Story by Dana Wickrowski // Artwork by Meghan Grube
In January 2006, Syracuse University mourned the loss of Tracy Halpin, a 21-year-old senior who, according to the medical examiner’s report, died from blood clots in her legs that moved up to her lungs. The clots reportedly caused her to fall on Walnut Avenue, resulting in a liver laceration. When I read about it in the Daily Orange, I remember feeling confused and shocked, but at the same time thinking, how weird, that could never happen to me. One year later, it nearly did.
This past August, I started packing my boxes and suitcases a bit later than I usually do. As a junior at SU, I was looking forward to moving into my first apartment and catching up with friends, but I swear that last week in August came out of nowhere. Somewhere between scrambling through my closet and stuffing the trunk, I became overwhelmed. That’s when the chest pains and shortness of breath started, and I casually passed it off as stress.
I arrived at SU on the evening of August 24, in time for pre-semester weekend festivities. My two roommates and I lived in a second-floor South Campus apartment, and we lugged my suitcases up a flight of stairs in the record-breaking 90-degree heat. Around our fifth trip up the stairs, it felt like I was breathing through a straw. I remember thinking, I’m a healthy, athletic 20-year-old; why is it so hard for me to breathe all of a sudden?
As the first week of classes began, my breathing continued to worsen. What were once aches in my chest became sharp, stabbing pains each time I inhaled. To compensate for the pain, I started taking shorter breaths. It was like someone was standing on my chest, putting pressure on my lungs with weight.
Looking back, I’m ashamed that I passed off my symptoms as if they meant nothing, but it’s so common to think “nothing happens to me, it’s not a big deal.” I had a big weekend coming up with birthdays and parties and reunions, and I didn’t want to put my fun on hold to go to Health Services. A night of restless sleep forced me to reconsider and make an appointment.
I felt silly. As I sat in the waiting room, I looked at all the miserable people with fevers and sore throats and broken arms. Those are real conditions, I thought to myself. I even pathetically checked a few times to make sure my chest still hurt when I breathed. It still did. When my nurse practitioner found nothing on my X-rays, she sent me to Crouse Hospital as a precaution.
At the hospital, I got a CAT scan (computed axial tomography, which uses computers to generate a three-dimensional image from flat X-Ray pictures) and waited for the results. My emergency room doctor told me that I would most likely be going home with a pulled muscle that was causing the pain. I remember glancing over the pages of my Rolling Stone magazine when the emergency room doctor returned and said, “Surprise! You have four blood clots in your lungs,” as if it were anything close to being a good thing. I’ve never broken any bones in my life. I’ve never gotten stitches or had an operation. The only time I have entered hospital doors was to visit my mom after her surgery and that was once. But within 10 minutes, I was confined to a hospital bed, hooked up to wires and a breathing machine, and had over eight vials of blood drawn. Everything hit me at once.
I had a pulmonary embolism. Four quarter-sized blood clots traveled through my lungs until they became lodged in vessels that were too small to let them through. Although mine did not, this condition commonly results from deep vein thrombosis (what Halpin reportedly had), in which blood clots form from the deeper veins in the legs and travel through the body. According to the University of Arizona College of Medicine, each year 630,000 cases of pulmonary emboli arise in the United States. Out of the 560,000 patients who survive past the first hour of their first symptoms, about 400,000 are misdiagnosed. Once I saw the face of my new doctor and internist, Dr. Albert Tripodi, I knew this didn’t happen to 20-year-olds like me that often.
“It’s rare for healthy, young people,” Tripodi says. “Normally, people who are immobilized in the hospital after surgery or on long car trips have a tendency to clot more because they aren’t moving. Muscles squeeze the blood into your heart, and not moving your legs can cause blood to become stagnant. When it’s sitting around like that in your legs, it can clot.”
People who are obese, have a genetic history in their family, smoke, or take oral contraceptives are also more likely to develop a pulmonary embolism. According to the American Academy of Family Physicians, women who take oral contraceptives have a greater risk of developing blood clots than women who do not. These women have an even higher risk if they pair oral contraceptives with other risk factors.
After the diagnosis, I was moved to a single hospital room, unable to physically move without moaning in pain. My condition worsened quite rapidly. In only one day, I was in so much pain that I couldn’t physically breathe without additional oxygen. I couldn’t even sit up, let alone walk. I didn’t have enough energy to feed myself or go to the bathroom. Thankfully, Tripodi influenced my mom and dad to take the four-hour trip to Syracuse as soon as possible, so I was able to depend on them for my basic needs.
“The lining of the lung has nerve endings, which get irritated when the blood clot rubs against it,” Tripodi says. “This causes a type of sore where the clot is rubbing the nerve, causing the patient to be in a lot of pain.” Breathing is an involuntary action, but for me it felt like knives piercing my chest. It took every ounce of energy to muster up enough courage to take each breath. According to the Penn State College of Medicine, pulmonary emboli may also cause patients to cough up blood-stained phlegm if their lung tissue dies. I was fortunate to experience no further complications from my condition.
Because my blood clots were already lodged in my arteries, the only possible cure was to wait. In the meantime, Tripodi put me on blood thinners to make sure I would not develop any more clots. In the hospital, I was given Lovenox, a blood thinner administered intravenously, until my symptoms subsided. Tripodi then sent me home with Coumadin, another type of orally-administered blood thinner. I was on Coumadin for six months.
“When on Coumadin, you basically want to make sure you don’t smack your head,” Tripodi says. “You don’t want to get in a situation where you’re bleeding but you can’t see it.” Patients on Coumadin are not able to drink alcohol or eat foods with vitamin K in them, like broccoli and spinach. These types of foods cause blood to become thicker, reversing the whole point of blood thinners and putting them at risk for more blood clots.
Within six months, my body reabsorbed my blood clots and the problem took care of itself. I later asked Tripodi what could have happened to me had I not gone SU Health Services. He paused for a moment and answered warily, “Well, you could have died.” Being faced with my own mortality at age 20 is a story in itself, an age when our independent lives begin and we all tend to feel like nothing can touch us.
The aftermath has been especially hard to deal with because my doctors have no answers to how I ended up with four blood clots in my lungs at such a young age. I am not obese, and I have never smoked a cigarette in my life. Through blood tests, Tripodi has been able to abandon heredity as a cause. It is pretty scary thinking that I could be doing something in my daily life that caused my condition. The blood clots could have been caused by a number of factors — sitting in the car too long, birth control, or other unknown factors. I am an anomaly, and I will never really know the real reason behind the blood clots.
If there is one thing to learn from this experience, it is that you should always listen to what your body is telling you. I don’t mean that symptoms will always lead to something this serious or that it’s a wise idea to become a hypochondriac. But in this busy world, between job interviews, projects, parties, and relationships, please stop, listen, and don’t hesitate like I did.