‘I want ev­ery­one to know that blood clots can af­fect any­one’

Af­ter sev­eral brushes with death due to blood clots, Ann Marie O’Neill wants ev­ery­one to know the warn­ing signs

The Irish Times - Tuesday - Health - - Health Lifestyle - Ar­lene Har­ris

Re­cently, the HSE launched a new di­rec­tive to raise aware­ness of the fact that 11,000 peo­ple are af­fected by blood clots ev­ery year in Ire­land and they are the big­gest cause of pre­ventable deaths.

Not know­ing the signs of an im­mi­nent clot is one of the main rea­sons for these sta­tis­tics. It can hap­pen to any­one – young or old.

When new mother Ann Marie O’Neill suf­fered from ex­cru­ci­at­ing pain af­ter an op­er­a­tion in 1995, she had no idea she was suf­fer­ing from a pul­monary em­bolism (clot). Thank­fully, it was caught in time, but she didn’t ex­pect it to hap­pen again – sev­eral times.

“When I was preg­nant in 1995, I also I had gall stones,” says the mother of three. “I de­liv­ered my first son in Fe­bru­ary and in May had surgery to re­move my gall blad­der. But within days I was back in theatre with a bowel ob­struc­tion due to ad­he­sions – so I had two surg­eries in two weeks and then a hos­pi­tal bug. I was also de­hy­drated and im­mo­bile and a week later I couldn’t breathe with­out a re­ally sharp pain in my chest. [Af­ter in­ves­ti­ga­tion] I was di­ag­nosed with a pul­monary em­bolism (PE) and pre­scribed an­ti­co­ag­u­la­tion drugs for six months.

“I left hos­pi­tal af­ter six weeks, with no real un­der­stand­ing of what had hap­pened to me and why, or that it may have been life threat­en­ing and could hap­pen again.”

Five years later, the Dublin woman be­gan to ex­pe­ri­ence chest pain once again and al­though she was wor­ried she may be suf­fer­ing from an­other clot, she car­ried on with what she was do­ing and tried to ig­nore the pain. How­ever, two weeks later, it be­came so bad she had to go to hos­pi­tal where her sus­pi­cions were con­firmed.

“When I started getting chest pain again, I tried to ig­nore it as even though I had my sus­pi­cions of an­other PE, I didn’t know it could be fa­tal,” says O’Neill. “Two weeks later, I was driv­ing on the M50 to go shop­ping in Blan­chard­stown with my two older boys, Eoin and Kevin, when the pain be­came acute and I had dif­fi­culty breath­ing.

“So I pulled in and called my hus­band and asked him to meet me in the near­est hos­pi­tal. Tests con­firmed that I had an­other PE and I was ad­mit­ted for a week and put on an­ti­co­ag­u­la­tion drugs in­def­i­nitely. I was be­gin­ning to think I might have a prob­lem but no­body sat down and ex­plained ex­actly what was hap­pen­ing, that it may hap­pen again or how I could pro­tect my­self go­ing for­ward.”

In­creased her risk

In 2001, O’Neill be­came preg­nant again, which in­creased her risk of an­other blood clot. Due to her his­tory, she was mon­i­tored through­out her preg­nancy and has been deemed at risk of fur­ther com­pli­ca­tions ever since.

She be­lieves not enough in­for­ma­tion is given to post-op­er­a­tive pa­tients who may be at risk of a sim­i­lar fate.

“For the du­ra­tion of my third preg­nancy, I was looked af­ter by the truly amaz­ing team in the Na­tional Coag­u­la­tion Cen­tre and put on daily in­jec­tions of an­ti­co­ag­u­la­tion treat­ment,” she says. “My third son was born fit and well and I con­tin­ued my an­ti­co­ag­u­la­tion ther­apy in­def­i­nitely and was ad­vised not to get preg­nant again.

“Then, in 2012, I needed a pro­ce­dure which in­volved an in­jec­tion into my femoral artery and re­sulted in an­other blood clot at the in­jec­tion site. I ex­pe­ri­enced the ex­cru­ci­at­ing pain of the blood sup­ply be­ing sud­denly stopped – but I be­lieved the doc­tor when he said I was fine and it wasn’t a clot. I was given painkillers and dis­charged – and only for a nurse friend no­ticed me limp­ing a few days later and ad­vised me to go back to the hos­pi­tal, I would prob­a­bly not be here now.

“In­stead, I had surgery to re­move the clot a few days later but there was dam­age to my artery and it clot­ted again. So I had surgery to put in a by­pass – but then it clot­ted and they tried again to clear the block­age in the by­pass and it clot­ted again. But six weeks later, I went home, still tak­ing painkillers and know­ing the blood sup­ply to my leg would never be the same again.”

Blood clots, or ve­nous throm­boem­bolism (VTE), con­sist of deep ve­nous throm­bo­sis (DVT) in the legs, which may travel to the lungs caus­ing a pul­monary em­bolism (PE). Ac­cord­ing to the HSE, at least 60 per cent of all blood clots oc­cur dur­ing, or in the 90 days af­ter, hos­pi­tal­i­sa­tion and about 70 per cent of these are pre­ventable.

Two decades af­ter her brushes with death, O’Neill says the lack of in­for­ma­tion she re­ceived put her life on the line sev­eral times.

“I know I’m lucky to be alive and am aware of the signs and symp­toms to look out for,” she says. “I want ev­ery­one to know that blood clots can af­fect any­one, male or fe­male, young or old, fit and healthy and they can be fa­tal if we don’t know what to look out for. A lit­tle knowl­edge can save lives. I would like the con­ver­sa­tion to be opened up be­tween pa­tients, fam­i­lies and health pro­fes­sion­als so we can all work to­gether to pro­tect our lives with that cru­cial knowl­edge – as in many cases, blood clots are pre­ventable.

“I sur­vived three po­ten­tially fa­tal blood clots but live ev­ery day with the side ef­fects. Know­ing what I am deal­ing with and what to do makes me feel safer.”

Last month, the HSE launched pa­tient alert cards, a na­tional re­port and tool kit to as­sist hos­pi­tals in pre­vent­ing blood clots.

“The HSE has been mak­ing great strides in pre­vent­ing blood clots,” says Ciara Kirke, HSE clin­i­cal lead for med­i­ca­tion safety. “Dur­ing a year-long im­prove­ment col­lab­o­ra­tion, teams in 27 hos­pi­tals im­proved blood-clot preven­tion, re­sult­ing in a one-third in­crease, or 34,000, more pa­tients getting the cor­rect preven­tion for them per year. Over 100 health­care pro­fes­sion­als at­tended train­ing and par­tic­i­pated in im­prove­ment projects lo­cally.”

Ann Marie O’Neill wel­comes this move and says in­for­ma­tion is cru­cial to sav­ing lives so in 2016, set up throm­bo­sisire­land.ie to raise aware­ness.

Ann Marie O’Neill: “I know I’m lucky to be alive and am aware of the signs and symp­toms to look out for.”

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