STOP Your Anxiety

A lot of people ask me, “Do you ever worry about another clot?” Sometimes, but not daily, and only if I have a reason to worry. So then they ask, “How do you not worry?” It’s not that I don’t worry – I do – but what I don’t do is let the worry consume me, or stop me from living my normal life. Read on to discover the tools I use to help stop your anxiety, especially about blood clot recurrence.

On my list of things to worry about, a recurrent blood clot is not near the top of the list, surprisingly. While I do struggle with health-related anxiety, it stems from the next unexpected thing that might take me off guard. My blood clots came out of nowhere – nearly ending my life – and I worry more about something else like that happening. Still, there are some times when I worry that I have a blood clot again, and I wonder what that means for me if that were the case: Is my blood thinner suddenly not working? Or, is the disease that caused my blood clots – antiphospholipid syndrome – causing another problem? In this way, I don’t worry about another clot, but I do worry about what one might mean. I won’t know until (or if) it happens, and I can’t control that any more than I already am by taking my medication, going to follow-up doctor appointments, and managing my INR with a healthy lifestyle and regular checks. What I can control is what I do if I think I might have another blood clot.

Occasionally, if my left leg hurts my immediate thought is “blood clot.” This doesn’t happen every time I notice something different with my leg, but once in awhile if I have a pain that feels like a pulled muscle, because that is what my blood clot felt like at first.

Not too long ago, I felt this type of pain in the care on my way to run an errand. All the way to the UPS store and back I thought, “This is it, what if I don’t make it through this one?” Then, I remembered what I learned in counseling: Anxiety is a never-ending race track, I’m the race car, and I need to put on the brakes – before I crash. I pushed the brake pedal and put it in park – figuratively and literally as I returned home and pulled into my garage.

I have a very specific checklist that I go through if I’m worried about a blood clot. It helps me stay calm and act accordingly. In this example, I didn’t think it was a blood clot, and below is the checklist I go through to put my worry in park. I also included my answers to myself.

  • Is this pain the the same exact blood clot spot? No, it’s not.
  • Does it feel like a blood clot with regard to pain? No, not even close, it just feels like a cramp.
  • Have you done anything different with your treatment that’s worked for you this far? No, I took my warfarin last night and at last check, my INR was in range.
  • Could anything else have caused this pain? Yes, I did not get up from my desk enough times to move around today.
  • Does anything help it to feel better? Yes, stretching and moving around helps.
  • Did stretching and moving help your blood clot? No, not even a little. It made it worse.
  • Could it also be a blood clot? It could, but so far, it’s not feeling like it. If it does, you know what to do, or where to go.

There are also some very clear things that would lead me to seek medical attention without further questioning:

  • Pain in my leg and in my lung that doesn’t go away with rest
  • Pain in my leg that interferes with my inability to walk
  • Difficulty breathing or being unable to talk in full sentences
  • Being unable to lay down flat

This is not to say that coming to this conclusion is easy or that it happens overnight. I have to work really hard to think about these very clear questions and answers, rather than panic first. Sometimes it even takes a visual to remind me to get off the track, like a STOP sign or parked race car.

Your questions and answers might be different, and as always, if you can’t decide if you have a blood clot or not – or if you suspect that you do – seek medical attention right away.

Blood clots can happen to anyone, even people who are younger, active and healthy. Learning the signs and symptoms can help you avoid a potentially life-ending situation. You can read about them, and about what I felt, here. It’s also a good idea to see if you have any known risk factors for blood clots. You can read more about those here. And, just about anyone can take steps to help prevent blood clots before they become a problem. Here are some of my thoughts about that.

There is hope for healing from blood clots, and you are not alone.

Reader Writes In: Do you worry about a repeat blood clot? How do you handle your worry? Have you experienced a repeat blood clot?

Share your story in the comments below.

 

15 Tips to Help You Handle Holiday Stress After A Blood Clot

Holiday Stress Cover

The holidays are here – and so is the holiday stress. While many people look forward to a house full of relatives on Thanksgiving, a White Christmas filled with friendly get-togethers and a New Year celebration even better than the last year, facing the holidays while recovering from a blood clot, or other serious illness or injury, can be downright scary and even extra stressful. But, there are some things you can do to handle holiday stress.

I suffered a blood clot in my leg or deep vein thrombosis (DVT) and blood clot in my lung or pulmonary embolism (PE) at the beginning of summer, but I was still unprepared when the holidays rolled around that very first year. To be honest, the whole season from November to January filled me with dread as soon as the Halloween candy was gone. I did not expect to feel any anxiety around the holidays because after all, I never had before. Yet, about a week before Thanksgiving I was suddenly filled with dread for the plans I had made and an overpowering grief that somehow the holidays would never be quite like I remembered them because I, in fact, was a different person than I remembered.

