A sudden shortness of breath

August 4th, 2009

Late last week, on Thursday or perhaps Friday, I noticed that I was winded after walking the stairs to the first floor of our apartment. I have felt tired for some time now, but winded from a flight of stairs is something I usually am not. Yesterday I took the boys shopping and had to stop and rest as we walked home from the bus-stop, a walk of all of three minutes that I make nearly every day.

I started a new birth control pill two months ago, not out of any reproductive necessity but in the hopes that it would even out my increasingly severe PMS – the last lingering symptom, I think, of the post-partum depression and anxiety I suffered through last spring. I remembered blood clots can be a side effect of birth control pills, though Dr. Fantabulous and I both thought that would be unlikely in my case since I suffer from a Factor VII deficiency. But I ran through in my mind a list of the warning signs he had given me: leg cramps, especially in the calves – yes; headache – yes; chest pain – yes; shortness of breath – oh my, yes. I called Dr. Fantabulous’ office only to find him on vacation. The other doctor in the practice recommended magnesium, lots and lots of water, and to wait and see how it was in another month. I made an appointment to see Dr. Fantabulous when he returns from vacation. I hung up the phone.

I had a panic attack. I called R at work, asked him to come home. I sat on the kitchen floor and asked Small Boy if he knows what to do if something happens to Mama when Dada isn’t home. “Ob Unfall, Feuer, einerlei, in Notruf whale ich eins eins zwei” he recited.* Thank you, two dozen fire department books we have in the house.

R came home. I explained the story, explained that Dr. Fantabulous was away, that I didn’t know what to do next, that I was scared. He called the emergency room and explained the situation and asked if we should see our GP or what.

They said to come to the ER. Now.

We called the in-laws to come stay with the boys. We went to the ER. They got me into a bed right away. They drew vials and vials of blood right away, they administered an EKG and ordered a CT. I had to wait nearly two hours for the CT and by the time it was my turn I had convinced myself that I had just wasted 10,0000 Swiss Francs worth of medical tests over a panic attack. The CT results came quickly – five, perhaps ten minutes – and confirmed multiple pulmonary emboli in both lungs.

I said, in all my bi-lingual eloquence: “Wow. Really. Wow.”

The doctor, who would give brusque a bad name, said the hematologist would be in to see me and left. Really. The entire conversation proceded thus:

“The CT confirms multiple emboli. We’ll need to start therapy right now with a shot. The hematologist will be in to see you.”

“Wow. Really. Wow.”

“A nurse will be in to give you a shot.”

And she left. And I started to cry. And I had a dozen questions. Am I at immediate risk for a heart attack? A stroke? Am I at long term risk for pulmonary hypertension? Am I going to die this year? The Boychen is just starting to talk, am I going to die before I get to hear him say I love you?

The hematologist came in and talked me down off the ledge, explained the treatment (anti-coagulant drugs I have to inject daily for the next six to twelve months depending on how I respond, follow up visits, and those charming compression stockings), explained how little risk there is now – now that we know about the emboli, now that treatment has begun – of serious long-term consequences.

Now that we know. I have been walking around with these emboli that could take me from my sons for who knows how long and didn’t even know. I’ve been painting, decorating my studio in my mind, making lists of all the house and garden projects to start on at the new house, writing poems and ordering books on line, and all the while these emboli – these things – have been digging in and stealing my breath.

Breathe, I tell my boys when they are scared or hurt and crying too hard to stop, breathe. Look at me. Look at Mama. Breathe. As always, I find it easier to dispense advice than to follow it even if it is my own. But it is the only advice there is. Breathe.

* Whether accident, fire or anything, in an emergency I call 112