I haven’t written on this blog in a long time, and for good reason. I’ve been writing books instead. Since May of 2017, I’ve written four books and rewritten five others. That’s been a very good thing, but also means other things fall by the wayside.
On Friday of last week . . . what was only six days, but literally a lifetime ago, I got the feeling something was wrong. Simple tasks, that I’d been managing for three weeks by way of crutches and a wheelchair, were becoming more difficult instead of less so. I found myself short of breath more often, and worry set in that I wasn’t doing enough, and my body was atrophying.
Saturday night, after a relatively normal day where I did more resting than moving around, I was making my way via wheelchair to the dinner table. Halfway there, I was out of breath. I felt as though I could go to sleep right there at the table. I mentioned a couple of times that I was afraid something was wrong; my Apple watch was registering a consistently high heart rate, and the shortness of breath thing was out of left field.
Sunday morning I got up, determined to do more, and thus, start working my body a little harder. My goal was to build my stamina back up. I showered, which is work when you can’t put weight on one leg, have to transfer from wheelchair to shower chair and back. From what I recall, that may have tired me, but not enough for me to remember.
A few minutes later I made my way from the bedroom to the kitchen. I remember feeling tired, and annoyed with myself for being so. I puttered around getting coffee, putting things away, and taking intermittent breaks in the wheelchair. Soon I found myself so out of breath, that I was literally gasping for air. I stopped everything, tried to get my breathing under control while intermittently splashing my face with cold water.
Once I felt as though I could breathe, I got from the kitchen to the bedroom in the wheelchair, and from the wheelchair to the bed. The extreme shortness of breath kicked back in, my skin was clammy, I was sweating, my heart rate was hovering at 150, and I had a lot of pain in my chest and back. I yelled for help a couple of times, thinking I was surely having a heart attack. At the same time, unbeknownst to me, Charlotte had felt dizzy, so she had laid down on the floor in the hallway outside the bedroom door.
When Doug ran upstairs to answer my call for help, he had no idea which of us I was calling for help for. He went back and forth between the two of us, not sure who was in worse shape.
I told him I was sure I was having a heart attack, and went through my symptoms. He found a blood pressure cuff, got me an aspirin and we discussed what we should do.
For those of you thinking, “why the hell didn’t you call 9-1-1?” Yes. Why didn’t we? In the moment, it’s harder than you think. I sent a group text to three close friends simply saying, “we need help, I think I’m having a heart attack.” One immediately called and told me to call an ambulance. When I briefly attempted to explain what was happening, she told me to hang up and call 9-1-1. About the same time, Doug was taking my blood pressure again, and turned gray when he saw the results, I was already calling. If I hadn’t been, he would’ve.
In the moments prior, I was vacillating as to whether something was really wrong or not. And Doug was reacting to that as well as trying to help his mother. It is surreal when it is happening, and I think it is human nature for us to consider waiting a minute to see if maybe we’ll be okay. Most times we are.
The 9-1-1 operator asked several questions, told me to chew more baby aspirin, and stayed on the phone with me, until the EMTs arrived. At virtually the same time, so did the two other friends on the group text.
After a series of protocols, the EMT confirmed what one friend stated the minute she looked at me. “Pulmonary embolism,” he said. I looked at her and she nodded.
The ambulance transported me to the hospital, kept an eye on me, started an IV, ran more tests, while the two friends and Doug’s mom determined she was okay, so Doug could go with me.
After I arrived at the emergency room, things started happening relatively quickly. The PA call for an x-ray and then a CT-scan, but the ER doctor said to bypass the x-ray and put me next in line for the CT.
Just sliding from one gurney to the other for the scan winded me. The scan went quickly, and I was back in the ER a few minutes before the doctor came in.
“The radiologist hasn’t read the scan yet, but the techs do enough of these that she was able to confirm you have a PE. A very large PE.”
He left for a few minutes and came back saying he’d talked to the pulmonary specialist and both of them believed I was a candidate for TPA. This is what stroke patients are given—the stuff that if it’s given early enough, can reverse the stroke symptoms before lasting damage is done.
It took longer than the doctor thought it should for me to get on TPA. I saw him fist-pump from several feet away when the answer finally came back affirmative after the twenty times he asked whether it had been delivered to the ER yet.
I was sent up to the ICU, TPA running through an IV, and essentially told not to move. At all. If I needed to move, at all, the nurses would move me. What I know now is they didn’t want the clot to move. After two hours, the TPA was finished, and I was put on a heparin drip. Based on my vital signs, it was evident the TPA had done its job and the mass of clots had been dissolved.
My heart rate, blood pressure, and oxygen levels slowly returned to “normal,” over the course of a couple days. My biggest issues were massive, debilitating headaches, nausea, and fatigue.
At some point, one of the doctors drew a picture on a dry erase board. “You had a saddle pulmonary embolism with 70 percent occlusion,” he said. I haven’t been a able to find an image as simplistic as the one he drew, nor as illustrative.
By Tuesday, they were ready to move me out of the ICU, and into the cardiac-moderate-care unit. Once I moved, I had fewer restrictions, and was slowly able to start eating solid foods again.
I was taken off of oxygen, off of the heparin drip, and put on blood thinners in pill form. I learned that I can no longer use crutches, just going a few feet on them resulted in a huge hematoma under arm. This is the life I’ll need to get used to as long as I’m on blood thinners, probably for six months. I’ll bruise easily and something like a minor car accident could be devastating.
As I was listening to the nurse going through discharge instructions yesterday, I realized that there wasn’t much I needed to do or not do, with the exception of the blood thinners. I knew the statistics, I knew I was one of the few lucky ones who lived through such a significant PE. So, why wasn’t this harder?
“You’re very, very lucky,” she said, looking me in the eye. “You aren’t like any other PE patients I see. Most can’t sit up without fatigue. Most are in far, far worse shape than you are.” When my eyes filled with tears, she said, “Heather, most don’t live.”
Okay. I heard that. It’s still difficult for me to process . . . that I came that close, but now feel really “okay.” It’s miraculous. Truly. The combination of getting to the emergency room, and having them administer TPA right away, is why I’m okay. It was all about paying attention to my body telling me something was really wrong, and then getting to a place where medical professionals could help me.
I don’t remember which day or night it was, but at one point, Doug was sitting next to my bedside and told me what he’d learned from researching a saddle PE. “Only one to two percent recover without an damaging effects,” he told me.
I’m in that one to two percent. Grateful. Thankful. And acknowledging, at least on a clinical level, how lucky I am. I expected to “feel” it more, and maybe it just hasn’t hit me yet. I’m still thinking it should be harder.