Outrun Danger: Why Fit Women Get Blood Clots
Jenny Fletcher should have been at the top of her game. In the fall of 2012 the triathlete and former model had scored her first victory in a half-Ironman, just three years after turning pro. But seven months later, in April 2013, she found herself struggling to cross the finish line at an all-woman half-marathon in New York City. "After the race I was nauseous and had to sit down," Jenny, 37, says. "I ended up back in my hotel room, sleeping all day."
Things got worse when she went home to Los Angeles: Jenny awoke on the night of her return with a stabbing pain in her rib cage. Out cycling a few days later, her breathing was so labored that she lagged behind her training partners. And after a tough pool workout, she curled up on her couch with a massive headache, in tears, barely able to move. What's wrong with me? she wondered. Still, she convinced herself that she was just tired or stressed out. "I got off my couch and did a hard bike ride," Jenny recalls. "As an athlete, I'm trained to push through pain."
When she coughed up blood the next morning, it scared her enough to finally see a doctor. A CT scan led to a shocking discovery: Jenny had blood clots throughout her lungs, almost entirely blocking her right pulmonary artery. "The doctor told me that if I had waited one more day to come in, I might not be alive," Jenny says.
After shots of a powerful medicine to break up the clots and an overnight hospital stay, Jenny went home with the prognosis that she would be on blood thinners and unable to race for at least six months -- and with a question that kept nagging at her: How could this have happened to me?Hidden Risk
Most of us associate blood clots with having major surgery, smoking or being elderly or overweight. But the truth is, they can strike anyone, even fit women, says Stephan Moll, MD, the medical director of the University of North Carolina at Chapel Hill's blood clot education outreach program, Clot Connect. In fact, about a quarter million women suffer from dangerous blood clots every year.
Typically, clotting is a good thing. It's the body's natural protective response when a blood vessel is injured during an accident or an operation. Think of it as patching a crack in drywall. "That's what our bodies do with damaged blood vessels," says Andra H. James, MD, an ob-gyn and advisory board member of the nonprofit National Blood Clot Alliance.
Clots can also occur, however, when the blood circulates sluggishly during long stretches of inactivity, like sitting on a plane or in a car; when hormone levels are elevated; or because of a blood disorder. If the clot doesn't dissolve on its own, it may grow in a deep vein in the body -- a condition known as deep vein thrombosis (DVT) -- where it obstructs the circulation of blood from the extremity back to the heart. About 90 percent of the time, DVT forms in the legs. In more than 30 percent of cases, the clot (or a piece of it) breaks off and travels to the lungs, causing a blockage in the artery there. This is known as a pulmonary embolism (PE). When the lung clot is large or there are many small ones, the heart has to work especially hard to pump. Untreated, the pressure becomes too great and the heart stops.
DVT can have warning signs. The affected leg may become painful, swollen, red or blue, or feel warm to the touch. PE often causes chest pain, coughing or shortness of breath. Yet it's easy to dismiss these symptoms as everyday workout aches. "Fit women may think they have a charley horse or a twisted ankle or that their chest pain is due to a muscle strain," Dr. Moll says.
That can be a fatal mistake. As many as 100,000 people a year die from DVT/PE in the United States -- more than the number of deaths from breast cancer, HIV and car accidents combined -- according to the Centers for Disease Control and Prevention. "Women need to be aware of the symptoms of DVT/PE and seek medical attention immediately if they have any of them," says John A. Heit, MD, a professor of medicine at the Mayo Clinic College of Medicine in Rochester, Minnesota.
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