It’s been Two Years.


I am two years into my recovery from a DVT and subsequent massive PE that occurred in early June 2012. The incident left me reeling – not only physically, but mentally and emotionally as well.

It is difficult to explain what this recovery was like. It was not like taking six, eight or even 12 weeks off for a stress fracture or shoulder surgery. It’s not like having the flu or bronchitis or pneumonia that just won’t go away. It’s not like fighting an infection or a nagging running injury. No matter how much you think it might be, it’s just not. What it is like (so I’ve been told via comparison) is going through chemotherapy, recovering from a heart attack or learning to live again after a stroke. Cancer. Heart Attack. Stroke. Blood Clots. Except recognition of the last one comes far less often than the predecessors.

Public awareness of the signs, symptoms, risk factors and effects of blood clots are are not widely known, both is the public and medical sectors. Yet, blood clots kill an estimated 300,000 Americans each year (source), which is more lives than those claimed by AIDS, car accidents and breast cancer combined. Blood clots are also the leading cause of preventable hospital deaths. Every six minutes someone in this country will die of a PE, or blood clot in the lung. The lifelong effects of a DVT, or blood clot in the leg, can be devastating and far-reaching ranging from constant pain and swelling to skin ulcers physically and PTSD emotionally. Often, a diagnosis of a DVT or PE is a result of an underlying condition, sometimes previously unknown, such as hereditary or autoimmune clotting factors, lupus or cancer. Sometimes, the diagnoses of a DVT or PE comes as a result of pregnancy, sitting for long periods, smoking or weight gain. Sometimes, the diagnosis of DVT or PE comes out of the blue. Blood clots can happen to anyone, of any size and physical ability, at any age.

At my two-year follow-up, my hematologist stopped what he was doing and said to me, “You look like I imagine you did before this happened to you. I didn’t know you then, but I imagine this is more of the real you.” He was silent for a moment and then continued, “I just don’t see many people come back from as ill as you were. You’re really lucky to be here.”

Two years post-PE, I would agree that I am physically recovered from what happened to me. I can breathe without oxygen, walk without assistance and get out of bed every day. While I am not back to running yet, I feel like I could start exercising to the best of my ability again. Before this time, the desire to even try was gone. To say I am “healed” is another story. I will constantly need to have my blood monitored via intravenous draw (weekly to monthly) to monitor my blood clotting levels due to the disease that caused them to go awry in the first place; manage medication; deal with continuous pain and swelling in my affected leg, chronic fatigue and constantly be under the watchful eye of specialists for diseases like Lupus, mixed connective tissue disorder and rheumatoid arthritis, not to mention another clotting incident. I know running saved me physically. I believe training for long distances and being healthy before this happened is what helped my body physically overcome what is the worst thing to have ever happened to it.

Two years post-PE I would agree that I am very much in the middle of recovering from the emotional and psychological trauma of DVT and PE. I am nowhere near recovered from that – and I don’t yet anticipate when I will be.

Talking about what happened to me and advocating for increased blood clot awareness has become a primary focus in my life. I find that most people do not know what a DVT and/or PE is and if they do, they do not think it is something that could ever happen to them. I find that the athletic and health communities in particular – communities that I am still very much engaged in – are particularly unaware of the dangers associated with blood clots. Perhaps most frightening is that people just do not know what the symptoms of these conditions are, more proof that we need more awareness. I am grateful to have recently had the opportunity to share my story and awareness efforts in an interview with Everyday Health as part of my ongoing efforts. Please read and share!

While I have come so far in my recovery, I have some distance to go, but I know there is hope for the future. Hope that I will continue to recover and hope that the world will get out about blood clots, their symptoms and their devastating, often deadly effects. And, while I will always face the burden of health and an uncertain future in terms of it, I know I also have much to be grateful for. I am one of the lucky ones who survived.

Tell me about you. What has been the toughest recovery period of your life? How have you overcome physical struggles? Mental struggles? Did you previously know about DVT and PE?