My thoughts ran wild and ranged from “What if I couldn’t make it to where I said I would be, when I said I would be there?” to “What if I fell on the ice and cracked my head at a relative’s house?” to “How was I going to afford Christmas gifts in light of recent and debilitating medical bills?” to “What if I ruined Christmas and all of the New Year for everyone I happened to come into contact with?”

All rationale flew out the window with the last of the fall leaves and as the winter chill settled in and enveloped the world outside, my feelings about the impending festivities were also cold. I wanted nothing to do with the holidays because I clearly could not handle them anymore. I certainly did not want to be around anyone at the holidays, especially myself. Everything was a chore, overwhelming and it seemed like I couldn’t trust myself to interact normally with people. It was a fear I had never experienced before and I had no idea how to handle my feelings.

Since then a couple of seasons have gone by, and I have started to enjoy the holidays – and myself – again. It hasn’t been an easy process and it has taken me some time to adapt to the way things are now. I noticed that most of my holiday anxiety comes from stress I unnecessarily put on myself. Maybe before my blood clots I could handle that stress without a second thought, but now I have to take careful steps to take care of myself and not let the holiday hustle, and in turn my own well-being, get out of hand.

Here are 15 tips to help you reduce and manage holiday stress after a blood clot (or other serious illness).
  1. Take time for yourself. The holidays are without doubt some of the busiest times of the year and they are filled with spending time with friends, loved ones and even colleagues. During the season, it is important to also take time for and spend time with just yourself. Do something positive that does not involve someone else, unless it is a close friend of family member you want there. Go for a walk, watch a movie, read a book or take a bubble bath. Whatever you want to do – whether it be alone or with someone special – just do it and do it more than once or twice. I like to go for a walk in the park with my husband and dogs or read a book by myself in the evening. I make a plan to be home from events by ten or eleven at night, just to make sure I have some reading time.
  1. Don’t feel pressure to buy a gift if you are facing financial hardship. You can still do something to let someone know you are thinking about them during the holidays, but it doesn’t have to cost a lot of money. For example, you can handwrite a letter or card letting them know how much you appreciate them, write them a pending invite to a home-cooked dinner (for after the holidays and when you are feeling better), make them a CD of their favorite songs or bake a special treat. Pinterest has no shortage of affordable craft ideas for those who like to make things and being crafty is also creative and relaxing. It feels good to make something that makes someone feel special, some would argue even more so than buying a gift from the store.
  1. Set your boundaries – and stick to them. It’s easy to want to do everything for everybody, especially when in the spirit of selflessness and giving. It is the holidays, right? True, but you also need to take care of yourself first. If you’re not comfortable driving three hours to get to your favorite cousin’s Christmas party – don’t. Call instead to see if you can arrange a visit at a later date or drop-in on via Facetime or Skype. If you’re not in a position to plan the company holiday potluck – don’t. Instead offer to help find someone who can take your place. If you don’t want to talk about how you are feeling – don’t. Instead stick to a single phrase and use it often, “I’m doing the best I can right now, it’s good to spend time with friends. How have you been?” Set your boundaries in the beginning and don’t lose site of them.
  1. Don’t over-commit yourself or over-schedule yourself to be places during the holidays. You do not have to be perfect – and you do not have to be everywhere. I overcommitted a lot when I was recovering and then not only did I feel bad about not going where I said I would, but it was even worse to tell the person I was supposed to see that I wasn’t going to see them, especially if I cared about them. If you usually take on multiple projects during the holidays or go to a lot of celebrations, assess them one by one and determine as you go, what you can and can’t do. Give people notice that you might not be able to make it and say, “I would love to come by for coffee after dinner, but I just don’t know how I will be feeling because so much can change for me in just a day. How about I call you in the afternoon to let you know for sure?” When people are prepared for change, it is much easier to deal with. If you usually cook all of Thanksgiving dinner, how about asking others to join in this year and say, “I would love to have Thanksgiving at my house still, but I am going to need help preparing and cooking the food. Who can be here early to help out?” Or, “Thanksgiving at my house will be difficult this year because I’m not feeling myself quite yet, but I would love to make my mashed potatoes and casserole to bring to your house this year.”
  1. Agree to something you can do – and delegate the rest. Something about the holidays makes as want to be and do everything we can be and do and then some. It can be hard to stop doing all of the things that once came very easily. If you usually coordinate your child’s holiday party at school you can say, “I would love to be involved with setting up for the party, but I am going to need some extra help this year. What other parents can I call for back-up?” Then call them. Do you usually organize your friend gift exchange? This year, call on your Bestie to stand in until you’re feeling better. You don’t have to do it all yourself, unless you take it all on. Just like you, people want to help out and you might even find they jump at the chance to take on an extra roll this year.
