I just found the clotboard

I am so happy

The Importance of Being Earnest

When I am not thinking of blood clots, I am most certainly thinking of word games. Or pizza.

Semantic satiation is a thing. I have used the word "clot" so many times over the last two weeks, that it has virtually lost all meaning. Clot. Clot. Clot. C-L-O-T. After awhile, it starts to sound like a dirty word, tee hee hee. 

Semantic satiation aside, words are powerful things. They are like tiny fists delivered in chirpy, nasal tones. . Words can make you question your beliefs. Words can elucidate ideas that you would prefer to remain muddy. 

When I first started experiencing calf pain, I chose to ignore it. If I refuse to acknowledge it, it's not there, right? It only became serious in my mind when my bff, Creeps, sat me down and told me (in a much nicer way) that I was being an irresponsible idiot for denying something so obvious. That was what prompted me to go to the hospital. (Thank you, Creeps, for saving my life. Let me buy you a coffee sometime for your trouble). 

Since my discharge, when asked, I have been open with the reason why I was hospitalized and missed a week of work. I have experienced the normal gamut of illnesses that affect most people - strep throat, influenza, painful diarrhea, etc. - and telling someone about those ailments elicits an entirely different reaction than telling someone about a pulmonary embolism.

Non-lethal ailment: "Oh, you have strep throat. That must suck. Drink OJ and get lots of rest!"

Pulmonary embolism: "Holy shit, I am glad you are standing here talking to me right now." 

Ever since I received the diagnosis of PE, I was completely aware of the gravity of the situation. However, the reactions I have been receiving from friends and coworkers have made the whole experience more "real." (I mean, it was never fake, It just wasn't so scary that I felt like peeing my pants). 

Of course these responses trigger a panic response in my brain. However, it is never a bad thing to be reminded that you are lucky to be alive. On a very basic level, it is an amazing coincidence that I was ever born. Now that I am here, it is incredible that I survived something that has killed so many wonderful people. 

It is easy to feel pity for oneself. It is difficult, but more profound, to view negative experiences as a building block for one's future. I have learned a lot about myself from this experience and I fully intend to use this knowledge to make a better life for myself going forward. I encourage anyone who has gone through something scary or painful to try to view their situation in this light. Everything is a learning experience and we owe it to our fellow humans to be good teachers. 

A Night to Remember (In the ER)

That is an awfully intuitive animal. 

So, where was I....oh, yes. Ativan. Ahhhhhh-tivan. The very lovely ER physician decided to give me a benzo to shut me up. Benzos are like grown-up versions of the lollipops they give you at the dentist's office. "If you are a good girl and stop crying, you can have an ativan." Ok!

It seemed that as soon as the doctor came back to deliver the diagnosis of PE and tell me I was being admitted, a team of nurses mobilized to hook up my IV to Heparin to make sure the meds were delivered immediately. Their actions were very quick and precise - I felt like a race car that pulled into a pit stop for a tire change. During all of the poking, prodding, and dosing  they explained that the sooner the medication is in my system, the sooner clots will stop developing. Here is an interesting fact: Heparin, Coumadin, and similar medicines do not actually break up the clots. They just prevent the blood from forming further clots.

Hmmm...so if the clots are still there, is my leg a virtual ticking time bomb?

I've asked several doctors about this and received only the vaguest of answers. This is my understanding based on the conversations I had:

• Yes, a piece of the clot in my leg could break off and cause another pulmonary embolism (eek!), however, this is "rare". (To one of the physicians, rare = a 1/100 chance). Laugh-out-loud!
• Yes, clots can still develop while I am taking blood thinners. Again, this is "rare." I didn't even bother to ask about statistics this time because, frankly, I do not want to know. 

Ignorance truly is bliss, especially when you are a hypochondriac with a life-threatening condition who has terribly bad luck. On a scale of 1-10 of how terrifying this is to me, I would say probably 12.5. Since I've received this information, every tiny ache in my body is a blood clot the size of a softball travelling to my brain in order to explode it. 

