This post, on the surface, hasn't got much to do with the paleo diet. It’s also pretty self indulgent. I’m writing this post in the hope that people who relate to anything I’m about to write below, will get in touch. Perhaps we’ll be able to compare our stories – maybe someone will point out similarities we hadn't even considered?
Apologies – this is a long post, you might want to make a cup of tea first…
So, let’s go back. In early 2010 I lost weight, A lot of weight. About 20kg (44lb) in fact. I found out about paleo, completely transformed my diet, started walking/ running to work and developed a mild addiction to taking dance classes. Over the three months I lost the weight, I could almost see it falling off. Every day at work people would comment. But then as quickly as the weight loss began, it stopped. A huge plateau (I’ll be writing a lot more about this in future posts). I remained 17kg lighter, and didn't put any back on.
Around three months after my weight hit a plateau, I travelled back to the UK for the wedding of one of my oldest school friends (that makes her sound old, but you know what I mean). This is a long, long journey, that I’d made several times before. I had never been as slim and physically fit as I was then; I felt great and was itching to show my family and friends in England the new me.
The Flight
It’s a long old flight, is Sydney to London. I opted for the shortest time, a mere 26 hours, meaning I had just a couple of hours stopover in Singapore. I've always been cautious on flights, walking around lots, moving my feet and ankles constantly and wearing flight socks. I even special-ordered my flight meals, with the aim of keeping to my healthy paleo diet. I never drink alcohol on long haul flights, and even carried my own water bottle to make sure I kept hydrated. I must have been one of the most health-cautious passengers on the entire plane.
So I got to England, went to the wedding, saw my friends and family and generally had a great time. Due to the level of fitness I’d built up, I went out for a few runs during my trip. I had been diagnosed with asthma in 2005, but it had almost disappeared earlier that year, after adopting a paleo diet – or so I thought*. In England, on my last run, I really struggled to breathe. Really struggled. In this situation in the past using my inhaler wasn't an instant remedy, but it always made breathing a bit easier. This time however, it didn't even touch my breathing difficulties, which was quite scary. I put it down to the change in climate (that November in the UK was pretty cold and wet) and decided not to do any more runs until I got back to the Australian sunshine.
Towards the end of my trip I’d started to feel, what I assumed was, a really uncomfortable heartburn sensation. My “asthma” wasn't improving either. The pain got progressively worse – and I did think it odd that it didn't seem to make a difference whether or not I’d eaten. I chose to blame it on eating white potatoes for the first time in ages – see – proof that paleo is the right way to eat!
I left England, with what had become quite constant pain, and headed to Bangkok, Thailand. I had a few days planned to see the sights, before heading back home, to Sydney.
Bangkok
When I woke up on my first morning in Bangkok, I was in a lot of pain. I knew it was my lungs, and I kind of knew it was a “serious” pain. To breathe, I had to double over and take very shallow breaths. For some stupid reason, the night before I had thought it a great idea to unpack my suitcase so I could repack it neatly the following day. It took me most of the day to repack as the pain was so great, and the effort so exhausting. I had to sleep sitting upright, but as I needed to bend forward to breath – and was in pain, and scared – I didn't get any sleep.
I foolishly decided not to tell anyone, whether in Thailand or back home. I knew if I did, I’d have to go to a Thai hospital, and my panicked self thought that would not be a good thing**. So somehow, I and my suitcase, made it to the airport and through check in, despite being doubled up and probably quite obviously in pain. Very, very foolish, I know.
I got back home to Sydney, made it through what seemed like a never ending queue for immigration and went immediately to my doctor. After hearing I’d just got off a long haul flight, my doctor was very concerned and called the emergency department of the nearby hospital, to tell them I was coming. I declined her suggestion of an ambulance, and drove myself, feeling scared, but relieved it was all about to be sorted out and this horrific pain might actually stop.
