Doc, need help with pulmonary embolism

look 171 · 01-18-2016, 09:44 PM

My father is a lung cancer survivor, coming up 16 years this February (yeah). He spend the last 3 weeks in the hospital with Pneumonia. He was in pretty bad shape the first week and couldn't move. The antibiotic started kicking in days later then he's feeling better. All vitals started to look normal but his Pulmonologist decided to scan his chest two days ago for clogs due to his lack of activites. They found clots. The Hematologist have him on Heparin drip and Lovenox and blood thinner. One of those doctors want him bed ridden with absolutely no movement. He usually feels better when he sits up on a regular chair to eat. He has COPD from years of smoking starting from his youth and a section of his lung removed from the cancer. Pulmonologist thinks its stupid for him to stay in bed and that the clog wouldn't travel because its already in his lung and will stay put. He wants him walking. He's been so weak with the time he spent in bed with little food (can't eat, feels bloated). Normally he drives, goes out to eat with mom, and walk between 1/4 to 1/2 mile daily. What do you think, walk him or not.

Do the clogs dissolve over time? A couple of doctors seem to think so, but no one seem to be able to give us an answer on that? Thanks

Jeff

NY65912 · 01-19-2016, 02:35 AM

Jeff,

I had 5 blood clots to my left lung post laminectomy surgery. I was told to get out of bed and sit for a while the day after my 7 hr surgery.

Initially they treated me with Heparin and I was told the clots would dissolve, and they did. I was told to do bed reast the day after the event and was then asked to start walking the next day. I was on Coumadin for 2 months after.

Did they insert a Greenfield filter in the vena cava to prevent any more clots from traveling up from the legs? Does he have the compression devices that inflate on his legs to keep blood from pooling? It is my ubnderstanding that the clot has reached it's limit of travel, dead end in the lung.

I am not a doc but a survivor of pulonary emboli and am speaking from my experience.

Best of Luck to your dad!

gchappel · 01-19-2016, 02:41 AM

So sorry about your father, my prayers go out to him.
Yes pulmonary emboli "dissolve" over time-with treatment.
Treatment will depend on their size and location.
They also need to make sure no new clots migrate to the lungs.
He will be on blood thinners for several months at least.
I assume they have looked at his legs for dvt, the most common location for the clots that move to the lungs. If there are still large clots in the legs treatment becomes more complex- as these could "break off" and migrate to the pulmonary vessels. That might be a reason to limit movement. At times an ivc filter is placed, basically a filter in the main vein in the abdomen that goes from the legs to the lungs- stops the bigger clots from making it to the lungs. This has its own limitations and risks, so not an easy decision and only useful in the correct settings.
Patients usually do pretty well, he is at higher risk because of his other lung disease.
Best of luck to him.
Gary

Jim Richards · 01-19-2016, 03:04 AM

Best wishes for your father's speedy recovery, Jeff.

look 171 · 01-19-2016, 10:57 AM

Thanks guys. I think he'll be alright. Coming off antibiotic today or tomorrow.

They looked at his legs and arms and no VDT. My sister and I think it might be an old clot but docs do not think so. How long did it take your clots to go away, Gary? My father's clots seem to be small according to the docs and no filter is needed, only drugs.

He's a pretty tough old man, at 80, his mind is sharp and I think getting out of the hospital will do him some good.

bivenator · 01-19-2016, 11:36 AM

Best of luck to your Dad. It is my understanding that the clots will dissolve and do get him out of the hospital ASAP. Those places are for sick people.

gchappel · 01-19-2016, 12:46 PM

The symptoms go away pretty fast- couple of days.
The occlusive portions of the clots also tend to resolve fairly quickly- often a week or less.
Small residual chronic components- usually small amounts of clot stuck to the wall, can take a long time to completely clear- but usually cause no problems, the center of the vessel is open and blood flows along normally.
If this is his only problem, usually out of the hospital in a couple of days. It takes that long to get the oral agent, usually coumadin, under control.
He will likely be on some type of blood thinners for at least 6months, maybe forever.
Glad he is doing well.
Gary