Hello, I’m 43 year old male, non smoker, training 5x a week for past 25 years. 10 days ago admitted to ER due to sharp chest pain and shortness of breath.
Diagnosed with PE on both lungs and a small lung infarction.
PESI class 1, HAS- BLED score 0.
Non-massive PE, low risk, no leg swelling, no deep vein thrombosis, all veins on ultrasound are clear. They don’t know the cause of thrombosis.
Got released from hospital 3 days ago, was put on apiksaban 2 x 5 mg.
Doctor said I got lucky and should make full recovery, just to take it easy with getting back to my training (running, boxing, lifting weights).
Chest pain went away after few days in hospital.
What I’m concerned about is my breathing. I still sense shortness of breath, even when I’m sitting and doing nothing. I can take deep breaths, have no chest pain, but despite deep breaths, I still sense lack of oxygen. It is making me anxious and I cannot fall asleep at night, since it is forcing me to take deep breaths every minute or so.
Has anyone had this type of illness and how long did it take to come back to normal and start training again?
I don’t have any experience with this, but I’d be sure to communicate how you’re feeling with your doctor and be sure to follow their guidance on this one!
AN unfortunate way to join the forum, but there are a few of here that have been through it, so you found a place to get some insight. Welcome.
Had my PE’s ~15 years ago, but my return to serious training was delayed due to an ongoing Achilles tendinitis. But, IIRC, I was back on the bike spinning lightly within 2 weeks.
@eddiegrinwald is 100% correct….consult with your doctor re: return to training as each case is different. And don’t hesitate to get a second opinion.
As for the cause of the PE, have they done blood work to rule out genetic issues? I found out that I have Factor V Leiden, so I am on blood thinners for life. If you can, determining the root cause is important, for cases like mine. But sometimes PE’s seem to just be spontaneous with no found cause.
Since my PE, I have continued to race and compete….for awhile I switched to triathlon just because of my concerns re: crashing in a crit or road race while on blood thinners. Eventually qualified for the Ironman 70.3 World Champs, so yes, you can come back to compete at a high level. Now mostly doing gravel races and doing relatively well in my AG.
There are a number of threads on the board re: DVT’s and PE’s, so definitely do a search and you will find a wealth of information.
Keep us updated on your progress……the good news is this is just a temporary blip and you’ll be back at it on no time!
And hopefully you can find/have a physician that is knowledgeable on athletes and training. It’s been hit/miss for me to find docs who are knowledgeable and can provide good meaningful comments and advice. Even if it’s just what to expect when training resumes and being able to bounce ideas and performance concerns off. There are some really capable and knowledgeable physicians around here who are also very active athletes, but you have to almost fight to get an appointment with them. Some of the ‘sports medicine’ docs aren’t into training and just got a certificate or something and just phone it in, sadly.
Thank you. They didn’t find yet the cause of this clot, but they did sent me to testing so I have to see it yet. For now, 3 months on apixaban is my therapy.
Did you have difficulty breathing when returning to your training, and if so, how long did it last? Did you do your lung testing, capacity, functionality? Are they compromised with respect to previous period, or are they restored completely?
I was largely asymptomatic for my PE, so I had no issues with breathing once I resumed training…but my training was also very light due to the Achilles.
Absolutely no long term ill effects on my lung capacity, etc. Hit my highest FTP numbers years after the PE…like I said, this should be nothing more than a slight blip for you (even though it can be pretty unnerving in the moment).
Got it, thank you! Hopefully will be back on track soon. My doctor says I should make full recovery, but it will take weeks or maybe months, before full lung capacity is restored.
IDK, but for what it’s worth, CO2 is by far the predominant controller of respiration. When you feel like you’re out of breath or can’t get enough air, it’s due to an excess concentration of CO2 in your blood, not lack of O2. In most cases, lack of O2 isn’t sensed and with O2 deprivation, you just get dopey and sleepy. Bad enough you fall asleep and then expire.
Not certain the comments re: CO2 vs O2 are relevant to a PE. PE is a blockage of an artery in your lungs, thereby preventing O2 from getting to your lungs.
Good point. What I’m pointing out doesn’t help. It’s just a technical point that the blockage also prevents expiration of CO2, which is what makes someone feel short of breath. It’s the buildup of CO2 that causes the sensation of being short of breath, not the lack of oxygen.
Sorry to hear about your PE situation, but sounds like you are doing better al ready
Unfortunately, it can take your body a month or longer to break down the clots or your PE. The clots can make it harder for your heart to do its job causing you to become “winded” easier. It could explain your shortness of breath. I don’t know the details of your specific situation.
Unless you received a clot busting medication and in that case even then residual clot could be present. Your apixaban medication prevents clots from forming and getting larger. It doesn’t break them down. Your body will do that itself over time. The body does this quite well.
I strongly agree what was mentioned before in the thread, share your thoughts with you doctors office. They are uniquely qualified to help address your concerns. It may be wise to inquire about how to get back into exercise from them. If you do look up information online make sure you’re getting your information from a valid source as well. There is lots of bad information online. Your doctors office will likely provide you information as well or at the very least point you to a good resource of asked.
The characteristic blood gas in a PE is respiratory alkalosis (LOW pCO2) except in the setting of massive PE/shock. The problem in PE is V/Q mismatch where you’re ventilating dead space. The dyspnea is caused by increased PA pressure and angina.
I’m not much of a cyclist yet, but I had a PE with infarction last year after surgery. The first month, my symptoms were bad enough that walking outdoors was challenging, and I had to build up stamina.
Guidelines from my PCP were to avoid raising heart rate above Z2, and I was put on Apixaban as well. Right about the 2.5 month mark, I went to the ER for light chest pain, as I had been told to go for any symptoms. The ER docs ran another CT scan, and the PE was almost completely dissolved at that point, and I was taken off of the apixaban (since my PE was provoked by the surgery).
My biggest issue, about 9 months later, is stamina for hard sets lifting weights.
Be patient, the blood thinner drugs really work, but it takes a couple of months. The first month is the most dangerous, they take about a week to ramp to full effectiveness. If it was me, I would do a lot of easy Z1 type stuff for the first 2+ weeks, and then move on to easy Z2 until given more clearance by my doctor (I got approval for intense exercise at the 3 month mark).
In case of non-massive PE, is dyspnea reversible, meaning if there will be revascularization of damaged tissue and eventually full lung capacity restored, without this shortness of breath?
