Monday, June 25, 2012


    I often make a comment as a joke , that there are 3 causes of problem in this world. one Money , two Sex and three. In laws. Most of the people that I meet , they laugh when I make this comment.This story is one where the in laws did cause the problem .
    I was called in on a consult for a 60 years old male with the pulmonary embolism . The patient was quite active , physically , had not travelled any long distance . So the cause of his lungs was not clear . When I saw him he was quite comfortable . Only history that he had was that of high blood pressure . This was well controlled with the medicine . His lungs were clear, heart was OK and except some tenderness in both legs there was no positive finding on his examination .
    He had CT scan scan which had shown the clots .His Doppler examination of the legs showed that he had clots in both legs . Normally patients get clot in legs due to immobilization of the legs . This could be due to fracture , post surgery period and long distance travel etc. Females who take birth control pills also are at higher risk for these clots . My patient had none of these 'risk ' factors . So why did he get it . ?I was not too sure . We also do work up to make sure that patient does not have cancer . We also do work up to make sure that patient does not have blood disorder that causes blood to clot too quickly. We had ordered these tests .
      On the third day when most of the work up was found to be negative , the mystery was solved . I was also surprised that he had clots in both legs and that too in the thigh .  I was asking him what he had done the day before this embolism . Then he told me  and the the puzzle got the answer .
       His mother in law had moved with him , when the father in law had died . He set up a room fof her . They had a old TV in one of the bed rooms and he decided to to take it to her new room . He lifted it and started to take it from one bedroom to the other  The TV was quite heavy and he got tired . He had to sit in the living room . He sat in one of the chairs keeping the big , heavy TV resting on his thighs . When he caught the breath , he stood and took the TV to his mother in law's room . This heavy load on the thigh , caused the circulation , the venous return to be compromised. THIS CAUSED THE CLOT IN THE LEGS  and then it traveled to lungs and that caused the breathing difficulties . So the cause of the clot was the Mother in .(moving in with him ).

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