Should a lung test have been ordered after discovering DVT?
Ten days ago, Grandma was diagnosed with blood clots. The tech doing the ultrasound asked a bunch of questions and the doctor sent Grandma to the ER. The only thing they did was a blood test that the hematologist looked at. Then they prescribed a blood thinner and sent us home. A few days later, we were at the doctors for a checkup. The doctor said he sent Grandma to the ER to make sure she didn't have any lung problems (I forget his exact words) based on the answers we gave the tech. I didn't think too much about that until later when I wondered what was the point of sending us to the ER. They didn't do anything. If the doctor was concerned about lung problems (embolism, I guess), then why wasn't some sort of test done to rule that out? In the 10 days that Grandma's been on blood thinners, I've noticed the following things: 1) She's been complaining of shortness of breath more often, but only on exertion and usually once per day. 2) She hasn't been coughing anywhere as much as she had been. It was primarily only when she ate. 3) I don't think she's been coughing/spitting up as much sputum as she had been - it was brownish The coughing and sputum were originally thought to be related to old age and the muscles in the throat area not working as well. But now I wonder. The fact that there's a reduction in these symptoms make me think she did/does have a lung issue. The coughing and sputum, and swollen lower legs has been going on for 2 1/2 years - since Grandma was taken off her blood thinner by her doctor. He thought she didn't need to be on it since the clots originally occurred following surgery/hospitalization many years ago. Although, I could have sworn that they occurred after a fall. There's no way to really know as she was living in her own home at the time. Grandma had an ultrasound two months after she was taken off blood thinners. Her lower legs had swollen so bad, but the tests showed no clots. Her legs were swollen until she recently went back on blood thinners. I don't know what to do or think anymore. Should the ER have done a test on the lungs? Should one be done now? She's not due to go back to the doctor for a month. The doctor thinks the shortness of breath is due to inactivity.
Were you with Gramma at the ER? Did you see all of procedures that went on? You say they didn't do any testing, but having a hematologist look at blood samples seems like one kind test.
Has Gramma increased her activity level, even a little bit? It would be good to go in in a month and have the doctor determine if the activity has helped.
Most medical decisions involve some tradeoffs. Seldom is something purely beneficial without some risks. An ER doctor got a C Scan to determine if there was any bleeding in the brain after my husband suffered a fall. There wasn't. Whew! Then he talked to us about dropping or continuing the blood thinner. Having thinner blood decreased his risk of having a stroke, but it also increased the risk of a brain bleed from a fall. The ER doc thought it might be time to focus on brain bleeds instead of strokes. My husband's PCP agreed, and the thinner was discontinued. Sometimes you can only pick the least bad among the options.
The Mayo Clinic's website contains a clear and easy-to-understand explanation of Pulmonary embolism, including symptoms, tests, and treatment.