I didn't meet any of the non-flying risk factors associated with Deep Vein Thrombosis (DVT) as I was young, a non smoker, didn't have it in the family, hadn't had surgery and was not taking the contraceptive pill. So I was given an x-ray, which (of course) gave me the all clear. I was told it was probably muscular, and to go back to my doctors in a week if it hadn't improved. I knew it wasn't muscular – but these were the experts – the x-ray showed nothing – they had to be right?
At this point, the story goes off on a bit of a tangent, which I’ll include for completeness, but feel free to skip…
Anaphylaxis
Before being discharged, the nurse gave me some Nurofen to help with the “muscle pain”. I’d already told her I was allergic to drugs like aspirin and ibuprofen, but just to be safe, I asked her if that was definitely ok for me to take, since I was allergic to aspirin and ibuprofen. She went away and “checked” and came back to assure me it’s fine, take them. I knew Nurofen make ibruphen, but since it’s a brand name, I assumed they must make other drugs too and took the two white pills she gave me from the little plastic cup and off home I went.***
I got home and was heading to the shower when my face began to feel really odd and tight. It felt odder and odder by the second. I went back downstairs, where my housemate took one look at me and told me to get straight back in the car. I thought it odd that Kev kept looking at me and telling me it had almost gone, whilst at the same time driving fast and straight through several dodgy amber lights… most unusual behaviour.
As soon as I got back to Emergency, they took one look at me, realised I was having an anaphylactic shock and took me straight to the resuscitation area, despite the fact there was a huge queue – and I hadn’t even filled the registration form in. I then had seven doctors and nurses around me and was being given adrenaline in one arm, and antihistamine in the other – as well as wearing a mask giving me more adrenaline (and who knows what else). All I could see was a little corner of my hand, tight, swollen and covered in bright red hives. I could feel my face was tight and swollen. I really thought I was going to die****. After a while the anaphylaxis went away and I started to feel more relaxed (except for the shaking, which I think is a result of the adrenaline) – but then it came back again. Round two followed – more adrenaline, more doctors, more fear – before finally, it went away and stayed away. I spent the night in the emergency medical unit being monitored every 30 minutes or so. Everyone had completely forgotten about my chest pain, and I was still recovering from the adrenaline and shock.
Back to the main story….
The chest pain. I went back to work a couple of days after the anaphylactic incident and spent the week trying to carry on as normal, it was just muscle pain after all. I forced myself to go on walks at lunchtime, but it was excruciatingly painful. That Saturday morning, I went straight back to my doctor, who was horrified and convinced it wasn’t muscle pain. She sent me straight back to emergency, who this time did lots of other tests that they hadn’t even mentioned the previous week. A nurse scanned my legs, looking for a clot, but nothing was found. I had a couple of different scans. The first one, I think, was a CT scan. The VQ scan turned out to be the crucial one. For the VQ scan, you’re given a funny tasting radioactive gas to breath in, then your lungs are scanned. Next you’re given a radioactive injection in your arm, so the scan can match the first scan to the blood vessels in your lungs. I’m not remotely medical, so this is a very basic (and quite possibly inaccurate) explanation. In healthy lungs, the scans match. If they don’t match it indicates a clot. Lo and behold, there was a mismatch.
It turned out I had a Pulmonary Embolism (PE), at just 30 years of age without any of the major risk factors (well, except for flying). PE’s often happens after DVT, due to a clot leaving the legs and travelling to the lungs. It’s often hard to tell what caused it, unless a clot is found in the legs. Apparently the clot can break away from your lung and go to your heart, which would be fatal. And to think I was wondering around for ten days in ignorance trying to (as they say here in Australia) “man up”… I was admitted and immediately given Clexane (heparin) injections twice a day to thin my blood, until the Warfarin (also know at the anticoagulant Coumadin) drugs I was given took effect.
As much as I try to avoid drugs and anything artificial, in situations like this, I’m always thankful for science. Three days later I went home, but had to take the Warfarin for a further six months and go to the doctors every few days to have my INR levels checked. You have to really watch your Vitamin K intake when taking Warfarin, and can’t have certain foods, which wasn't exactly the situation I wanted to be in. The drug was originally developed as rat poison apparently, so I was keen to come off it as soon as I was out of risk.
