Could YOU Have a Blood Clot?

One of my running friends said it best, “It would be nice to know how to tell the difference between muscle pain and the type of pain you felt. Or maybe the really scary thing was that you couldn’t tell?”

I’ve been thinking a lot about that. And yes, one of the really scary things was that I honestly had no idea the pain I was feeling in my calf and lung was anything to be that concerned about until it was almost too late. That being an acute blood clot known as deep vein thrombosis (DVT) and a pulmonary embolism (PE), which developed as a result of a complete autoimmune meltdown. Why you ask? Because my immune system mistakenly produces antibodies against certain normal proteins in my blood, also known as antiphospholipid syndrome. You can read more about my hospitalization and diagnoses here and here.

The truth of the matter is we are all runners, cyclists, walkers, lifters – athletes – and we have learned through racing, training and pushing our bodies to the limit that pain is not only acceptable, but sometimes just the way it is. I know, I’ve struggled with Patellofemoral Syndrome (a.k.a Runner’s Knee and yes, everything really is a syndrome nowadays) all but the first year I ran. Knee pain for me? Completely normal, something I’ve had to live with if I want to run. It hurts worse at times, feels better other times and with no apparent rhyme or reason can totally make or break my run. And, I’m not alone. Most runners I know and run with seem to struggle with some sortof ongoing pain, injury or bodily malfunction.

We see each other in the Physical Therapists’ waiting room and don’t recognize each other because we are dressed normally. “How was your run?” becomes “How’s your PT going?” or “How’s that knee holding up lately?” We live with pain. In fact, some people might even argue it’s what makes us real. I thought that at first, Yes! My first running injury. I’m a real runner now! Um, no. That got really old, really fast and yet; we still run, bike, swim and tear up the gym with pain. Push through. Get over it. What doesn’t kill you makes you stronger. You can run 26.2 miles with pain, what’s stopping you now? You’re fine. Walk if off. Rest, Ice, Compress and Elevate. You know all the right things to say to yourself.

Given all of this, it only makes sense that when we have real pain that we need to be really concerned about, we shrug it off. We’re runners, right? We live sometimes everyday of our lives with an ache here or a pulled muscle there. We run long on Saturday and hobble around on Sunday and Monday (and maybe even Tuesday if you’re like me) until we’re recovered. Why are you walking like that? Someone asks us at the office. I ran 22 miles on Saturday (meanwhile we’re thinking, I bet you didn’t). And we go about our day, proudly displaying our battle scars.

Looking back, now? Yes. I should have known something was wrong. Really wrong. I blamed in on my knee.

The pain was different.

First there was the leg pain. I had been complaining about leg pain for a couple of weeks or so. I distinctly remember telling Duane, not only did my knee hurt, but my calf hurt too. I told him this pain extended down into my ankle and bottom of my foot. The thing that was different is this pain was not as a result of running. I had it even when I didn’t run. In fact, when I ran, I noticed it less.

I have always had a discolored left leg:

June 2012

You can see the brown, which now looks like freckling, but before this incident, it turned almost purplish. In fact, the other thing that makes my situation complicated is that I have had more than one doctor look at my leg for the discoloration. It had been discolored ever since college, from what I can remember. I even had a biopsy on the skin about two years ago in which a dermatologist determined it was a pigmentation issue and not cancerous or anything like that. Even my gynecologist was fascinated by the color of my skin and listened to my blood flow. No one ever heard a disruption of blood flow. Hence, no one assumed it was a clot. I didn’t have varicose veins, either, further indicating a blood clot was out of the question.

DVT Causes:

  • Slow blood blow (often due to lying or sitting still for an extended period of time – such as in the case of a long plane ride or car ride)
  • Pooling of blood in the vain often due to immobility, medical conditions, or damage to valves in a vein or pressure on the valves, such as during pregnancy
  • Injury to a blood vessel
  • Clotting problems due to aging or a disease
  • Catheters placed in a vein

Symptoms of a Deep-Vein Blood Clot (DVT):

  • Swelling in one or both legs
  • Pain or tenderness in one or both legs, which may occur only while standing or walking
  • Warmth in the skin of the affected leg
  • Red or discolored skin in the affected leg
  • Visible surface veins
  • Leg fatigue

DVT can partly or completely block blood flow, causing chronic pain and swelling. It may damage valves in blood vessels, making it difficult to get around.

