Educate Yourself Before the Emergency

A few weeks after her emergency procedure, the author is enjoying life aboard a friend's boat on Lake Michigan.

“You have exercised-induced asthma,” my primary doctor told me.

I told him that was impossible since asthma didn’t run in my family, and, I had exercised throughout my life. He replied that asthma, sometimes, emerges during adulthood. I sarcastically thought in my head if there is such a thing as “work-induced asthma?”.

How could this be? I think back to less than a week ago when I was jogging on a treadmill and, all of a sudden, couldn’t breathe. Once I stopped running, my breathing returned to normal.

My doctor prescribed an inhalant. He instructed me to use it for a week before any physical activity. After an unsuccessful week with the inhalant, he ordered pulmonary testing. I was back a week later doing breathing exercises into machine tubes.

The day after the pulmonary testing, I sat at my desk all day to finish a project. By four o’clock, my right leg had swollen three times its normal size. It felt like a dead log and throbbed in pain. In taking the holistic approach, I elevated my leg and applied ice. An hour later, it hadn’t gotten any better so I start calling my nurse and doctor friends.

My nurse friend, David, suggested that my symptoms could be a result of deep vein thrombosis (DVT) — a blood clot deep in the vein of the leg and to immediately go to the hospital.  I drove myself to the closest ER and waited almost four hours. When the ER doctor saw my leg, he asked me several questions:

  • Was I  over the age of 40? (No. At the time, I was 37);
  • Was I on birth control pills (Yes. Two months ago, my new ob/gyne had put me on Ortho Tri-Cyclen Lo);
  • Did I smoke? (Yes, if you count one cigarette a week with a drink.)

His eyes widened and he immediately ordered a CT scan.

The results showed I had bilateral pulmonary embolism (PE) and DVT. Large blood clots had formed in my leg, broken off, and traveled to my lungs. An accumulation of these clots, over time, would be fatal. I was checked into the intensive care unit (ICU), hooked to intravenous fluid (IV) and, had blood thinner injected into my stomach.

Two days later I moved into a regular room and stayed in the hospital for several more days, then sent home with blood thinner medication.

Surprisingly, several weeks later, the same leg swelled up after a walk to the beach. I contacted a vascular specialist who recommended a procedure where a drug, called tPA, (imagine blood thinners on steroids) is intravaneously injected thru a catheter in my neck and into another two catheters in a vein near the groin area of the affected leg. The intention was to directly attack the main clot in the leg.

They inserted a small metal clot filter device in a vein to “catch” the clots. Sometimes the filter gets removed or stays permanently. I was awake throughout the four-hour ordeal. It was horrific seeing and feeling this “tugging” between the two catheters from the side of my neck down to my leg but, told myself, that whatever I needed to do to get through this, I would do it and stay positive.

From then on, every three months, I was required to get a leg and chest CT scan. Each time, the tests revealed that the clots slowly going away, and my leg was no longer swelling. Within a year, the doctors took me off the blood thinner, Coumadin, and my life returned to normal, albeit, with some residual restrictions.

Diagram: A pulmonary embolism. Courtesy of the Yale Medical Group

Diagram: A pulmonary embolism. Courtesy of the Yale Medical Group

I learned a lot, about my own health and wellness, as a result of this experience. I could have died a sudden death. Massive pulmonary embolism is second only to sudden cardiac death. Patients, like me, who survive a pulmonary embolism, may have recurrent embolism and death can be prevented with prompt diagnosis and therapy. Unfortunately, the diagnosis is often missed because patients with pulmonary embolism appear to have non-specific signs and symptoms.

If left untreated, about a third of patients who survive an initial pulmonary embolism will subsequently die from an embolic episode.

In retrospect, and after further research, I realized I had a litany of bad care throughout my entire ordeal beginning with the ob/gyne who prescribed the oral contraceptives (it was done so without considering the side effects) to when the  vascular specialist took me off Coumadin without taking a final chest x-ray to see if I had lingering clots in my lungs (turns out that I did, when I complained several months later.)

I can’t change what happened to me. But, as a result of all of it, I am educating myself and learning about my own body. I hope my experience will help other women when they’re making healthcare decisions. ♥

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