I am a 56+year old male. I have occasional asthma, primarily exercised induced. If I notice asthma symptoms while working out, I can usually push through them and finish the work-out, although I do use a bronchodilator when I need to.
I am an avid martial arts devotee – black belt in one style, brown belt in another style (working to black). I do some weight work (not heavy lifting), occasional pull-ups and about 30 push-ups every other day for strength training. I typically train for about two hours 3 times per week.
Martial arts involve repetitive kicking and punching. We punch and kick a heavy bag to develop power in our techniques.
Recently, I noticed what looked like a big purple bruise on my left outer bicep, which I ignored. The next day, I noticed my left arm was a little sore, but I attributed it to my routine of pull-ups and/or karate. Once again, I paid no attention. Five days later, my arm was still sore and noticeably swollen, but it was not really painful and I was able to move it in all directions.
I went to karate on that day anyway, and did a full 2 hour work-out without noticeable aches, pains, or shortness of breath. I worked up a good sweat, which is normal. During that particular practice, I worked on the punching bag. The next day, my left arm felt sore and was sensitive to touch from my left elbow up to the center of my armpit.
I could feel the vein underneath my armpit, and it felt like a rope. I thought I pulled a tendon, so I took it very easy on my left arm while I exercised two days later. This was another 2 hour work-out, and other than being slightly winded by the end of practice, I did not feel any discomfort or pain. My breathing returned to normal within a few minutes after the practice. That same evening, my left arm was noticeably swollen, but there was still no pain. It still felt like muscle soreness.
My left armpit was very swollen and the vein under my armpit still felt very rigid and very sensitive to touch. I saw my doctor ten days after my first symptoms, and she ordered an immediate ultrasound of my left arm. It showed a “massive” blood clot in my subclavian vein. My doctor sent me immediately to the Emergency Room which was on the next floor. The doctor there ordered a CT scan that showed 5 clots in both sides of my lungs.
They also did a heart ultrasound that was normal, as were my blood pressure and heart rate. I was not experiencing any chest pain or shortness of breath, despite my diagnosis of pulmonary emboli. Nevertheless, I was immediately admitted into the hospital and began low molecular weight heparin and Coumadin® treatment that night. The final conclusion is that my clot was “idiopathic,” which means there is no specific cause. I was discharged two days later.
I do not know exactly when the blood clots broke off and traveled to my lungs, or how many days I was actually walking around with a pulmonary embolism. I’m not even certain when my “massive” blood clot developed. All I know is that I had blood clots in my lungs that got everyone’s full attention, mostly my own.
I have no abnormal issues with my blood-no familial or genetic predisposition to blood clotting, nor is there is any family history of blood clotting.
I have already seen a blood specialist. She had nothing more to add to my very limited understanding of this. I am planning to get a second opinion. No doctor is willing to advise me as to how soon I can resume my normal work-out schedule. At this point, I have been on blood thinners for almost three weeks. I have read that “within 2-4 weeks” I can likely begin training, but I am sitting this out until I can get more definitive medical advice.
I am trying to get answers from my doctors. I have been reading like crazy. Thus far, doctors have dismissed my questions because they tell me that blood clots very rarely happen to “healthy” athletes. I see blood clots as a serious issue that does not get enough press.
I believe that there are many people like me out there who may think they have a routine sports injury when in fact they have something much more serious. I feel very fortunate that I had my symptoms checked out, even if I did wait for a number of days. This is like having a ticking time-bomb strapped to your chest. From what I read, there is up to a 30% chance of the bomb going off and killing a patient with an undiagnosed pulmonary embolism. What if I didn’t go to the doctor? I definitely would have continued going to the gym according to my usual routine. Would I have made it? Would I be around to write my story?
Take Home Messages
- Seek medical attention for symptoms that seem like a muscle pull or soreness, especially when they seem to get worse, since DVTs often appear in that way.
- Persist in asking questions of your healthcare provider if you think you are not being heard, or your questions seem unanswered. It may help to write them down and to have a close family member or friend who can help you get answers.