My Second Pulmonary Embolism

It happened about a year and a half after my first one. Thankfully (?), I had the experience to know what was happening, so it didn’t turn into a massive pulmonary embolism (PE) like the first one. But a PE is never a good thing.

A migraine in the days before

The events leading up to the second pulmonary embolism were rather anticlimactic. There was no big surgery, and I was no longer on birth control pills (both of which contributed to my first PE). It happened from an IV stick in my left elbow. And no, I’m not kidding.

A few days before the clot developed, I had a really bad migraine that I hadn’t been able to get rid of myself. I have a history of horrible migraines and sometimes have to go to the emergency room for stronger meds than I can give myself at home. So I made my way down to one of the local ERs, where they placed an IV in the crook of my left arm and administered the medications and fluids I needed to get rid of the migraine. The migraine was gone, and I was discharged.

Discovering a bump on my arm

The spot where they had put the IV was painful, and I noticed a type of lump called thrombophlebitis, which is a small blood clot that forms in a vein under the skin. Thrombophlebitis can occur in the spot where an IV is placed. It’s not uncommon, and most people never have any serious complications except for the bump and some minor discomfort.¹

I, on the other hand, had to take it to the extreme. I’m sure you see what’s coming.

A rare result of superficial thrombophlebitis

A day or 2 later, I was at work, and that lump was getting bigger and more painful, not smaller and less painful. I was starting to get a bit short of breath and started wondering if there was any small chance I could actually be having another pulmonary embolism. At the time, I worked in a non-clinical office at my local hospital, and some of my coworkers were nurses. So I pulled one of them aside and asked if she thought there was any way I could have another PE from the IV stick.

There’s not much data on pulmonary embolisms that arise from superficial veins; in fact, according to a case study published in the Journal of Clinical Medicine Research, "Pulmonary embolism secondary to upper limb superficial vein thrombosis (not combined with upper extremities deep vein thrombosis) is a very rare clinical manifestation with few cases reported in the literature."²

Rare indeed. I can’t tell you how many medical professionals I’ve told how I got my second PE, and they all shake their heads and look at me like I’m an idiot because "there’s just no way." Well, there is a way, and I managed to do it.

Another ER visit for suspected PE

My coworker doubted, as many since have, that I actually had another PE. But after another hour or 2, my symptoms were progressing, and I decided I needed to go get looked at.

So, I made my way back to the ER, where, after a plethora of tests, they did indeed find another pulmonary embolism. They used ultrasound to look for any deep clots in my arms and legs and didn’t find any. I finally asked the tech to look at the veins in my left elbow, and sure enough, that’s the only place that had a clot.

On blood thinners for life

Thankfully, this pulmonary embolism was small compared to my first one. They kept me overnight in the observation unit so they could restart me on blood thinners, but I was able to go home the next morning.

I’m now on blood thinners for the rest of my life. My dose varies based on temporary risk factors, but I will be on them forever.

Have you had multiple pulmonary embolisms or just one? Let me know in the comments! I’d love to hear your story.