Hello, my name is Don. I am writing you to share my story and to express my sincere appreciation for your efforts with public awareness of clotting disorders. I am a Paramedic employed with a Non-Profit medevac helicopter organization. We transport high acuity patients on a regular basis. These patients range on a very broad spectrum, from multi-system trauma to acute medical emergencies including stroke, heart attack, and pulmonary embolism. Education and clinical experience has informed me of specific manifestations to assess for, when differentiating acute pulmonary embolism (APE) as the causative culprit. A classic text book description of pulmonary embolism is “atypical” chest pain, among many other descriptors. Atypical meaning APE manifests in a way inconsistent from other chest pain causing conditions, hindering diagnosis and impacting prognosis. In my career I have cared for and treated many patients impacted by acute pulmonary embolism.
Prior to my grandmother’s passing, some early childhood memories of mine are visiting her during her many hospitalizations for deep vein thrombosis. Her unfortunate “condition” was passed along to her children, specifically my mother and aunts. All have been plagued with numerous DVT hospitalizations, varicose veins, coumadin life changes, and lovenox shots. Factor V Leiden has been confirmed as the genetic clotting disorder that has been passed down from generation to generation.
I am a relatively healthy 35 year old male that lives an active life with a beautiful wife and two young amazing children. I’ve committed my career to helping others in their most worst times of need. I volunteer a large portion of my free time to our local volunteer fire department and ambulance, serving as the Fire Chief and also a volunteer paramedic.
Just about a week ago, I developed pain and discomfort in my right bicep. The medical side of me dismissed the very “different” pain and discomfort to that of a typical pulled muscle, and life went on. A few days ago, while tapping maple trees with my brother-in-law, one of our snowmobiles became stuck resulting in strenuous lifting. The following day I began experiencing “atypical” chest pain. Yet again, the medical side of me dismissed the chest discomfort and pleuritic pain as that of just another pulled muscle. After all, what else could it be? Following a few sleepless nights racked with severe stabbing pain radiating to my right shoulder, I relented and sought evaluation at my local emergency room.
Personally knowing the majority of the staff on hand, including the physicians and mid-level practitioners, still didn’t preclude my assessment to that of a strained muscle, despite my colleagues thinking differently. During evaluation and initial work up, labs were drawn, and my D- Dimer was found to be elevated. During my contrast CT scan, I was still convinced that I was experiencing a strained muscle, that is until the results came back. Multiple acute pulmonary embolism with pleural effusion. Ultrasound confirmed a large DVT in my right bicep. Not until that point did my years of training, assessments, and experience finally clear up my personal tunnel vision. It was all too clear. Family history of Factor V Leiden, family history of DVT, pain in right bicep, strenuous physical activity and exertion, atypical chest pain and shortness of breath EQUALS pulmonary embolism.
How did I miss this? The answer is evident among the medical community as a whole. One out of every three pulmonary embolism patients presenting to the ER are misdiagnosed, according to a recent retrospective observational study. Education and awareness to the community, healthcare workers, and first responders is paramount. This disease is quickly overlooked, and can be so very debilitating or even fatal. So again, I express my appreciation for your commitment to public awareness and education, which unquestionably will save many lives. God willing, I will continue my passion and save many more future lives. If I could ever be of any assistance, please don’t hesitate to ask.