Not exactly like Captain Phil, but sort of...

I've thought a million times over the past few days about how to write this blog post - let alone start it. But from the beginning is best, so that's where I'll begin.

First thing's first. I'm alive and okay - doing great, given the circumstances. I've managed to keep my sense of humor, even while flashing an entire corridor of patients and hospital staff. And yes, I was grateful when my nurse kindly brought me an extra gown. So...sense of humor: check.

Second: Holy Cankle Batman!

And notice that I say "cankle" not "cankle-s". Because I've got one, not two. And from the angle where I now sit - hospital bed with my right leg propped up on several pillows, my awesome Cankle is joined by a Fat Foot. Seriously - it has it's own zip code.

Let me begin - back up for a bit. And in all seriousness - keep in mind that you are reading this blog after the fact, and I'm alive. Here we go-

Monday morning I went in for a routine appointment with my awesome Primary Care Doctor. Remember how she fixed my sinus and pneumonia woes? Because of her help, I've been able to regain my health, start training, and return to my normal lifestyle.

I was hoping to get a referral for an Orthopedic Surgeon, as I suspect that I have Chronic Exertional Compartmental Syndrome (CECS) in my lower right leg. The varicose veins are a side-effect, and I thought that by treating them in the beginning of the month - I could rule out those veins as the culprits to my leg pain. My Vascular Surgeon was very helpful, but ultimately the sclerotherapy didn't eradicate the problem. I continued to train with the medical grade compression hosen though, I was still experiencing swelling and discomfort akin to CECS.

Just before the appointment ended, I asked my Doc if she could take a look at my right leg. It was swollen and uncomfortable - even without running. I thought I may have twisted my ankle while trail running the previous week... it was sore and painful to the touch - but not SO painful that I couldn't continue to train and run.

And that's when things began to pick up.

Without pausing for thought, she informed that I NEEDED to have my leg examined via ultrasound, just to rule out a blood clot. I had no idea swelling could be associated with blood clots or Deep Vein Thrombosis (DVT) - but it can.

REPEAT: SWELLING OF YOUR LIMBS CAN BE ASSOCIATED WITH DEEP VEIN THROMBOSIS. IF YOU ARE EXPERIENCING ANY OF THESE SYMPTOMS, HEAD TO THE NEAREST EMERGENCY ROOM IMMEDIATELY. YOUR LIFE COULD DEPEND ON IT!

Scripps Clinic in Vista had an ultrasound machine, and I was booked immediately. I didn't really think I had a blood clot - but I followed my doctor's instructions and headed over. Before I left, she informed me that IF something was going on, the ultrasound techs wouldn't let me leave and she would contact me shortly. But that I would probably be fine... but she really wanted me to get the ultrasound for peace of mind.

Driving to Vista, I was slightly alarmed - but I easily talked myself out of any real concern. I'm a 29-year old VERY ACTIVE triathlete, in great shape, and I ran 1:45 yesterday morning... had a fantastic bike ride the day before.... IF there's a clot, well - that just can't be. Whatever. She's just being thorough - and that's why she's awesome. But man - that would suck... It's like a Milan Kundera novel, where the characters go through tons of shit before finally finding happiness, only to die in the end.

So - I may have broken a few speed records. Oh well.

In Vista, the staff was really good at getting me in and prepped for the ultrasound.

I really didn't think they would fin anything. I had had an ultrasound before my Sclerotherapy injections back on May 21st. BOTH legs were completely clear of clots - superficially and the potentially deadly DVT kind.

The ultrasound tech even joked with me that she routinely saw cases, where people had swollen limbs - but they rarely turned out to be blood clots. My ears perked up when she saw my leg and commented, "Well, gosh! You do have the symptoms, though."

10 minutes passed, and I could feel her rolling the ultrasound device on my upper right leg, near my groin. I tried to make conversation - after all, I'm a talker - but I figured I should let her do her job and that distractions for something like this would NOT be good.

20 minutes passed. She was still working in the same area.

30 minutes, and I was finally allowed to turn, allowing her access to the back of my leg.

I tried to stay relaxed and not fall asleep. Instead, I started fingering violin pieces with my left hand, trying to pick out notes and remember all the proper fingered passages. My favorite stand-by was Fritz Kreisler's Praeludium and Allegro. I got through it at least six times before we were all finished.

