For the better part of 20 years, I’ve been a runner with a capital R. Ten marathons, countless half-marathons and a heaping helping of other race distances have made me feel like a superhero, magically inoculated against life’s mighty medical take-downs.
But my cape was abruptly yanked off in early September when I found myself in the emergency room facing one such take-down. The words still ring in my ears: “You have a bilateral pulmonary embolism — they are significant, fairly large.” Translated: Sizable blood clots in each of my lungs.
“Ninety percent of pulmonary embolisms come from the legs,” said Dr. David Visokey, a pulmonologist with Covenant Medical Center in Waterloo. “The clots begin in the calves and migrate to the lungs” where they wedge in an artery.
In my case, they wedged bilaterally — on both sides — cutting off blood supply to parts of my lungs.
“You could have knocked me over with a feather when I saw your CT scans,” my primary care physician later told me.
Me too. It seemed so out of the blue. Except it wasn’t.
For more than two weeks I made excuses for the shortness of breath I was experiencing. Easy runs became difficult. Climbing a flight of stairs winded me. Singing along to the car radio left me breathless. On a 6-mile run the day before my ER visit, I struggled to keep up with my pack.
A pulmonary embolism is a blood clot that, most often, begins in the legs and travels to the lungs, where it becomes lodged in an artery and blocks blood flow to lung tissue.
SHUTTERSTOCK ILLUSTRATIONStill, I waved it all away because I am a Runner. Runners are good at listening to their bodies to avoid injuries and burnout. But my body was giving me grave warnings and I called it a liar.
“If you have shortness of breath that’s not normal (for you), and you don’t feel sick — you just can’t breathe — you need to seek medical attention,” Visokey emphasized. “Don’t worry about feeling foolish. Our job as doctors is to make sure you don’t have bad stuff.”
A pulmonary embolism is bad stuff. It is life-threatening. About one-third of people with undiagnosed and untreated pulmonary embolism don’t survive, according to the Mayo Clinic. When the condition is diagnosed and treated promptly, however, that number drops dramatically.
In a last-straw attempt to sound the alarm, my body delivered me the worst pain of my life. Sharp pains shot through my left collar bone and rib cage with every breath. I was terrified I was having a heart attack.
“(The clot) shuts off the blood supply to the lungs and you get what’s called ‘pulmonary infarction,’” the death of lung tissue, Visokey explained.
Meta Hemenway-Forbes prepares for a run in downtown Waterloo.
Emergency room staff wasted no time getting a diagnosis. Though I was a most-unlikely candidate, my symptoms were textbook for pulmonary embolism. ER blood tests were off-the-charts positive for markers of a blood clot. I was immediately sent for a CT scan, which revealed the interlopers that had taken up residence in my lungs.
“It’s a tricky diagnosis for a young person with no risk factors,” said Visokey.
Risk factors for developing migrant embolisms include heart disease, certain cancers, recent surgery, bed rest, long trips in which legs are immobile, obesity, smoking and supplemental estrogen, such as birth control pills. In my case, doctors believe it was the latter that put me at risk.
I will be on blood thinners for six months to prevent new clots from developing. Now, five weeks out from diagnosis, it’s believed the embolisms have dissolved, and I’ve been given the go-ahead to resume running. It’s been a bit of a struggle, physically and mentally, starting over as an athlete. But I’m counting my blessings with every deep, life-giving breath.
“This is a pretty good-sized blood clot,” Visokey said, pointing at my CT scan images. “In terms of size, you got lucky.”
I guess even superheroes need a little luck now and again.
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