There were two finding that bordered on being useful and I’m assuming their border-line nature is the reason they want to run the whole battery of tests again. There were some indications of a possible Protein S deficiency (which affects less than one percent of people in the United States*, so it kind of figures that that would turn up since it seems beyond unlikely that somebody with Factor VII would end up with emboli in the first place.) Apparently I might also have a Vitamin K deficiency, which can lead to the Protein S deficiency. However, a Vitamin K deficiency can also inhibit blood clotting – and the fact that those two things coexisting makes absolutely no sense to me at all is why I am not a hematologist. Furthermore, nobody can explain how I came to have not just a thrombosis but a full-blown embolism (more than one, in fact) in spite of having an underlying condition that inhibits blood clotting. One would think that it would have been almost impossible for me to end up with emboli, but apparently I am some sort of medical oddity and it’s time to call in Dr. House.

I also seem to be developing an allergic reaction to my anti-coagulant, which is a heparin solution that I inject daily. Under ordinary circumstances drug therapy in the aftermath of an embolism, or prophylactic treatment in the case of a diagnosed clotting disorder, is quite simple: there’s an oral anti-coagulant. Under certain circumstances (pregnancy, for example) people can’t take the oral medication and have to inject. Other conditions for which the pill form are contra-indicated include Factor VII, so I’ve been injecting my anti-coagulants since August 3. Which on its own has been no fun, but to make it worse I suspected I was having some sort of reaction to the Fraxiforte quite some time ago, what with the swelling and the welts and the kind of itching that would send a horse running off a cliff in crazed agony. The blood test confirmed this with some anti-body level (that’s about as specific as it gets, I’m afraid) that should hover at around 4% (of what, I do not know) charting in at about 35%. So yeah, I’ve developed an allergic reaction to my anti-coagulant.

All of this leaves me sort of nowhere. I’ve been given a prescription for several massive doses of Vitamin K to take before the next round of blood tests. I’ve been switched over to a different anti-coagulant – the one other one I seem to be able to use – until the next round of blood tests. I’m to keep going on as I’ve been going on until the next round of blood tests. And we’ll see if they show anything.

And then I’ll call in Dr. House.

* For purposes of putting me in a medical chart, the fact that I was born in the US to parents who were also born in the US and then spent the first thirty years of my life in the States over-rides my Swiss residency.

The blood work is to try to find, or not find, a cause for my embolism. The doctor running my intake paper work was the same nice doctor from my ER visit; not the brusque one who told me I had multiple pulmonary emboli in both lungs and then left but the nice hematologist who came in afterwards to clean up her mess, the one who talked me down out of my panic, the one who drew little pictures of lungs and circulatory systems on a loose piece of paper and explained to me why I shouldn’t worry about a stroke, about an aneurism.

The phlebotomist who drew my blood was kind and cheerful, chatting away while deftly switching vials, distracting me with questions about my kids, about where I’m from, if I have Heimweh (homesickness, though a more literal, and literary, translation is pain; pain for home). People see my name – I never changed it to R’s über-Swiss last name, it was too much trouble and anyway to this day I don’t think I pronounce it quite right – and they hear my book-German and they know I’m not from here. They ask how long I’ve been here, they complement my German, they ask if my boys speak English or German. They are always pleased to hear “both,” say what an advantage the boys will have with English as a mother tongue, say how good it is that they can speak Swiss with the other kids. They are always nice to me. Switzerland is gaining a reputation as Fremdfeindlich (xenophobic) – hm, perhaps campaigns like this have something to do with it? – but people are always nice to me, curious. I am, of course, the “right” kind of foreigner, but that is a post for another time. For the woman drawing my vials of blood it was probably a godsend, my Ausländerin status – something new and different to chat about as she distracts yet another patient from the sixth, seventh vial of blood.

And then it was over. She gave me a bottle of water and told me to go straight to the cafeteria to eat something. (I disobeyed, took the five minute bus ride here instead). She said it would probably be two weeks, a little longer, before my results come. There will be a letter. In two weeks, a little longer.

In two weeks, a little longer, the Boychen turns two. In two weeks, a little longer, there will be a letter, telling me a little something – or nothing at all – about  the rest of my life.

I couldn’t find my key.

There was no paper on the toilet paper roll.

Boychen mashed a brown lump of Play-Doh together with a purple lump of Play-Doh and now we have browple- colored Play-Doh.

The boys and I missed a bus. (This is not a big deal, it’s Switzerland after all – there’s another bus in six minutes.)

My husband offered to pick up Small Boy from the grandparents’ so that I didn’t have to.

I special-ordered compression stockings and started crying right there in the pharmacy.

Small Boy and I found a dead songbird and set it under a tree and covered it with leaves and branches. “Good-bye, pretty song bird,” we said.

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