I am officially through 3 months of Pulmonary Embolism recovery exercise and working toward my 4th month. While my general trajectory for recovery has been positive the journey through this process has been rough on me.
I don't want to ever come off as complaining about all of this too. I am grateful that I'm not in the hospital and that I am out exercising. My goal here is to explain my situation for my own sanity and so others can reference from it if they are experiencing anything like me.
Painful and slow describe the first month. This is after I spent my required amount of time sitting in the hospital (1 week) and at home on the couch (3ish weeks) without any physical activity. I just sat, kinda laid around, and attempted to really uncomfortably sleep (ie. no sleep for me).
The idea during this first month of recovery movement was to handle the pain of my infarctions, slowly let them heal, and to actually use my lungs again.
Literally, I had to re-learn how to breathe.
While in the hospital my lung function fell below 10%. I was breathing so shallow that both lungs partially collapsed (the 2+ liters of fluid surrounding them didn't help either). My first month of Pulmonary Embolism recovery was about learning to use my lungs again. Literally, I had to re-learn how to breathe. And breath deeply.
So I spent my first month building up stamina and my ability to walk for longer periods of time. I did most of this on soft surfaces like sand, trails, and the grass. I was determined to start my recovery process exactly as the doctors had ordered. Slow and steady progress would surely come.
And the progress did come. Week after week I found I could walk just a little bit longer and was just a bit less dizzy each time. I was able to work myself up to 40 and 50 minute walk durations. The process was painful but optimism was very high.
I should add that all through this first month of recovery exercise (which started about a month after my PEs were found) I spent a lot of the time exhausted, sore, and unable to communicate well. I couldn't move my body very well due to all the pain and soreness, and too much movements through my lungs and diaphragm resulted in crazy, sharp stabbing pain due to the infarctions. It was ouchie all the time.
Month 2 in my Pulmonary Embolism recovery process saw me extend out the duration of most walks and I was slowly able to increase the intensity. By "intensity" I just mean I could hold my heart rate at a reasonable level and walk faster. Nothing was actually intense about what I was doing.
Ok, I guess I tried to make walking an intense activity...
I started my first walks easily in the 20+ minute per mile range for pace. By the end of month 1 I was able to hold myself in the 15 to 17 minute per mile range. Now during month 2 I was working into speed walking (for me) pushing some miles into the 13 minute per mile range. There was no running happening here. This was all speed walking.
I wore a heart rate strap every day. I had no idea how to gauge my relative perceived exertion (RPE) with my new heart rate levels post-PE. For the longest time my 'walk-heart-rate' at 13-20+ minute pace was easily as high as when I'd previously been running somewhere in the 6 minute per mile area. My new fitness level was a whole different world for me to adjust to.
So how did I feel during month 2 of PE recovery? I felt antsy. Walking wasn't cutting it as far as my need to de-stress, regulate hormones, and clear my mind. I found myself feeling like the walking itself wasn't hard enough any more. I was averaging 1 hour, 7 days a week for basically the entire month. I probably took one day off during month two. I wanted progress and progress doesn't come without consistency. So I was going to be freakin' consistent. I was just walking after all (yes, I know I was essentially unable to walk for a period of weeks).
Generally speaking my lungs felt ok. I was probably at 50-60% lung capacity at this point. The infarcs were still there and they still hurt but the hurt was much duller now. I could string together sentences in a conversation without getting too tired and I could start doing some core movements if I was careful. Things were absolutely improving.
Month 3 started the run intervals. I started by breaking up my 1 hour walk with an attempt at :30 seconds of "running" every 10 minutes. So :30 run / 9:30 walk. The interval seemed reasonable to me. I even asked my Pulmonologist if that was ok... after I had already done this for a week and Christa was going to smack me for not asking the doc first.
My body felt lethargic, over-weight, stiff, horrible, terrible, no good..... you get the picture. I did it though. I ran a touch faster than I was walking. I guess it was actually a jog. Maybe. I don't know the difference really.
I started with :30 / 9:30 and worked toward 1 minute of running and 9 minutes of walking, then 1:30 running and 2:00 running. I wasn't running fast but I was running. I would rotate days between just walking and using a walk/run interval. I tried throwing in some run intervals for consecutive days but that usually beat me up so badly I couldn't function very well for the rest of the day.
The biggest improvement I felt during month 3 was the ability to laugh again. I distinctly remember a point when Christa and I were watching a movie or TV show and I laughed with no sharp pain. It felt amazing.
Up until that point any movement like laughter or coughing was typically pretty painful and would put me on the floor hunched over and grabbing my ribs like I couldn't do anything to stop the pain. This time around the pain was super dull. Score!
But back to exercise! One day during month 3 I decided I felt "ok enough" just keep running past a 3 or 4 minute interval. I think I made it to 10 or 11 minutes. I was thrilled. This was my new strategy, run until I couldn't.... then walk.... then run until I couldn't, rinse and repeat.
I wasn't fighting pain issues at this point it was mostly about getting light-headed and my body just being really out of shape for running. I just kept pushing and pushing until I finished an entire run one day. Then I finished more runs. And now the vast majority of my exercise tends to be running with very little walking.
Well no shit, of course this recovery is going to take forever. Some people, after they experience what I did, would still be in the hospital right now, or re-admitted at least once. I'm doing ok, I'm still not there yet though.
I can run through most workouts these days but when the humidity is higher or I feel more run-down there is still plenty of walking. I am yet to swim (mostly I just don't want to quite yet) and I haven't ridden past 45-minutes yet (mostly because I get too tired too quickly on the bike still).
The pain is all but gone. I have very light discomfort in my ribs from time to time but it's barely noticeable.
The thing that gets me now is the freaking fatigue, sweet baby jeebus. I'm soooo tired all the time and most afternoons I'm struggling through burning eyes and just general exhaustion. Like, what gives!?
After scrolling through a million posts and board on the internets it looks like I'm not alone in my fatigue struggles. There is a pretty common theme among most survivors of PEs that they experience varying levels of fatigue through a year or two of recovery. Yeah, please don't sign me up for that. This exhaustion is for the birds.
With patience. Sooo much patience. A dose of humility helps. You should probably add two scoops of understanding for those around you helping you through all this. And finally, add another sack of patience.
My life since I was a young child has just been a series of events and circumstances that have forced me to be more patience, more centered, and more contemplative. Every time I experience a new medical issue I'm forced into a situation that requires a lot more patience than the last time. When I finally work through one situation I always think, "now I'm prepared for anything". And then I find out how wrong I am, again, and again.
The point I'm trying to make here is that Pulmonary Embolisms and everything that comes with them are fucking awful. But you can do it. You can get through them. It does get better with time (friends and family help too of course). If you can be patience and do the work necessary (or at least most of it) you will get through this. And hell, if I can do it, you can do it.
You will get through this and be stronger for it so you can manage the next crazy thing the universe throws your way.
Through all of this, you will have patience. Your bestest bud.
And hey, since you've made it this far you should check out my latest Youtube video about my recovery (latest as in the video I shot before I published this post):
Have patience. Today is a good day :)
March 16, 2021