Last Tuesday, after scratching incessantly at a mosquito bite, I noticed my left calf was swollen. I had no other symptoms, but, since I had a massive deep vein thrombosis (DVT) ten years ago in the same leg, I sheepishly asked for an ultrasound at the nearest ER. Sure enough, there's a blood clot in my left femoral vein. It's taken residence all along the vessel, from my knee to my groin.
In late December of 2002, an acute and extensive deep vein thrombosis (DVT) was found in my left leg and pelvic region. Specifically, my iliac vein, common femoral vein, popliteal vein, and posterior tibial and peroneal veins were completely clogged. I was 36 weeks pregnant at the time. I was hospitalized and put on blood thinners (heparin), a temporary filter was threaded through my blood vessels and placed in my inferior vena cava, and I was carefully monitored. Thankfully, labor went well and I delivered a healthy baby girl after six short hours of labor. Unfortunately, I hemorrhaged twice after giving birth, lost a ton of blood, and required emergency surgery.
My health, in other words, was a complicated mess ten years ago. At least they caught the clot in time -- I would have otherwise died in childbirth (if not before), since parts of that clot broke free during labor (and were trapped by the filter).
Why the DVT? I'm active, and I'm young (by DVT standards)!
One of my genes is to blame. Specifically, methylenetetrahydrofolate reductase (MTHFR). I'm homozygous recessive for a specific mutation that increases my risk for blood clots and certain types of cancer. Pregnancy is an additional risk factor for DVTs; I avoided clots during my second pregnancy by giving myself daily shots of Lovenox (blood thinner).
What does all this mean for hiking?
To be safe, my doctors would like for me to wait another few days before heading off into the wilderness; they'd like me to be fairly stable on one of my my meds (coumadin) before doing any hardcore hiking. Also, the risk for pulmonary embolism decreases with every day I'm on blood thinners.
I will still take the girls out, but we'll choose our trails and destinations carefully according to my medical status each week. For example, Alex and I did the Lovequist Loop yesterday -- that's a gorgeous little one mile loop trail right next to a busy tourist area off Route 112. If anything had happened to me, Alex could have quickly and easily gotten help. Therefore, for me, the answer is NOT to stay at home. Hiking is part of my recovery, and the White Mountains provide trails of all shapes, sizes and difficulties. There's lots to explore out there; we'll just stick to low ground and/or short and straightforward trails for a week or so. Life should be fairly back to normal by early next month, if not sooner; I'll just have to be extra-careful not to take a serious fall since, for the rest of my life, I'll bruise and bleed easily (blood thinners forever!).
When your leg feels like a cramping block of wood...
Post-thrombotic syndrome (pain and swelling after a clot has damaged the veins) will likely be a life-long hassle. Which, actually, is nothing new for me. I've had post-thrombotic syndrome for the past ten years, I'm just not the type to complain about it all that much. It comes and goes, and is especially bad when wearing anything heavy on my left foot (snowshoes!!). The leg feels weak and painful cramping occurs in my calf and thigh. Exercise helps, stasis doesn't. I'll probably have to deal with increasing pain and weakness over the years, but I'll still hike. Also, I'll continue NOT to wear snowshoes unless postholing is extreme, and I'll never be able to break trail (uphill) for more than a few tenths of a mile (if that). Still, I'll work with what I've got.
The good news --
My first clot did not kill Alex or me. Sage is happily on this planet.
I can still hike.
Life-long blood thinners will greatly reduce my future risk of DVTs.
The way to potentially save my left leg from severe post-thrombotic syndrome is to keep it moving. In other words, not only can I hike, I should hike.
I'll post some more on all this later. Heading out to visit a waterfall with MadRiver and Sooze.
- UP: REVIEWS and PRESS
- GraniteGals PODCAST
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- Alex in the White Mountains (Alex's hiking blog)
- Sage's White Mountain Treks (Sage's hiking blog)
- California's Lost Coast Trail. June 8-9, 2019
- England's Coast to Coast Trail 2018
- Cohos Trail 2017
- Iceland's Laugavegur Trail 2016
- Great Wall of China Trek 2015
- John Muir Trail 2014
- El Camino de Santiago 2013
- NH Four Thousand Footers (Alex and Sage)
- NH Four Thousand Footers -- WINTER (Alex and Sage)
- Trailwrights 72 (Alex and Sage)
- 52 With a View (Sage)
- The Terrifying Twenty-Five
- The White Mountain Grid