It’s World Thrombosis Day.
I wrote this on August 12, 2016. I share it every year on October 13.
My chest hurts. It’s not a “Call 9–1–1. There’s something really wrong here!” sensation. It’s a “something’s not quite right.” I know the difference.
Eight years ago, August 13, 2012, I was admitted through the ER to the cardiac ICU step-down unit for a pulmonary embolism that, unbeknownst to me, had tried for months to kill me. It did not succeed.
Shouldn’t a PE have symptoms? Sometimes one has a burning, throbbing ache in the calf, symptomatic of a deep vein thrombosis (DVT). A smaller chunk of dead, clotted blood breaks free and travels through the venous system and lodges in the lung. I’m a cyclist and a gym rat. My legs always hurt.
Sometimes one has a raging pain in the chest. One Olympic cyclist I interviewed for an article on PEs and athletes described the sensation as “it was like someone was ripping a chef’s knife through my chest.” My chest didn’t hurt. Maybe a slight twinge but not so you’d notice.
I was definitely short of breath. When I had to rest on the golf course between a shot and the 20 yard walk to the cart, when I had to stop on the landing on the way upstairs, I knew something was wrong.
I called my doctor, an old friend from my ski racing days in college. I came to the office. He took an x-ray. We stood in the hall and looked at the film. I didn’t need to be a radiologist to recognize that the film was not normal.
“Mark, that doesn’t look good.”
“No, Dave. It does not look good at all. Sit tight for a sec.”
He ordered a stat Doppler and the CT scan at a nearby lab. After the exams, I was sitting in the exam room when my cell rang.
“Dave, you are going straight to the ER. No, there is no discussion. Don’t go home. ER, Dave. Stat. Do nothing else.”
“Mark, should I be scared?”
“No, but you should be very concerned.”
I walked into the ER, and had barely said my name when I was swept up by a nurse pushing a wheelchair, rolled into a room, and hooked up to cardiac monitor and a heparin drip. For the next 36 hours, I was not even to leave my bed to poo, so concerned were they that my clot might break free. I spent 6 days in hospital.
I saw the CT scan. It wasn’t one clot. It was multiple clots scattered throughout the upper left side of my chest. Picture a British Navy cat o’ nine tails in my chest. Walking Dead, indeed. At the time, there were around sixteen different known clotting disorders. I had none of them. I’m still on Coumadin, 4 mg once a day for 2 days. 5 mg once a day the next. Repeat. I’m not dead yet.
But I digress.
My chest hurts. It scares me a little. Feel for your left collarbone? Slide your finger towards the center of your chest until you bump into your sternum. Count down three ribs. Right there.
On Tuesday, July 26, 2106 (I know this because I’ve kept a training journal since 1979. Want to know my work-out on May 17, 1982? I can tell you.), I was doing supine fit-ball pullovers in the shed I lovingly call my gym. For pull-overs, you lay across the ball on your back. You grasp a dumbbell behind your head with both hands. Keep your elbows straight and pull with your torso muscles until the dumbbell is overhead. I felt a pop in my chest. Not a muscle pop, but a rib-sternum pop. It happens.
I’ve had one before. It stings a little. Take a deep breath, sometimes you can feel it. Sneeze, you can definitely feel it. Roll over on it at night, it might wake you up. It’s called costochondral separation. I have a very mild case.
But it scares me. Here’s why. That spot, three ribs down? That’s exactly where the main body of my PE was centered. That’s exactly where the slight pain caused by my PE was focused.
My body can’t tell the difference. Ergo, it sends the signal to my deep reptilian brain that things are not right. It’s an awesome phenomenon; the subconscious mind’s memory of a long ago dissolved clot that can stimulate the exact same sensations of fear in a totally unrelated, and pretty much benign, injury.
My chest hurts. I’m scared. And that’s why.
Today is World Thrombosis Day. Be aware.
Now You Know:
PEs are the #1 drop dead killer of otherwise healthy individuals. You have an aching, burning calf and/or chest pain, shortness