Half of all DVT cases cause no symptoms.

My Symptoms:
  • Swelling in one or both legs
  • Pain or tenderness in one or both legs, which may occur only while standing or walking
  • Warmth in the skin of the affected leg
  • Red or discolored skin in the affected leg
  • Visible surface veins
  • Leg fatigue

What I Felt:

Excruciating pain that extended from the back of my knee down to my ankle whenever I put any amount of weight on it. I was nearly dragging my leg by the time my husband and I went to the hospital. I have said it previously and I will say it again because it is the only way I can describe it: It felt like someone had the soft, fleshy skin behind my knee in a vice and just kept on tightening. Runner’s Knee caused me to hobble, caused me to scoot down stairs, sidestep curbs and grimace when getting in and out of the car. Runner’s Knee never caused pain in the back of my leg. Also, the side of my calf was tender to the touch, but not overly warm, now I know that soreness was primary along the femoral vein. I did not notice any swelling, especially in my lower leg. My knee is always slightly swollen to being with. I will note, remember Goofy when I was limping at Mile 4 of the full marathon due to my severe kneepain? It wasn’t knee pain. It was this pain that caused me to slow to the point of being pulled from the course and after a three hour plane ride and countless hours on my feet after that, I’m not at all surprised in hindsight.

I just wonder how long this clot had been building. It is terrifying to think about.

Then there was the side pain. I texted Judi on Sunday when she asked how my knee was doing, “Sore but okay. The weird thing is my left side. Hurts when I breathe like I can’t catch my breath. Slept propped up. No idea what the hell happened. Started mid-day yesterday.”


Symptoms of a Pulmonary Embolism:

  • Shortness of breath that may occur suddenly
  • Sudden, sharp chest pain that may become worse with deep breathing or coughing
  • Rapid heart rate
  • Rapid breathing
  • Sweating
  • Anxiety
  • Coughing up blood or pink, foamy mucus
  • Fainting, lightheadedness or dizziness
  • Heart palpitations
  • Signs of shock

Pulmonary embolism may be hard to diagnose because its symptoms may occur with or are similar to other conditions, such as a heart attack, a panic attack, or even pneumonia.

Also, some people with pulmonary embolism do not have symptoms.

My Symptoms:

  • Shortness of breath that may occur suddenly
  • Sudden, sharp chest pain that may become worse with deep breathing or coughing
  • Rapid heart rate
  • Rapid breathing
  • Sweating
  • Anxiety
  • Coughing up blood or pink, foamy mucus
  • Fainting, lightheadedness or dizziness
  • Heart palpitations
  • Signs of shock

What I Felt:

I honestly thought this was a really bad side stitch. Only, it got worse over time. A pretty good indicator that it was not a side stitch was that it did not happen while I was running. It happened much later in the day once my body had a chance to relax. As time went on, the pain became nearly unbearable and not only that, it became hard to breath. I could not lie down at all – the pain was excruciating.I never really felt chest pains, but I did feel like someone was jamming their thumb into my rib cage. My breathing became shallow and I could only say two or three words at a time. The best indicator? I could not draw in a deep breath – very similar to when you are trying to catch your breath during a hard or hot run, but it doesn’t go away with rest or pain meds. One of my doctors told me, there should have been a moment in time when I realized I couldn’t breathe (when the clot entered my lung and obstructed air flow); however, I think this happened when I was taking my nap and I didn’t know the event had occurred. If I had been up, walking around or running errands, I may have noticed it as it happened and thought differently about it. Although this was serious, I am convinced my symptoms did not feel more life-threatening because thankfully my heart was not affected by the trauma to my lung.

The pain in my leg/knee/calf combined with the new pain in my side should have been an indicator that something was wrong and I needed immediate medical attention because a PE is most commonly caused by a blood clot that breaks off from a leg or pelvis vein and travels to the lung, creating a big problem.

(Now we know? I should have put the two pains together.) 

