It wasn’t supposed to end this way: a teacher at the pinnacle of her career, a mother approaching “grandchildren time,” a wife secure in 32 years of marriage. She was taken from her students, her children, her husband, her family and her friends by a silent killer called Pulmonary Embolism.
The tragedy began with a simple broken ankle sustained when Paula tried to put up her Mardi Gras decorations in January 2002, when she was 54. I quickly drove her to a local hospital and wasn’t too concerned … after all, it was “only” a broken ankle.
People break bones all the time. But Paula knew better. When the doctor told her she needed surgery (she would eventually require a plate and five screws) to stabilize her ankle, Paula told him, “No surgery, I’m afraid of blood clots.” You see, she had a family history of clots and was afraid of ending up like her grandmother – crippled at age 55. I convinced her to trust the doctor and he did a wonderful job in repairing the break. Neither the doctor nor the hospital warned us about the dangers of blood clots after surgery.
I thought we were home free when Paula came home from the hospital. What we didn’t know was that the first 10 to 14 days after surgery are the most critical times to develop blood clots. The hospital didn’t have her in compression stockings (TEDS) or in pneumatic pump stockings. In addition, neither the doctor nor the hospital told Paula or me that she had five of the factors that placed her in the high-risk category to develop blood clots: She was over 40, she was 25 to 30 pounds overweight, she was taking HRT (hormone replacement therapy) drugs, she had lower leg trauma and was immobilized and most importantly, she had blood clots in her family history.
She was doomed and I didn’t know it. I was ignorant of the signs and symptoms of PE; I couldn’t help save her life.
My mission since her death has been to educate as many people as possible regarding a condition that still frustrates many doctors. The symptoms of blood clots, especially PE, are similar to many other diseases. But let’s look back, was there anything I could’ve done to save Paula? Did she tell anyone she felt she was dying? Was her death unnecessary? The answers are yes, yes and again yes.
On her third day home from the hospital, five days after surgery, Paula called for me to come and rub her lower back. She said she was experiencing excruciating pain “worse than childbirth.” Those words didn’t sound an alarm for me; I told her I didn’t know what it could be and to call her doctor. She did. Because this doctor had also treated her months earlier for a condition called Sciatica, he thought the pain might just be flare-up and told her to take the muscle relaxant he had prescribed for her.
Two days later – seven days after surgery – Paula woke me up in the middle of the night with the same complaint: stabbing lower back pain worse than childbirth. I remember barking back at her, “Paula, I don’t know what it is. I’m not a doctor so call your doctor.” She did, but her doctor wasn’t on call that night. The physician advised Paula to take a couple of Aleve to see if that would help. I now know the doctor was wrong and so was I. I should’ve been more sensitive, more concerned and caring. She was nearing death and I had no clue. All I had to do was drive her to the emergency room and they would’ve discovered her lungs were filling with blood. Instead, I drove to a nearby pharmacy and got her some Aleve.
Paula never told me she felt she was dying. However, she confided to her close friend Kathy that she was afraid of death since she had heard of people passing blood clots to their lungs. Kathy told her that nobody dies of a broken ankle. Now we know differently. Kathy shared my lack of medical knowledge regarding lower leg trauma – a leading cause of DVT (deep vein thrombosis). Had we known of the danger to Paula due to her broken ankle, Kathy would have told me to get Paula to the hospital as severe pain means something is terribly wrong. Kathy had also told Paula to call her doctor. But two calls to her doctor resulted in the same response – a lack of urgency to a condition that allows little room for error.
In the weeks and months after her death, I discovered Paula shouldn’t have died. I learned that PE isn’t only treatable but is, more importantly, preventable. Since Paula had five of the factors that placed her at high risk for developing blood clots, she should’ve been taking a low molecular weight heparin (such as Lovenox) after she left the hospital. Lovenox is a drug that prevents clots from forming.
But Paula’s death has allowed others to live.
FOX 8’s Nancy Parker has done several special reports detailing the signs and symptoms of blood clots. Shortly after these reports, area hospitals initiated a protocol that screens every incoming patient regarding their risks for blood clots. TEDS and pneumatic leg pumps are now standard procedure for high-risk patients.
Unfortunately, often when the patient leaves the hospital, that attention to detail ends. It is still the responsibility of the individual to know one’s body and to educate oneself to whatever danger surgery may bring . Pain means something is wrong. And if it’s something you’ve never experienced before, always error on the side of caution. Get to the hospital and give them the chance to save your life.
If you’re going to have any type of surgery below your waist, (Such as hip replacement, or knee replacement,) make sure you ask your doctor, “What are you going to do to prevent blood clots after surgery?” If the doctor says, “Don’t worry about that,” go find another doctor.
Educate yourself regarding any surgery you’re going to have. Visit www.preventdvt.org online and discover your risk factors for developing blood clots. I have also learned that up to 20 percent of Americans have a “hypercoagulable disorder” that makes their blood over-clot. These disorders are inherited and go by the names of factor V Leiden, Protein C deficiency and Protein S deficiency. I’m sure Paula probably had one of these conditions as she had such a strong family history of developing blood clots.
Look back in your family tree. See if any grandparents, aunts, uncles or cousins died from strokes or heart attacks. They easily could have died of PE, sending you a clear signal that you have family history and reminding you to pay attention to your health anytime you get injured or have surgery. Take charge of your body so you can help your doctor keep you safe.
I have found happiness again with my new wife Brenda. I will never take her health for granted. This is a second chance for me and I have learned by my mistakes. We live for today as tomorrow may never come. Paula’s story will guide me for the rest of my life and I hope it will do the same for you.