40 minute passed.

50.

60. I changed positions and she ran the ultrasound device over my lower leg. I thought about asking if she could see a minute broken ankle bone, but kept my mouth shut.

70...75 minutes later, she announced she was finished.

And I knew I was in a world of trouble.

As I started getting dressed I commented, "It's bad - isn't it?"

She looked at me and said, "I can't tell you anything. Your doctor will have to discuss this with you."

So I casually said, "Okay - I'll just get dressed and leave."

"I'm sorry. I'm going to need you to stay in the waiting room until we can have someone talk to you."

Oh fuck.

So I got dressed, choked back a few tears, and made my way to the waiting room. That was the most frustrating part - knowing that something was very very very wrong, but not knowing exactly what it was, or the extent of it. As I sat, I noticed two pregnant women and their significant other's seated next to them. They seemed so excited and happy - both sets of parents were learning the sex of their baby. I think they were 22 weeks along.

And me, fighting back tears, with a ticking time bomb in m leg. My fat leg.

The irony didn't escape me: didn't Alanis Morissette write a song about something like this?

I thought about WHO I could call - because I was so scared and alone in that waiting room full of hope and anticipation. I ruled out my parents - I didn't want to alarm them when I didn't even technically know WHAT was going on (even though I suspected a blood clot). And Nathaniel was flying and out of touch - so leaving a voice mail on his phone was quickly shot down as well.

So instead, I called the closest person to Family that I have out here - Mer Trowbridge.

I had just been out with her, Dave, Soren, and her wonderful Mom Lynne the night before. We had margaritas and awesome food at Mama Testas, the San Diego eatery that defeated Bobby Flay with their version of Fish Tacos in his "Throwdown" Food Network TV show. Sorry for that run-on sentance, oops. But really - I had a great time and enjoyed my scalloped soft tacos.

Mer was wonderful and offered to drive 45 minutes up to Vista from Scripps Ranch - but I squashed the idea. I wasn't sure how long I was going to stay or what was going to happen. Though I WAS pretty sure that I would miss my Master's swim workout. That much I knew.

By 11:30 pm, I was told to meet my doctor back at Scripps Coastal in Carlsbad. I figured it couldn't be that bad, right? I mean - they wouldn't let me drive 75 mph down the freeway, endangering my life and the lives of others...right? I mean - they would helicopter me to an ER if they thought I was going to drop dead. Right?

The drive passed by in a blur. And all I could think about - was that I love Nathaniel. I've had a great life with him...and I'm so happy. I'm just so happy. I've finally figured out a lot of things... and I love my life. I love my friends. I love my family. And House Monsters. And I love Nathaniel - most of all. This WILL be okay - because whatever it is, I'm going to fight it.

I love Nathaniel. What if I never see him again? I just...I just love him.

A few more tears were shed and I made it in record time back to my original clinic.

Very quickly I met with my doctor and a few nurses. They gave me a shot of Lovenox, an anticoagulant therapy indicated to help reduce the risk of developing DVT, or deep vein thrombosis, which may lead to pulmonary embolism (PE).

Actually, they taught me how to inject myself with Lovenox - and I did so. My doctor said that she wanted me to learn how to administer it to myself because I would have to do so 2X per day for an unspecified amount of time. But I still wasn't sure what was going on...

My doctor returned to the room and confirmed that the ultrasound had indeed yielded the presence of several DVTs, and that it was pretty serious. She quickly inquired about any shortness of breath, any wheezing, vomiting, heart palpitations.... I told her that I hadn't experienced any of those symptoms... expect for the shortness of breath. But that was from training, I figured. Story of my life - right?

And then the final kicker: she wanted me to head to the Scripps Encinitas ER for a CT scan - just to rule out a clot in my heart or lungs. In her words, "They are expecting your immediate arrival. It's probably nothing, but I would really feel better knowing that you don't have a clot in your chest or anywhere else."

Double fuck.

But I felt fine. Just fine. Absolutely okay. Normal. Fine. Great. Dandy. Like nothing was happening. Great. Annoyed that I was missing my Master's swim. Ticked that I didn't have my computer and my phone was about to die.

Normal.

I decided to make a quick detour to the house. On the off chance that Nathaniel was home from his flight - he could be there. But more importantly, to grab my phone charge. I timed myself - 5 minutes to get as much stuff as I could...

