How To See Clexane As Your Friend.....
My last clexane injection was 14 months ago now. When the doctors first told me I would have to inject myself everyday, I was horror struck, and I certainly never thought I would ever get used to it but it didn't take long until I started to see them as my lifeline.
I fell pregnant with my third child when I was 38, 15 years after I had given birth to the last one.
Many people say surprise baby, I say shock. In fact I found out I was pregnant during an ultrasound to check how bad my fibroids had become, and to find out whether a hysterectomy may be needed. There on the screen was my five week old foetus. I had had some sickness but I hadn't clicked at all.
I kind of carried on with life in a dream and couldn't quite get my head around things. At 8 weeks my partner and I went to Lisbon for the weekend as planned and I hoped that it would take my mind off it. We had the most beautiful weekend even though I drove him mad with an incessant cough that I had caught. On the plane home I was the person you don't want to be with. I coughed and coughed and riled around because my legs were agony, aching and sore, a problem that I have had since I had my daughter in 93, but never this bad. I think he was ready to throttle me by the time we got home!! It never occured to me for a second that these could be thrombosis symptoms.
By ten weeks, the upset of finding out was wearing off and I started to feel a little more excited but I was feeling more and more ill. Even though it was only October it had started to snow and I was managing a factory shop floor of temps with the doors open all the time. Eventually I gave up and snuggled under the duvet, in an attempt to try to shift the pressure that seemed to bearing down on my ribcage. Three days after I "collapsed" into bed, I woke from dreadful nightmares to the most excruciating pain that was literally making me see colours around me. I was coughing continuously and bringing up blood. After being told by one doctor that I had a chest infection, then another in the emergency rooms that I had pleurisy, three days later I was sent by ambulance to treated for a blood clot in my lung.
Pulmonary embolism symptoms. Probably a result of a deep vein thrombosis from the pain that had found its way to the lungs. The pleurisy was a result of the irritation in the pleura.
That was the beginning of the stuff nightmares are made of.
11 weeks pregnant, with an oxygen mask on because there was none in my lungs and no-one would check my baby.
Untill 20 weeks a foetus is not considered viable and no-one from obstetrics or maternity or anywhere would check the baby no matter what I asked. Worse than that no-one would explain what was happening to me.
I was given blood tests that determined that my blood had indeed coagulated and given an injection right into my belly with a drug called enoxaparin. Well that’s what it says on the syringe and on my notes but everyone kept telling me I had to have Clexane, I was confused and terrified and no-one explained anything to me.
Luckily my sister is a midwife in Cardiff and realised how frightened I was and went and chatted up one of the consultants at her hospital to get me some information.
Clexane- The Science.
It was she who finally explained to me that Enoxaparine and Clexane are in fact the same drug and they are made from heparin, another term they kept using. Other women on my ward were on warfarin for the same complaint but that is not safe for the baby. Heparin based products do not pass through the placenta wall.
Well, at last that was reassuring because they really didnt seem to care about the baby otherwise! Not until I had been in hospital for 4 days and the Birmingham Mail newspaper called because my mum had tipped them off that they wouldn't scan the baby, strangely hospital policy changed and I got to see that my baby was still alive on an ultrasound.
I was given a very high dose of 120mg to really thin down my blood. An average does is 40mg to maintain the levels. I learned that Clexane has what is called a half life of 12 hours which means that after that 12 hours it stops working. What this means is that you get gradually better consistency of blood for safety. Obviously too much can cause your blood to become too thin.
So that afternoon I had to have a one to one with a nurse who tried to teach me how to inject myself with the Clexane. I am not usually a soft touch but I just couldn't stop crying. I was terrified that I was going to stab the baby. The injection stung and I couldnt imagine how the baby could be viable with no oxygen and this horrible stuff going into him (which of course now I know the baby is safe from the Clexane)
Clexane And The Emotions.
That was in fact the only time that I injected myself because after that my partner, Darrell did it every day. It's quite a bond that grows between you, I have to say, it's a kind of dependency somehow. You have to have the clexane injection at the same time every day so we did ours at 8pm....I think that must have been when the first one had initially been.
After a while it becomes as much a part of your routine as cleaning your teeth, and we referred to it almost fondly as "the stab".
I say fondly, but it’s no walk in the park. Especially as information about it is sparce but more because some days it flippin' hurts.
