Pulmonary Embolism Recovery: To ER or not to ER?

I want to rub his head for good luck. (That's what she said).

Surpassing "what is the meaning of life?" the above question has become the most profound and frequently asked by my little spark of consciousness over the last few weeks. Based on things I have heard from other pulmonary embolism survivors, this seems to be a common dilemma. So what is answer?

I haven't a clue.

When I was discharged from the ICU on 04.30.2013, I was thrown into an entirely new world in which every ache, pain, bruise, tickle, cramp, and flutter is a potentially fatal symptom that deserves immediate attention. As any anxiety-sufferer/hypochondriac will tell you, even the most seemingly insignificant unexpected bodily responses are symptoms of a disease that is murdering you from the inside out.

Even "well-adjusted" people who have suffered a pulmonary embolism rarely escape the experience psychologically unscathed. Trauma is trauma - some are better equipped to handle it than others, but it still leaves an imprint on one's mind. Anxiety is a totally normal response to an event that almost caused your demise.

So, to get back to the question - when should you go to the ER? I haven't found a good answer to this problem yet. However, the more I learn about my condition and my body, in general, I feel that I have become a better listener to my internal processes. I am becoming accustomed to the chest pain, fatigue, and shortness of breath. Over the past three weeks, I have paid close attention to the nature and duration of my pain. Deviations from the norm would be one factor that would invite me to consider the emergency room. Any new and troubling symptoms will probably prompt me to go without too much hesitation.

During my last ER visit, which turned out to be an intense flare up of my existing PE symptoms, the nurse told me that, even though they did not discover any new clots, it is never a bad idea to go to the ER when you are experiencing shortness of breath and chest pain. The fact that she said that made me feel much more at ease. I do not want to be the girl who cried wolf, but, I have decided that is better to be safe than sorry.

Also, it's not a bad idea to have a list of phone numbers you can call to ask for advice before you decide to take the ER plunge. For example, if my problems are related to medication side-effects, I will call my pharmacist. If the symptoms involve chest pain or shortness of breath, I call the nurse at my doctor's office or the NurseLine through my health insurance. These have all been effective tools to make the decision easier.

I am still figuring all of this out and will probably never develop a 100% effective formula. I am learning to trust and listen to my body and, at this point, I think this is the best thing I can do for myself.

If there are any other PE survivors out there reading this, how do you make this determination? What prompts you to go to the ER? Or what helps you calm down enough to feel like you can treat your symptoms at home?

Post title

Proof positive that there is room for improvement when implementing a plan for improvement

Irony = being too sick to go to your previously scheduled doctor's appointment. 

fml

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. 

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