Yes - that competitive instinct is still there. DVT or not.

I packed a backpack in record time, dumped a bunch of food in the House Monster's bowls, threw in my makeup bag (because I want to look good in the ER), grabbed the camera, and debated weather or not I should clean the cat box.

And yes - with my bag packed and ready to depart on my way to the hospital to confirm that I DO NOT have a Pulmonary Embolism, I decided to take care of the box.

I figured - I was already there... I had been given a dose of fast acting Lovenox... and God forbid something should happen to me, I DO NOT want friends and family thinking I neglect my cat box.

After all - Nathaniel's call sign is "Litterbox". And no - not because we have two cats. But because "Lauterbach" is hard to pronounce. Or maybe because we DO have two cats. Who knows. Funny how that world of call-sign-giving works...

With a clean cat box and clean conscious, I bid farewell to Tabbitha and Anabelle and sped down the five towards Scripps Encinitas.

My brief wait in the ER waiting room was expedited by a combination of people watching + menial check-in tasks. I gave the usual urine sample, an unusually high 12 vials of blood (by number 12, my vein had stopped cooperating. Dude - I would have stopped cooperating if I was that little vein), watched World Cup replay action, and burst into tears when Meredith ran into the waiting room - bearing gifts and happy feelings.

She mentioned that Soren was sleeping in the car and that her Mom was reading - and that she wanted to stay with me as long as I needed. I think I cried again.

The time passed by quickly, and before I knew it, I was ushered into a bed deep in the bowels of the ER. Mer offered to step out while I changed into my hospital gown - but I've had plenty of hospital experiences before. And unfortunately, I know that maintaining a fair amount of modesty isn't always possible.

So she stayed.

And - while the tech applied EKG stickers all over my chest and abdomen - joked that I was the "Female Lance Armstrong".

"Really? Did you write a book?" he asked, with obvious interest. Nothing about mad cycling skills or fathering 5 offspring post cancer.

"No - she has a blog" Mer triumphantly explained.

I wanted to pull the covers over my head and hide. But as it was - I was flat on my back, boob exposed and flushing with embarrassment. And I laughed as well - how could you not. Leave it to Meredith to say something like that. And I loved her for it.

Later she shared the bag of loot - pretzels, peanut M&Ms, Red Vines (no Swedish Fish, she explained!), trashy magazines, a paperback, diet coke, squirt, and a toy that Soren had decided to share. I was touched. And wanted to devour the M&Ms right then and there - but wasn't sure if that was kosher, given the fact I was awaiting a chest CT.

So I waited. While my stomach growled and the machines I was hooked up to beeped away.

At some point, my ER doctor came in - and I recognized him as the SAME one who had diagnosed my pneumonia. I liked him already. Mer commented, "Good, he's old and crusty. He knows his stuff."

Time was passing, and I knew Meredith needed to feed Soren and spend time with her Mom. Nathaniel was still at work and I knew he wanted more than anything to be with me - to be by my side - but it was just beyond his control to be at my side. And besides, we didn't have all the answers and I refused to alert family and friends before I had a clear picture of the situation as a whole.

I insisted that she leave - even though she made it clear she would stay - gave her a HUGE hug, and told her I would update as I learned more. And that I loved her.

Time seemed to slow down and speed up. I thought about the what-ifs and pondered many different hows and whys...But before I knew it, I was being wheeled into the CT Scan room.

I tried to settle my mind... I knew blood clots anywhere were dangerous, and in all honesty - I was doubtful of one's presence in my lung. I would have felt it, right?

The CT Scanner has always been slightly disconcerting. I always think of the scene from "Contact" starring Jodi Foster - when she's sitting in the machine that's going to send her to a different universe. And I know that the CT machine won't harm me - but I'm always afraid that some piece of metal I had implanted will get ripped from my sternum when it gets fired up. FYI: I don't have any metal in my sternum.

But because it was a chest scan, I got VERY up close and personal with the machine.

The tech explained that this was all routine - that they saw plenty of DVT patients for suspected Pulmonary Embolisms and that, even though he couldn't confirm I was okay, things usually were clear. No worries.

I've heard THAT before. But I kept my thoughts to myself.

