My orthopedic surgeon dubbed me his “airplane” girl, because of an ironic twist of fate (and twist of my knee!). Believe it or not, I tore the anterior cruciate ligament (ACL) in my right knee as I was getting onto an airplane in October 2006. One would think I might be injured throwing a football or playing softball, yet I was merely starting a business trip. My orthopedist and I have shared some good laughs over my unexpected injury. Even though I was nearing age 40, a torn ACL is not an expected part of a routine business trip. I had surgery to repair the tear on January 5, 2007, and I adhered to the prescribed physical therapy (PT) religiously, meaning that I kept my PT appointments, and repeated the exercises at home.
About 3 weeks after my surgery, I noticed I was having a hard time breathing, even when sitting down. This was unusual, and upsetting. Fortunately for me, my mom was at my home when I first noticed my shortness of breath. As soon as I could catch enough breath to talk, I quietly told her, so that my kids would not hear, “Mom, I can’t breathe!” I’ll never forget saying those words, and how frightened I felt. There is nothing more terrifying than struggling for breath. I called my surgeon right away, who told me to call an ambulance immediately. I knew that my mom could get me to the ER faster than an ambulance, so I asked her to drive me to the ER. In retrospect, I realize it may have been wiser to go by ambulance. My ER visit was smooth, because my orthopedic surgeon alerted the ER staff that I was coming and that I was very short of breath.
The ER doctor ordered an immediate ultrasound of my leg, and found a blood clot that went from my knee to my groin. The CT scan revealed a lung clot, a pulmonary embolism (PE), so I was immediately started on blood thinners to treat my clots. All of us breathe in and out every moment without even thinking about it, until we can’t catch our breath, which in my case was due to my PE. I learned quickly that breathing is not something I can take for granted.
The blood clot in my leg was more than likely related to my knee injury and surgery, although it formed “under the radar.” I did not have any symptoms from my blood clot, despite its size. A piece of my undetected leg clot broke off and traveled to my lungs, which is why I was so short of breath, my first noticeable symptom. I did not feel any chest pain, even though it is also a common symptom of a PE.
I was not given any blood thinners after my surgery, but ever since I developed a PE, my orthopedic surgeon has a protocol to give blood thinners to anyone he assesses as “at risk” for a blood clot. He is taking a very proactive approach to prevent DVT (deep vein thrombosis). I took blood thinners for a year and a half after the blood clots in my leg (DVT) and lungs (PE) were diagnosed. I wore compression stockings for a period of time, but stopped doing so, because they were “hot, hot, hot.”
I only learned about complications of DVT and how compression stockings are key to prevention of post-thrombotic syndrome, after I first submitted my story to National Blood Clot Alliance, and I plan to discuss this with my primary care doctor.
I take blood thinners whenever I have a procedure. I recently had an endometrial ablation, and took an injectable low molecular weight heparin (blood thinner) before it. I chose ablation over a hysterectomy, because of the risk of blood clots with surgery.
I now know that a pulmonary embolism is a very serious condition that takes up to about 100,000 lives each year in the US, and needs immediate medical intervention. I was one of the lucky survivors, and was overjoyed to find out six months after mine that I was pregnant. My pregnancy extended the time I was on blood thinners, (again, low molecular weight heparin) that I took throughout the nine months of my pregnancy plus three months afterward. I was tested for clotting disorders by my primary care physician, and none were found. I still do short business flights, about 2 hours each, three times a year. Now I pray whenever I fly, but also do heel toe exercises and circles with my feet to keep my blood flowing, and I do wear my compression stockings on a plane.
Now that I am nearing my mid-forties, I realize that I will have to re-think how I will handle impending menopause, because my history of blood clots makes hormone replacement dangerous. I’ve had a talk with my husband, so that he is aware that even though I am willing to do everything right, such as exercising and making healthy food choices, I may be prone to the unpredictable influence of fluctuating hormone levels on my emotions and mood. I want to warn him in advance that if I seem upset, my behavior is not targeted at him. My blood clot has changed my life in many ways, and I want to make informed decisions that are best for my health, and work with my doctor to decide together what is best for me.
I feel blessed to be alive, and delighted that I was able to bring my little boy, Zach, into the world to join his two sisters. I am lucky to be here to raise my girls and their brother, who is now 2 years old. On top of the delight of living through a safe post-clot pregnancy that produced our son, I now have a 4 month old “perfect” granddaughter, Jolie. They are so close in age, and it is so much fun to watch them grow up together.
Most of all, I can now breathe freely!
Take Home Messages
- Blood clots can occur even with a “minor” orthopedic injury
- DVTs can happen without symptoms
- It is safer to call an ambulance for transport to the ER in case anything life-threatening happens on the way
- Compression stockings are most effective when worn daily after a blood clot is diagnosed to prevent complications such as post-thrombotic syndrome
- Blood thinners to prevent clots are important with invasive procedures or surgery
- Hormone replacement therapy is riskier in a woman who had a blood clot
- Talking about healthful lifestyle choices is beneficial, both with one’s doctor and family
- This orthopedist responded proactively by adding prevention of blood clots to his surgery protocol