Arm Swelling Continues w/Lovenox Bridge

[ALCapshaw2]

As reported before, my arm was badly bruised by a BP Cuff that went to Full Pressure and S L O W L Y dropped down.

Just above the elbow, my (right) upper arm measures 12 inches. While in the Hospital for an invasive procedure, my Left Arm swelled to 13 inches. Tonight (6 days after the injury), my left arm measures 14 inches and my lower left arm is swelling also.

My concern is that BLEEDING may be continuing either in the muscle or the vein that was used for a blood draw continues to leak. The BP Cuff slipped down before inflation, just reaching the Blood Draw site.

I resumed taking Coumadin Tuesday night following the procedure (5mg Tues, 5mg Wed, 4 mg Thurs, and will take 4mg Friday at 10 pm). I resumed the Lovenox Injections Wednesday morning and was instructed to continue until Sunday p.m. INR will be tested Monday morning.

SO, what to do on a Friday Night?

Go to ER?
Wait until Morning to see if it is still progressing?

If there is bleeding, what can be done given that I'm taking BOTH Coumadin and LOVENOX?

(My) Life is getting too complicated!

'AL Capshaw'

 

[geebee]

Al,

Can you call your doctor to find out whether this is something to be concerned about? I think I would be on the phone to ask the question.

I am sure bleeding into the muscle could potentially be an issue but I do not know just how dangerous it is (i.e. life or limb threatening).

 

[Debbrn]

Al,

Is your right hand the same temperature and color of your left hand? When you press on the fingers of your right hand does the color come right back? Can you feel the pulse in your right wrist? If so, is it as strong as your left wrist? If the answer is to any of the above question is no, I would suggest that someone see your arm as soon as possible. If the answers are yes, I think that Geebee has a good suggestion.

Debbie

 

[Nancy]

You could also have sustained some kind of injury to the lymphatic drainage system. You should have a doc take a look and maybe some ultrasound of the area.

 

[EireCara]

''sods law''

''sods law''

Hi Al, I know how you must be feeling...seems to be 'sods law' that things happen or get worse on Fri evening and your left with the worry of what to do. Like everyone else I would say, dont hesitate, go to er or at least phone your gp. But I know, when Iv been in similar situations Iv talked myself out of it. Its as if we are doing some awful thing by just looking for help over the weekend. When its someone else you can see that they should definitely go get help but when its ''yourself'' you cant. The reality is, one shouldnt hesitate to look for help if something major like this is troubling us. This is our one and only ''life''. There are no medals for ''grin and bear it people''. I hope everything turns out good for you. 8)

 

[Persianlady05]

About the swelling arm

About the swelling arm

Al, Im sorry your having such complcation , I have experience this problem also its better to play it safe than sorry, especially swelling and bleeding my body is so sencetive to this coumadin i was in the hospital two mths ago for pain and swelling in mulcels or tissues, I went to the dr the other day i had had swelling and brusing on my shoulder with pain and then it started on my hand and my legs oh my gosh i am tired of this its worst than a diabetic sometimes so my dr said i feel a hemotoma go to the er they have a bed for you i did and they checked me in for having a 4.0 only so i went off coumadin for 3 days thats right it finally lowered to a normal range i didnt do anything different than i usually do i am wondering will stright medi-cal pay for a machine for me because of my complcations i understand how you feel take care chris

 

[ALCapshaw2]

Well folks, I finally took everyone's sage advice and went to the ER this afternoon (after taking my morning Lovenox shot). Sure got a LOT of stares from the ER staff! ...and there was NO waiting.

Bottom Line: ER Doc granted my wishes (INR and Ultrasound Scan). NO Bleeding and NO Clots but there is a LOT of SWELLING. I will sleep better tonight (assuming those nasty arm pains don't wake me...again...)

Oh yes, INR was all the way back up to 1.6 (from 1.2 after taking 5, 5, 4, 3 mg the last 4 nights). ER Doc said "You DEFINITELY need to be on Lovenox". So why did I have to threaten the nurses that I'd "rattle the cages" if I didn't get my Lovenox shot by noon Wednesday (24 hours after my procedure)?

I hate to think what would have happened to a "Compliant Patient" who just went along with whatever the nurses (and doctors) did without question ! I'm guessing there isn't a procedure in place for developing an Anti-Coagulation Schedule for Bridging patients who come in through the ER. (I saw 3 different cardiologists in 5 days). When the nurse finally called my principal cardio, he issued the order without hesitation (as I knew he would).

'AL Capshaw'

 

[Ross]

Al I'll never understand why they do make us wait. My Cardiologist stood there and told me that the risk is very very small. I looked at him and said,"Sure, but it's an unnecessary risk and I do NOT HAVE LUCK!" He got the message.

 

[Guest]

I think that Al's experience demonstrates very well the risks and benefits of bleeding.

1.The best outcomes are those who do not bridge and have no complications.

2.Close after this are those who bridge and have no complications.

3.Next comes the group that Al is in, those who bridge and do have complications.

4.The worst are those who do not bridge and have complications.

Groups 1 and 2 have the biggest risk - the outcome is either best or worst.

Groups 2 and 3 have the middle outcomes and entail the least risk.

Al fell into group 3 which is certainly less desirable than group 1 but far more desirable than group 4 which often ends in a stroke. While his complication is temporarily ugly and scary, it is far better than paralysis.