Clot

On Wednesday October 12, while driving to work, the vision in my left eye slowly began to black out. It seemed as though dark clouds were forming around the center of my view. I pulled over and within 3 minutes of when it started, my vision was almost all gone in that eye, with a small pinhole in the center. Then, it started to get better and in a total of 5 minutes, my vision was completely back.
After consulting my nurse friends, I excused myself from work and drove myself to the ER, which was absolutely useless. Loma Linda ER is a trauma center, and during the 13 hours I spent there, it took 8 hours to get a bed, 10 hours to see a doctor, and the only tests they did was blood tests and an eye exam. They did not feel that it was necessary to look at my heart. This is the 2nd time in my life that the Loma Linda University Emergency Room overlooked my condition. The first time was back in 2014 when they were unable to notice that my newly implanted valve was infected and falling off. This time, if they were able to simply perform an echo on me, then they would have noticed what is going on currently.

Today I went in for an echocardiogram with my cardiologist. I was an emotional wreck. My biggest fear was that I had endocarditis again. It turns out that I have some tiny fibrous blood clots on my mechanical aortic valve. One of these tiny clots dislodged and briefly clogged the blood flow to my eye. The condition is called Amaurosis Fugax.
My anticoagulation therapy is Coumadin. Without the Coumadin, clots form on the rigid edges of my mechanical valve. My INR (how ‘thin’ my blood is) was supposed to be between 2.0-2.5. A normal person who isn’t on anticoagulation therapy will have an INR of 1.0. The day of my episode, my INR was 1.8. This means that clots were more likely to form. I missed a dose of Coumadin on Monday, which means my INR was probably below 1.8 then. These clots could have formed then. There’s no way to know though.

Endocarditis can cause Amaurosis Fugax, as can blood clots. Luckily, the clots are very tiny. Even if the clots that are currently in my heart were to dislodge, they would not cause serious damage, such as a stroke. The goal is to keep them from getting larger.

I was just admitted to the cardiac unit at the hospital. I will stay here for a few days to be given heparin while my Coumadin dose is increased. Heparin will keep the clots from getting larger and stop new clots from forming. My INR will be increased to 3.0 and I will now try to maintain that level at home from now on.

They are doing a blood culture to be 100% certain that it’s not an infection again (Endocarditis). They said that bacterial vegetations don’t normally form on the valve leaflets like how it appears in my echo, but since I’m here, and because of my history of endocarditis, they want to be sure. At this point I’m not worried.

I will hopefully be discharged this weekend. I am super disappointed that I will be missing two amazing concerts that I was planning on going to this weekend. As my friend told me,

“There’s a lot of magical stuff goin on in the world. Concerts and Music festivals are like condensed reminders of the beauty, engagement, and interconnectedness that is possible for humanity.”

Check them out the artists that I was going to see this weekend below:

How To Dress Well and Moses Sumney.

9 thoughts on “Clot

  1. Dana Diemer

    Ugh! So scary! Fingers crossed this is a minor blip on the radar screen. Some positive news, son played in polocrosse national championships this past weekend, his team won and he was awarded a best player award. Life post mechanical valve(s) triumph! Please keep us posted!

    Reply
  2. Heather Streeter

    Wow, I had this happen to me 2 years ago. They also gave me an eye exam and sent me on my way. Luckily haven’t had it happen again. Good to know that I wasn’t crazy. Take care!

    Reply
  3. Kim B

    The title of this post had me freaking out when I was scanning through my email. I know we’ve never met and have only shared a few brief communications, but I do keep up with your blog regularly, and as both a reader and a fellow heart survivor and blogger, I wish only the best for you and yours. It sucks that you got such a nasty scare—but I’m glad it seems like everything is under control. I’ll keep my fingers crossed for your speedy release and recovery. 🙂

    Reply
  4. Aida

    Good morning Anthony! Wow! I was scared as well reading your post this morning but relieved to hear that you are in good hands now and that they are being so proactive. Thank you for sharing your very own real life situation of what can happen with mechanical valves if INR falls below a certain range. It is an ongoing concern as we all know too well but you sharing with us takes courage. So thank you Anthony. Sending our support!!!

    Reply
  5. yesplease72

    How are you feeling now mate?

    I’ve had the same vision loss that you described, while I was driving at 100kmh. It’s scary stuff!

    I hope you’re feeling better!

    Pete

    Peter Gallagher 0400 293 620

    Reply
  6. mckiersey

    Hey man,
    Your description of vision loss is almost identical to how I described it happening to me.

    I think we’ve got pretty similar profiles: I had endocarditis in 2015; 10 years after my first valve replacement. Had my pulmonary replaced last summer and have had a few scares since, one being a loss of vision in my right eye, just as you describe.

    I also had a shit time in Accident & Emergency. I was left on a chair for 24 hours before I simply walked out. (The following Monday I got back into the system via my cardiac team).

    I’m impressed by your resilience in dealing with this. I managed to get through the surgery alright, but now feel I’ve ‘paid my dues’ and as a result get absolutely shattered by anyone suggesting I might have endocarditis again.

    Would love to hear your thoughts on my heart surgery writing. I’ve got an overly wrought Medium post and a full blog, which you should be able to find via my profile picture here.

    Medium: https://medium.com/@mckiersey/growing-pains-my-year-of-illness-changed-me-542f95fc27eb#.mpzz2znke

    Reply
  7. Pingback: 3 Year Valve Anniversary | Anthony's Heart Valve Replacement Saga

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