Indeed, I was.
Back in Washington a few days later, I again was out of breath. But this time, I had just walked up two flights of stairs at home. Something was wrong. I opened my laptop computer, connected to Google, typed in “shortness of breath + calf pain + long flight,” and found a possible cause that turned me cold: deep vein thrombosis (DVT), or blood clotting, that could travel up to my lung and cause a pulmonary embolism, a sudden blockage in a lung artery. And that, I read, could kill me.
A half-hour later, I drove to Sibley Hospital. There, I told the admitting nurse that I believed I had DVT and cited my conditions. She checked off a box on the form for “urgent,” and 15 minutes later an ultrasound technician was looking at the veins inside my right calf.
“Oh, my god,” she said in a whisper.
“You found a clot?” I asked.
“Don’t move,” she said.
She had found two, one a large clot just below my knee. She was worried that if I moved, the clot could travel up to my lungs. An orderly wheeled me back to the emergency room, where a nurse quickly gave me anti-clotting medicines.
A doctor came a few minutes later and said that based on my story, I had almost surely had a pulmonary embolism in Manila and again in Washington. And at that moment, he said, I probably had several clots in my veins. He told me that the anti-clotting drugs would not break apart the clots — medications to do that can cause serious bleeding and generally are used only in life-or-death moments in the emergency roon. Instead, he said, I would start a regimen of two medicines— Coumadin orally and daily shots of heparin — to prevent my clots from getting bigger and further clots from developing. I was not yet out of danger, and so I would be kept in the hospital for a few days to make sure everything was okay, he said.
“You’re lucky,” he said.
Actually I felt I had been lucky twice — first in Manila and then at home.
So began my education on deep vein thrombosis. After calling my family to let them know about the diagnosis, I returned to Google and learned that 350,000 to 600,0000 Americans get DVT every year, and up to 100,000 die from it.
I found out that the biggest risk factors for DVT include surgery, immobilization, smoking, obesity, genetic tendencies to form clots (see box at right) and . . . long-haul flights. I started poking around some more and found the story of David Bloom, the NBC correspondent who died of a pulmonary embolism in Iraq in 2003. He had prolonged periods of immobility in several situations, including a long flight and time a tank during which his knees were pulled up to his chin. Bloom’s autopsy also revealed an inherited blood coagulation disorder.