Thursday, March 1, 2012

Deep Vein Thrombosis

      I have been a truck driver since 1987 and have been healthy all of my life.  Recently I woke up with a swollen ankle and leg.  I thought it might have been from all of the Christmas foods that I ate during this time.  My Safety Director instructed me to go to my family doctor and have a check-up to see what was causing this swelling.  My doctor looked at my ankle and leg and informed me that I had Phlebitis.

     For a week I wrapped my leg in an Ace Bandage and increased my Aspirin dosage to thin my blood.  I also was taking 800mg of Aleve per day to correct the problem.  After the week went by and visited the doctor again with my ankle and leg still swelling,  he sent me to a Vein Specialist for an Ultrasound and thigh high compression stockings.   The Vein Specialist found that I had a large DVT (Deep Vein Thrombosis) in my left thigh.  I was given a prescription for  Lovenox,  80mg injection twice a day and 5mg of Coumadin (Warfarin) once a day.  I gave myself the injections twice a day and took the 5mg of Coumadin once a day for almost 3 weeks.  My doctor then discontinued the Lovenox and increased the Coumadin to 7.5mg per day.  I have been taking the Coumadin everyday since.  My blood test have been up and down each week since starting the therapy and slowly getting my blood leveled off to an acceptable level. (Diagram of a DVT on the right)

     Many people that acquire a DVT have pain in the extremity and swelling.  If you have pain and/or swelling you should consult a Doctor immediately before the Blood Clot can break up and travel into your lungs or heart.  This is a very serious situation because it can lead to you death if not seen about in a timely manner.  A blood clot can also be hereditary and you should also check you families history for any Venous Diseases.

wikipedia has this definition of Symptoms of a DVT:

Signs and symptoms

There may be no symptoms referable to the location of the DVT, but the classical symptoms of DVT include pain, swelling and redness of the leg and dilation of the surface veins. In up to 25% of all hospitalized patients, there may be some form of DVT, which often remains clinically inapparent (unless pulmonary embolism develops).
There are several techniques during physical examination to increase the detection of DVT, such as measuring the circumference of the affected and the contralateral limb at a fixed point (to objectivate edema), and palpating the venous tract, which is often tender. Physical examination is unreliable for excluding the diagnosis of deep vein thrombosis.
In phlegmasia alba dolens, the leg is pale and cool with a diminished arterial pulse caused by spasm. It usually results from acute occlusion of the iliac and femoral veins because of DVT.

     I was also given a prescription for Compression Stockings which are a pain to get on and off.  I empathize with anyone that has to wear these.  I had to buy a pair of  Latex gloves (dish washing gloves, I got mine at a discount store for just $2) to put them on and off.  Latex gloves make it easier to pull the stockings on because of the gripping action and add a little baby powder to your legs and feet to make your stockings slip on faster.  The Compression Stockings are very comfortable once you have them on (they're great in cold weather), the only problem is that while out walking the mid thigh Compression Stockings slide down your thighs below your knee's and you must go to a private place to drop your pants and pull up you Stockings, pretty embarrassing  if there is someone watching you pull up your Stockings,  they just do not understand and there is NO explaining that the Stockings are Compression Stockings for Blood Circulation and that I am NOT a Cross Dresser!!!

     I have an Insurance Policy for STD (Short Term Disability) and received my first check in the mail about 2 months into the process.  To receive STD you must get doctor reports that indicate that the blood clot is a danger to your health and submit them to the Insurance Company for their evaluation.

     Now that I have received my first check in the mail I must have another form filled out and send to the doctors office to be filled out for the STD.   The doctor at this point must have a written statement from the companies doctor as to how long I must be off Coumadin before being allowed to return to work.

   **  I have learned that Coumadin is not a Disqualifying medication for a driver to take as long as all the levels are correct and that there are no underlying health problems related to your DVT.**

     This is an ongoing process between the doctors and the Company.   The DOT regulations state that a person with a DVT must have their blood levels equalized for 1 month before returning to work.

     I searched the Internet for DVT and Drivers and found three good sites on the web.  If you are interested in reading these publications, here they are--taken from;


     2.  Cardiovascular Advisory Panel Guidelines for the Medical Examination of Commercial Motor Vehicle Drivers - Federal Motor Carrier Safety Administration


     I researched these sites and found the answers that I was looking for, or almost all I was looking for.

     Most of everything that I read said that there is a minimum of 3 months to regulate your blood and up to 6 months before you can be released to work if all the levels are correct.  They also stated that a driver must be able to stop and walk every 2 to 3 hours to get your blood circulating to prevent another DVT from developing again.

     Finding a doctor that knows something about the DVT and driving a truck is almost impossible because there are none out there that understand our job or job description.  The doctor assumes that after only a few months of therapy a driver can stop and take walking breaks every 2 to 3 hours.  As you know this sometimes is not possible because of time of delivery, loading or the location you are at and cannot possibly get out of you truck to walk for safety reasons.

     I am still at home waiting for the next blood test to see what my blood level's will be and what the doctor, my company and the FMCSA company doctor decide on my condition.