Misdiagnosed With Asthma: Carlos’ Story

Misdiagnosed With Asthma: Carlos’ Story

My experience with deep vein thrombosis (DVT) and pulmonary embolism (PE) started in June 2010 when I was 37 years old.  My symptoms began a couple of days after I returned to Miami from a two week trip to Israel with my wife and best friends.  I felt a sharp pain in my left calf that I assumed was just a cramp or stiffness from being on a plane for over 15 hours.

My calf pain disappeared in 2 days, so I didn’t give it any more thought.  About a week later, I started having difficulty breathing while I was exercising.  This worried me because I am someone who exercises rigorously 5 times a week, without any noticeable shortness of breath.  Exercising in summer in Florida can be tough, but I knew that my symptoms were probably not due just to the heat.  The critical moment came when I couldn’t run 5 feet without feeling like I was drowning.

I visited a cardiologist the following month, who did a stress test and an echocardiogram.  I was told that my heart was perfectly fine and I was in excellent physical condition.  He told me there may be a problem in my lungs, so recommended that I see a pulmonologist.  The pulmonologist diagnosed exercise-induced asthma, and prescribed two inhalers to use when needed.  I used my inhalers for about a month, and thought they helped a little bit, but I was still feeling winded fairly easily during exercise.  I figured this was my new normal, since I was assured it was asthma.

In mid-September, I noticed my left calf was swollen and red.  Since I played tennis and exercised the prior weekend, I thought I might have overdone it and pulled a muscle.  When I went home that night I put ice on my calf, kept it elevated, and wrapped it in a compression bandage.  It went from bad to worse within two days.  The swelling became more pronounced and my foot began to swell.  After an unsuccessful attempt to see my primary physician, I drove myself to the ER.  They immediately ordered a scan of my leg that revealed a DVT just below the back of my left knee.  When I mentioned my breathing symptoms, they scanned my lungs, and the scan showed PEs in both lungs.  I was admitted to ICU, where I stayed for 24 hour observation.  All of my doctors were fantastic, and I was started on heparin and warfarin immediately, and stayed in the hospital for 5 days.  I had pain and swelling in my leg, and was unable to bend my leg for several days.  My vital signs were fine, and I do not have any blood clotting disorders.

I have resumed exercising and stopped blood thinners, which I took for six months.  I am very fortunate to be able to share my story, and it is certainly not lost on me that things could have turned out very differently.  I realize that I am here because of God’s mercy, something for which I am thankful every day.

While my life hasn’t changed greatly since my DVT/PE experience, I have taken some steps to prevent a possible recurrence.  I make sure to stay very well hydrated and have started wearing compression stockings daily, because my lower left leg sometimes becomes swollen after a long day.  When I am on an airplane, I also make sure to wear the compression stockings.  And most importantly, I get up and walk around during a long flight.  The in-flight magazines list exercises you can do to get blood circulating in your legs.  So next time you are on a flight longer than 4 hours, GET MOVING!  In fact, it is wise to do heel toe exercises and move your feet in circles while you are in your seat, at regular intervals.

Take Home Messages

  • Pay attention to unusual shortness of breath and seek medical help as soon as possible.
  • Get a second opinion when symptoms persist after treatment, in this case, inhalers for exercise-induced asthma.
  • Wear compression stockings after a DVT.
  • Get up and move at regular intervals during travel that is longer than 4 hours.
  • Do heel-toe exercises and move your feet in circles when seated in a bus, train, or plane on trips over 4 hour.  Stop driving or riding and get out of a car and move around at regular intervals.
  • Drink fluids and limit alcohol during travel over 4 hours.
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