Post Pain vs Should I be worried pulmonary embolism

[powderhound]

I was diagnosed and hospitalized for 4 days for a pulmonary Embolism that infarcted.   I was realeased 6 days ago and have been continuing my recovery at home.  I am an active 42 year old skier and adopted so finding the reason to why I had this happen has been a good mystery.
I am on narcodic pain relievers
During this last week I have had good days and some bad days with the pain.  Twice now I stopped taking the pain meds to get a feel for where my body is at and the main discomfort that started this whole thing is still there on my right side of my back.  Not  to mention still minor pain when I breathe in and even sharper pain when I take a deep breathe.    What has been worrying me and don't know if I am just scared on every pain issue now, but I have had some very intense shooter or zapper pains just inside me crotch on my reg leg which is the side of my PE. Whether sitting or standing it is pretty intense and last for a few minutes.    I find myself squeezing my interior leg. Closer to my gentile regaion than the knee but a good 12 inches or more of an area kills me.Tomorrow is my first appointment with my doctor and want to make sure I let her know what is going on and not be reporting issues that are not a issue,  
Question is how long does it take the PE to disipate?  If I don't take the meds I get up to a  to 6 scale. On the meds I get to a 2 or a 3 but my body and mind know that it is a discomfort to sit to long, lay down on my back.  since it infarcted and killed a part of my lung will this pain take longer to go away?  I am a IT tech ( computers and network)  is wanting to return to work this week to soon?  So is my pain normal in my back?  What about my leg  pain should I be worried?

[Nurseoklahoma]

hi, I hope that you are doing well after your PE. I am a LPN. I recently was hospitalized with a bi lat PE. I am 28. Have your dr's don't an Anteriogram on your leg or a Venius doppler. (Spelling) To check for clotting in you femorial Arteries? I know my first night in the er they did the venius doppler of both my interior legs starting from my groin down to my ankles to check for any more DVT"s since in PE normally the blood clots form in the legs and break off only to lodge in your lungs because the veins in there are alot smaller. I got out of hospital on 3/8/09. I am still having pain at night and coughing up blood. Just to ask you are you still coughing up blood or did that stop? If so when? My daily INR has been 2.5.. Thanks NurseOklahoma

[powderhound]

1st thank you for replying. since my question was posted I am 4 weeks into my recovery.  I still have pain in my chest at times both front and back. Some of the pain in my back side is very similar to the discomfort I first felt days before the embolism was diagnosed just not near as intense but enough for me to say hey I know you are there and why my last episode was just last night after a day of dealing with a spike or 2 in my leg which is the reason I have returned to Med Help.  

2 times now in 2 weeks I have been to a doctor about the frequent leg pain I get.  Reason I say a doctor is I live in a small mountain town and my doctor was out so I saw another one from the clinic.   She said this pain comes from muscle tension or I strained the muscles in my quad. We did a full workup of EKG, vital signs and all was normal she meaused my legs they were the same size.  When I had the PE all my vitals were good except for my pulse. Everytime a stethascope has bee put to me not one of the doctors or RN's ever said they hear anything bad yet I had a PE in my right lower lobe of my right lung.  I left her in a state of disbelief and feel that I am not being heard.

This pain in my leg that comes and go's is not a muscle strain,  I know the difference and what I deal with are spikes and they are inside by my groin and very intense.  I even noticed recently that I do have this followed by pain in my right side or chest.  I am very concerned that this is a circulatory problem.  I am 4 weeks into my recovery and doing everything that I am told.  I definitely feel my recovery is heading in the right direction.  I feel much better and I have some very good days, but I also will have these sudden issues in my right leg and again problems with pain in my chest and back. good news is no problems with breathing and no pain breathing.  In the reply  I am told to not take no for an answer regarding this leg pain and I  I am convienced my body is telling me that issue that started this whole thing is still there.  I was adopted I have no medical history and the doctor or doctors still have not come up with an answer as to why I had this PE and I am comfortable knowing I may never know. My only problem is the reoccurring pain I get in my right leg. I feel there is more to this than just a strained muscle and need answers and guidence on what I should be doing next. I am not a hypercondriach.  I have definitley had my fair share of injuries over my 42 years being an active skier, hiker, fly fisherman  etc. So I am not one to jump just because I feel pain.  This leg issue I have had for awhile even before the PE but not as often since the PE.
Thanks to anyone and everyone that has taken the time to read my questions. Your time is valuable and I appreicate it very much
Tim G

[National Jewish Health]

Yes, in the context of pulmonary embolism with infarction, you have reason to be concerned about your leg pain, given that the large leg veins would be the most common source of the blood clot(s) that caused your infarction.  Infarction is uncommon, if not rare, in a person with no coexisting cardiopulmonary disease that compromised either bronchial arterial flow or airway patency.  Not uncommon in people with chronic heart failure.  I mention this to raise the question you should raise with your doctors and that is, “What might predispose a healthy 42 year old man, such as yourself, to a pulmonary infarction?”

The length of time for dissolution of a clot varies greatly from days to weeks to months.  The pain comes not from the clot but from inflammation of the pleura that abuts the infarct.

The real concern here is that there be absolute assurance that you are currently optimally anticoagulated with low molecular weight heparin.  The next is that you and the coagulability of your blood be assessed by a doctor with great expertise and experience with the diagnostic evaluation required for a person in your circumstance.  That is of the utmost importance for recurrent pulmonary embolism is a life threatening disease.  Do not take no for an answer.

As for a return to work, it depends on the work.  Under no circumstances should you return to work if the work does not allow for frequent walking and does require you to remain seated without moving your legs for long periods of time.