the terror of your heart ripped from your solar plexis

some of you are already aware, but for those of you who don't know, my wife was admitted to the hospital this past Friday afternoon for a pulmonary embolism. her "PE" was due to a deep venous thrombosis (blood clot in her calf muscle) that was released into her bloodstream and then lodged in the arteries in her lungs. PEs are potentially fatal (allegedly 26% die from them), but we got lucky, caught it early enough and she is currently on treatment.

the story:
two Fridays ago (the 4th of August) my wife woke with a searing and horrific cramp in her left calf muscle, just below the knee pit. she had just begun working out for the first time about a month and a half and we initially thought it was a cramp due to that, and maybe some of the stress from her job (see previous post). the cramp responded to Ibuprofen and was only really bad at night and in the mornings. suddenly, the cramp stopped and the calf only ached a little. It must be getting better we thought.
then, on Wednesday (the 9th) my wife began experiencing a peculiar shortness of breath. suddenly, walking the dog around the block nearly floored her. merely walking up our one flight of stairs would wind her to the point of exhaustion. she knew something was wrong.
as luck would have it (not really, but the cliche works here), her father has a history of DVTs and PEs due to a sports-related injury he received when he was a teenager. he's lived with the fear ofsuddenly dying his whole life, having been on blood-thinners (Coumadin) since he was a young man. my wife knew of his condition and wondered if she might be experiencing the same thing.

she went to see our Primary Care Physician on Friday the 11th (having cancelled a previous appointment the day before because she couldn't get out of work early enough!!). our physician didn't think the muscle pain was due to a torn muscle, or muscle fatique, and ordered an ultrasound of the calf.
my wife drove to the clinic for the ultrasound, which showed a small (1 cm) clot behind the knee. the clot most likely caused the cramp. problem solved.

but what of the shortness of breath?

our physician's husband just so happens to be a cardiopulmonologist. she consulted with him and he suggested my wife high tail it to LDS Hospital for a pulmonary angiograph CT. she was pumped with radiocontrast dye and put in a CT tube. the angiograms showed multiple emboli in both lungs!

she was admitted to the ER for emergency treatment, then admitted into the hospital for 4 days of further treatment.

we got lucky. we got lucky that my wife's father had this condition in the past and it sparked a moment of recognition (or at least worry) in her. we are lucky our physician was concerned enough to order an ultrasound of the leg. we are lucky the leg still had a small thrombus that was visible. we are lucky our physician's husband specializes in this area of the body. we are lucky we caught it early enough for treatment.

and now we are home, after 4 harrowing, terror-filled days, and are on treatment. she was given a shot of Lovenox, a low-molecular weight heparin, in the subcutaneous fat of her belly immediately upon admittance in the ER. she continued those shots every 12 hours (and still will until Thursday of this week) -- i'm the one giving her the shots, which is so horrible for me as it bruises her something fierce. she was then given Coumadin by mouth and will continue that for 6 months, whereupon she will be removed from treatment, have further genetic testing, another angiogram and we'll go from there depending upon the findings of all the tests.

i mentioned the genetic testing above. this is done to assess a reason for her DVT and subsequent PE. so far, the doctors are mystified as to the reason. the main causes of DVT (and PE) are all non-factors for my wife (pregnancy, cancer, sedation, major surgery), except for the oral contraception she is on. oral contraception is a risk factor for DVT, and the older a woman gets the more at-risk she is. however, my wife is on a very low dose, and the doctors are fairly certain (and all are in agreement on this) that the birth control pills most likely had NO play in this episode.
if that's the case, then what caused it? with everything else ruled out, the only remaining options are genetic disorders (which are very rare, but so is getting a DVT and PE at her age with no other risk factors) or just plain, dumb luck (something you generally want to avoid, but is now something we are desperately hoping for). some of the genetic tests were done while she was in the ER, and all came back from the lab while she was admitted except one -- which should be back shortly. they all came back negative, except one (Protein S deficiency), but this test could have been skewed by the clot itself (which tends to gives a false-positive result) and by the fact the blood for the test was taken after her first dose of anti-coagulant (which definitely can skew the results). therefore, she needs to be retested after the 6 months of Coumadin treatment (plus 2 weeks for normal recovery of her blood clotting factors). Protein S deficiency is extremely rare (only 0.2% of the population has it) and her father DOES NOT have it, so she most likely doesn't either, but it is a concern. if she does have it, she'll be on Coumadin for life (not a great thing as she's so young, but better than the alternative). all we can hope for is a negative on the genetic testing, and no further PE or DVT episodes. if not, at least we know what to look for and can catch the DVT early enough that it should never progress to a PE.

NOTE: she may very well have a genetic disorder even if all current genetic tests are negative. the medical establishment is finding new disorder almost daily, and very likely will find another that could cause clotting issues. obviously, we would never know about it, but it's still a possibility.

so, that's the story of our weekend. i nearly lost the one person in this world i could afford to lose least. we experienced a terror unlike any we've experienced up to that point in our lives. unfortunately, we'll be faced with such terror in the future (almost all of us will) but i hope it's not for a long time to come.

we still get waves of panic at times, but we are working on getting back into our lives. it will take some time, but it will happen eventually.

for those of you who sent us emails (and/or visited us in the hospital) we THANK YOU from the deepest recesses of our hearts. the words THANK YOU don't convey how much your sentiments and words meant. we truly appreciate it.

and we are thankful for many things: for having such good friends and family; for being able to spend more time together with each other (and with you); for gaining a deeper understanding into our lives; for being so god damn lucky; and for gaining a fuller appreciation of each other.

things will probably change in our lives. strike that. DEFINITELY change. our diets will improve. our fitness levels will improve. our stress levels will decrease. our love for each other will grow stronger. and the things we care about most will NOT be put on the back burner of the stove of life, but instead will be moved to the front.

and lastly, again, THANK YOU ALL!