Until the next mile marker,

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The Long Run

Today marks the second month anniversary of the event that yet again changed my life forever. On June 3 my husband rushed me to the hospital late that Sunday night with excrutiating pain in my left leg and lung. Early Monday morning on June 4, I was admitted to the hospital with a clot deep within my left leg from which a piece broke free and lodged in my left lung, causing a pulmonary embolism (PE). Both were more serious than I could have ever imagined. I was hospitalized for a week and could barely walk on my own in the hours and days after my admission. I had IV’s, oxygen and spent what seemed like countless days in the cardiac intensive care unit. My recovery since then has been slow and at times, painful.
I am eternally grateful that I am here given one in three people die from a pulmonary embolism.
I may be alive, but I am nowhere near out of the woods yet. Given the severity of the trauma my body experienced and the complications from various blood disorders that followed, my doctors told me I could expect to be in recovery months if not years after my discharge. Not to mention what might happen if something goes wrong.
Late last week I mentioned I wanted to train for and run a local 5K in August.
Yesterday my body decided to remind me that it has a long way to go before we’re up and running again – literally.
Wednesday afternoon and evening I had pain on my right side – in my lung – that hurt primarily when I took a deep breath or tried to lay down. While it was painful, it was nowhere near as painful as the PE; yet, I initially thought I pulled a muscle running that day. This felt like a pulled muscle and wasn’t gone when I woke up yesterday morning.
I admit I panicked slightly. I don’t think I can handle the pain of another PE. I called my doctor who got me in for an emergency CT scan at his office. I was terrified I would ultimately end up at the emergency room, which is where he initially recommended I go. Thankfully there was a last minute cancellation at his office. Did I mention how much an IV hurts going in when you aren’t high on Morphine? A LOT.     
It seems like it took forever to get the results of the scan. “Good news!” the nurse exclaimed, “You don’t have a blood clot.” Thank God.
My next concern, however, was that I was imagining the pain. I’m not, though. My right lung is filled with fluid. It hurts to breath, talk a lot, lie down, yawn, cough, hiccup or move at any pace faster than that of a snail. Again. Still.
I feel like I have taken a giant step backwards. No running. Again. Still. At least not for awhile yet.
My doctors don’t know why my lung is filled with fluid so I’m on prednisone until I can get in to see yet another specialist.
I feel like I’m at Mile 4 in the marathon. I made it a little ways, I thought I could do it and maybe I still can, but it’s going to hurt. Maybe I’ll have to get on a bus at Mile 22 and start all over. Or, maybe I’ll finish the race this time.
Either way, I’m on The Long Run. And I’m at the complete mercy of my auto-immune system. No amount of training, preparedness or fitness will get me to the finish line this time. It will take every ounce of strength and willpower I have just to get to the start line.
I want to run so badlyand right now it is just not in the foreseeable future. Not until they figure out what is wrong with my blood. I can’t give up hope that I will run again, though. I won’t. A running buddy of mine said it best, “I know it’s hard to start over but keep in mind most people don’t ever start to begin with, let alone endure major medical issues and then start AGAIN. You’re an inspiration, Sara!”
I hope so. My biggest challenge will be learning to inspire myself. But, I won’t give up – not now, not ever. It’s just one step at a time to the finish line. Until then, I’ll be on The Long Run, making my way back to the beginning one step at a time.
Until the next mile marker,  

In Case You Missed It:

Pace Points: Could YOU Have a Blood Clot? Learn more about my symptoms of DVT and PE and how you can help make sure you don’t have to experience the same thing!

April Showers

The day begins all sunny and bright;
It fills a young heart entirely with delight.
Then, suddenly the sky turns dark,
Like a horror movie during the approach of a killer shark.

                           -Excerpt from April Showers Bring May Flowers by Stephanie Selleck

For a month that began a week or so ago, it’s been a long one already. I know I’ve been pretty quiet on the blogging front lately. I’ve been swamped at work (and home), haven’t run in two weeks and frankly, have been dealing with a slight case of writer’s block. Then again, I don’t always find it easy to write when I’m not running because my mind is not clear, and I am not as in tune with my emotions and feelings. I can always think the clearest and write the best right after a long, hard run. If it’s not work, writer’s block or something else, it’s lack of sleep that has kept me away. Running – exhausting energy – helps me sleep too. A deep, calm sleep that I rarely get without a good run first. It is on one of the reasons I enjoy running in the evenings so much. Running does as much for my mind and soul as it does my body.

