Pulmonary Embolism

[squatpuke]

Hello all...

I'm 41 y/o male, 6'2", 260lbs, 15%bf....married, 3 kids.

I tore my left knee's meniscus about a year ago (MRI revealed later)...didn't get an MRI or anything at the time...just "toughed it out". Did see a PT, but the knee pain lasted for SEVERAL WEEKS until finally it started to ease back.

During that time, I had a week of excruitating pain in my left calf that I thought was muscle cramping from the severe limp I endured. The PT tried various stretches and deep tissue massage and it went away on it's own after about a week.

TWO MONTHS later, I was back lifting and was able to make it back to the ellipticals (no treadmills yet). It was at this time that I had a VERY hard time getting oxygen. I simply thought I was so outta shape from the not working out, I let it go a few days...

Finally, I saw a doc, who immediately thought I should go to the ER with what he called a "pulmonary embolism" (blood clot in lungs). After numerous tests, Ultrasounds and Cat-scans, it was concluded as a PE. However, the med profession can't confirm it's origin. Most think it was the calf pain; that I had a DVT that broke off, traveled through my heart and into my lungs. I would like to believe this is the cause, but since there is no conclusive evidence after MANY various tests, I'm left wondering. This leads to some pretty extreme anxiety about my health, despite the fact that I'm in pretty good shape. Every little ache/pain I get caused mental anguish as to a clot, or what type of death I'm about to go through.

It's been a year now, I'm pain free, off the coumadin and my bench is stronger than ever; I can hike and even light jog now...but I'm still worried about my health....and worried about getting the knee fixed (or even if I should bother).

Anyone have any suggestions for me?

 

[musclemom]

I don't have any suggestions for you but I will tell you my ex husband, at the age of 21, suffered a PE as a result of a skiing accident. It was his first time ever trying it, and it was a severe twisting injury to his knee. He was in a stiff knee brace for a long time (shit, I don't remember how long). About a week or so after the injury a PE traveled into his lung. It pretty clearly came as a result of the knee injury. He never had another one so it was a fluke thing. Granted, his happened within reasonably short time of his initial trauma so there was clear cause and effect.

One thing I'll tell you, being in your 40s sort of predisposes you to thinking about your mortality. It's gonna happen soon enough and there ain't shit you can do about it so take reasonable measures and don't worry about what you can't change. As for the aches and pains, most of it comes with the territory.

You probably had the thing from back when you first tore your knee and it finally dislodged. If you want to get your knee fixed, the doctors will keep extra tabs on you knowing you suffered a previous embolis and can take steps to preventing another one.

 

[guest username]

The majority of PE's come from the lower extremities. Those that don't originate in the pelvic, renal, subclavian, or upper extremity veins. The chances of developing a PE from an upper extremity DVT is low (around 15-20% if memory serves me correctly), but subclavian and internal jugular thromboses have a higher risk. The risk approaches 60-80% with pelvic and femoral DVT's.

I'm hoping you had a hypercoagulable workup (protein C/S deficiency, antithrombin III, cardiolipin antibodies, etc.

I've had a PE before. Went on an emergent mission in the Middle East. Flew over there, did our thing, came back all within 3 days. I was so tired from not sleeping a wink that I crashed on the plane and didn't move for the entire flight. Woke up when the plane landed, had calf pain, stood up, passed out, and then had chest pain and shortness of breath. Ended up in the ICU getting thrombolytics, heparin, and placed on warfarin for a year. Had to stop the warfarin and do Lovenox shots whenever I was sent overseas again. Fun times!

 

[squatpuke]

They took a LOT of blood while I was in the ER...it was for some kind of blood study...

Doc said they were testing for heredity things that would cause me to have stickier blood....there were about 10 tests in all (I'll see if I can find the names)...they were all negative, which also surprised the doc. As well, I had chest-xray, 2 lower ultrasounds, 2 CT Scans, an adomininal ultrasound, an echo-cardiogram, and an EKG...supposedly everything was a-ok. They did ask me if I was on steroids (never have been)...hehe.

I was in ER for a day, then moved to the cardio floor for a few days...was on lovenox for about 15 days until coumadin kicked in (wifey was a sport doing those stomach injections)...had a tough time with coumadin going up to 18mg before my PT/INR hit 2.0...then tapered off to 13-14 for my 6 month therapy.

Another thing that bothers me is the two-month delay from the calf-pain and the PE. Could a clot really have stuck around all that time then broke off and traveled into my lungs?

I do remember NOT wanting to walk at all...it hurt so bad, I have a deskjob so I'm sure I was sitting alot, not gettin' that blood flowing!!!

As well...I was drinking high-potency "green smoothies"...a wifey breakfast morning special, with lots of spinach and kale (Vitamin K). Probably had 4-5 of those per week...

Live and learn I guess....as long as I live to learn that is....

 

[guest username]

I've seen people with symptoms of a DVT for a year and then come in with sudden chest pain that turned out to be a PE. It takes about 6 months for a clot to fully dissolve while on warfarin, and up to a year to dissolve without it. Even though your genetic profile was negative for hypercoagulable workup, it doesn't mean you don't have a genetic condition. We just haven't discovered it yet probably.

Do you do a lot of driving? What about sitting in an office all day long? I've seen people who drive an hour each way develop DVT's/PE's, sit in an office chair for 8 hours a day, and in one person, a World of Warcraft marathon of 24 hours straight left him with a DVT.

 

[squatpuke]

Not much driving...about 20-30 minutes to work each way.

I do work in IT, but usually never sit more than an hour at a spell...I'm conscious to the fact I need to move. As well, I work at a university health center...so I have first hand access to nurses and docs...get my BP and STATs checked almost weekly.

I had a 6 month coumadin therapy...and it's been almost a year since....however some shit happens that makes me think I've had a reocurrance. For instance, I ran about 50 yards from my truck the other day and was REALLY outta breath...got me thinking, worried and anxious...ruined the rest of my day. Went to the gym that night and got on the treadmill....I jog/walk quarter mile intervals and my breathing and heart rate were the same as always...yet mentally I just sometimes feel defeated...like I could die any day/moment.

Other times, I'll have a bit of chest pain or tightness, or tiny pains in thighs....freaks me out in my head. I think when I get anxious, I get dizzy. When I get dizzy, I think brain clot...

Should I see a shrink? (I definitely don't want any more meds than I have too....on thyroid now and it's bad enough)

btw...here are the blood tests I had...

Lupus Anticoagulant
Hexagonal Phase Confirm (not required)
dRVVT Screen
dRVVT confirm/mix (not required)
Protein C
Protein S
Cardiolipin AB Screen
Cardiolipin AB IgG Igm
Antithrombin III
Factor V
Prothrombin Mutation
Homocystein