To save money on lodging, the group drove in shifts. After arriving in Boulder, Colorado, after 20 hours of travel, they all felt nauseated, headachy, and a little short of breath, symptoms of altitude sickness. While camping at a national forest that night, Burgess noticed that her left leg was swollen and painful. The next day, when the group began climbing Mount Elbert, Colorado’s highest peak, Burgess felt even worse. “But we had driven all this way, so I decided to power through it,” she says. After a grueling 12 hours, the group reached the peak, then began their descent, and that’s when Burgess’s leg pain intensified. She decided to seek medical help. In the hospital emergency department in Ouray, Colorado, Burgess was diagnosed with a superficial vein blood clot — a clot just below the surface of the skin — in her leg. “I was told to rest, apply heat, and I would be fine,” she said. But her leg became so painful, “I couldn’t even do my share of the driving,” she says. As the road trip continued, the group stopped in another hospital emergency department, where Burgess was told her superficial vein blood clot was getting bigger, but that she would feel better in the morning after a dose of aspirin and a painkiller. Again, her symptoms got worse. On the drive home, strong painkillers kept Burgess’s leg from throbbing. But she was still having trouble breathing. “That’s when I knew something was really wrong,” she says. As soon as the gang arrived back in Maryland, Burgess saw her primary care physician. When a pulse oximeter test showed that Burgess’s oxygen saturation was low, the doctor sent Burgess to her local hospital emergency department. There, doctors discovered that Burgess’s superficial blood clot had turned into deep vein thrombosis (DVT), which developed into a potentially deadly pulmonary embolism (PE). “Up until that point, I hadn’t realized how serious my situation was,” Burgess says. “I had just assumed I was being a wimp, that Mount Elbert had been too big for me to handle.”
Vein Clots Decoded
Blood is supposed to be fluid. But if your circulation becomes sluggish, which can happen after you sit for hours without moving, a gel-like clot can form inside the veins. If a blood clot develops in a deep vein, usually in the legs, it’s known as deep vein thrombosis (DVT). If the DVT blood clot breaks off and travels up to the lungs, it becomes a pulmonary embolism (PE). “We think of DVT and PE as the same disease, it’s just that the symptoms are different because the blood clots are in different locations in the body,” says Marcelo Gomes, MD, a vascular medicine specialist at the Cleveland Clinic. By itself, a DVT isn’t life threatening. But a PE can be. It can clog an artery in the lung, robbing your body of much-needed oxygenated blood. “At some point during my trip, my superficial blood clot must have become so large that it connected to my deep vein system, broke off and traveled to my lungs,” Burgess says. About 20 to 30 percent of people with a DVT will develop a PE, Dr. Gomes says. The good news? “Most people with PE will survive if they seek immediate medical attention,” he says.
Signs of DVT and PE and How to Prevent It
DVT can cause pain, swelling, and redness or purple discoloration of the skin in an arm or, most commonly, the legs. If you experience these symptoms, see your doctor. PE can cause chest pain and shortness of breath, and you may cough up blood or faint. Have someone drive you to the emergency room or call 911 if you experience these symptoms. The risk of DVT and PE increases if you sit for long periods without moving, such as on lengthy car trips or long-haul flights. To prevent a first or subsequent DVT and PE experience, take the following steps.
Wear compression stockings on long car rides and flights. “Compression stockings don’t have to be super tight or prescription,” Gomes says. What’s available over the counter will suffice. Burgess will be wearing compression stockings on her upcoming honeymoon to New Zealand.Avoid alcohol and drink plenty of fluids, such as water. “Dehydration plays a role in travel-related DVT events,” Gomes says.Move about the cabin. Get up from your airplane seat and make frequent stops if you’re driving, at least every two to three hours. If that’s not possible, exercise your calf muscles to keep your blood circulating. “The calf muscles serve as pumps for the veins that run through them,” Gomes says. Draw each letter of the alphabet with your right foot, then your left, or vice versa.Be careful if you’re on the birth control pill. Birth control pills can put women at increased risk for DVT and PE. Before her DVT and PE, Burgess was on birth control pills for menstrual issues. After her PE, Burgess has since switched to a safer, lower-dose form of hormonal therapy.
To treat her condition, Burgess took the blood thinner warfarin for six months. If she develops another DVT, she may need to take the anticoagulant for the rest of her life. In any event, it was a close call. Burgess credits her primary care physician’s persistence for saving her life. In this or any health situation, “trust your gut, advocate for yourself and develop a relationship with a primary care physician so you have somebody to turn to who knows you well when something feels off,” she says.