What It’s Like Living With Pain After Blood Clots
Ive worked so hard over the past few years as an advocate for fellow blood clot survivors to help them navigate their personal health and recovery journey. What I havent done is shared enough about my personal experience with chronic pain, including post thrombotic syndrome, and disability following my battles with blood clots.
First of all, lets go over what blood clots are. Blood clotting normally helps prevent us from bleeding too much. A blood clot, however, forms when your blood thickens too much. Blood clots that form in the veins are known as deep vein thrombosis. If the blood clot breaks off and travels, its known as an embolus. If the embolus travels to the lungs, its known as a pulmonary embolism. Its important that we all discuss our individual risk factors and the common symptoms of blood clots with our doctors. If you are concerned you might have a blood clot, get immediate medical attention.
Blood clots are a leading cause of death and disability worldwide and the third common cause of vascular death after heart attack and stroke. In the U.S., many blood clot survivors will develop post thrombotic syndrome, which is often a long-term complication that can increase your likelihood of being granted disability. If you suspect you might have post thrombotic syndrome, consult with a knowledgeable vascular specialist.
Thrombosis And Disability Benefits: What You Need To Know
Deep vein thrombosis, or DVT, occurs when a thrombus, or blood clot, occurs deep in your veins, typically in your legs. When the clot develops, it restricts blood flow to the affected area and causes pain or swelling. What makes DVTs especially dangerous is that the clot can disengage and lodge in other parts of your body, causing an embolism.
Symptoms of deep vein thrombosis include redness, swelling, and pain in the area where they have developed. After the clots have been diagnosed by blood tests, X-rays, ultrasound, and evaluation of the blood flow in your legs, your doctor will normally treat them with blood thinners. Occasionally, however, surgery is required.
Having DVT puts you at risk for a stroke or pulmonary embolism, both serious conditions that may make working inadvisable. It could also qualify you for Social Security disability benefits if you can demonstrate that your condition is expected to last at least 12 months.
The Social Security Administration will review the impact DVT has had on your life and your functional limitations, and use your medical record to develop a residual functional capacity for you.
Upper Extremity Deep Venous Thrombosis
Upper extremity DVT is less common that lower extremity DVT, occurring in 2% to 5% of the population. Arm DVT is most commonly encountered in association with indwelling mechanical devices such as pacer leads or central venous catheters . Venous thrombosis may also occur in conditions of venous compression or obstruction due to lymphadenopathy or tumors of the arm or lung .15 Upper extremity DVT is also associated with repetitive arm movement or prolonged abduction . Inherited thrombophilia or malignancy should also be considered in any patient with arm thrombosis yet without other identifiable risk factors.63 Recent studies have shown that acute upper extremity DVT is associated with a 10% to 30% risk for PE , and a 10% to 15% recurrence once anticoagulation therapy is terminated.64 Up to 50% of patients continue to have symptoms due to venous obstruction.63-65
Nathan I Cherny, in, 2003
Symptoms And Causes Of The Disease
May-Thurner Syndrome occurs when the right common iliac artery compresses the left common iliac vein, restricting the drainage of blood from the lower extremities. MTS is most common in women who have been pregnant and rarely occurs in women who have not had children. MTS can also occur in men though it is less likely. When left untreated, May-Thurner Syndrome may progress through three stages:
Stage 1: Iliac vein compression – symptoms may or may not be present.
Stage 2: Venous spur formation – fibrous shelves that develop in the vein, restricting blood flow and increasing disposition for deep vein thrombosis .
Stage 3: Deep vein thrombosis – formation of a clot in the vein. Blood flow is severely restricted, leading to pain and swelling in the legs and the formation of varicose veins.
Center for Vascular Medicine is one of the leading out-patient based practices in the nation for the treatment of venous conditions in the pelvic region which cause pelvic pain.
Patients with mild narrowing of the vein will often experience no symptoms. As May-Thurner progresses, the following symptoms are common:
- Generalized pain in the lower abdomen and pelvis
- Varicose veins in the upper leg
- Swelling in the leg
- Chronic pain in the legs that worsens as the day goes on
- Chronic Hemorrhoids
What Is The Association With Blood Clots
Some people who have a narrow iliac vein are more prone to developing thrombosis if they have additional risk factors for clotting such as being on oral contraceptives or estrogen therapy, pregnancy, extended periods of sitting or certain inherited disorders which increase the risk of abnormal clotting such as Factor V Leiden mutation, Factor II Prothrombin mutation, Protein S or Protein C deficiency orAnti-Thrombin III deficiency. This is known as iliofemoral deep vein thrombosis. Iliofemoral deep vein thrombosis usually presents with a sudden onset of leg pain, swelling and a blue discoloration of the leg. Roughly 80% of patients who develop iliofemoral deep vein thrombosis involving the iliac and leg veins will be found to have an iliac vein narrowing.
