Friday, January 4, 2008

From blood clot to baby...the whole story.

I mentioned in my first blog that I would tell the story of my blood clot sometime. Today, I had my finaly hematologist appointment before the birth of baby, so it really made me reflect on my whole ordeal. I guess I should put my story in print.
In the summer of 2006, I decided to work the extended summer program in my school district for the pre-school handicapped class. The summer was going great. I had two classes of really adorable kids, 2 wonderful aides, and looked forward to a nice change of pace. These feelings of ease and relaxation were quickly replaced with anxiety and fear as the third weekend of July rolled around.
As we did many weekends in the summer especially, we'd make the trip down from our place outside Trenton to visit Bry's mom and go the beach. As we went to the beach on Saturday, July 15 my chest was really uncomfortable. As I attempted to lay on my towel in the sand, it felt like someone was standing on my ribs. I also noticed that when I took a deep breath in or laughed or coughed it felt like I had a side stich. Being a former distance swimmer, I knew those pains quite well and just figured I pulled a muscle. We went back home and relaxed. That night, I attempted to sleep on the couch the pain continued to intestify. I couldn't get comfortable and felt like my muscles must be spazzing. As Saturday night transitoned into Sunday I promised myself I would head to a doctor if the pain continued. I kept popping advil and early Sunday afternoon we made the trek back home. The side stitch pain remained, varying in intensity, and it felt like I had a huge knot in my shoulders. Being the awesome husband that he is, Bryan took to massaging my shoulders with Flex-all. When I asked how big the knot was in my shoulder, he commented that he couldn't really feel one. Looking back now, I realize that should have been a sign for me. Exhausted, I popped a few more advil and attempted to get some sleep. Around 1 am, as my night owl husband watched t.v. downstairs, I woke up with the most horrible chest pain I have ever felt in my life. It literally brought me to my knees. I SHOULD have went to the ER then, but my brain starting to question the pain. Was I being hyperchondriac? I popped a few more advil and then pain lessened. I then found a position on my stomach, with my arm across my chest which helped ease the pain. I got a few hours of sleep and woke, and got ready for another day of pre-school.
July 17, 2006 is a day I will never forget. As I made the 40 minute commute to school, the pain came and went. At one point, I remember taking my left arm and reaching it across my body almost touching the passenger seat door trying to stretch out what I thought was a muscle cramp. I get to school and immediately strike up a conversation with the school nurse. She eases my fears, saying it sounds like a muscle pull or spasm, and recommends taking Advil and using a heating pad.
Somehow I make it through until 12:30 and get back into the car to head home. I'm still in pain, but still exhausted. As I get home, I search the web for a new doctor, since we'd just moved. I call up someone who says they can see me August 10. Yeah! Sign me up?!?
Distraught and exhausted, I took another dose of advil, pulled out the heating pad, and fell asleep.
About 2 hours later, I woke up and the pain was there...still...strong...and uncomfortable. When I woke up, I just knew in my gut, something was wrong. I skimmed through the internet again and found a doctor's office just around the block that had walk-in hours from 5-11 p.m. Wearing a pair of grey cotton shorts, and a Roxy t-shirt I drove around the block to the office and walked in exactly at 5. I filled out the appropriate paperwork and signed in listing my symptoms as chest, neck, and shoulder pain. I was surprised when they took me back quickly.
I met Dr. Young, a new member of the practice fresh from her residency in family medicine. As I spilled out my symptoms, she nodded and said that it sounded like a muscle spasm or pull. She had the nurse do an EKG in the office to rule out any heart issues. After that, she came back and said that everything was normal, however she wanted me to go to the Emergency Room for a chest x-ray just to be certain.
As I walked out to the car, I started to cry. I got on the phone and called Bry who started giving me a hard time. Did I really need to go to the ER when this was just a muscle pull? he asked. I asked him to come home and come with me, and lucky for me, he did.
By the time we got to the ER it was about 6:15. Bryan asked if he should call my parents. Why? I asked. Everything will be fine.