Again?
About nine months after the first instance, I travelled to America for the Ancestral health Symposium in LA in August 2011. I was off Warfarin and completely clued up. These things don’t happen twice. I didn’t only have flight socks, I now had whole body skins. I spent most of the flight pacing up and down. I managed to use my Qantas points to upgrade one of my flights to business class. I gave myself Clexane injections, before during and after the flight. It was only half the distance of a trip to the UK. What could go wrong?
I remember having a pain in my calf when I got to San Francisco, but put that down to all of the hills and thought I’d probably pulled a muscle. I had a great trip, the symposium was amazing, all was well. On my return flight I felt great, really well and full of healthiness. All of a sudden, I felt very really ill, from completely out of the blue. I got up and walked to the bathroom. The next thing I remember is being in a really nice deep sleep and being abruptly woken up by two aircrew (who were also registered nurses – how good is Qantas!) It turns out I’d passed out on the way to the bathroom and had hit my head on the way down. They insisted on me breathing from an oxygen canister for the rest of the flight, and I felt fine. The next few days I didn't feel “quite right”, so went back to the specialist (who I’d been assigned nine months before) and had another VQ scan. It turned out I had a new, but very small, Pulmonary Embolism. Another one! How is that even possible?
I ended up taking Warfarin for another six months before getting the all clear again, and coming off the Warfarin. I had all of the genetic clotting tests, and nothing was found. My specialist said it seemed to be “just one of those things”. I don’t agree with “one of those things”. Even if it was the long haul flight, something else must be going on to make me more susceptible to this. I live on the other side of the World to my family, I can’t simply not travel ever again? I have taken a lot of long haul flights since this, and been completely fine. I don’t fly more than eight hours without at least a night’s stopover. I have also exhausted all of my Qantas points upgrading as many long haul flights as I can, to business class, so I can keep my legs in what seems to be a safer horizontal position.
So, this is how it was left, until a chance conversation with one of my friends in Sydney. Her fiancé is also on Warfarin, having had a PE too. He doesn't have the typical risk factors either. We then realised he and I had both lost a considerable amount of weight just prior to getting the PE. An interesting coincidence. I mentioned this to a doctor I saw recently, who realised she had seen the same in one of her patients too – a PE after a significant weight loss.
Do processes to do with circulation not adapt quickly to reduced body weight? Do people who have recently lost a lot of weight, still produce too much of certain chemicals? I wish I was a scientist…
I’m now seeing a functional doctor and am having a lot of tests (more on this soon), so I hope to find out if there is anything underlying going on.
Why am I posting this?
I want to hear from other people who’ve had out of the blue PE’s (or DVT) like this. If you or someone you know has had a Pulmonary Embolism, I’d love to hear more about what happened to you – and what you think caused it or made you more susceptible. Had you also lost weight soon before getting the PE? If you don’t want to leave a comment, please send me an email, I’d love to hear from you.
* Incidentally in another interesting discovery, my asthma completely disappeared, after the massive doses of adrenaline I was given. I’ve found a few studies (I’ll link to them here when I find them again) that use adrenaline in asthma treatment. Very interesting.
** And before you ask – yep, I had a very comprehensive travel insurance policy. I should have used it.
*** I now won’t even take paracetamol without reading the packet myself. I also wear a medic alert bracelet, to make sure this won’t happen again.
**** Perhaps the worst moment was when I asked one of the medical team this exact question and they wouldn't answer me. This still puzzles me, I'm sure they aren't allowed to say you’re going to be ok (for legal reasons?) but in that situation, I just want to be lied to and reassured that everything is going to be fine. Even if it isn't. Lie to me, please!
TL/DR: Went paleo, lost a lot of weight fast, got a Pulmonary Embolism; wondering if rapid weight loss makes people more susceptible to DVT & PE’s?
