A Perfect Storm with a Remarkable Ending

How Coordinated Care Saved a Young Woman’s Life

Before 2018, Ami Doubblestein didn’t even know what a blood clot was. But on February 7, 2018, she began a crash course on clots and so much more.

It all started when she got up one morning and had trouble walking on her leg. After she took her children to school, she removed her boot and noticed that her foot was white and cold. That’s when she decided to call her primary care physician — who works for another health system — to see if she could get a same-day appointment, which she did.

“I thought maybe I had strained my leg, but my doctor said he thought I had a blood clot in my artery, and he called an ambulance to take me to emergency. He didn’t want me to drive myself or wait to be seen. The ambulance took me to Mercy Health Saint Mary’s.” Doubblestein is forever grateful for her doctor’s quick response.

Not the Way She Planned Her Day

While she was in the Mercy Health Emergency Department (ED), Vascular Surgeon John Morris, DO, FACOS, was immediately consulted about Doubblestein’s case. After performing tests, he informed her that she had a blood clot, and he would need to perform surgery.

Looking back now, Doubblestein can laugh. “I didn’t even know what a blood clot was,” she admitted. “My husband was out of town so I asked when I could schedule the surgery in the future so he could be there.”

Morris explained the serious nature of her condition and, with her permission, immediately performed a four-and-a-half-hour surgery to remove the clot from the arteries, which were located in a tricky spot behind her knee at a juncture of several blood vessels. It had been at least nine hours since Doubblestein’s leg had adequate blood flow.

“He saved my leg,” Doubblestein said with gratitude and amazement. Today she can walk without a cane, ride a bike with her children and enjoy many other activities, although she has lost some feeling in her foot.

Mysteries to be Solved

Morris believed that one of Doubblestein’s medications had contributed to the formation of her clot, but he wondered, What had caused a blood clot in this otherwise healthy 43-year-old woman with no history of vascular disease? There was also another mystery: How did the blood clot develop or move to an artery without any underlying blood vessel disease?

Morris wanted answers.

Enter Cardiologist Kristopher Selke, DO, FACC, who joined the care team to determine how or where the clot developed. Testing revealed that a blood clot had developed in her leg vein and moved (embolized) through her circulation into her chest. After additional tests, he discovered a congenital hole in the patient’s heart that had never been detected, which explained how the clot had moved from a vein into an artery. If the clot had taken a different path, Doubblestein could easily have suffered a stroke.

In April, Selke performed a minimally invasive catheter-based procedure to close the hole in his patient’s heart, but one mystery remained: A medication may have added to this perfect storm, but what had caused the clot in the first place? Hematologist Frances Wong, MD, of Cancer and Hematology Centers of Western Michigan, also joined the care team and was able to give Doubblestein an answer that surprised everyone.

“She told me I had a rare, inherited blood clotting disorder called Factor V Leiden [mutation] that, together with my medication, had caused the clot in the first place.” The second mystery was solved.

Calm After the Storm

Doubblestein is grateful for the thorough, expert care she received at Mercy Health — from the ED staff, Morris, Selke and Wong to the “amazing” vascular nurses on the floor where she recovered from surgery.

Today this wife and mother is back at work and caring for her family. She is on blood thinners and will undergo a follow-up procedure with Selke in October to ensure the tissue surrounding the device in her heart has closed. Once that takes place, Doubblestein’s care team will discuss next steps to keep her healthy. She has also “graduated” from physical therapy for her leg.

“The care I received at Mercy Health was excellent. They couldn’t do enough for me. I feel blessed that everyone relentlessly pursued the answers to their questions, so that today I know about my congenital heart defect and blood clotting disorder,” she added. “I woke up one morning in a perfect storm but now I’m safely on dry land, thanks to Mercy Health.”

Learn more at MercyHealthHeartAndVascular.com

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