He continued on and explained that the timing of the scan was important - because we had exactly 90 seconds from when the special CT scan dye was injected through my IV, to take the pictures of my chest. I felt the warmth of the dye spread up my arm and over my shoulders, and down my other arm. Quite relaxing, actually. I was surprised when I felt the warmth spreading through my groin and made a mental note that yes, it DID feel like I had just peed myself, like he warned it would. Noted.

I held my breath when the machine told me to hold my breath. And I breathed when it told me to breath.

And then we were done.

Even though I was wheeled out of the scan room and back to my regular spot, I realized I had been holding my breath. Even though medical personal had been telling me - all day - that "this was routine" and "most people are negative"... I had been positive for every test. I was nervous and scared.

I know the nurses realized this - because they waited with me and cracked jokes about the World Cup. We discussed mountain biking and swimming - and I commented that I REFUSED to ocean swim anymore for fear of sharks AND that mountain lions sketched me out so I carried bear spray.

And if you think I'm kidding - I'm not.

While waiting for my pulmonary embolism test results, I was STILL confessing my fears of rogue sharks and mountain lion attacks. Hey - it only takes one!

45 minutes later, I overheard my doctor on the phone with (who I'm assuming was) the cardiologist or radiologist. I could see the scan of my chest and lungs from across the room - and in spite of the seriousness of the situation, I couldn't help but be fascinated by the image. It was the same thing when I broke my sacrum.

And then my world came crashing down, when I heard my doctor say:

"Well - that's one sizable clot. Do you see that? How can you now? Yes, I've got a lock on it. Wow. Look at that thing."

The red haired nurse looked at me nervously. I could tell he didn't want me to hear the news that way. I could see other staff in the room and pause - looking between the computer image to me and then back to the computer image. "It's okay..." I whispered, afraid that if I spoke too loudly I would miss the rest of the conversation. "It's not like he's not going to tell me anyway..."

But the shock of what I had just mistakenly heard, negated any future conversation processing.

I felt like Roy Scheider from "Jaws" - where during a shark attack, the camera zooms to his shocked face while the background slips further away. I think the producers of "Lost" use this cinematic trick as well.

I was dimly aware of my doctor coming over and breaking the already-known-news. Very large clot...embedded in lungs... passed through heart.... lucky to be alive... athlete, right?...lifestyle saved you...clot....very lucky girl...clot....clot in lungs...lucky....alive.

I honestly don't remember a lot after that point. I pulled myself together enough after the doctor left to call my parents. I explained that I would be in the hospital for an estimated 3-5 days depending on how my body adjusted to the bloood thinners and medications they were putting me on. I know that my folks felt awful that they weren't with me and that thy were actually out in Philladelphia with my siter, her fiance, and his family.

Honestly - I was really happy they were all together. It was the best possible scenario to receive news like this. Although, I think I repeated word for word the line that I used in 2008 when my Dad picked up the phone and I told him I was in the hospital.

"Hi? I don't want you to panic. I'm okay. I'm just in the hospital..."

And from there the rest is history.

It's two and a half - almost three (because this entire process started Monday morning at 8:30 am) days after the fact. I'm still alive, still processing, still dealing with the aftermath of learning I should have died from a blood clot that passed from my legs through my heart and into my lungs.

When you're in the hospital, hooked up to various machines,monitored around the clock for any sudden change, and chased down by a very worried intern when the battery pack on your portable EKG machine dies -it give you a lot of time to think.

For now - there are SEVERAL factors that most likely contributed to my DVT and PE. We can't choose one alone - but the combination of a few caused for the 'Perfect Storm'.

*Suspected Chronic Exertional Compartment Syndrome (injury to the lower leg, possibly caused by an undiagnosed stress fracture stemming from shin splints. I DID have quite a bit of lower leg pain back in January and February, and I found an entry from Training Peaks where I noted acute right shin pain during a run in Wisconsin...)

* Varicose Veins and treatment of Sclerotherapy. Even though the superficial veins of my right leg were treated, it's still a shock to the body when 11% of it's normal blood pathways are suddenly zapped into oblivion.

* Possible twisting of right ankle during June 21 trail run. It was AFTER that run where I began experiencing swelling... and it got progressively worse last week.

