Recovery

This is never normal. 1 in 10 patients will cough up blood. If you are coughing up blood it could be due to high pressure around the lung and can worsen on an anticoagulant. Blood clots usually don’t leave a scar in the lung, and pain is usually associated with pulmonary infarction.

Most of the time there will be no damage. The two places you could have lasting issues are in your leg and in your lung.  Damage in the leg would be from both the blood clot and the destruction of the valves that move blood along and cause swelling in the leg.  Most of the time this is just an inconvenience, but if you get significant swelling it may prevent you from doing a job where you must stand up repeatedly.  You may need to wear compression stockings to squeeze the blood back to the upper part of the body. As far as the lungs are concerned, 96% of the time there will be no serious damage, but 3 to 4% of patients develop post thromboembolic pulmonary hypertension where you might have some continued shortness of breath that requires a specialist to repair the damage done to the vessels in the lungs.

• After PE: Shortness of breath and mild pain or pressure in the lungs are common. You are likely to notice pain when you exert yourself, during physical activity, or whenever you take a deep breath. Shortness of breath gets better over time, and exercise helps you use your breath more efficiently. These symptoms should resolve in several weeks.
• After DVT: Post-Thrombotic Syndrome (PTS); persistent swelling, pain, and discoloration of the skin in the affected arm or leg. These symptoms may persist to some degree and are long term in one third to half of cases. Wearing knee high compression stockings for the first 3 months may reduce this risk.

It takes around 3 months to complete active treatment of VTE, although recovery time varies per individual, so there is no standard for how long it will take to recover. Download NBCA's New Patient Guide to learn more about the blood clot recovery timeline.

The majority of patients do not have a repeat blood clot. However, risk is higher than for the general population whenever you had a clot. The degree of increased risk depends upon where the clot was, how many you clots you had, family history of blood clots, presence of blood clotting disorders, and any underlying medical conditions.

Someone should go over your medications, especially the anticoagulant prescribed, and the risk of bleeding associated with it. They should also advise you on when you need to schedule a follow up visit, how to take your medication, and how often to take it. Different anticoagulants have different follow up protocols. If you are on Coumadin, you will likely have to go in every 2 to 3 weeks because that drug is subject to variation and there are very narrow limits between what is effective and what is too much or too little.  However, if you are taking one of the direct oral anticoagulants (DOACs) such as rivaroxaban, apixaban, or dabigatran then you will not need to go in frequently. Someone should also talk to you about any potential drug interaction with your anticoagulant and how to handle high risk situations like air travel, long automobile travel, and what kind of activity you can be involved in without risk for hurting yourself.

About one-third to one half of patients experience some form of long-term complications after their blood clot, including but not limited to:

• Post-thrombotic syndrome: persistent swelling, pain, discoloration of the skin in the affected arm or leg; and rarely the skin can break down (ulceration)
• 2-4% of PE patients will have chronic lung damage (thromboembolic pulmonary hy­pertension)
• Further episodes of clotting
• Anxiety and/or depression

While not a long-term complication, once someone has a blood clot, they have an increased risk of developing another one.