Blood Clot Anniversary and Pregnancy

Today marks the fourth anniversary of learning I had a blood clot in my brain. It still feels so strange to think that this happened in the first place. I must also note that I was ever so fortunate to not only survive this event but also have no significant detrimental outcomes. I can still vividly remember hearing the doctor reading the results of my CT scan and feeling like my world was collapsing.

Fortunately, the outcome is a rather happy story. Other than a few modifications during my pregnancy, I often forget that I even had a blood clot. Below is my story!

My Blood Clot Story

On July 20, 2017, I woke up with a severe, unrelenting headache. This was especially odd for me because I never get headaches. The headache persisted as the day went on, and I didn’t sleep well that night. I was hopeful that it would improve, but I sensed something was wrong.

Before heading into work, I stopped at an urgent care because the pain had worsened and was now accompanied by nausea. The whole visit was pointless, and I was seen by a doctor who diagnosed a “tension headache.” He told me I needed to relax and that I would just have to learn to manage the pain. I was given a shot for pain management and an anti-nausea medication. From there, I was on my way to work. The medication had taken the edge of slightly. By the end of the workday though, I was feeling delirious from the pain. I tossed and turned on the couch that entire night.

On Saturday morning, July 22, my husband Rob was so worried and immediately said we were going to urgent care or the emergency room. The doctor at a different urgent care seemed deeply concerned about my quickly worsening state and symptoms. She immediately ordered a CT scan at a nearby hospital and rushed us out the door.

The Diagnosis

After what felt like an agonizing eternity, the results of the CT scan were finally available. The official diagnosis was an acute dural sinus thrombosis, which is the fancy way of saying a type of blood clot in the brain. I was rushed over to the emergency room, where I was quickly admitted into the ICU. Thankfully, I did not require brain surgery and was treated with the blood thinner heparin and given morphine for the pain. It was a rough day of dealing with excruciating pain.

The care I received was exceptional in the ICU, and I ended up being discharged a few days later. Once home from the hospital, I continued taking blood thinners for about 7 months so that the clot could continue to dissipate on its own. Later follow-up MRIs showed that the clot had completely dissolved, and continued use of warfarin was not warranted.

Additional details can be found in an earlier post here.

Life After My Blood Clot

The blood clot scare really changed my perspective about life. One of the doctors told me during the hospital stay that I was lucky to be alive. I could have suffered a stroke, permanent brain damage, or even death. So eerie to even have those thoughts. The question that remains largely unanswered is:

 Why did I have the blood clot in the first place?

The answer is: we will probably never know. The doctors suspect it was a combination of factors, which may have included dehydration and hormonal birth control. They suspect dehydration did play a role because I had run 10 miles in 90-degree heat the evening before the pain started. All of my blood work came back normal, and I do not have any sort of clotting disorders.

The location of my blood clot was also unusual. Blood clots often form in the legs and travel upward to the lungs, but the doctors believe the clot originated in my the brain. Fortunately, I have never had pain since then, and everything has checked out normal in follow-up appointments.

The most significant change after my blood clot has been psychological. I have a greater appreciation of my health and well-being. I also am more grateful for my loved ones, especially for those who came to my aid during that scary time. The support and outreach I received was truly remarkable. Events like this change you as a person, and I truly believe this health scare made me a better person.

Aside from annual visits to my hematologist, I normally have no other changes to daily life. However, this changes during pregnancy. There are a few extra precautions that I must take to keep baby and me safe.

How it Affects Pregnancy

I will preface by stating I am not a doctor. None of this information should be perceived as medical advice. I am simply sharing my pregnancy experience and how my blood clot history has affected them. As background, pregnancy increases the risk of blood clots. You can read more about this topic here. The overall risk is still very low, but this is of concern for women like me who have had a past blood clot.

As a result, my hematologist has prescribed a blood thinner called enoxaparin solely out of precaution. Many blood thinners are not safe during pregnancy and can cause severe birth defects. However, enoxaparin does not cross the placenta but still safeguards me from developing a blood clot. It is a daily injectable that I will take until I am 36 weeks pregnant. The shots I've taken so far this pregnancy are shown below.

Once I am at 36 weeks, I will switch over to heparin injections twice a day. The advantage of heparin is that it has a shorter half life since thin blood could be problematic when I go into labor. I will return to the enoxaparin for about 6 weeks postpartum. Giving myself a shot each day isn’t exactly fun, but I have figured out the places on the sides of my belly where it is essentially pain free most days. I will do anything to keep my baby safe.

Maternal fetal medicine doctors are also involved in my prenatal care periodically to monitor my progress. Once again, there are no concerns medically about baby or me. It is just out of an overabundance of caution, which I think anyone would appreciate in my situation.

I am already 31 weeks pregnant, still running, and feeling amazing! We are looking forward to meeting our little one, but I also want time to slow down just a little bit. Looking back to my life four years ago, so much has happened. I wouldn’t change a thing!  

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