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Guest Post: Post Partum Pulmonary Embolism and My Return To Me

My name is Caz and I’m 33 years old, married with 2 boys, William (5) and Teddy (2). On the 30th May 2016, I was diagnosed with multiple blood clots in my left lung, known as a Pulmonary Embolism - a life threatening condition that can cause cardiac arrest and death at any moment.

On the 22nd April 2016, I gave birth to a healthy (but very grumpy) baby boy. I’d had a very straightforward pregnancy and a great labour, all active, drug free and in a fabulous midwife led unit. I was within a healthy weight range, I was 30 years old and had never had a blood clot before, so I ticked none of the boxes for being at an increased risk. I was sent home a few hours later and settled into my life as a mum of 2 and a very unsettled baby. Teddy would only stop crying if he was on me. I spent hours sitting and after advice from a health visitor I co-slept while feeding him. This meant I did not move from the same position for hours on end at night. I’ve been told this may not have contributed to what happened, but I personally feel it did…

5 weeks after giving birth I started to feel a little off, as if a chest infection was coming, but as a busy mum I just carried on. The next day I had a nasty back ache and again, I carried on with the usual mum stuff. By the third day, I woke up with the worst back pain ever and it hurt to take a breath. I called my mum and asked if I could bring the boys over as “my back had gone and I just needed a few hours to rest”. As a mum would, she insisted I called the GP as the difficulty in taking a breath got worse. Luckily, they had a slot there and then. I was expecting to explain my back hurt and leave with a prescription of strong painkillers so I could continue parenting! But I explained my symptoms and got told to go to A&E immediately with a letter. Of course, no one said how serious it really was so I went back to arrange further childcare for the boys (mum had a broken arm).


pulmonary embolism post partum hospital
The picture I sent my niece saying look how over the top they are, it's only backache!

Once there, I was seen within 4 minutes and whisked into A&E majors, had bloods taken and an ECG. I was told I had suspected blood clots and the blood test would indicate this so I had to wait.

The blood test came back positive, so I was given an anti-coagulant injection to be safe then would have a scan on my legs to check for clots there. They didn’t want to go straight in with a chest CT scan due to breastfeeding and the higher risk of breast cancer due to increased tissue. The leg scan was clear so I was sent for a CT. After 8 hours of tests, the CT scan showed I had multiple blood clots in my right lung. The seriousness still hadn’t hit me and no one had given me more than a paracetomol for the intense pain that was on par with child birth! (Seriously!) Turns out the restricted blood flow and lack of inflation on the lung causes pleurisy which causes the intense pain. They booked me in for the anticoagulant clinic in 2 days time and showed me how to inject myself with anticoagulants at home. By midnight I was discharged and collected by my dad.

I went home to a newborn baby that never stopped crying and tried to breastfeed all night while unable to take a proper breath or sit up properly. I felt so lonely. By 5am I’d got baby asleep and was in so much pain, I went down stairs and collapsed in tears on the floor which caused even more pain (never cry when you have pleurisy). I called my sister to come and take me back to A&E as by now I thought I was actually dying. I left hubby in charge and back I went. I was re-admitted and seen by an amazing Army consultant, he explained everything in more detail and gave me some Morphine! (AMAZING)

I’d exclusively breastfed for almost 6 weeks, I was so proud of myself. I’d not fed him since the early hours (don’t worry daddy had formula at home) so I was beginning to become engorged, at this point I had no pump. I’d leaked through my bra and my top, I stank of stale milk and had to ask for a sick bowl to express into…no one offered me a gown to change into.

I was told I was staying in and was given a bed. The relief that I could finally get a nights sleep was amazing! The nurses laughed when I said I could get some sleep on the ward. Best nights sleep ever!

I was discharged the next afternoon. I was given a bag of injections to administer at home and warfarin tablets. I had to attend the hospital every 2 days and be careful not to eat too much vitamin k or do any exercise! This was where things got a little worse.

 

I’d just had a baby, I had gained weight, I was exhausted and my baby didn’t stop crying. I needed to train hard, but couldn’t. I was told I had to be very cautious for 6 months then I was allowed to get back into exercise and increase my fitness. But I’d got fat, I hadn’t had more than 3 hours sleep in a row and my fitness had dropped so low. I hated life. I still hadn’t bonded with my baby, I felt vile and felt my career was over and I couldn’t see a way out. Very dramatic on paper, but I’d envisaged this happy new bundle, me buggy running and getting back into my skinny jeans and have these perfect two boys to spend time with! Reality was, my gorogeous first born didn’t get a look in, my newborn hated me, my house fell apart, my belly overhung my jeans, I was bruised and totally wiped out.

I was diagnosed with Post Natal Depression when Teddy was 7 months and I didn’t tell anyone what the doctor had said and carried on trying to handle it all on my own. Fast forward 3 months and I told my husband. He was amazing and so supportive. He made me realise everything I was so down about could be sorted. Teddy wont cry forever, he will let me rest more and I can get my fitness back, even if it takes time.

So I set out on getting me back. I joined slimming world (the groups gave me a reason to go out even if Teddy had to come with me) I lost weight and began my journey back to fitness.

I was terrified the clots were still there and I would drop down dead. This was battle number 1. Battle number 2 was going back to the gym where I used to teach classes, but bigger and incredibly unfit. I took a deep breath and I went. No one was rude, no one laughed, everyone was encouraging and I didn’t drop down dead! The first two steps were done and I was on my way to getting me back.

I decided to set up an instagram account so others could find some comfort or support in not only my post partum weight loss and return to fitness, but my recovery from a pulmonary embolism. I found there was a huge gap in support for post partum mums who had gone through this. I also found the account helped me, it meant I could put things out there and not feel I was burdening or annoying people with my fitness and weight loss plan, people could look if they wanted otherwise they could just pass on by. It was motivating. I now always try and warn new mums not to rush into exercise, as if I had, it could have been a very different story. The 6-12 week message of not returning to proper exercise is there for a reason. Your blood remains very different for at least 6 weeks after birth. Gentle exercise like walking is great as you are moving so reducing that risk of the clots forming and it will make you feel better, but you're not pushing your body when it’s not ready.

I’m hoping this post will raise awareness of the dangers of blood clots, especially post partum. Maternity units need to discuss and give out leaflets with the warning signs of a DVT/PE. Currently if you’re not at risk no information is given. If I’d been told the signs I would have got help sooner. I was lucky, sadly many others aren’t. Pulmonary embolisms are one of the leading causes of maternal deaths in the UK.

The signs and symptoms of a Pulmonary Embolism (PE) can be found on the NHS website.

https://www.nhs.uk/conditions/pulmonary-embolism/


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