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Kirsten asked...

Complex vascular condition

Hello, I'm a 38 year old British woman who has been refused any further treatment other than a blood test, through the NHS for DVT symptoms and heart problems. I'm currently in between moving homes but haven't been able to register with a temporary GP anywhere near my families home. I have had to go three times to A&E for continuous swelling of my calfs, internal vein pain which doesn't seem to be varicose veins. The d-dimmer test has come back negative but they don't provide ultrasound for DVT in NHS A&E hospitals they told me, so they wouldn't scan the veins in my leg in case the blood test hadn't missed a blood clot. There are numerous medical researches though the British vascular society indicating that Ddimer blood test are 90% accurate and that an additional ultrasound examination of the effected veins should be carried to discard any missed blood clots that may turn into embolisms. I have been doing Yoga, I drink plenty of water and watch my weight and diet. I use muscle creams, voltarol, iboprofin, nothing works. I did have several journey back in November that lasted for longer than 9 hours. I wore some ill fitting flight socks from Boots that damaged a vein near the back of my knee and seemed to make my circulation worst. My symptoms are related to DVT or indicating a complex vascular problem that may effect my heart condition further. All I was advised by doctors in A&E is to be assigned to see a vascular specialist as soon as possible but am struggling at the moment to even find an nhs surgery that I can register with. My circulation is a mess, my legs feel heavy walking up stairs, I'm short out of breath and have barely slept for two months. I had a GP damage the vein in my arm whilst taking blood, it's been two months and the vein still hurts, I have tried different creams and exercises they pain won't go away. I can't afford Bupa not even through health insurance and other private clinics you need to be registered with a GP. Is there any where in the North of the UK or midlands where I can self refer to have an ultrasound and further examinations regarding this complex vascular condition, to have it examined further? I would appreciate any advice please, as this is stopping me from getting on with my life and effecting my daily life, I feel exhausted and out of breath probably because I can barely get any sleep each night. I do have a history of DVT in my family and heart problems. thank you

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The answer

As you are more than aware the threat of a Deep Vein Thrombosis (DVT) is increased where there are health issues present which impact on your mobility or when mobility is restricted due to long flights/ journeys where exercise is limited.

You say that you try to take preventative measures such as exercising, drinking plenty and wearing Anti- Embolic stockings (AES) and this is a good thing to do. If you do wear AES they must be properly fitted so that they do not cause restriction to your blood flow as this can lead to further issues.

You are correct in saying that the D-Dimer test to exclude DVT is very effective but if further clots are suspected then the usual treatment is to commence you on blood thinning treatment until further scans are done to confirm diagnosis.

You say you have recently moved – we would encourage you to try and register with a GP as soon as possible so that your health and well- being can start to be monitored correctly again.

We would urge you to visit the NHS website and look at the GP location section as this would give you details of all GP services in your vicinity and also inform you which surgeries are accepting new clientele. Once you have registered with a GP, we would suggest that you arrange with the Practice Nurse a full health check up screening to check your bloods, blood pressure and other health issues. It would also be pertinent to see the GP so that he can examine you and review the swelling and pain in your legs. This GP will then be able to refer you to the Vascular Team and refer you for any other tests deemed appropriate.

We are sorry but we are unable to recommend any particular surgeries or treatment centres as you do not supply me with specific location details.

You say that you are not sleeping well, are more lethargic and finding day to day living difficult partly because of your on going anxiety over this issue and we would also encourage you to speak to the GP about this too as you may be suffering from a touch of depression- The GP may be able to offer some support for this too.

In the meantime if your symptoms carry on worsening then attending A&E would be appropriate and if they feel things are serious enough they can refer you to specialist clinics.

Answered by the Health at Hand nurses

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