So there you have it. If you at all think you are suffering from a blood clot in your leg or lung, please do not wait to get emergency medical attention. Most people who are going to die from a PE do so within 30 to 60 minutes of the event, which is why I am so lucky (since I took well over 24 hours to go to the hospital). PE causes or contributes up to 200,000 deaths annually in the U.S. alone. One in every 100 patients who develop DVT dies, due to a PE. Immediate medical intervention is essential to reduce the risk of death to less than 10 percent. I’m still here!

As runners and athletes, we all live with pain, some of it more severe than not. We will probably always have to deal with pain. Its part of what makes us who we are – we push and workout and run until sometimes we just can’t go anymore and in those moments, we do sometimes find victory whether it be setting a new PR, going a new distance or achieving a negative split. But, listen to your body. If something doesn’t seem right, doesn’t feel right or just as even the slightest tweak to it, seek medical attention. Even if it is putting a call in to your family doctor. After all, I am convinced that is what saved my life. I wouldn’t be here had my family not been persistent in checking in with me and eventually calling my physician who then called me and told me to go to the E.R.

Until the next mile marker,

In Case You Missed It….

  • What the #$%! Happened. In June 2012, I was incredibly lucky to survive a pulmonary embolism (or blood clot in my lung) that broke off from a clot that had formed deep within a vein in my lower leg. Read my story here.
  • What the #$%! Happened: The Aftermath. What caused this, what my treatment entails and what the future holds for running, my job and life.

  • “That’s Why I Pray.” God is not finished with me yet – and that’s why I’m still here! Do you believe in the power of prayer to make a difference? Do you believe there is hope when all seems hopeless? Do you believe in better days? I do now more than ever! The lyrics and meaning of this song got me through some seemingly hopeless moments in the days after my discharge from the hospital.


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!

Celebrate Week #12: Cap City Half Marathon Training Report

This week, CELEBRATE a Sparkly Soul!

Check out MY Sparkly Soul Headband that I won a couple of weeks ago from the lovely Elle at Eat Run Sail! I love them! Thanks, Elle and Sparkly Soul!! Have you tried Sparkly Soul Headbands? Do you like them? So far, I do because it has not slipped off my head, but it also is not so tight that it gives me a headache. Perfect.  
This training week was oh-so-not-good. I ran four miles. The whole week. Ouch. In more ways than one, actually. I set out for an eight mile training run with MIT on Saturday and made it not even one mile before my knee decided it wasn’t going to work anymore. It hurts every time I put pressure on it. It still hurts today and I am still shuffling around. I was hoping it would be better and that it just needed to rest.
I am trying really hard to be positive and think:

How was your training week? I am so proud of the Lucky 13’s who ran eight miles for the first time!! You guys are going to rock at Cap City! I can’t wait! 🙂
Until the next mile marker, 

Hot vs. Cold

It seems like we have all been there. It’s a beautiful day; you get up early, get dressed for success in your favorite pair of running shoes, and head out the door for a quick run. You’re feeling great. What a way to start the day! Then it happens – it may be quick, or it may be gradual, but it happens. A nagging pain starts in your shin, you feel something pop in your ankle, or your knee gives out with little warning. Perhaps you finish your run feeling the freedom of the runner’s high, but you get back home and your hips start to ache or your calf muscles tighten up. Uh-oh. Now what? Do you apply an ice pack? Maybe a hot pack? Which one might work better? Which do you choose? Does it even matter?

Yes! It does matter whether you apply ice or heat when treating an injury. Below are some quick and easy-to-remember tips to help you decide what course of action to take when an injury catches you off guard.


ICE, ICE Baby!

  • Ice packs are generally used for NEW injuries that have a rapid onset and are fairly short-lived. For example, a sprained ankle, a recent bruise, a sore wrist or elbow after playing a sport, or at the first signs of aching joins for arthritis or tendonitis. If you see swelling, find some ice!
  • COLD reduces swelling and eases inflammation and pain by numbing the nerves. If you are suddenly injured (i.e. stepping off a curb and twisting an ankle), applying an ice pack can help to provide immediate relief. Ice is a vaso-constrictor (it causes the blood vessels to narrow) and it limits internal bleeding at the injury site.
  • Need an ice pack right away? Grab a frozen bag of peas (or any vegetable, I usually use broccoli) right out of your freezer as a fast, inexpensive way to treat the pain.
  • Apply ice for 20 MINUTES at a time. DO NOT wrap ice pack in a towel/cloth. You must apply the ice directly to the skin to get the full benefits of icing. A towel or cloth creates a barrier, thus preventing the cold from reaching the injury. Remove for at least 20 minutes before reapplying. You can ice an acute injury several times a day for up to three days.
  • Cold therapy is also helpful in treating some overuse injuries or chronic pain in athletes. An athlete who has chronic knee pain (like me) that increases after running may want to ice the injured area after each run to reduce or prevent inflammation. It’s not helpful to ice a chronic injury before exercise.

