How I got the clot

Day Six. Having mostly absorbed the shocking idea of a huge blood clot running the length of my leg, and feeling fairly reassured that meds were protecting me from a PE, my overactive brain focused next on how it happened.

It's impossible to know for sure, but my DVT appears related to a bicycling accident I had about six weeks before my diagnosis. I went over the handlebars and got very bruised up all over. It's possible that a deep tissue injury from this accident damaged a large vein in thigh and led to the thrombosis.

After the accident, I spent 7-10 days behind a desk, moving much less than usual (in fact, I enthusiastically reframed being chair-bound as a chance to catch up on a year's worth of unentered bookkeeping for my small business). A DVT could have developed in an injured vein during this period, or even in a healthy one as a result of spending so much time sitting relatively still.

After this week+ of rest, I felt ready to exercise a bit. I decided on a light walk on a treadmill. Soon after starting, I felt an intense, painful tightness in my left calf -- like my muscle was in bad need of stretching. I tried stretching, which didn't seem to help, but still I kept going for the rest of my light 2 mile walk.

The next day, I woke up with much more painful and swollen leg -- possibly the DVT. (Calf muscle pain misinterpreted as a strain is a common theme in articles and forum posts by DVT patients. It's unfortunately common to wrongly assume these injuries are ordinary pulled muscles.)

Confusingly, the pain all but disappeared in a few days. The swelling was minimal, too (although in retrospect, the fact that it never completely disappeared was a big red flag).

A day or two after this "recovery," though, I experienced what I assumed was just another muscle pull. In what seemed like just a fluke of bad ergonomics, I felt a stabbing pain in the upper thigh upon getting up from my desk. Once again I was swollen, limping and resting. (If the painful incident I thought was calf muscle strain wasn't the DVT, then this thigh pain may have indicated when it started.)

None of this seemed like anything more than a series of garden variety, klutziness-related muscle strains. I theorized that all the different injuries led to each other because of reduced activity and extended resting of isolated muscles.

About 10 days after the thigh pain started, I began to feel better -- ironically, though that was when I finally realized something was really be wrong. Though I had little pain, my leg was increasingly swollen. When the swelling wouldn't go away on its own, I finally went to the doctor and was diagnosed.

Looking back, there were warning signs I should have considered, even though my symptoms were confusing:

• continuous swelling that never fully dissipated
• heat coming off the leg (very noticeable)
• mild fever (at one point, I had a fever of 99.5 or so that lasted about 2 days)
• although it disappeared quickly, initial pain was unusually intense for muscle strain

It's possible that I had a DVT for as long as six weeks before seeing the doctor -- and I definitely had it for at least 10 days. I dodged a bullet, and hope this post discourages anyone reading it not to put off a doctor visit if they're experiencing similar symptoms. Better to risk wasting a few minutes of your doctor's time than to risk a life-threatening clot moving to your lung.

By the way, diagnosis is simple and painless by ultrasound. They run a wand-like ultrasound instrument over the areas of your leg where the deep veins lie. They apply just a little bit of pressure -- not painful at all. The test shows whether the veins can be compressed -- if the sound waves can compress the vein, no clot, but if the veins are not flexible, a clot's inside preventing compression.

It only takes minutes, it's totally painless, and it could save your life.