* Birth control. Six or seven weeks ago, I stopped taking Ortho Tri Cyclin Lo and began a course of Seasonique. I hate getting my periods, and the benefit of Seasonique is that I would only have 4 periods per year. I used to ALWAYS just skip the sugar pill on Orth Tri Cyclin - but with a change in my insurance, I couldn't refill my perscription every 3 weeks...I needed to wait the full 28 days. Seasonique seemed like a great alternative.

* Genetic predisposition to blood clots. I have a family history, and this could certainly be a factor.

Where to begin? Again?

For now - I'm SAFE and well cared for at Scripps Hospital. I keep reminding Nathaniel that they fixed my back and extensive nerve damage back in 2008. This should be a piece of cake!

Still, Nathaniel kept repeating, "That's like Captain Phil from "Deadliest Catch". You're just like him...and he died."

Well - that's partly true. On the flip side, I'm not a male, chain smoking, 300 pound, seated on my rear for 40 hour stretches, alcohol slugging, 60-year old Crab Fisherman. I love Alaska - and I love seafood. But Captain Phil - God Rest his soul - wasn't exactly the poster child for "healthy living."

I thought I was.... I'm 29 years old... healthy... active... lively... non smoking... not sitting for long stretches... healthy eating (YEA TOFU STIR FRY!)...happy...in love.... married for 7 years (today!)....healthy...normal....29 year old...

The most firghtening element of all of this - I feel fine. Aside from one really fat foot - I feel fine. Normal. Healthy. Like I want to go for a swim or pound out a run... return to Del Dios Highway and bike like a woman posessed through Rancho Santa Fe into Solana Beach. I DO NOT feel like I had a clot pass through my heart into my lungs.

By the doctor's estimate - the moved several days ago...and a nurse friend commented that even though I may not have felt the usual symptoms of wheezing, coughing, chest tightness - the symptoms could have manifested themselves in some other way. She suggested extreme fatigue, and something suddenly 'clicked' in my brain.

Friday afternoon. It happened so suddenly. I was supposed to head out to lunch with Meredith, but our plans changed at the last minute. Instead I had taken out my violin in effort to get some practice into my fingers. Half way from putting the violin under my neck, I had a sudden urge to go to sleep. Exhaustion overtook me and I decided that my BEST course of action - was a quick nap. Back could wait.

I fell asleep nearly as soon as my head hit the pillow, and awoke nearly three hours later to my cell phone ringing. I answered it, but with much confusion. I had NO idea who the caller was, and lied my ass off in order to prevent hurt feelings. Sorry!

But I felt wiped - and I NEVER take naps that long. Ever. Yes I'm tired from training (yea!) - but that is NOT normal.

Our suspicion (and it can never be substantiated), is that sometime around that time, my body was fighting for oxygen. While the clot made it's way through my heart and into my lungs - my body was struggling for life. I still feel physically ill when I think about the chances of me laying down to take a nap - and never waking up.

And then going for a 4+ hour bike-run workout Saturday morning, hitting the tail end of a volunteer beech cleanup that afternoon, and a late dinner with another couple. And then Sunday - a 1:45 run along PCH, routine housework, snuggle with Nathaniel, and dinner with Dave and Meredith. Normal stuff. At least normal for me/us.

I just don't know how to explain it. I can't. I don't think I ever will.

But I WILL say this: IF YOU HAVE ANY LOWER LEG SWELLING - IMMEDIATELY HEAD TO THE ER! YOU MAY HAVE A LIFE THREATENING BLOOD CLOT AND YOU NEED TO BE ASSESSED.

So far my EKG is normal, vitals are all good, and x-ray of my ankle showed no broken bones. We're still awaiting the results of the ultrasound done on my heart - hopefully that will come through in the next day or two. But the biggest factor is the blood thinner medication.

Right now I'm getting two shots per day of Lovenox. Additionally, I'm taking Coumadin and trying to get my INR (International Normalized Ratio) levels between 2 and 3. Right now I'm still hovering below 1. My hospital stay is contingent on my body's ability to adjust and adapt to the Coumadin - the SOONER that the INR levels rise and stabilize, the sooner I can smoke this Turkey Joint.

Nathaniel would love that. The House Monsters would REALLY love that.

And let me tell you - I would REALLY REALLY love that.

But we're also working on ensuring that the clots in my legs dissolve. I know that now I'm receiving the proper medical treatment and therapy, my risk of throwing another clot has greatly subsided. But I still have a hard time and night falling asleep for fear it will happen again and I won't survive. I was so lucky last time - so incredibly lucky.