As many of you know, I went to see the doctor on Tuesday about my knee(s). It depends on the day, hour, rotation of the Earth and phase of the Moon which knee hurts for how long and why. Sometimes they both hurt. Sometimes they don’t. (Ah, those were the days). I have spent the last two weeks hobbling around, inching sideways up the stairs and sliding down stairs on my behind. I have to take a deep breath and squeeze my eyes shut before getting out of the car. Sometimes my knee throbs in the middle of the night, waking me up from an already restless sleep.

The doctor’s appointment took all of ten minutes. Dr. B. moved my left knee around, pressed on it and asked if it hurt. It seemed okay. He started to do the same to my right knee when I winced in pain and he decided not to. You can see the swelling in it now – it hasn’t gone down since the last time I ran. Before I was diagnosed with Patellofemoral Syndrome or Runner’s Knee, which is an aching pain around the kneecap (mine is a result of a biomechanical imbalance which causes a misalignment). Now I am diagnosed with a worse case of Patellofemoral Syndrome or Runner’s Knee, which is an aching pain around the kneecap (mine apparently has turned to a gristle-like substance). The fat pad under the kneecap is inflamed, hence the swelling and additional pain.

With Physical Therapy (again), Rest (still), Ice (more), Compression (regularly) and Elevation (now) I will live to run another day. I may, however, have to move into a refrigerator box down by the Olentangy River due to my PT bills. April sure did bring on the rain showers.

Don’t run when it hurts; run when it doesn’t. Strength train. And then strength train some more. Seems like a simple solution to an ever-nagging problem.

The 21st of April will mark the one year anniversary of my mother’s unexpected passing. Has it really been that long? Yes? No? Sometimes it feels like it was yesterday, the pain is so fresh, so raw; and yet, other days, I can’t remember something small about her and I feel like it has been decades. April is dumping now. I do, however, remember every single solitary detail from that day and I am dreading re-living it this year. I don’t know what to expect. I mostly wish I could crawl into a hole and come out with May flowers.

April showers do bring May flowers, right? And for everything ugly we must face, there is something beautiful waiting, just below the surface. I can’t let myself believe anything different.

Until the next mile marker,

Views from the Road:

Pace Per Mile host Chris Nicholas, is running across America to raise funds for the Children’s Miracle Network Hospitals. He is currently on Day 12 in Chillicothe, Ohio and has run over 300 miles so far!

Follow Chris’ journey and see more Views from the Road with Pace Per Mile or Run and Finish. Please donate; 100% of the proceeds will benefit Children’s Miracle Network and stay withing the community from which they were donated to help local families and children. No amount is too small to help make a difference in the life of a child today.

Be a part of the event HERE!

Are YOU Running Inspired?

Little known fact about me: My running career (if you want to call it that) actually began in middle school. I joined the Cross Country team in 7th grade only because it was not called Track and therefore implied I did not have to be fast. Then I found out the team name was the Huskies and once again worried about the fast part. I was pretty sure there were not any slow Huskies hanging around. I ran Cross Country for a season or two, I was slow – usually last to finish – but I had fun. I had friends on the team and looked forward to spending time with them (someone tell me exactly how that is different from today). I joined the marching band in high school and didn’t really think twice about running.
In college, my roommate took Running as her gym credit and I thought, “Seriously?! She’s going to run for a semester?!” Ugh. I took swimming instead and then I took weight lifting. Anything to avoid having to run around campus. That sounded too hard and she was getting up before the sun. Not me. After college, I made several attempts to start running (it was never start running again), but never followed through. Most notably was when I signed up for the Columbus Half Marathon several years ago and then drove my car from my house to work one day and noticed that my odometer said 10.9 miles. Not even a half marathon? Not hardly. I never even made it to that start line.
In 2009 I started running again, this time training for a half with the help of a training group, Marathoners in Training. And, I guess you could say it stuck. Often times, I look back on what was different about that time than all the others. Why did I keep running? I firmly believe it was because I had the encouragement, advice, support, guidance and instruction from top-notch coaches and veteran runners to help me. They taught me to run. Without MIT, I felt like just another idiot trying to run laps around the park with absolutely no idea what I was doing. Who knew you had to learn to run? Apparently not me.
I get a lot of questions about running – people want to know how I run, why I run, where I run, do I run by myself or with friends, what do I wear, what do I eat, how far and how fast but mostly, other people want to know how I started running and how I stick with it. I am fortunate enough to have access to an awesome training group and many experienced runners and coaches, but I also know that not everyone is so lucky. For people who aren’t in Central Ohio, I wish there was a place I could direct them, a good resource for a good running start. After all, there is no reason for us not to run. It is simple, you don’t need a lot of gear, it doesn’t have to be expensive and anyone can do it. Yes, anyone.
I was recently given the opportunity to read and review The Ultimate Beginner’s RunningGuide: The Key To Running Inspired by Ryan Robert. Enter my great resource! In fact, Ryan’s book is written for people who want to get off the couch and get running.