It’s not actually the needle going in that’s the problem, that’s OK as long as you have a sharp one but as the drug starts to disperse it stings like hell, it kind of hits you 10 or so seconds after and can be sore for about 2 hours after. As the pregnancy progressed, I could feel the baby kicking more and more. Each evening about 5 minutes after the stab, I could feel fingers scratching away at me from inside for a few minutes and then he would go quietly to sleep. Since Dexter has been born I now know that he scratches quite viciously at me when he is nearly asleep. I am not sure how he knew, whether he could feel a difference in me, or maybe could hear the conversation going on but the stab sent him to sleep for the night!
I was unlucky enough to get the one bloke that doesn’t fancy pregnant women, so I really don't know how he stayed in love with me really!!! The first 3 months I was having the Clexane injections I looked absolutely awful. The coughing was so bad that I was sick all of the time and if I had a particularly bad episode all of the blood vessels around my eyes exploded so I had this frightful rash around all over my face. I am very pale anyway but I looked like Morticia Adams, all the redness in my complexion disappeared. My skin became very dry and flaky, and I was absolutely coved in bruises from where the Clexane had thinned the blood and I marked so easily. Somedays I looked like I had gone ten rounds with Mike Tyson.
The bruising is something that they monitor when you go to see the haematologist each month because you obviously have worse bruising the higher dose that you are on. My poor tummy, it looked like someone had pelted me with a pellet gun there were little black marks all over it and my stretch marks were like viscious black channels!!
Nobody warned me about the effects on my gums either, and how they would pour with blood each time a toothbrush went near them. That took a while to get used to, but you get used to it all eventually and it is all completely normal.
The other thing that I found hard was that the pains in my legs were getting worse and worse and I wasn't able to sleep at all at night. By this time I had been made redundant from work (nice huh?) and so had plenty of time to try to search for answers on the internet. I eventually came across a leaflet by the Birmingham Womens Hospital (ironically less than 10 miles from here when I am searching the worldwide web for answers) talking about the importance of taking calcium with Clexane. Again, no-one told me that!
Of course calcium is the mineral that makes us sleep and makes up the density of our bones, and clexane strips it out of your blood pretty much completely. No wonder I was having the restless legs and insomnia, a few days taking some calcium pretty much sorted that out.
I think the worst thing about being on Clexane is fear. A bit like a junkie, you are absolutely terrified of what will happen if you forget to take it. I had it on monthly prescription and they come in individual syringes, some of which are quite big because they have retractable needles, so the boxes are very large.
I would come out of the chemists with great big carrier bags of what looked like christmas shopping...goodness knows what people would think if they realised it was my "fix"!!
One month there was a problem at the factory that make all the enoxaparin and Clexane products and loads had to be recalled and we couldnt get them from anywhere, we had 6 chemists all trying to get some for me. I was just psychotic, I really thought that I would die if I didnt have it. Actually you are fine for a good four or five days I should think.
Clexane and Natural Birth
The other thing to be worried about was the same for me as every expectant mum. The labour. My lungs stayed weak though the whole pregnancy and my obsteotrician was clear that although I was still weak, a natural labour was a better option to putting my lungs through an aneasthetic.
I was to be induced earlier so that they could take me off the clexane in case they needed to do any emergency surgery.
I really, really wanted a water birth and set to learning everything that I could to ensure that it could be as none invasive as possible.
I should point out at this point that I live in Walsall in the West Midlands, England. Officially the town with the highest rate of teenage pregnancies in Europe, people in Walsall don’t usually do "natural birth". I would go to antenatal sessions and to get my blood checked and one occasion I heard one girl, maybe 16ish, mutter to her friend that having a baby when you are over 30 was gross!! Not bad enough that I was having a small baby that was not growing very well, I had to contend with that too....I felt like I was 110 years old.
The community midwives thought I was a bit odd I think, but I was determined that I was going to get through as naturally as possible but was told there was no chance of a water birth because there was such a high risk of intervention.
There was always this dilemma. There had to be an induction, which was counted as intervention so therefore I had to have a bed delivery.
I learnt everything I could about visualisation. I made the most enormous collage of images and mantras to help me to stay focused. Loads of "every contraction is a gift that brings me closer to my baby" and that stuff.
I spent hours learning to breathe again. My wonderful sister gave me a copy of Hypnobirthing: The Mongan Method: A Natural Approach to a Safe, Easier, More Comfortable Birthing with CD (Audio) (B) where I learned the most incredible control to prepare me for the labour that I wanted. It was full of the most incredible (and easy) exercises such as: Slowly in, visualising my tummy filling up with a blue balloon on my inhale and then floating away as a red one on the exhale. My lungs grew so much stronger and so did my confidence that everything would go just how I wanted them too.
