Friday, September 26, 2014

Dissected Aorta and Hematomas, Keeping a Heart Valve Clicking also can Cause Bleedout

Hematoma is what the doctor at Florida Hospital in St. Augustine called the lump on my back.  It was very large.  I am not sure how it got there but after three days of pain I had my son drive me to the ER.
Bleeding from recent hematoma

I'd never really researched what a hematoma was before.  The ER doctor gave me a couple information sheets about the causes, symptoms and cures and sent me home with written instructions to rest and place an ice pack on the grapefruit size lump, four or five times a day.

Hematoma is generally defined as a collection or pooling of blood outside of normal blood vessels, due to an injury where internal bleeding has occurred.   My injury occurred around my right shoulder blade.  At the worst, I estimated that I bled about a half gallon of blood that eventually collected and pooled around my waist.

This was a big one.  I lost so much blood that I could only walk a few steps without having to sit down and rest.  However because of my warfarin (Coumadin) regime to keep my mechanical heart valve from clotting up, any trauma - large or small - could precipitate spontaneous internal bleeding and fluid collection.

Most of the time for me the hematomas are small to medium size and resolve themselves within several months.  This larger one is being persistent.  It has been two weeks yet is still bloody looking and quite swollen near the original injury site.

Importantly, though hematomas are collections of blood they do not have blood flowing through them.  This opens up the possibility of infection setting in where the blood is pooling.  Ugh.  After my six month episode of endocarditis and fungal growth on my Dacron aorta graft I really am in no mood for another bout with heart infection and peripherally inserted central catheter line with anti-everything treatment.

So I am taking lots of vitamin C and turmeric and supplements, staying well bathed and eating good foods and resting in my recliner without moving much at all.  I've seen the ER doctor and my cardiologist also.

My cardiologist says to watch the size of the hematoma closely and if it becomes hot or grows in size to seek medical attention immediately.

I want to stick a sewing needle in the lump and allow the fluid to drain but of course I would not because of the risk of infection.

To top all this off my connective tissue disorder (Marfan Syndrome) subjects me to daily situations where I can bend over, reach up or do any number of regular, normal body movements and I'll tear a muscle or ligament or something inside.

Then with another tear the bleeding starts again.  Another hematoma.  Double whammy.  Warfarin and Marfan.  Tear bleed, tear bleed, tear bleed.

And each time a tear occurs and bleeding starts I always foremost wonder it I am bleeding out from an aneurysm; or 'is this the big one?' as Fred Sanford eloquently said.  After all, my dissected descending aorta is... paper thin.

Life with connective tissue disorders and anti-coagulant medications is a challenge.  Yep, it is the new reality for me.  But I am also so very glad to be alive to experience it.

1 comment:

Dhonna said...

I hope this subsides quickly. I had my aortic valve and root replaced in Dec. '05 by appointment and chose a bovine pericardial valve. This week is the first time I was having some regrets of my choice. I take an enteric coated 325 mg aspirin every day instead of warfarin. Though I have experience with warfarin, I took it for about a yr. when I had a cardiologist that insisted on it, but that is another story. This past week I had some kind of gut attack or bug so I took some ibuprofen to treat the severe aches I was having and the result was black tarry stools in combination with an upset gut. I realized I must have an ulcer as a result of the aspirin. I immediately stopped the ibuprofen and have been taking my aspirin with food and my stools are back to normal. Any way your lousy situation has reassured me that I am better off with my aspirin than warfarin. I sincerely hope you are feeling better ASAP and I want you to know that your stories here are greatly appreciated. ~ Dhonna