I have Pulmonary Embolisms (and I'm a healthy athlete)

My name is Nick and I have pulmonary embolisms. I actually have multiple pulmonary embolisms, at least 6 per lung, this is known as bilateral pulmonary embolisms. A pulmonary embolism is a blood clot in the veins inside my lungs. The doctors don't know how or why I have them.

I'm basically the model for a healthy lifestyle too. I have no family history, thus far all my tests are coming back negative, I have had no lifestyle circumstances recently that would attribute to clots and I live the exact opposite of a sedentary lifestyle. I'm a former professional triathlete who still trains 2-4 hours/day, 7 days a week and eats really healthy.

I'm also 32 years old (technically I started feeling the symptoms of these clots a few days before my birthday when I was 31!) putting me on the extreme end of the age span for someone who could or should have a pulmonary embolism. Right now I'm an anomaly.

On one hand that's kind of fun but on the other hand that's really depressing. While I'm now on blood thinners there is no medical explanation yet for my clots so, in theory, I could develop new clots right now and they could be worse than the current dozen I'm experiencing.

*Along with my pulmonary embolisms I also have pleural effusion, infarctions, collapsed lungs, and cysts. I'll speak to some of these in those post but will go into more detail on other posts.

This post is about what sent me to the hospital, what I needed to do to leave the hospital, and what I was like when I was finally discharged. This is the first post in a series of posts helping me and eventually some others understand what is going on inside my body and how to deal with it.

I'll try to start from the beginning. I was at work on a Friday, my boss said a joke and out of the blue my ribs really start to hurt. I had been sitting a bit more than normal over the past few weeks and had been working at a computer through all that sitting so my first reaction was that I tweaked a muscle or was experiencing some weird manifestation of my current stress. I had a few more hours of work left that day and as time passed my pain levels increased. If we're talking about a scale from 1-10 I was working into solid 5 territory. Nothing I couldn't handle but certainly something odd was going on. That Friday night I tried to sleep in bed and was just not having it. The whole left side of my ribs were hating me.

The next day I woke up pretty early to get in a 3 hour trainer ride. I started the morning with breakfast and a realization that my ribs were working themselves into a 6 or 7 on the pain scale. I got on the bike anyway because I'm tough and I still didn't think this was anything more than muscle strain. I basically cried through the first hour of my bike ride trying to work through the pain and discomfort. I started thinking maybe it was pneumonia or something like a chest cold. I wasn't really coughing but I certainly wasn't breathing very well. My heart rate was up a good 10-15 beats at any given time during my ride. Again, I assumed I was just getting sick so I tried to keep watts and effort in check.

As Saturday progressed things started getting worse. I slowly stopped being able to eat or drink without a ton of pain. Saturday evening I attempted to sleep on the couch basically sitting upright all night long and sleeping for maybe 30-40 minutes at a time. At this point Christa and I were convinced this was a manifestation of stress and resulting in some pretty awesome muscle stress.

Sunday started the "spasms". The best way I can describe these acute attacks is to think about getting a "charlie-horse" in your calf muscle. You know when your calf muscle gets crazy tight and balls itself up like a softball. I started to feel like I was getting that sort of sensation rolling through the left side of my rib cage AND I felt like I had the craziest knot ever in the center of my left shoulder. I tried sleeping upright on the couch and just passed out and woke up all night long from the discomfort and pain.

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ER visit #1

On Monday I decided I should try to go to work and have a normal day. I worked to stay virtually still for the vast majority of the work day just sitting at a computer. I was in a lot of discomfort but the whole not moving thing seemed to keep the intense pain in check. After I walked the couple hundred yards to my car and within moments of beginning to drive I began to have crippling "spasm" pain through my left rib cage. I'm talking well past a 10 on the pain scale. As I was attempting to drive the tears were streaming from my eyes and I was gasping for air. I was on a stretch of road that didn't make for a safe area to pull over so I choose to drive through the pain at a controlled speed and call Christa. The call was like the type of call you see in a horror movie when all you hear are the blood curdling screams of someone on the other end being viciously murdered. This is what Christa listened to for 10 minutes as I tried to work through the pain as I was screaming at the top of my lungs and gasping for air to keep going. I felt like I might not be able to keep breathing for most of the attack. The pain was so severe I can only image it was akin to being stabbed repeated in the chest with a rusty, half-dull knife. The pain was incredibly sharp but it also lingered as I can only assume I was stressing every muscle in my torso to it's max.

This attack would eventually subside few moments before arriving at the chiropractor. I figured if anyone could help me right then and there it would have to be a good chiropractor. If they couldn't help they would surely know if I needed to go to a doctor. Not only could the chiropractor not help but his immediate recommendation was to get a chest x-ray the next day. Thankfully my wife is an incredibly intelligent woman and met me after my appointment. She figured I wasn't going to be able to make it home on my own so she took the bus to come get me and the car. We didn't make it home that night. We went straight to the emergency room to get that chest x-ray.

This is how the ER went:

"We think you might be having a heart attack... nope, we think you might have a collapsed lung... nope, we think you might have pneumonia... nope, as a last resort we will check you for blood clots in your lungs... ding ding ding we have a winner with the Pulmonary Embolisms." Ok doc, what do we do? "Well here are some blood thinners and some pain killer, just go home, see your general practitioner tomorrow and you'll get better." Umm.. ok.

Next day (Wednesday)... things get worse. Spasm attacks get worse. I can't eat. I can't sleep. I can barely walk. My breathing is super shallow.

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My very own hospital room!

Next day (Thursday)... I have an appointment with a pulmonologist. Within 5 minutes of seeing me she says "I'm sending you back to the ER, you need to be admitted, you are getting much worse". So I am admitted into the hospital.

I spend the next week of my life in a pain killer haze as I'm told it's all about "pain control" (note: I now truly understand how all of those "pain management clinics" exists in Florida and other states, I can not explain to you the amount of narcotics they were happy to pump into my body). In the picture to the left you can see my IV drip and a ton of other pain killer drips including my Morphine button drip.

So what happened between my first and second ER visit?

  1. Pulmonary embolisms in both lungs stayed the same
  2. Infarctions in both lungs stayed the same (dead tissue spots)
  3. Due to the amount of pain I was in and how shallow my breathing became I began to build up more and more fluid around my lungs through the infarctions. This fluid is known as Pleural effusion. I had a fluid build up during the first ER visit but it got much, much worse by the second visit.
  4. The bottoms of my lungs collapsed because of the fluid and because I wasn't able to breathe deep enough.
  5. My lung function fell to about 10%.

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Playing with my spirometer with my favorite nurse standing watch

How did we fix any of this?

  • Pain meds so I could attempt to breathe
  • A chest tube to drain over 1.5 Liters of fluid out from around my lungs
  • Inhaling through a spirometer to attempt to begin to use more of my lungs again
  • Time... I guess

How did I get well enough to go home?

Basically it was about not needing a morphine button any more, my oxygen levels staying steady as I went for a walk, and no more fluid filling into the area around my lungs after the initial fluid was drained. I'm certainly still in a lot of pain and don't have much lung function back yet but I'm generally trending in a more positive direction now.

I have soooo much more to talk about but this is the run-down of what put me in the hospital, what I needed to do to get out and where I stand right now. More to come!

I am breathing today, so today is a good day.

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By

Nick Brodnicki

March 16, 2021