Injuring your ankle shouldn't be a big deal, right? I was 35 and otherwise in perfect health. But three weeks after I sprained and broke mine by tripping on a stair, I was being rushed to a hospital, weak, gasping for air, literally minutes from death.
What happened? It turned out that a large blood clota serious condition known as deep vein thrombosis (DVT)formed in my leg as I tried to recuperate. The clot broke off and traveled to my lungs (what's known as a pulmonary embolism), where it blocked blood flowand threatened my life. You may recall that in 2003 NBC correspondent David Bloom died from a pulmonary embolism after being dehydrated and sleeping curled up in a tank for weeks while reporting in Iraq. And recently, tennis champion Serena Williams made headlines when she was hospitalized and treated for a pulmonary embolism and related complications (see "Behind Serena's Scare," below).Easy to miss
Unfortunately, my doctors failed to recognize DVT when it developed, probably because the injury was fairly straightforward at first. In the emergency room, X-rays showed a small bone chip in my ankle, in addition to the sprain. The physician gave me a splint and crutches, and told me to keep my leg elevated and iced. When I followed up with an orthopedist, he said it was a sprained ankle that would take six to eight weeks to heal and would look worse before it got better. That's why I wasn't terribly surprised when my ankle became even more swollen and turned bluish-purple.
But after about a week, when I was first able to put some weight on my ankle, I started to feel a stabbing pain in my calf that got worse and worse. Even the pressure from a pillow felt agonizing. No amount of pain reliever helped. When I couldn't get back in to see that ortho, I went to a different one. But he had no idea why my calf was hurting so much. "I've never seen anything like this," he confessed. He told me to stay off my leg and keep it immobilized. Another mistake.
About three weeks after the injury, I woke up shaking and couldn't catch my breathI felt nauseated and light-headed. My husband called an ambulance.
At the ER, a nurse took my O2 reading, which shows how much oxygen is in the blood. It was at 50 percent and droppinga sign that there was a problem in my lungs. My blood pressure was also dropping, they saw that I was wearing a splint, and when asked I'd told them I was on birth control pillsall red flags.
The ER staff sprang into action, with the doctor issuing rapid-fire orders, reading off my vitals and preparing me to be intubated. All the commotion started to freak me outI couldn't breathe, and I was being held down. "Can you wait till I calm down?" I pleaded. "No," he barked. "We need to stop the clotting now." He injected me with a blood thinner, which is probably why I'm alive today. I spent the next 36 hours in a drug-induced coma, breathing through a respirator. Then I spent six days recuperating in the hospital.
In a perfect world, the ER docs I saw when I first got injured (or the orthopedists who examined me later) would have advised me to take steps to avoid developing DVT, like stretching my legs as much as possible, even in the splint. When your legs are inactive for more than a couple of hours, blood can pool there and increase the risk of developing DVT, particularly if you have other risk factors (see How to Prevent a Blood Clot). That's why long airplane rides can be hazardous. Taking birth control pills, as I did, can also increase your riskby up to four timesbecause they increase your blood's tendency to clot. Or at least the doctors might have said, "If you feel severe pain or if your ankle starts turning blue or purple, go to the ER."
I was on blood thinners for six months to prevent a recurrence, and I had several follow-up doctor appointments. Once you've had DVT, you're at a higher risk of getting it again, so I now take preventive measures: I've gone off the Pill, I drink lots of water (dehydration can contribute to the risk of blood clots), and I stretch constantly. Since pregnancy also raised my risk for another episode of DVT, I saw an OB-GYN who specialized in high-risk patients, and I was on special blood thinners before, during, and after my pregnancy.
I wanted to prove to myself that I had really recovered. So a few months after my DVT ordeal, I started running; a year later I completed a marathon in San Francisco. After the birth of my son, it's the second greatest accomplishment of my life.Behind Serena's Scare
In February, tennis champ Serena Williams suffered a life-threatening pulmonary embolism, then needed emergency treatment for a hematoma (a pocket of blood caused by a leaking blood vessel) in her stomach. How could this happen to a 29-year-old pro athlete? Williams had undergone two surgeries to treat a foot injury. And just before being diagnosed, Williams had flown cross-country. The combination of surgery (particularly on the lower body, a common source of clots) and a long plane trip put her at increased risk for a clot, says Kenneth Prager, MD, a pulmonologist and professor of clinical medicine at Columbia University Medical Center (he did not treat Williams). The hematoma could have been a result of blood thinners Williams may have been given to treat clots; these drugs can increase the risk of internal bleeding. Fortunately, she received prompt care and has since recovered. Sarah DiGiulio