In conclusion, internal organs are stupid, gross and more trouble than they are worth. In my next life, I want to come back as an amoeba. 

NEXT UP: My hospital tour diary

Super Important Business

Before I continue my personal saga, I wanted to explain how important it is to know the risk factors and warning signs of a developing blood clot.

THIS IS REALLY IMPORTANT.

 Because I am cocky and believe that I am invincible, I ignored very clear warning signs indicating that I had a clot in my leg. Had I not been such an idiot, my clot may not have broken off and lodged in my lung. In fact, the only reason I finally did go to the hospital was at the insistence of my good friend, Creeps, and that was only to shut him up. (Just kidding, Creeps! I <3 you!).

Please learn from my mistake and realize that THIS CAN HAPPEN TO YOU. It doesn't matter if you are young, old, active, sedentary, healthy, etc. Anyone can develop a potentially lethal blood clot.

DISCLAIMER: this is not medical advice. I'm just someone who wants to raise awareness for what many call a "silent killer."  If you believe you have a blood clot or pulmonary embolism, go to your local ER or call 911 immediately. DO NOT WAIT. The below lists are not a comprehensive review of every risk factor or symptom. Contact your physician for more detailed information.

These are common risk factors in the development of clots:

• Recent surgery
• A period of immobility (as in a hospital stay or prescribed bed rest)
• Taking hormonal birth control pills
• Long trips
• Working a desk job or sitting for long period of time
• Smoking cigarettes
• Being overweight/obese
• A family history of DVT
• A previous DVT and/or Pulmonary Embolism

These are the symptoms of a DVT

• Pain in your leg, ankle or foot. This pain can feel like a sprained/bruised muscle, but unlike a sprain/bruise, the pain will become worse over time and not better. 
• Swelling. Compare your calves - does one appear to be larger than the other? Does one feel "tighter" than the other?
• Redness. Often times, the skin above the DVT will become red. Sometimes the affected area may turn blue or be drained of color. Have you experienced any recent trauma to the affected area? If not, you may want to try to determine why your skin is changing color.
• Warmth. Is the affected area warm to the touch? Even if it turns out not to be a clot, this is still something that should be reviewed with a physician.

These are the symptoms of a Pulmonary Embolism

• Chest pain
• Shortness of breath
• Sweating
• Fever
• Anxiety/nervousness
• Heart palpitations
• A racing pulse
• Cough, with or without blood
• Collapse and sudden death. As scary as this is, some DVTs and PEs present no noticeable symptoms. 

The most important thing to remember is to listen to your body. If you feel there is something wrong, DON'T WAIT. GET IT CHECKED OUT. 

Don't listen to them. Dry shampoo DOES NOT work. 

In regards to my specific case, I had many factors working against me. I smoke (stupid), take hormonal birth control, and was hospitalized for a week during which time, I moved very little. Ladies, if you are like me, you probably just throw away that warning on your BC that says "smoking while taking this medication may cause blood clots." This girl here, the one over there on the right, is living (thankfully!) proof that BC + smoking do not mix. This makes me sad, because few things are more satisfying than a post-coital cigarette. But I digress...

When I began to develop symptoms (the tenderness & swelling in my leg were the first to materialize), it was easy to explain away as a sprain. The mild symptoms lasted approximately three days. However, when my calf started to turn red, warm, and  became extremely painful, it was harder to ignore. By Friday, I was limping. The PE symptoms appeared in the early afternoon on that fateful Friday. It started with a SHARP pain underneath my heart, transitioned to extreme dizziness, and then became severe shortness of breath. I'm either dedicated to my job or stupid, because I stayed until the end of my shift and then went to the hospital after work with the same sense of urgency with which I would return library books. 

The moral of the story is: Know the risk factors for clotting. Know the symptoms of DVT and PE. Share this information with everyone you know. And, please, please, please seek immediate medical attention if you think you may have a blood clot. If you ignore it, it becomes a ticking time bomb in your body that could kill you in an instant. 

Smile Mighty Jesus, Pulmonary Embolism's Got me Down

Oh, that giant needle is going into my arm? Cool!

