Part VI: Prevention

Earlier this year, I experienced a sudden pulmonary embolism (PE), from which I am still recovering.  Having been extremely healthy all my life and a very active person, I was not prepared for becoming a temporary semi-invalid.  Part of my journey to recovery has been to learn all I can about the condition, so that I can have the best recovery possible and also educate other people about my own experiences. In this final article I wish to give a “shout out” and thanks to the hundreds of friends who rushed to my side and stood by me (literally) and via email and phone (got your messages even though I never answered the phone) and of course to Carol (who made sure we got the keys to the house) and to my children – Adina, Ilan, Gilad and Dafna who each have contributed to my recovery but more important to my education of Life with a PE and PE with Life!

My Story

As I’ve mentioned previously, having a pulmonary embolism was a complete surprise to me, because I am a freak of preventive medicine and was told I was in such good health.  Even with the benefit of hindsight, I find few of the risk factors associated with PE on my personal check list.  Because I don’t plan to become another statistic, I am committed to doing everything I can, however, to reduce the chance of suffering another and potential more damaging pulmonary embolism and also to educate as many people as possible about PE.  And so I have developed my own prevention plan, of sorts:

• Continue to follow healthy diet and exercise program. Now that I’m clear to resume all normal activities, I’m going to pick up the pace again at the gym (OK, I’m pushing myself already – perhaps more than I should – but I’m determined).
• Exercise increased travel precautions.  Airline travel is the linchpin of my business endeavors, so discontinuing extended travel is not an option.  However, I can make my travel safer by doing more in-seat stretching exercises and walk-around breaks.  I’m also going to break down and start wearing compression socks (CONFIDENTIAL) to decrease the potential for blood pooling in my legs (please don’t try and get a peak as they’re really quite nasty).  I’m going to drink even more fluids in-flight (and do my best to stay away from Diet Coke and no it’s not an opportunity for Pepsi to step in)). -
• Obtain comprehensive health assessment.  After having made inaccurate assumptions about my health risks before, I am averse to future surprises.  I’m currently undergoing a complete battery of all kinds of medical tests.  I find myself wondering if what happened was a possible warning sign for something else that is awry with my health.  Just knowing other potential health vulnerabilities will allow me to expand my own health promotion program to address any other relevant risk factors.
• Practice (a little more) moderation in my schedule.  An 18-hour work day sounds extreme to someone who doesn’t have my particular personality, metabolism, and joy in what I do.  But even cutting back a few hours per day will create less wear and tear on all my body’s resources.  Learning the fine art of relaxation may be a challenge, but I’m willing to give it a try!

So that’s my own plan.  Lesson learned:  be prepared.  What do the experts tell us that you can apply to your own health promotion and disease prevention plan?

Reducing Risks of Prolonged Inactivity

You can reduce the overall risk of pulmonary embolism to practicing habits that will reduce the likelihood of having blood clots form in your legs.  The single most common cause of deep vein thrombosis is prolonged inactivity – often associated with surgery, bedrest, or travel.  Follow these guidelines to lower your own risk:

• Avoid long periods of inactivityat work– If your job involves sitting at a desk, get up at least every hour or so and take a stretch break.  Flex your feet and legs, using the following exercise:  Point your toes up toward your head.  Feel your calves stretch.  Hold, then relax.  Repeat this frequently.
• Taking reasonable travel precautions – If you’re on an extended car trip, take at least hourly stretch breaks.  On plane rides, get up at least hourly to stretch or walk the aisle.  Practice your leg stretching exercises, as described above, as you sit.  If you are at high risk for PEs, use compression stockings or socks when you travel.  Always drink plenty of fluids to avoid dehydration, but stay away from alcohol or caffeine.  Wear loose-fitting clothes that don’t constrict your waist or legs.
• Taking reasonable post-surgical or bedrest precautions – Try to get up out of bed and begin moving as soon as allowed after surgery or an illness.  If you’re confined to bed, do the above leg exercises to keep your blood circulating.

Reducing Lifestyle Risks

Smoking, overeating, and leading a sedentary life are manageable risk factors associated with increased incidence of pulmonary embolism.  All three factors are also associated with a variety of other health risks, including heart disease.  For the best cardio-pulmonary health promotion, try to follow as many of these guidelines as possible:

• Eat a reasonable, low-fat diet;
• Avoid any use of tobacco;
• Drink moderately, if at all;
• Get 30 minutes to one hour of exercise at least 3-4 times per week;
• Avoid use of hormones found in birth control pills or hormone replacement therapy, unless they are prescribed to reduce other health risks.

Following Physician Advice

If there’s ever a time to listen to your doctor, this is it.  After a PE, you’re likely to be on a regimen of blood thinners for several months.  In order to get maximum benefit, it’s critical to take them as prescribed and follow up with blood work and physician appointments.

Listen to your physician’s advice about when to return to work, as well as other precautions you may need to follow, depending upon your own particular situation.

Conclusion

Over the past six weeks many of you have endured my writings about MY LIFE WITH PE.  In doing this writing I’ve had only one goal – TO TRY AND PREVENT JUST ONE PERSON FROM ENCOUNTERING A PE.  For those that have passed on any or all of the writingsIthank you and trust that the one person will be saved without any of us ever knowing and in doing so making thousands aware of this deadly killer.

As I stated at the beginning of this article series, the end of my story has not yet been written.  And neither has yours.  While no one knows for sure what the future holds for any of us, we can take the saying that “knowledge is power” and apply it to our personal healthcare.

It’s never too early to take an inventory of your own health and the lifestyle practices that inform it.  Waiting until a health crisis to take action is the least effective way of promoting your physical health and well-being.

I hope you’ll take some of my own lessons learned to heart (and to health):

• Pulmonary embolism (or insert your own choice of “disease of the day” here) can happen to anybody.  None of us are immune.
• Knowing the signs and symptoms of PE or any health problem for which you may be at risk, is critical, as timing is everything.
• Knowing your own degree of risk is crucial.  Feeling healthy does not give you immunity.
• Listen to what your body is telling you.  With medical providers, become a vocal health advocate for yourself, as you’re the expert, too.
• Healing takes time, and recovery is a process, not just an outcome.
• Be pro-active with your health. Choose the ounce of prevention any time.

And if you have travel insurance – Israeli or otherwise, don’t wait until you’re in the ER to determine whether it’s comprehensive.

Most people are not diagnosed with Pulmonary Embolism until autopsied.  I cannot tell you how many times I heard the word “lucky” when I was hospitalized.   Starting with the attending EER Physician who’s words I continue to hear – “You beat this one by 3 hours” and the assortment of doctors and nurses would come into my room and see me, sitting up reading, or perhaps blogging, all with a smile (often a painful one) on my face and some energy I had pre-PE and ask, “are you the patient?” as if someone else would willingly impersonate me at a time like that.  I was well aware of the severity of what I went through, but I WENT through it…time to move on.  I am literally a survivor and am trying to appreciate life differently now.  Whether you are a survivor, as well, have questions, or are a caregiver or support someone who has experienced a PE, feel free to comment.  There are times I will also need reassurance.  After all, recovery is a process and of course some days will be better than others.  I will surely look forward to your comments, especially then.

Those of you that know me — whether for 48 years or for 48 minutes – were probably shocked with the openness of my first article and that I continued to tell the story in the subsequent five.  As a very private individual I can say it wasn’t easy but I felt that it must be done

Finally, enjoy each second that life has to offer – whether it’s working, traveling, family time, or embellishing and furthering your faith.   Each second is truly precious.

Good luck on your own health journey, and wish me the best in mine, as my (NOT SO patient) recovery continues.Now, back to the private life.