In the Emergency Room With a Pulmonary Embolism

To find out what led up to Christy’s ER experience, read more here.

Everything was a whirlwind when I got to the ER that morning. I knew there was something wrong, but I didn’t have any idea of the insanity that was about to ensue.

A flurry of tests and imaging

I think the doctors had a pretty good idea of what was going on as soon as I arrived, but, never having had a pulmonary embolism before, I didn’t really know what was going on, why they were running what tests, or what they were looking for at the time.

They ran a series of tests and did some blood work. I’m sure they started out with an EKG and some labs. I’m also sure that both the EKG and labs were very telling of just how bad things were.

They sent me to imaging to get an urgent CT angiogram, where they quickly injected dye into my veins and then took pictures to see how the dye diffused throughout the veins. I remember getting an ultrasound of both of my legs (they did both for comparison). They also did a bedside echocardiogram to see if my heart was working okay. All of those tests came back abnormal.

My scans showed pulmonary embolism and heart failure

The ultrasound of my left leg found blood clots in pretty much every major vein. The CT scan showed “filling defects” in many of the arteries in my lungs, meaning that I had blood clots throughout my lungs that were preventing almost all oxygen exchange from happening.

There was also something called a “saddle embolism,” where the blood was clotted at the intersection of the major arteries connecting the right and left sides of my lungs. And best of all, the echocardiogram showed I was in right-sided heart failure; my heart was pumping so hard to get blood into my lungs but couldn’t because of the clots.

Misconceptions I had about pulmonary embolism

Finally, the doctor came in and told me what they had found. At that point, I still didn’t quite get what was going on. Again, it was one of those things where I had heard of a pulmonary embolism, and I knew it was a really bad thing, but I didn’t know exactly what it was. I was under the false impression that it only happened to “old people.”

After delivering the news, she calmly told me that there would soon be a lot of doctors coming in to see me.

The moment my pulmonologist recognized me

There were so many doctors from so many different specialties that were in and out of my room — interventional radiologists, internists, respiratory therapists, anesthesiologists, cardiothoracic surgeons, and pulmonologists. I very distinctly remember the pulmonologist coming down the hall.

My pulmonologist had been lead in the pulmonary ICU that week, so he was routed to the ER when the page went out about a pulmonary embolism. As he walked down the hall, he stopped just short of my room, crossed his arms, and leaned against the wall. It was another second before he looked into the room to lay eyes on the patient — me — and as soon as his gaze met mine, his face just dropped. I will never forget the change in his countenance when he realized it was me in that room.

But boy, let me tell you, I was relieved to see him standing there in the hall. My pulmonologist is, hands down, the best doctor I have ever had. He is incredibly smart, a fantastic listener, is great at collaborating with me, and has the best bedside manner. I affectionately refer to him as “the good doctor” because of how wonderful he is.

My care team gave me treatment options

After each doctor peeked in the room to see me and find out what was going on, they gathered in the hall outside my door to come up with a plan. I was grateful when my pulmonologist was the one who walked back in to give me my options and help me make a decision on what to do. We really had 3 options moving forward:

• Option 1: Administer clot-busting medicines and blood thinners and hope that my body would start to clear the clots on its own, under close supervision.
• Option 2: Start both of the aforementioned medicines AND go to interventional radiology, where they would go in with a catheter through my groin area and use ultrasound to break up the clots and remove them manually.
• Option 3: Surgically open my chest and take out the blood clots that way.

I had NO idea what to do. I was in utter shock and disbelief about what was going on. And I still didn’t really understand the severity of it, either. So, I looked at my pulmonologist and asked him what he would do. After a short discussion, he and I agreed that we would proceed with option 2.

Whisked away to surgery

With a plan in place, the different doctors slowly dispersed. The anesthesiologist and interventional radiologist went over the consent for the procedure they were about to do, and once I had signed those papers, I was whisked up to the radiology suite for emergency surgery to remove the massive clots that were making it nearly impossible for my body to function...

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