When asked about their vision of hell, some people would certainly answer "an ER waiting room." It is difficult to argue against this one. Not only are you waiting. And waiting. And waiting. But then, you are waiting some more. However, Tom Petty was incorrect when he nasally crooned that waiting is the hardest part.

*******************
Open Letter to Tom Petty
Dear Tom Petty,
Contrary to what you believe, waiting is not always the hardest part. Sometimes the hardest part is watching someone vomit yellow bile into a clear ziploc bag. Other times, it is the necessity of touching surfaces you KNOW are contaminated with MRSA. Sometimes, it's listening to someone scream in pain as they are being poked and prodded. In conclusion, Tom Petty, waiting does suck but there are worse things out there.
*********
I digress.

After being taken back to an assessment room, the doctor spoke to me within 5 minutes. She listened to me, took my concerns seriously, and ordered blood tests to determine the D-dimer level in my blood, among other things. D-dimer is an anti-clotting substance found in your blood. If the levels are high, it suggests the possibility of blood clots. Before I was even notified of the results, I was taken for a CT scan with contrast to see if there were any clots in my lungs. After both of these tests, I waited. And waited again.

When the the doctor had the opportunity to review my results and began speaking to me in low tones, I knew she had bad news. She confirmed the presence of a clot (or clots) in my right leg, which I expected. This is called deep vein thrombosis (DVT). Then she dropped a bombshell: She also found a small blood clot in my right lung, which is called a pulmonary embolism. The process of the clot forming and then embolizing is called venous thromboembolism (VTE).

After I heard "blood clot in lung" I stopped listening and started crying. People DIE from this. People like my very own grandmother. Before I could rejoin the conversation about my course of treatment, I had to take a few moments to curse my terrible luck and (probable) genetic link to clotting disorders. Thankfully, the nurse was kind enough to give me an ativan so I could once again form complete thoughts....

To be continued...
(Next chapter: Treatment)

So what if I am limping so badly I can barely stand up? I'm cool, man.

Look at my swelling. I SAID LOOK AT IT!

In the middle of April, I was hospitalized for being crazy (completely different, yet hilarious story.) About a week after getting of the hospital, I started noticing pain in my leg that felt much like a strained muscle. It wasn't getting any better, it wasn't getting any worse so I chose to ignore it.

As anyone who has spent time in a mental institution can understand, a doctor's office is the second-to-last place I wanted to be (the first, of course, being the mental institution). Anyway, who goes to a doctor for a pulled muscle? They would probably laugh at me.

When you have a strained muscle, you expect the pain to diminish day-by-day until it is completely healed. With the leg pain I was experiencing, it was not getting worse but it was not getting better. During this time, it was suggested to me that I could possibly have a blood clot. Being the person I am, my response was something like, "meh, meh, meh, blah."This conversation continued over the next few days until I promised to go to an urgent care center after I ended work for the day.

It is terrifying to think of how close I came to being not-ok (aka dead).

On the afternoon before my promised doctor's visit, I experienced the scariest chest pain of my life. It was sharp, like a knife puncturing my chest cavity, and was terrifying, although it only lasted about 20 seconds. When I regained my senses, I realized I was very close to passing out and I was short of breath.

The funny thing about this is that I was carrying my lunch, which consisted of a greasy pepperoni roll, back to my office. I remember thinking, "of course I have to have a heart attack while I am carrying probably one of the most unhealthy lunches in the history of lunch." When I laughed at the joke I told myself in my head, I felt like I would be ok. One can't be amused while they are dying, right? Stupidly, I finished the rest of my shift at work but went to the emergency room immediately after.

EDIT: My bff, Creeps, who drug me (kicking and screaming) to the ER just reminded me that I wanted to go to dinner before going to the hospital. The pepperoni roll I ate during the day was being digested and my stomach wanted something else. Creeps compromised by buying me a bag of Sun Chips and a Coke from the hospital vending machine. 

And this is where my adventure begins....

TO BE CONTINUED