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Pulmonary Embolisms

Last Tuesday night, on my younger brother's birthday (1/27/09), I drove myself to the hospital with serious chest pains. It wasn't my heart - it was to the left and a little lower - but it had been hurting for 40 minutes, and hurt so badly I had to pull over from driving. After setting myself a time limit of 40 minutes for pain, and after being strongly encouraged by my friend Max N to go in because he thought it was blood clots, I drove in.

It sounds melodramatic, but I almost died last week. Rack this one up on my list of spent lives out of my 9 lives.

I was just released Sunday afternoon, and am still recovering (still have chest pains and trouble breathing). Apparently those symptoms are "normal" and I shouldn't worry unless they get worse, so I'm just trying to take it easy.

I have never experienced such pain in my whole life - not even when I broke bones or had the adenovirus almost two years ago to the day. Dilaudid didn't even help with the pain, if that helps give you an idea... I'll shorten the story to a reasonable length, but will try not to leave out any pertinent details. Thinking back now, I realize I had symptoms for at least three weeks, but when you are short of breath and have a cough in the middle of a Michigan winter, who thinks that is abnormal???

I had crushing, stabbing pains in my left chest not two days after I returned from my trip to Jamaica. I now realize just how lucky I was to not have gotten this sick while there. Who knows what would have happened.

I drove myself to Beaumont Royal Oak, and after a chest/ribs xray, a d-dymer test, a CT scan, and an ultrasound of my legs, was admitted and was told I had blood clots in my lungs and legs. It started out that I had four or so, and after more tests, I was informed I had "extensive" blood clots in my lungs and my legs, and was forbidden to move, on strict bedrest. That means, no bathroom either. There goes privacy and pride.

The first night was spent in the ER because they had no rooms for me (bad weather), and I didn't see a doctor for four hours. Fortunately, an ER nurse was an angel and gave me pain meds while I was waiting so I wouldn't be in such extreme pain in the meantime.

They then moved me to the 5th floor, but not for very long. After additional tests (which is where they learned how extensive my PEs [pulmonary embolisms] were, they immediately moved me to the 8th floor for further monitoring. For those of you that don't know, the 8th floor is the cardiac floor. I was put right by the nurse's station so they could keep a close eye on me. I was the youngest patient on the whole floor.

Because my case was abnormal, I got presented as a case to the Chief Resident (just like two years ago). It was fascinating.

I spent almost 6 days on that floor. They gave me heparin, coumadin, xanax, dilaudid, morphine, and tried all different kinds of painkillers - most didn't work. I ended up on morphine and oxycodone. Many friends visited me - and each one made me feel better - even if I don't recall exactly who was there when. I got so many flowers that I got comments from nurses.

After almost 3 days, I was finally allowed to get up and go to the restroom (it's the little things). The pain is amazing. Even now, it's hard to talk and breathe... Normal sucks.

I asked my doctor what would have happened if I hadn't felt my blood clots (even after 3 weeks). She said I could have had a cardiac arrest at any time, had a heart attack, and died. Glad I came in.

After thinking and sharing those thoughts with my doctors (cardiologist, radiologist, hematologist, and other "ologists"), we decided that it was probably a good thing that I trained and ran my marathon three weeks ago. It helped increase the strength of my lungs, the oxygen exchange of my lungs, and the strength of my heart (the doctors were very concerned about my brain and my heart). Again, who knows what might have happened if my heart and lungs were not in the shape they were in.

Long story short, I am now on Coumadin, and will be for at least 6 months. They still don't know exactly what caused the clots. Some of the doctors thought it was a combination of my birth control meds, my recent travels, and my leg injury (healing stress fractures), but the hematologist didn't think that those factors would account for such extensive blood clots throughout both my lungs (all lobes). He thought that I might have a clotting disorder (despite no family history, no smoking, etc), so the vampires took 7 vials of blood before I left - collapsing one vein in the process. My arm looks lovely; great colors. The results haven't come back yet.

So that's where I am now. Trying to take it easy (unsuccessfully) and trying to breathe. I have follow-up appointments every week to get my blood taken so that my Coumadin and INR levels are appropriate (watch out for Vitamin K-rich foods and follow the AMS instructions), and have to follow up with my other doctors in the meantime. Temperatures affect my blood, as do foods and alcohol.

I'm not allowed to drink, cross my legs, I have to take frequent walks, I have to exercise my lungs slowly (breathing shallowly for too long can cause pneumonia), and I am not allowed to fall down. It would be funny if it weren't so life-threatening.

It seems 2009 is turning out to be just as interesting as 2008.

As my friend Chris said, each breath I now take is a gift.


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