  1. Do less. Do less. Do less. You know the old saying, less is more? Well, it’s true, especially when recovering from a blood clot. And doing less does not mean doing nothing. Take some stuffing off the proverbial plate and take a break. You can always get back to your regular holiday routine as you start to feel better and only if you want to.
  1. Enjoy yourself. Do not let rules rule your holiday, either. Yes, I enjoy a glass of wine or two with dinner and eat as many green beans as I can (I will even enjoy cranberry sauce). If you have concerns about your diet or what you can or can’t do, talk to your doctor before the holidays are here about what is acceptable for your treatment plan. If you want to go ice skating, find out if you can wear a helmet, if needed. If you want to take time to stroll the neighborhood to view Christmas lights, plan a light day ahead of time or make plans to have someone drive you through the streets. Do something you love this holiday season.
  1. Take time to be grateful. Being thankful can be hard, especially when it feels like you don’t have a lot to be thankful for. I assure you, you do. I find gratefulness in small things, and sometimes those are the only things, like a pretty sunset or an extra half hour of sleep. Once you take time to be grateful for the small things, you might start noticing some bigger things like the opportunity to celebrate another holiday.
  1. Communicate with your loved ones, family and friends – face to face. It’s really easy to get wrapped up in text messaging, Facebook and phone calls, more so than I would like to admit sometimes. This holiday season (and maybe even after it), try talking to your loved ones about your needs in an actual conversation, with eye contact. Let them know how you are feeling, what you are struggling with and where you could use a little extra help. It will not only help you to feel more relaxed and less pressure, but good communication fosters better relationships and friendships between us all. Let someone know if you need to sit down, stand up or cut your shopping trip shorter than usual. If you need an afternoon nap, speak up during holiday planning and push that party back an hour or two. Make your needs known ahead of time. For others, who are not someone you want to share details with, it’s none of their business how you are feeling or what limitations you are facing. You are not obligated to tell all just because someone asks you.
  1. Stick to your routine. Change is hard for a lot of people to deal with, myself included and the holidays tend to bring about a lot of change. It is very important to stick to your daily routine as much as possible. Make sure you take your medication on time, move around if you are going to be sitting for long periods, remain consistent in your diet and hydrate with water regularly. If you read the paper every morning, continue doing that. If you have a cup of tea before bed, still do so even though you were out a little later. Stick to your routine as much as you can.
  1. Get out of the house. It’s really hard to be stuck in the house all the time, especially when recovering from a serious illness or injury. Make it a point to get out at least a few times over the next couple of months, even if it is difficult for you. Maybe you decide to go to one holiday party or meet a close friend for cheesecake and coffee. Get out, enjoy the scenery. You don’t have to be gone long and it doesn’t have to be complicated. You could visit a book store, tour a light display near you or drop off a pumpkin pie to your neighbor.
  1. Abandon your old customs, especially if you are lonely or depressed. A lot of my sadness around the holidays came from the fact that they aren’t the same as they used to be. Whether it be from illness, loss of a loved one or drastic change in living and financial conditions, sometimes things just can’t go back to the way they were. If that’s the case, change what you do for the holidays. If you always put up a six-foot-high Christmas tree, but can’t this year, put up a smaller tree in a new place with new decorations. If you always had dinner at Mom’s, but she’s not here anymore, make one of her dishes and bring it to Thanksgiving dinner at someone else’s house. Make a new tradition that you may or may not continue – it could get you through for a short time or become one of your favorite additions to your holiday customs when things return to normal.
  1. Listen to music. Music (preferably in the form of Marcus Mumford of Mumford & Sons) has saved me more than once from an emotional breakdown, yelling at someone or total wreckage of my entire day. And research from the University of Maryland has shown music can relax blood vessels and decrease blood flow so if you’re feeling anxious, hit play on your favorite song. Take your headphones with you to that party or dinner and if you’re feeling the holiday stress, excuse yourself to listen to your favorite song (I’ve hidden in the bathroom with iTunes more than once). Or, even if you’re not headed out, listen to some Christmas jams (or any jam) to lighten your mood throughout the day. I promise, it makes a difference.
  1. Think positive (and laugh while you’re at it). Surviving the holidays is hard, there is not doubt about that, but don’t be too hard on yourself. I believe nothing was ever accomplished with a bad attitude alone. If you can say something positive to yourself about the holidays like, “Hey, I didn’t have to do dishes by myself this year so I can spend more time with the kids,” or “Thank goodness Aunty Mary was able to make the pies so I can have more time to prepare the turkey,” it’s far more rewarding than focusing on the things that made you unhappy about your situation. Even better, if you can laugh about the forgotten whipped cream or fact that the tree wasn’t plugged in for the big lighting, you’re one step ahead of being positive.
  1. Be patient with yourself. A lot of these things are easier said than done, especially in the beginning. The important part is acknowledging your holidays may change, either temporarily or permanently, and that does not mean you cannot enjoy them.