As Ryan sums it up, his book will help the beginning runner:
  • Run with good form for maximum efficiency and to avoid injury.
  • Build a powerful mental training program that includes a running journal and visualizations.
  • Select the right shoes and gear for different conditions and weather.
  • Eat simply, with suggested menu items.
  • Get past embarrassment and being self-conscious.
  • Prevent and treat common running injuries.
  • Find support and encouragement in the running community.
What I like most about Ryan’s book is that it is simplistic in nature. If you are looking for great detail or have been running for years, this book is not for you. Who is it for then? The complete beginner, someone like me who is going from nothing to jogging a few days a week in an effort to maybe lose weight, get in shape or maybe take on a new challenge. In fact, Ryan’s book offers several training plans based on multiple reasons why someone may take up a running program: Active Beginners, Non-Exercisers, Weight Loss, and People 50 and Over. I wish I had copies of this book to hand out to people when they say, “I’m too (fat, old, busy, slow) to start running now.” If it can be done (which it can because I did it), Ryan will help you find the way.
For someone who has a lot of experience running, this book may seem too general or not detailed enough, which is what I first thought when reading it. Then, I thought back to myself when I first started running – I literally had no idea what to do if there was a raindrop, let alone if I had an ache or a pain. Proper footwear? What on earth does that mean? I have tennis shoes, right?
While reading, I immediately started to change how I was approaching it. I imagined myself back, almost three years ago, when I didn’t know anything. What would my old self have wanted to know more about? It was then that I realized this book is an all-inclusive guidebook for the beginning runner. In fact, I wish I had multiple copies to distribute to my new running friends.
Some of the topics that I found particularly helpful were Mechanics, including proper running form, stretching (with examples), heart rate and training zones (I really wish I knew more about this in the beginning) and the importance of proper footwear. Ryan also talks about self-consciousness while running and how to overcome it – definitely worth the read! Once you get the basics down, the book goes into a little more detail about improving performance with hill running and staying motivated. Finally, Ryan discusses nutrition, hydration, how to run in adverse conditions (rain, hot, cold, wind) and common injuries, including treatment. Ryan in no way claims to be a doctor or medical professional, but gives you enough information to determine if you have a serious injury as well as some basic tips to alleviate pain and determine whether or not you should keep running without further medical advice. All of which are invaluable for the first-time runner.
On a personal note, I found Ryan’s nutritional guidelines especially valuable because they are very similar to my own personal nutrition (when I am fully on track) even though I feel like I seldom find anyone who agrees with me. He promotes a clean diet (free of processed, boxed and sugar-laden foods) and encourages the consumption of complex carbohydrates including whole grains and pastas as well as vegetables. What I value is that Ryan encourages increasing the amount of proteinwe ingest when beginning a running program. I have to pay particular attention to this because of my insulin sensitivity – I must pair a complex carb or a simple carb (such as fruit) with a protein to aid in proper digestion. I find a lot of runners back off on protein, especially before a long run, but I feel like I am often doing just the opposite! Ryan also discusses alternative protein sources (and I do get tired of meat) like beans as well peanut and nut butters. He includes simple meal plans to get you off to a healthy, inexpensive and simple start.
So, I know from time to time I get new runners following my blog. This book would definitely be a great resource for you to get off the couch and get moving! You can find it through HERE. It’s only $2.99 and you certainly can’t beat that. You can also visit the book’s Facebook Page to stay up to date.
Until the next mile marker, 


Now What Do You Do?

Congratulations! You’ve crossed the Finish Line of your very first half marathon. You trained for weeks – months even – and now you are done. You savor your triumph. It is not every day someone runs a half marathon, after all. You wear your medal to work, in the car; you may even sleep in it. Go ahead! After all, you earned it! Your hours and hours of hard work, training, eating smart and running have paid off into one fantastic race day.

