Another question about 85-year old with DVT

Dear People: I hope that I am not being unkind to require so much time from all of you. You have been wonderful to allay some of my fears and worries. My dear husband is showing some signs of improvement in his overall condition. He is on Xarelto 15 mg at suppertime for his DVT and that's all the doctor thought was necessary. I have read and researched the internet to see if there is anything to be done to help eliminate the swelling. The swelling has gone down in his upper arm and the vein that was engorged has gone back to normal, but the swelling is now worse in his elbow, lower arm and is getting into his hand. The color is improving, and his temperature is normal most of the time but will go up to 98.2 (he normally is 97.6). So overall I feel that he is improving. Once when I had a suspect DVT, I was told to elevate the leg and apply moist heat to it. I don't know how to elevate the arm since he is not supposed to raise it very far as I read the going-home instructions. Should I be alarmed that the swelling is going down to the lower part of his arm and hand? I know that edema in the leg can be helped with a TED hose or that the arm could possibly be wrapped, but I can't find any information either here or on "Google" about if it should be done.

Please forgive me for intruding on your precious time, but I do appreciate the advice I have received so far; and I do trust your advice more than calling an after-hours nursing person now.

Thanks so much.
Anna

3 Comments

Anna - you are NOT intruding...

by donr - 2014-01-15 10:01:13

...that's why we are all here!

I'm NOT an expert on DVT's by any means & you have a lot of knowledge from your near miss. Follow you gut feelings & what you know.

It probably would not hurt one bit to raise his arm to about level w/ the shoulder. In actuality, raising it slowly & gently above the shoulder & supporting it there would for a while would not hurt. By now, those leads are pretty well embedded & he is NOT going to join the "Flying Wallendas" in a circus trapeze act or swing from the dining room chandelier w/ the PM side arm while eating a banana w/ the other hand.

If he is doing as well as you say in the temp/fever dept & feeling well, color improving, etc, one of the major forces of nature is affecting the swelling - GRAVITY! It makes all the blood settle to the lowest point - his HAND. Well, the fore arm is above it, so that gets its fair share of the blood & stray fluids.

I've seen big bruises start in the hip & slowly settle as far down as the tips of the toes; peopl3e sometimes have bruising in the area of the PM incision that settles under the arm while they are on their back then settles to the waist when they start standing all the time. That's because of GRAVITY. The exact same thing can affect Bill's arm. It appears that the body is resolving the clot nicely - from your description. For him to sit on a couch w/ his arm supported by a pile of pillows should not hurt him one bit.

BTW: It's really time for you to haul him in to see the Dr or his/her PA or NP to give you a progress report on Bills condition. After all, he's no spring chicken at 85. They should be pleased as punch to see him & tell you that things are going well. Do it before the weekend so you don't have to tough it out over a weekend when everyone is closed.

Don

Thanks, Don

by BillRussell - 2014-01-15 11:01:05

Thanks for the suggestions. He actually did see his doctor's partner on Monday who assessed the blood clot after obtaining an ultrasound. He is to see the EP who did the insertion on next Wednesday and the Pacemaker Clinic on the following Tuesday, so I think he is being what they consider adequately seen. I also talked to the triage nurse yesterday, and she was extremely helpful on signs to look for. I am rather impatient, and I want to see the fluid go out supernaturally. This very experienced nurse told me a few things that really opened my eyes. I won't discuss them here but may at a later post about a possible medication for glaucoma that possibly could have lowered his heart rate for the past 4 years and made it necessary to have an implantation of the PM. I may call the triage nurse in the morning and ask her about the swelling, but for tonight your comments have helped greatly--and a great big THANKS!!
Anna R.

Swelling

by Alma Annie - 2014-01-16 05:01:02

Hi Anna,
I was on 20 mgs of Xarelto for a suspect tia, and I am surprised your husband is only on 15 for a blood clot. I am an ex RN, and I don't like the sound of any swelling. Please have him checked out now. Don't wait until Wednesday. Maybe it is just fluid, but just in case take him to Emergency if you cannot get to see your local doctor. As I said before it is better to be told all is well than not to have a problem treated.
I am so glad that you are able to tell us all about this. There is no such thing as intruding, that is what this site is for. You just post as often as you want or feel insecure about what is happening.
Yes if you do have someone who can help you that will be good, but I can understand that you want to be there for your husband. Maybe there is someone who can go with you.
My prayers are still with you both.
Alma Annie

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