Happy holidays, friends. May your days be merry, bright and full of gratitude for the small things in life.

Reader Writes In: What’s your number one holiday stress reducing tip?

There is hope for healing and you are not alone,

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Dealing with Depression

Ever since you’ve had your blood clot, you’ve been feeling a little down. Maybe you don’t enjoy the activities you once did (either because you can’t do them or don’t feel up to it), you feel alone, are easily discouraged, emotionally charged and cry or react at the drop of a hat – literally (don’t worry, I cried for several hours over spilling spaghetti sauce in the kitchen once shortly after my PE).

Maybe you feel hopeless, like no one cares and even wonder if life’s going to be like this from now on, why not give up? It hurts to move, get up, lie down or even breathe. Feelings like this can lead to feeling hopeless and discouraged.

Dealing with depression after a blood clot is not uncommon. Experiencing a DVT or PE, brings a lot to cope with, both physically and emotionally. It can be normal to feel depressed, anxious or overwhelmed in your journey.

High levels of anxiety, depression and psychological stress are reported among patients with DVT and/or PE, and not only has research been done regarding the psychological implications of surviving a blood clot, but it has expanded greatly in the last several years.

The anxiety, fear and depression that are often felt after a blood clot can be attributed to things like: surviving a life-threatening event, limited mobility and daily function, the lifestyle impact of being placed on a long-term anticoagulant (blood thinner), decrease in quality of life, and fear of a clot returning.

The good news is, people are talking about it much more now than when I was first diagnosed with blood clots. There are several resources available regarding the emotional and psychological concerns that accompany a PE and DVT diagnosis, and as we continue to learn more, more information is becoming available.

Resources and information about depression and anxiety after a blood clot

One study also notes, “although thrombosis is rare in the young, [it] can cause severe psychological distress that influences the quality of life and the coping capacities of patients.” Surviving a PE was one of the most difficult things I have had to cope with.

If you are feeling depressed, anxious, scared or unsure about all that has happened to you during and since your DVT and/or PE, here are my top tips for dealing with depression.

My top emotional recovery tips

  • Remember you are not alone. Blood clots are a common medical condition. It is estimated that about 900,000 people in the United States develop DVT and PE each year.
  • Talk to your doctor.  He or she may be able to direct you to other resources or provide anti-anxiety or antidepressants. Even if you do not think your primary physician will understand your concerns about depression, still inform him or her about your feelings. It may also be beneficial to seek out a referral to a counselor or psychologist as an additional support for what you are going through. Do not be afraid to ask for help!
  • Understand post-thrombotic syndrome and do what you can to prevent it. One of the long-term, and potentially upsetting, effects of DVT is post-thrombotic syndrome (PTS) and it is not in your head. Find out more about PTS, including the emotional effects and how to help prevent it.
  • Seek out a peer support group. Finding support is important when dealing with recovery from a blood clot. While some in-person support groups do exist (ask your doctor if there are any near you), they are rare. You can join BCRN’s private support group on Facebook.
  • Learn about your condition. What you went through was a significant and even life-changing event. Learning about what happened to you through reading, relating to others and talking to your doctor and others can help you to feel empowered and knowledgeable about what did happen and what your recovery might entail.
  • Know that your condition is treatable and manageable. Be confident in your treatment plan by discussing it with your doctor and any trusted friends or family members you may have. Connect with other people who have been where you are now.
  • Write your feelings down. A daily or weekly journal of how you felt, what you did, progress you made or challenges you faced can help you to see how far you really have come over time. Writing, even if it is only a few sentences a day to express a particular emotion or event, is very helpful in releasing your feelings and giving value to them. Consider journaling or writing your story down. What you feel is important and sometimes it just feels good to get it out of your head. Read some entries from my personal journal.
  • Have patience with yourself. Recovery can take a long time and it’s not easy. Know what you are okay, you are doing what you can and you are right where you need to be. Something as simple as walking to the bathroom or making a sandwich is enough for one day. If you are struggling to get back to where you were pre-blood clot physically and emotionally, remember it takes time and it is different for everyone.
  • Be kind to yourself. Remember you are loved. You have been though a lot and your body and mind have been faced with a traumatic incident. It is okay to feel the way you do from time to time and it will take some time to adjust.

Where to go for help right now

If you are facing thoughts of self-harm or suicide, please call 911 or seek help right away from your doctor or a hospital. You can also contact the National Suicide Prevention Lifeline. They are a 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress.

Remember, even if it seems hopeless, there is hope for healing from blood clots and you are not alone in your journey.

Share your story. Have you felt depressed since your blood clot? How have you dealt with depression?

There is hope for healing and you are not alone,

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