Pulmonary Embolism

DECEMBER 2009 
Once upon a time I got a blood clot in my lung. The official name for this terrifying occurrence was a "pulmonary embolism". Thankfully when it happened I was in the best place possible: the hospital. I was literally in the process of being discharged from a week long hospital stay when the clot moved in my lung, making it hard to breathe. With a heavy weight in my chest I panicked, "I can't breathe, I can't breathe, I can't breathe." I thought I was having a heart attack! At first the nurses didn't take me seriously. (After a stressful week of IV steroids, sleep deprivation and getting poked with needles, I had become a dramatic patient.) Yet in that moment I knew something was VERY wrong. Instead of getting discharged from the hospital, I was rushed off for scans. 

A WHAT??
A Pulmonary Embolism happens when a cluster of blood suddenly blocks an artery in the lung. The blood literally clogs an important passageway. Symptoms include shortness of breath, chest pain, and sometimes even coughing up blood. Pulmonary Embolisms often arise from a blood clot that started in leg veins and moved to the lung.

HEPARIN SHOTS AND COUMADEN
The scans revealed a blood clot in my lung, which meant that I would spend a few more days in the hospital. Promptly the doctors treated the clot with a fast acting blood thinning drug called Heparin (also known as Lovenox). This medication treats and prevents further blood clots. Oh, and it causes crazy bruising at the site of injection!

Hit by a bus? Nope, just by Heparin!

Once discharged from the hospital I continued the shots from home. Actually I couldn't manage it, so I made my mom shoot me instant bruises. (Thanks, lady!) I was also put on a regimen of Coumaden (also named Warfarin). While taking these tiny white pills I was very closely monitored by a place called the "Anti-coagulation Clinic". At this outpatient center they prick your fingertips and/or draw your blood every couple days to determine what dosage of pills to prescribe. It didn't take long for me to become annoyed with the constant pricking; I was running out of non-bruised fingertips to play my guitar with!

RESTRICTIONS
There are a few rules to follow while taking blood thinning medication. 

*No spinach!* Silly as this sounds, its a serious rule to follow while on blood thinners. Spinach contains high amounts of vitamin K, which can have an interference with blood thinning medications. 
*No "dangerous" activities!* Defined as: any activity that could result in potential injury. In my case, snowboarding was banned because without my normal clotting abilities, I bruised very, very easily. In theory this meant that my brain could bleed to death if I crashed hard enough. I think the Anti-coagulation Clinic would have preferred me rolled up in bubble wrap.

Pssshaww, superheroes don't crash!

SUSPECT CAUSES:
There are several reasons that a person might form a blood clot, but I'll just list the factors I believe caused mine. ..
Strike #1: Inactivity. Prior to my hospital stay I literally lived on a couch for over a month. I was having a bad flare of Ulcerative Colitis at the time and well, IBD leaves very little time to react to toilet urges. I laid on that couch for weeks hoping that the oral steroids I was taking would kick in. (For the record the 'roids didn't turn the flare around.) It is a well known fact that if a person's legs are horizontal for too long, it slows blood flow and may cause the blood to group in the legs, which can lead to a blood clot. Dun dun dunnnn.
Strike #2: Supplemental Estrogen. As a teenager I had the WORST menstrual cramps in history and would nearly pass out from the pain. Taking birth control pills helped lessen the severity of the cramps. Unfortunately, scientists have found a link between the estrogen in birth control pills and clotting factors. 

#3. Strike #3: PICC line. 

A PICC line is a route for Intravenous (IV) access, which can be used for an extended period of time. While an IV only lasts a few days, a PICC line can last much longer. During my Colitis-related hospital stay I had a PICC line inserted into a vein in my arm. I've since learned that when a PICC line is removed, it sometimes causes a clot! This makes a lot of sense in my case; one of the final things done before to my (almost) hospital discharge was have the PICC line removed. Just minutes later I was gasping for breath. Coincidence?

HIGH RISK

Black & blue arm from Heparin shots

Regardless of what caused my P.E. I'm now labeled "high risk" for future blood clots. Research shows that once you've had one blood clot episode, you are more likely to get another at some point in life. This means that I'm not allowed to take supplemental estrogen ever, ever again. In addition any time I'm ever hospitalized I'm given Heparin injections as a preventative measure. Man, I had some colorful arms to show off during my three intestinal surgeries! I looked pretty tough...or pathetic...maybe both? 

IN THE CLEAR 
After 6 months of taking Coumaden I was finally cleared to stop taking it altogether. YAY! However I'm told that if I ever get another blood clot, I'll have to take Coumaden pills for the rest of my life! Why such strict rules?? Well guys, its not safe to tango with blood clots. Often a Pulmonary Elmbolism can lead to a stroke or permanent and irreversible damage or even death! Clots can kill a person if blocking a major artery for too long. Yikes! Experiencing a Pulmonary Embolism and enduring 6 months of treatment was a scary chapter in my life. Yet after the chapter ended, I had more reasons to praise Christ for his faithfulness in my life.

"The Lord will rescue me from every evil attack and will bring me safely to his heavenly kingdom. To Him be glory for ever and ever. Amen" 
-2 Timothy 4:18 

Everyday Sunday "Breathing For Me"