as I got to hospital, blood tests and a ct scan were done within the hour.

[paranoidmother]

Thank you. I think I'm going to call surgery tomorrow whilst DH is at hospital and leave a list of questions asking what happens next and how quickly etc.
DH has said he wants me to go on holiday with DC's without him if he's got to stay at home but I'd rather not go. Happily postpone it otherwise.
We're going to paris for three nights and then onto Disney - so no rides for him whatever happens!

[Itsallabout]

I am not medically trained but have personal experience of PE's.
I would have thought that the GP would have sent your Dh to the ER to be checked over and a chest CT scan, bloods and an ECG done.

When I was covering from my blood clots I was told that going on a long car journey was not advisable due to being inactive for long periods.

I should imagine if it is a blood clot your Dh will need quite intense medical therapy initially for 5+days though as I said earlier Im not an expert.
I will add that I also suffer from indigestion and acid reflux which can cause me to get breathless sometimes.
Hope your Dh will be Ok.

[Thumbwitch]

If I were your DH, I wouldn't stir an inch out of the UK until he has a diagnosis and treatment, sorry.
There is a very simple blood test that will indicate if he has a clot/PE - but if it shows he has, then it needs to be treated, and if it's being treated with warfarin then he has to be tested every few days to check his levels are correct, as someone upthread has already said.
Of course they might put him on clexane or another form of injectable heparin to thin his blood, but they do have to establish whether or not he has a clot and start treating it before he goes anywhere.

IF the GP is dragging his heels, take your DH to A&E.

[paranoidmother]

Thank you. DH has gone to Hospital to get x-ray and we're going to take it from there. I would prefer to get DH sorted and know what it is rather than go on holiday.
Blood test tomorrow and DH said he has to call a week later to find out results! I'm going to push for same day as it all seems a bit laid back for Urgent might be a blood clot!

Thank you.

[Thumbwitch]

Oh hell yes! If there is any risk of it being a PE then they need to get it sorted ASAP, not play fast and loose with his health!

The blood test takes minutes, honestly. Booking the blood sample in and getting the results out might take longer but if it was done in A&E it would be back within the hour.

[paranoidmother]

So hubby has had x-ray and asked for it to be checked there and they got someone in who basically said there as nothing on it and the results will be sent to his dr who will tell him the same thing in 7-10 days! So am taking this as a small positive. However I'm still in worry mode. Now to make DH push for the blood test to be rushed through and made to happen!

[Cocolepew]

This is so strange, if there is a clot it needs to be dealt with straight away, not wait a week for the results . A bloid clot is an emergency.
I had a suspected clot in my leg a few years ago, it wasnt clear by the blood test but I had the symptons. It was saturday night and I got a warfin injection immediately and had to go back to a & e the next night for another until I could get my calf scanned on the monday.

[PinkSparklyElephant]

DH had a blood clot in his leg after a long haul flight last year. He saw his GP and we ended up going to A & E (after being turned away from the walk in centre but that's another story). They gave him a blood thinning injection even though it wasn't confirmed as a clot at that stage and his GP booked him an appointment for an ultrasound the next morning.

DH had to self inject for a few days and was put on warfarin. He was told no flights and also no long car journeys.

I hope your DH is ok.

[GinIceAndASlice]

I was told that it was in the same category as a heart attack, in terms of the severity and need for emergency treatment.

I was met by a crash team as I had left the hospital the night before and had to return when the midwife picked up on how ill I was. They started treatment immediately just as a precaution although I didn't get a diagnosis for a few days as the scanner was fully booked. There was a shadow on the initial x-ray which wasn't definitive although pointed in that direction.

Good luck!

[UnleashTheBaby]

Hi OP, as I've said upthread, pulmonary emboli do not usually show up on a normal chest X-ray. Specialist scans such as a CTPA (CT pulmonary angiogram) or a nuclear medicine VQ scan are needed to diagnose them. It is impossible to diagnose a PE on a plain film alone, and the plain film is frequently normal.

As others have said, PE is potentially life threatening, and is usually investigated as an emergency, by being admitted through A&E or under the medics.

It sounds to me as if your GP is covering themselves. But really, it's not something that should be investigated as an outpatient, with all the associated delays that are thereby incurred.

IF you manage to get the results of the D-Dimer bloody test back before you go and it's normal, then to all intents and purposes your DH is very unlikely to have a PE. But you're no further forward with what is causing his symptoms.

But really, I must stress, this is absolutely not the way or timescale in which PE should be diagnosed!

[UnleashTheBaby]

Bloody test not bloody!

[UnleashTheBaby]

Aargh bloody autocorrect. blood test

[Musicaltheatremum]

Agree with above and the DDimer test for clots is one I don't think should be done in General practice. Too often I have had locums do a DDimer in the morning and had to sort out a positive one in the afternoon. There are also a lot of false positives too. If it's negative it's fine but if positive then you need to act. I think if you feel you need to do one you should be sending them up for assessment.

[Thumbwitch]

What's happening, paranoid? If you're not happy with the treatment your DH is getting, please take him to A&E where they can do all the tests there and then and get him sorted. It's not too strong to say that his life is at risk if they don't sort this out and he does have a PE.

[paranoidmother]

Hello

Sorry for the delay but everything rather took off! We saw another Dr who didn't think the same thing but DH had ECG etc and they were fine with it. DH had the blood test which they sent off and said we were ok to travel. Unfortunately half way across the channel the Dr called and said actually DH wasn't ok could we make our way to A&E. So DH went into Calais Hospital with a D-Dimer count of 9160 which highest you normally want is 500. Straight onto a drip and had a blood test. count dropped to 5000 by the time we reached Calais.

So we didn't make the holiday, Calais Hospital is very nice but nobody apart from ONE cardiology Dr speak any English and I mean any English! It's new and clean and NHS pick up most of the bill. DH is back at work now it's all cleared up but on tablets for another 3 months. Not Warfarin but another drug which doesn't need so many tests. Had no clots anywhere apart from lungs and arteries making their way to the lungs. Had at least 5!

He's referred to a Heamatology Specialist as he has no obvious reasons why this has happened.
Thank you for all your support, I wish he'd gone to A&E and had it all done straight away. You were all correct he should have gone but when we sawy 2nd Dr who said it couldn't be I think DH convinced me that it was all going to be ok. I'll never listen to him on that again.

Our Senior Dr in our local surgery is filling in Insurance forms for us having to state that the dr in her practice said we could leave the country for our holiday as did the emergency dr on the tuesday evening. I'm so glad that nothing worse happened than we missed our holiday.

Thank you