So now we watch and we wait.

As you can imagine - my 2010 Triathlon Season is over. Finished before it really even began. Nope, I couldn't catch a break between the sinus issues, pneumonia, and near fatal pulmonary embolism. Again - it's all perspective. Yes, I'm sad. But more importantly - I'm alive. It really sucks, yes. Is it fair? No. And while I'm really going to miss training for a little bit, and racing - deep down I felt that something was really wrong with regards to the compartmental syndrome. I was just waiting for confirmation from the orthopedic surgeon.

But this past year has also taught me a lot about living and life. I know that my NUMBER ONE PRIORITY is my health and happiness (and that of Nathaniel and the House Monsters!). And that in the end - I really just want to be able to throw my arms around Nathaniel when he returns from a flight, play with the kitties, and grow old while rocking on front porch swings with lots of grand children around the two of us. I want to be happy. I want to be alive.

Racing and triathlon - thanks in part to the Ironman corporation - isn't going anywhere anytime soon. And even if I spend next year racing only springs and olympic distances, I know I'll be okay. I'll be more than okay - I'll be alive and happy.

There are so many thank yous and people that I will forever be grateful for. My friends and family - there have been A LOT of emails going back and forth. I waited for a few days to publish a blog because I DID NOT WANT ANYONE to read this firsthand on a blog. Even if it was my blog.

My Primary Care Physician - who I am convinced saved my life. Without her quick thinking tenacity to figure out WHAT is going on, I don't think I would be here today.

The staff at Scripps Hospital Encinitas, Scripps Coastal Clinic, and Scripps Vista - simply put: thank you.

My wonderful coach and even better friend (and that's saying a lot), Jennifer Harrison was instrumental in getting the word out. I sent her a quick email Monday night without any information about what had happened... when I told her Tuesday morning we were both in shock. But she mobilized in a way that only Jen Harrison can do - and quickly sent out an email to 20 or so people.

I tried to respond right away and assure everyone that I was OKAY... feisty... joking about shark attacks...but lucky to be alive. And that they could pass on this email and forward it to anyone they wanted to. I KNOW that I had forgotten a few people - and for that I apologize. I would blame the lack of oxygen going into my system... but I can't because I'm at 100% full saturation.

To Nathaniel - I know it broke your heart when you couldn't be here right away. But I love you and I always will. Happy Anniversary Sweetheart! 7 years.... 107 to go... I can't wait to grow old with you, rocking in our chairs, while the crickets sing their midnight songs.

Additionally, Nathaniel's squadron has been WONDERFUL. I called them after I called the family - By Tuesday morning the amazing Gunfighter Gals had mobilized and brought more baked goods, "entertainment" magazines, candy, beef jerkey, clean underwaer, flowers, swedish fish, more flowers, diet coke, lilac shampoo and conditioner - and more of other things than I EVER though possible. Even though Nathaniel has been in the Marine Corps for nearly eight years - I feel like we're finally "home" with The Gunfighters.

Everyone who has stopped by (HOORAY FOR VISITORS!!!!!!), sent emails, texts, called, and left voice mails. My understanding is that my voice mail box is full. Please accept my apologies - your support, love, concern, and friendship means the world to me and I WILL get back to everyone. It may just take a while - but that's okay because my INR number is taking it's sweet time. And besides - I think the nurses are in awe of my popularity. As I was the fat kid with little social skills growing up, this is pretty cool. I feel so loved - thank you.

And finally - to the entire Trowbridge family. I love them all - and they've always been there for me. These past few days were NOT easy for many many different reasons - but the entire bunch, Soren and his wiley hair included, have been MY family. I love you guys.

I am so sorry if I'm forgetting anyone...blame the blood thinners.

I can't reiterate enough - IF YOU SUSPECT A CLOT, EXPERIENCE SWELLING, OR ARE UNCERTAIN - PLEASE DO YOURSELF A FAVOR AND GET IT CHECKED OUT IMMEDIATELY. IT COULD SAVE YOUR LIFE>

I know it's a long road ahead - but it's one that I get to take. And for that, I am grateful. Sharks, mountain lions and all. For now - I'll keep smelling the roses, ecstatic that I even get this chance.