And now it’s over. Just like that.

Now what should you do?

Recovery has to be an integral part of your training, and it begins the moment you cross the finish line. You must recover so that you can run and race again.

Take the first five or ten minutes after you cross the finish line and keep moving with easy walking – this can easily be the time it takes you to walk through the chute, collect your belongings and meet up with your family and friends. Walking at an easy pace allows the body to come down more gradually and circulates blood back to normal distribution quantities and regions on your body. It prevents fainting and blood pooling in the legs that occurs if you immediately sit down post race. It also allows your body to process the lactic acid that builds up during the race.

While you’re walking, start drinking the first liquids that are put into your hands. Keep drinking (small sips) even if you feel nauseated, you need to replace the fluids your body has lost. Sipping water is fine, but make sure you find a recovery drink such as Gatorade or fruit drinks to replace your body’s glycogen stores. Avoid diet soft drinks and alcohol – they do not offer any benefits to your body. I like to drink Chocolate Milk because it offers the perfect ratio of carbs to protein (4:1) for recovery.

After your walk, get off your feet! Sit down – or better yet – lie down and prop your feet up, easing the flow of blood to the heart. Many runners even stretch (gently to avoid further trauma to the muscles) horizontally. Your body will let you know what feels good.

Within an hour after your finish, you need to start thinking about eating some solid foods. A banana is beneficial because it is soft and easily digestible, plus provides extra potassium to your cells. They are my favorite post-race food as a matter of fact – I get upset when they are not available so I started carrying one or two in my bag just in case. As you progress throughout your day, start eating balanced food again. You need to replace the glycogen your body has burned. A 150 pound runner needs about 300 calories an hour to effectively replace lost glycogen stores.

When you get home (or back to your hotel) you may want to take an ice bath to relieve sore muscles and start returning your body to a normal body temperature. Take a cool shower instead of a hot one to further decrease muscle inflammation. Within 24 to 48 hours, you may want to get a gentle massage to help push waste products out of the body and regenerate healthy blood flow.

Next, take a nap or at least try to, for a couple of hours. I never have a problem with this. I could sleep all day after a race, but after three or four hours, you need to eat again – this time a full meal. Your first post-race meal should resemble your last pre-race meal. You need carbohydrates and protein. I usually crave a steak after a marathon or half marathon, and I make sure to pair it with extra bread, potatoes or pasta to make sure I am consuming adequate carbs. Remember, even high carbohydrate diets have some  protein in them, so don’t be afraid to eat the meat!

So, what about running? The most common post-marathon mistake is resuming training too soon.

Take one week off running and let your body heal. Research indicates that recovery is speeded and conditioning is not affected if you rest for 7 to 10 days after your race. Yes, take one week off running. Although the stiffness subsides in a few days, there is still internal healing happening and running too soon increases the chance of an injury down the road.

After your week off, you can begin cross-training easy for 20-30 minutes during the week and focus on flexibility, if you feel like you need to be active. Cross-training will also help to increase circulation to the healing muscles without major impact and pounding.  Gradually increase your mileage similar to a reverse taper. Start back running limiting the weekly mileage to only 25% of what it was before taper started. The next week go to 50%, then 75%, then back to full mileage. The general rule of thumb is to take one day for every mile to run easy and not race. Meaning, take 13 days of easy running before racing or running hard again.

To summarize: Drink plenty of fluids, carbo-load after the race (as well as before), and don’t start running again too soon.

The bottom line? You know your body best. If you are experiencing aches and pains or sore, take more time to rest. If you get sick, this is not uncommon since your immune system has taken a severe hit, rest until you are better. Listen to your body, recovery is important to keep you running happy and healthy for a long time to come.

Another important part of post-marathon healing is recovering your mental health, yet is one of the aspects of training that people do not seem to talk about very much. You may experience not only physical, but mental fatigue if not mild depression. This is a normal part of racing! Not much can be done except for you to understand it is normal, sleep more if you can and don’t exert yourself physically or mentally. Many scientists believe this mild state of depression is a result of depletion of neurotransmitters in the brain.

There is a wealth of information about post-marathon recovery. Two of my favorites are The Lore of Running by Tim Noakes, MD and Marathon: The Ultimate Training Guide by Hal Higdon. You can find a great deal of information and apply it to your specific situation.

Until the next mile marker,