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More Common In Females
Hearing lossEnlargement in the veins of your affected legA webbed neckRedness or discoloration of your skinPigmented molesA feeling of increased warmth in your affected legShort staturePain, tenderness or swelling in your affected legShield chest and widely-spaced nipplesLow-set ears. list of impairments
Social Security Disability Benefits For Deep Vein Thrombosis
In order to be found eligible for disability benefits by SSA, you must have a medically determinable physical or mental impairment which can be expected to result in death, or which has lasted or can be expected to last for at least 12 months. For most people, a DVT can be resolved quickly and they are able to go on with their lives. But for those with recurrent DVTs and underlying health issues that cause DVTs, the battle is ongoing.
The Social Security Administration can evaluate Deep Vein Thrombosis different ways depending on the cause of the DVT. Listing 4.11 Chronic venous insufficiency can be used. This listing requires Extensive brawny edema involving at least two-thirds of the leg between the ankle and knee or the distal one-third of the lower extremity between the ankle and hip OR Superficial varicosities, stasis dermatitis, and either recurrent ulceration or persistent ulceration that has not healed following at least 3 months of prescribed treatment.
If you meet the above listing, you are in excruciating pain. This listing, as with most listings, is difficult to meet. You may not be able to work long before you meet this listing. In my clients, recurrent DVTs are caused by chronic underlying health issues that only worsen with time. Also, post thrombotic syndrome can be a severe impediment. If those underlying health issues are severe enough to cause recurrent DVTs, you may be approved for Social Security Disability.
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It’s Difficult To Qualify For Disability Due To Thrombosis Unless It Has Led To Chronic Venous Insufficiency
By Melissa Linebaugh, Contributing Author
People who have deep vein thrombosis are at risk for pulmonary embolism or stroke, both life-threatening conditions, and are sometimes advised not to work. Depending on their particular condition, they may qualify for disability benefits from Social Security. A related condition is chronic venous insufficiency, which is recognized by Social Security as a condition that can be disabling.
What Is Vein Disease
Vein disease is a chronic and likely a long term disabling disease. Vein disease is a term that encompasses a range of disabilities. Veins are part of the Vascular System responsible for returning blood back towards the heart. To perform this function, each vein is equipped with a series of valves that keep blood flowing towards the heart and prevent a backflow of blood towards the foot and ankle region. When the vein walls or the valves inside the veins weaken, the result is a pooling of blood in the vein segment. Gradually the vein dilates, becomes visible and twists and stretches. With increasing dilatation of the vein the blood begins to flow backwards down the leg leading to increased venous pressure inside the vein resulting in a condition known as Chronic Venous Insufficiency.
Vein disease may not be visible at first, but as the severity of vein disease progresses, it will result in skin conditions such as spider veins, varicose veins, edema, hyperpigmentation, and hardening of the skin, that will eventually lead to ulcer formation.
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Cleveland Clinic Heart Vascular & Thoracic Institute Vascular Medicine Specialists And Surgeons
Choosing a doctor to treat your vascular disease depends on where you are in your diagnosis and treatment. The following Heart, Vascular & Thoracic Institute Sections and Departments treat patients with all types of vascular disease, including blood clotting disorders:
Section of Vascular Medicine: for evaluation, medical management or interventional procedures to treat vascular disease. In addition, the Non-Invasive Laboratory includes state-of-the art computerized imaging equipment to assist in diagnosing vascular disease, without added discomfort to the patient. Call Vascular Medicine Appointments, toll-free 800-223-2273, extension 44420 or request an appointment online.
Department of Vascular Surgery: surgery evaluation for surgical treatment of vascular disease, including aorta, peripheral artery, and venous disease. Call Vascular Surgery Appointments, toll-free 800-223-2273, extension 44508 or request an appointment online.
You may also use our MyConsult second opinion consultation using the Internet.
The Heart, Vascular & Thoracic Institute also has specialized centers and clinics to treat certain populations of patients:
What Are The Treatment Options For Mts
The goals of treatment are to reduce symptoms and reduce the risk of complications. Your healthcare provider will recommend the treatment option that is right for you. Before choosing any treatment, it is important to discuss the potential benefits, risks and side effects with your healthcare provider. You will receive specific guidelines to help you prepare for your procedure, as well as specific instructions to help your recovery.
The majority of treatments related to MTS are actually geared toward treating the DVT that is associated with the vein compression. The following are a number of different options that may be employed to treat patients presenting with DVT.
Your physician may prescribe blood-thinning medication to prevent blood clots. When use of blood thinners is indicated, your physician will closely monitor you to ensure utmost safety. You may be referred to the Anticoagulation Clinic.
Catheter-directed thrombolytic therapy
Angioplasty and stenting
Stenting of the iliac vein is often important in the treatment of MTS. Once the blood clot is removed from the vein , the compressed vein is forced open with the use of a stent.
This treatment will help reduce the risk of a pulmonary embolism, but will not prevent the development of more clots.
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Medical Evidence To Support Your Rfc
It is important to provide the SSA with objective medical evidence that supports your RFC. Some examples of the evidence you will need are lab reports, x-rays, CT scans, Doppler tests, ultrasound reports, and notes made by your doctor during your appointments. The SSA gives the most weight to evidence provided by a specialist, such as a cardiologist, who is directly responsible for your care.