After getting triaged, they moved me back to a curtained room, took some blood, and got me ready for x-rays. The nurse was great, telling me how it sounds like a muscle pull and to stop worrying. After a few hours and bad t.v. the nurse came back with some muscle relaxers and stronger pain pills. She also checked my lungs again. It was during this time as I was suppose to take a deep breath, that I noticed the expression on Bryan's face change. I could hardly breathe in deep without a sharp, shooting pain in my side. With each supposed deep breath, I would cringe and almost cry out. As the nurse walked away, my usually joking husband looked at me with a worry in his eyes as he said, you're really not okay are you?
It was around 10:30 by now and I was hungry, exhausted, and still terribly uncomfortable. I also felt bad for Bryan because he was still in his suit and loosened tie. The nurse came in again mentioning that the lab results would be in any minute and she started to talk about what I would do once I got home. The conversation stopped when the physician assistant walked in with a nervous look in her eyes.
"The bad news is the the d-dimer test is positive. You have a blood clot in your lungs, and need to be admitted ASAP".
Excuse me?
The nurse was giving me discharge instructions. Everyone said it's muscular. I have school tomorrow. I never get sick! What are you talking about, a blood clot!
Immediately I started to cry and Bryan looked dumbfounded. After moving me to a closed room in the ER, waiting for a bed upstairs, Bryan called my parents. Luckily, they only live an hour away and even more good news, my sister who was in medical school was on a break and home too. The three of them hauled ass to the hospital.
Immediately, they reviewed my chest x-rays and saw two clots, one in each lung. Two Pulmonary Embolysms. They started me immediately on i.v. heprian to thin my blood to help weaken the clot.
Around 12:30, they found a bed for me and it was around that time my family came to. I couldn't believe it. I was never sick! Hospitals were for sick people, why me?
Bryan made a run to Wendy's and seriously a cheeseburger has never tasted better! Around 1:30, my parents and my sister left to stay at our place while Bryan set up camp next to my bed on a metal framed chair.
The next few days were a blur. Every four hours my blood was being taken. Between chest x-rays, ultrasounds of my heart and legs, and even a cat scan, my head was in a frenzy. How did this happen?
I met with a hematologist, a cardiologist, and a pulmonlogist. They probed and prodded me as they asked any number of questions. I went from the girl looking for a primary girl doctor, to the girl who might need a crib sheet to keep all their names and specialities in order. The overwhelming thought was birth control was the culprit, however they didn't want to rule any other things out, so more tubes of blood were collected. It also was decided that I did not present typically most likely due to my lung capacity. My blood oxygen level never went lower, even though there were clots in both my lungs. They attribute that to my years as a distance swimmer. Thank you Seton Hall!
I don't know how i.v. drug users do it. My arms looked like a mine field and by Friday it took them 15 minutes to take a vial of blood! Once I became therapeutic on the heprian, they started me on oral blood thinner, coumidin.
I spent Monday evening through Sunday mid-morning in the hospital. I did not go back to working that summer school, and instead spent the rest of July and August recovering from the ordeal.
So for 9 months, I went to various hematologist and cardiologist appointments. I remained on a daily dosage of coumidin and waited to figure out what caused the P.E. At some point they thought I might have a clotting issue called: elevated levels of anticardiolipid antibodies. The good news is that there are relatively few side effects with this disorder. The bad news, the side effects that do occur are primarily associated with pregnancy, specifically late term miscarriage. During these few months on the coumidin, thinking I had elevate anticardiolipid antibodies, I worried if I would ever be able to get pregnant and carry a baby to term.
In June, we set up an appointment with a high risk OBGYN. While we weren't ready immediately to start trying for a baby, we wanted to know what risks he felt were there for us. It was also during this time my hematologist abruptly left the practice leaving me without a hematologist Bryan found this OBGYN because he has a history of working with women with clotting issues. We met with the Doctor, he basically said that if I were his wife, he would have me off the coumidin, so that weekend I stopped.
Amazingly, less than 2 months later, we're spending a Sunday afternoon down the shore, buying pregnancy tests so know one we know will see us, and low and behold, we're having a baby!

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