Immediate Care visit results in diagnosis of life-threatening blood clots

September 04, 2019 | by Edward-Elmhurst Health
Categories: Healthy Driven Heroes

On Saturday of Memorial Day weekend 2019, 51-year-old Dean Nickerson was about one month into his recovery from a knee sprain. That morning, he noticed an increase in pain and some swelling in his left leg. He figured it was part of the healing process, that he’d been on it too much and just needed rest. But when Nickerson walked to the kitchen to grab a cup of coffee, his wife urged him to get his leg checked out at nearby Edward-Elmhurst Health Immediate Care – Oak Park.

When Nickerson arrived, he was seen by Maria Hilgart, M.D., an emergency medicine physician, who quickly recognized an emergency situation.

“The doctor asked me if I had any other symptoms, like a cough,” says Nickerson. “And I answered that yes, I had a little cough and a little chest tightness.”

Things were quickly set in motion. Dr. Hilgart explained that Nickerson could have a blood clot and needed to get to a hospital emergency room (ER) right away. Nickerson felt like it was an overreaction, but because he was stable was able to call his wife to drive him to the hospital. Often, when a blood clot is suspected, an ambulance would be recommended.

“It was very straightforward,” says Dr. Hilgart. “The amount of swelling in his leg and calf tenderness, combined with immobilization related to the recovery from his knee pain, led me to suspect a blood clot and get him to the emergency room.”

Most immediate care centers aren’t equipped to manage cases such as Nickerson’s so a referral to the ER is warranted.

Once at the ER, Nickerson was seen immediately and kept from walking to limit movement of a potential clot. After a blood clot in the heart was ruled out in the cardiac catheterization lab, a CT scan confirmed not only a deep vein thrombosis (DVT) in his leg, but a pulmonary embolism in each of Nickerson’s lungs.

DVT occurs when a blood clot forms in one or more of the deep veins in the body, commonly in the legs. Immobilization, such as limited movement due to recovery from an injury, increases the risk of DVT. This condition is considered life-threatening as these clots can break off and travel through the bloodstream and lodge in the lungs — a pulmonary embolism.

Nickerson was transferred to another hospital where he received thrombolytic “clot buster” medication to help dissolve his clots, and blood thinning medications to prevent additional clots. In all, the leg pain that Nickerson almost disregarded led to six days in the intensive care unit.

“I look back and realize how grateful I am that Dr. Hilgart had the education and expertise to recognize it right off and escalate it,” Nickerson says. “At immediate care, I know this is routine for them, but holy cow, she probably saved my life.”

According to Dr. Hilgart, who has been providing care for 30 years, recognizing a true emergency is all in a day’s work.

“We’re calling an ambulance every day. People come here when they should go to the emergency room because they can’t always recognize an emergency,” she says. “I equate it to bringing my computer to be fixed. I have no idea if it’s something catastrophic or simple. That’s what we’re here for.”

Today, Nickerson is doing well, making his health a priority and feeling very grateful for the entire healthcare team who made his diagnosis, provided his treatment and helped him heal.

Learn more about Edward-Elmhurst Health’s emergency care.

Learn what level of care you need.

Learn more from Healthy Driven Chicago:

Men: It's time to own your health

Which level of care is right for me?

Related blogs:

How to recognize and prevent life-threatening blood clots

Deep vein thrombosis: a rapid response for a life-threatening clot

How to handle an emergency



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