Your RFC, along with your age, education level, and job skills, will be taken into account to determine if there is any work you can do. Learn how RFCs are used to determine whether you should be able to do your prior job or other work.
If You Have Been Denied Benefits
If you have previously been denied benefits for a blood disorder, we want to help you get the compensation you need. Call 402-933-5405 to speak with one of the attorneys at Cuddigan Law today or order our free guide, 5 Deadly Mistakes That Can Destroy Your Social Security Disability Case.
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What Is Recovery From Surgery Like
Some of the surgeries associated with May-Thurner syndrome are done on an outpatient basis, meaning you can go home the same day after having them. You should be able to return to normal activities within a few days to a week.
For the more involved bypass surgery, youll have some soreness afterward. It may take several weeks to a couple of months to make a full recovery.
Your healthcare provider will instruct you on how often you need to follow up. If you have a stent, you may need an ultrasound check about a week after surgery, plus periodic monitoring after that.
Disability Benefits For Deep Vein Thrombosis
This post discusses Social Security disability benefits for Deep vein thrombosis . If you are unable to work due to chronic venous insufficiency read on for how SSA will evaluate your claim for disability.
The below is not offered as medical advice regarding thrombotic syndrome. If you are having symptoms of venous insufficiency, please seek medical treatment.
Deep vein thrombosis occurs when a blood clot forms in one of more of the deep veins in your body, usually the legs. DVT can cause swelling and pain or no symptoms at all. Blood clots can be caused by anything that prevents your blood from circulating properly. Via The Mayo Clinic.
Surgery, cancer treatment, a blood-clotting disorder, hormone therapy, child birth, varicose veins or congestive heart failure could all be possible causes. Via WebMD. Treatment for deep venous thrombosis is focused on stopping the clot from getting bigger or moving to your lungs and preventing you from having blood clots in the future. Blood thinners are usually given for six months but your treatment may be longer or shorter depending on the cause of the DVT. Blood thinners can thin the blood too much so regular blood testing is needed. Via NIH.
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Can I Get Disability For My Dvt
To be eligible for disability, you must first show that you aren’t working or you’re not doing “substantial gainful activity .” level. You must also show that your DVT is expected to last at least 12 months or result in your death if you cannot prove this your claim will be denied. It may be difficult based on your DVT alone to meet this standard, because an uncomplicated DVT can be resolved effectively with treatment.
If you are able to prove that your DVT is expected to last longer than a year, the SSA will look at how your condition is affecting your life and what your functional limitations are. First, the SSA will look to your medical record to see what restrictions your doctor has placed on you, to develop an RFC for you.
Signs And Symptoms Of Venous Thromboembolism
Patients with lowerâextremity DVT may present with edema, erythema, warmth, and pain of the involved limb. Occasionally, a palpable cord and prominent superficial collateral veins may be present. Physical examination may reveal a lowâgrade fever or a positive Homan’s sign .
Dyspnea is the most frequent symptom of PE and tachypnea is the most common sign of PE. A small PE that causes infarction near the pleura is more likely to present with cough, hemoptysis, and pleuritic chest pain. Massive PE can present with dyspnea, syncope, and cyanosis. Other signs of PE include tachycardia, jugular venous distension, and accentuation of the pulmonic component of the second heart sound.
The differential diagnosis for PE and DVT is summarized in Table 10â2. PE can be a diagnostic challenge. Young patients with excellent cardiac reserve may present with subtle symptoms whereas PE in older patients may masquerade as other diseases, such as an acute coronary syndrome or exacerbation of chronic obstructive pulmonary disease.
Edwin C. Gravereaux, Magruder C. Donaldson, in, 2006
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Medically Qualifying With Deep Vein Thrombosis
It is difficult to make a successful claim for disability benefits due to DVT alone. An associated complication, chronic venous insufficiency , is listed in the Blue Book, the SSAs manual of disabling conditions. CVI arises when DVT damages the veins in your legs, preventing the proper flow of blood to your extremities and causing chronic pain, leg ulcers, and difficulty walking.
To meet the eligibility requirements for Listing 4.11 , you must have been diagnosed with CVI and experience one of the following conditions:
- Brawny edema: severe leg swelling accompanied by tissue thickening and discoloration
- Leg cramping, burning, or itching
- Wounds that recur and resist healing despite over three months of treatment
The report from your doctor must indicate the history of your deep vein thrombosis/chronic venous insufficiency, all treatments you have received, and the ways that your condition has impaired your ability to function.
If the SSA determines that you dont meet a Blue Book listing but your RFC analysis indicates that your condition leaves you unable to work, you may still be eligible for disability benefits under a medical vocational allowance system.
Premature Menopause And Turners Syndrome
- surgery to correct any heart defects
- growth hormone therapy to increase height
- hormone replacement therapy to trigger menstruation and the development of secondary sexual characteristics such as breasts
- regular monitoring to check hormone levels
- regular follow-up and management of medical conditions
- treatment for the management of complications such as high blood pressure
- assisted reproduction.
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