Crank up the HEAT!

  • A hot pack is used tor CHRONIC (ongoing) pain or muscle soreness/stiffness/tightness that develops slowly and is persistent or can even be substituted if the area being treated is especially sensitive to cold. For example, heat may be applied to a strained neck muscle or area of the body that is suffering from overuse.
  • Athletes with chronic pain or injuries may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow. Heat can also help relax tight muscles or muscle spasms. Don’t apply heat after exercise. After a workout, ice is the better choice on a chronic injury.
  • Heat increases circulation and raises skin temperature, so you should not apply heat to acute injuries or injuries that show signs of inflammation.
  • Apply heat to an injury using a moist, wet towel or cloth 15 or 20 MINUTES minutes at a time and use enough layers between your skin and the heating source to prevent burns.

As you know, injuries can be serious, so if they do not improve, are still causing you pain or even get worse within 48 hours of the onset, please contact your doctor.

Until the next mile marker,

My Knee: Take Two

Remember THIS?
Which lead to THIS?
And ultimately THIS:
Look at my face. I knew I was done by Mile 4 in the 2010 Columbus Half Marathon.
And remember that one time when I thought there was nothing else that could POSSIBLY go wrong with my life? Yeah, I remember too. Then my knee gave out after 0.12 miles of a 2 mile training run. 
I was wrong about that one time.
 My knee has been tender on and off since the Pittsburgh Marathon, but not painful. I have been able to run low mileage; I blamed the tenderness on recovery from running 26.2 miles.
Grudgingly, I went to see the doctor. I already knew what he was going to say:
Patellofemoral Syndrome. Good ‘ole Runner’s Knee.
What I did not know he was going to say:
Patellofemoral Syndrome in both knees. And tendonitis too – in both knees.
Just. Great.
Sooooo….it’s back to physical therapy for me. Good thing my insurance plan just started over. Great for more sessions, bad for the cost.  
Rest, Ice, Compression, Elevate. And take Aleve too. My freezer is stalked with Dixie Cups full of ice, per the Doc:
I have a jumbo container of Aleve. Judi said I can buy stock in it. 
I can run if I don’t have pain. If I have pain, stop running. If I am hobbling like I was yesterday going down the stairs at 5:20 a.m. – don’t run. Damn.
My post to the Lucky 13’s at 6:10 a.m. yesterday was this, “06/18 – Please don’t wait for me as I am NOT coming this am! 🙁 🙁 Seeing as I can’t go down stairs this morning without a slight limp, I better not run the hills. Although, it is tempting to “give it a try anyway.” 🙁 🙁 Someone tell me I am making the right decision [and pass the message on to Duane, please]. Thanks! I already miss you guys.”
Everyone said I made the right decision. Except for me. 
But, damn. I know I’m doing the right thing. I know that if I take care of it early, I won’t be out the whole season. I know if I miss a Saturday run here and there, I won’t have to miss every Saturday run. But, I love running – and I love coaching! I miss it when I’m not there. Like yesterday, when a lot of our group ran 4 miles for the first time ever. That’s exciting!
I’m super bummed. I haven’t been sleeping – not good for injury. I keep telling myself this is nothing I can’t handle – I’ve handled it before – it is just disappointing that is happening right now with so much coming up. Like the Goofy in 2012. I didn’t have to stop running altogether before, though, because I did the right thing. Right?
How do you handle injury? What keeps you motivated to do the right thing and take care of yourself? What do you do for tendonitis? 
And because cute little sleepy puppies make everyone smile (even when they can’t run, right?):

Until the next mile marker (which hopefully isn’t too far away),