In this case, the diagnosis process was totally wring due to the general assumption made by the care provider and the primary care doctor that the patient being an athlete could not in any way have such a serious problem as a clot. The diagnosis was made from an assumption-based view and there was no effort whatsoever to link the illness presented or the symptoms to the patient’s history to order any forms of diagnostic tests. In most cases, care providers do assume that athletes such as this patient regarded as an avid runner are less likely to exhibit clots because they are strong and healthy (Burrus et al., 2014). The medication list provided indicates that the care providers had a narrowed assessment of the patient especially after recognizing that he is an active runner. The Motrin 800 mg as a pain reliever and Flexeril for muscle relaxer indicates that the care providers were very sure that the pain on the right leg could have emanated from the physical activity or exercise.
The management and diagnosis of clots should be individualized as much as possible especially in cases where the patient is said to be an active athlete. The patient’s family history, cases of inherited and acquired clot disorders as well as other risk factors that encompass the patient’s life should be thoroughly scrutinized (Buttaro et al., 2013). The physical and visual examination of the leg could have indicated the visible cases such as the tenderness, swelling, erythema and warmth of the leg or a positive Homan’s sign could have provided a metric for physical pain or discomfort on the leg. These combined with diagnostic tests such as the Prothrombin Time test; blood test that determines or indicates the likelihood of the body to form a clot. An Electrocardiogram test would also provide significant evidence as to the probability of blood clot or any risk factors present in the blood (Birnbaum et al., 2014). Usually when there is a clot in the system, the ECG test which measures the electrical activity of the heart indicates a lack of rhythm in the flow of blood into and put of the heart and this can be translated as the presence of a clot. This is technically a sign of deep vein thrombosis and when this clot travels from the extremities such as the legs in this case, it could end up in the lungs and its impact on the blood flow rhythms is significantly felt; this condition is what can be referred to as pulmonary embolism. D-Dimer tests could also be confirm or rule out the presence of a thrombus or clot and specifically in relation to deep vein thrombosis or pulmonary embolism. Vascular ultrasound and Doppler ultrasound could have been used in this case too to help detect the any cases of unknown blockages as well as blood clots in the blood circulation system (Birnbaum et al., 2014). The use of anti-coagulants (blood thinners) such as xarleto and warfarin can be initiated to reduce the chances of clotting alongside minimal exercise and physical activity for the patient until a follow-up diagnosis is done (Hull & Harris, 2013).
References
Birnbaum, Y., Wilson, J. M., Fiol, M., Luna, A. B., Eskola, M., & Nikus, K. (2014). ECG diagnosis and classification of acute coronary syndromes.Annals of Noninvasive Electrocardiology, 19(1), 4-14.
Burrus, M. T., Werner, B. C., Starman, J. S., Gwathmey, F. W., Carson, E. W., Wilder, R. P., & Diduch, D. R. (2014). Chronic leg pain in athletes. The American journal of sports medicine, 0363546514545859.
Buttaro, T. M., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2013).Primary Care: A collaborative practice. (4th ed.). St. Louis, MO: Mosby.
Hull, C. M., & Harris, J. A. (2013). Venous thromboembolism and marathon athletes. Circulation, 128(25), e469-e471.