I filled my Ipod up wth music, fast music to jig about to at the beginning and then loads of pavarotti and enigma for the birthing.
I massaged my perineum with evening primrose oil to stop it tearing and to get the prostaglandins going to start labour.
Project labour was afoot.
By week 38 I was beyond done in. We had had so many false labours and health scares it was daft.
I had pre-eclamspia and I was still in agony from the pains over my lungs, my tummy was heavy, my hands were itchy because my liver was starting to suffer and the final straw came when my bloods showed kidney dysfunction. The hospital called me to come in and be induced.
I was ready to have a party!!!
That evening of course, I had no clexane stabbing, and I had my pessary put in. I settled down for the night and at 5am my first contractions started . By 7 oclock I was off on a trot around the hospital, walking round and round to try to get gravity going. By 9 oclock they were every two minutes and I was happily bouncing on my birthing ball to Peter Gabriel's Sledge hammer when Darrell came into the ward. All the other patients around me were screaming, and not anywhere as far on as I was.
When they put me on the monitor I needed Darrell to use my essential oils massage oil on my back to easy the pain, but was still able to breathe through all the contractions. The midwife could see that the babys heart beat was slow and was worried we may have to intervene.
Half an hour later, when I told her I wanted to push, she kind of smirked. We had been told that we sould expect the effects of the induction pessary probably wouldn't kick in till late that evening. It was 11.30am.
I insisted that she checked me and she looked just a little bit panicked and declard we needed to get to delivery room immediately.
Poor woman was in a right fluster, she had nothing laid out ready. Poor Darrell too, she was asking him to get some baby clothes out at the other side of the room and I announced " having this baby now, get back over here". He's a big bloke and not known for his speed, he moved pretty sharpish then though!!
After panting through the next contraction, while she sorted herself, I simply breathed a little boy out, Dexter. When I had said in my birthplan that I didnt want to push I dont think she thought it was possible....but he flipped out so quick she nearly dropped him.
Tiny he was, just 5lbs 4ozs (2.354 kg) And very grey, and he didn't cry.
It turned out that was because he just wasn't upset, and was very pleased to meet everyone. His heartbeat had been slow because he was absolutely OK with what was happening. He suckled straight away, and untill he was about 6 months old never stopped eating!!! He had to be in a hot cot for a couple of days to stabilise his body temperature but he pinked up in minutes.
I'll just take this opportunity to say just how important the hypnobirthing had been here, the midwives had never seen such a calm and natural birth. In my opinion every single pregnant woman should read this book, and if you want a natural birth it should be your bible!
Dex will be two in May and he is a very tall, strong and docile little boy. Apart from the fact that he still doesn't sleep there are no signs at all that we had anything but a perfect pregnancy.
I stayed on a lower dose of 60mg of Clexane for 3 months and then was tested to see if I had a genetic condition called Hughes Syndrome, that may have caused the problems. I don't and so no longer need to endure daily stabbings. (This fabulous book More Sticky Blood had helped me prepare myself for that, and I wished I had found it much earlier in my pregnancy, I would recommend it to anyone who is enduring any kind of sticky blood problems) I would have to have a start again anytime that I have surgery or if I became pregnant again. Apart from that the only thing that remains is that I need to wear support stockings on long journeys or plane rides. Every other symptom had disappeared by the time Dex was three days old.
My Top Ten Clexane Tips
If I were to give 10 tips to someone who has been put on Clexane I would say:
1. Take Calcium as soon as you can, ideally before the clexane starts to kick in.
2. Become your own expert on your own body, because none of the doctors or nurses understand the treatment. Know what dose you are on and when to take it. Remind them every time because they will forget.
Get someone else that you can trust on to inject you. Its dreadful doing it yourself
3. Use loads and loads of cocoa butter on your belly, the softer it is the easier the needle goes in.
4. Vary the points where you inject, alternate sides, inject near to the hip and on the fattest bit...it hurts loads less.
5. Get a good foundation and moisturiser in your new colouring otherwise you look like a jaffa orange!!!
6. But forget wearing a bikini... you are always going to have bruises.
7. Drink loads of water to stop your skin drying and becoming sore.
8. Don't look in the mirror when you clean your teeth
9. If you do have problems getting your prescription filled, ask your chemist if they network with any other companies to help them out.
10. Try to get past the fact that it hurts and just see it as keeping you and the baby alive.
From Clexane to pleurisy symptoms
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