what does a pulmonary embolism feel like?

Discussion in 'Medical Topics' started by Unregistered, Apr 9, 2013.

  1. Unregistered

    Unregistered Guest

    Male mid 50s a little overweight. Had a DVT in leg > 10 years ago. Just did three days of hard skiing at 10k feet plus. Have serious pain in chest. Only some eggs juice and toast for food today. Hurts more when I walk or get out of chair. Ibuprofen makes it a little better. Other ideas?
     
  2. Skylane81E

    Skylane81E Final Approach

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    Re: what does a pulmonary edema feel like?

    Go to the doctor/hospital if you are having chest pains!!!!!!!
     
  3. AdamZ

    AdamZ Administrator Management Council Member

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    Re: what does a pulmonary edema feel like?

    Other idea? Pain in chest go to ER! NOW! really.
     
  4. DrMack

    DrMack Line Up and Wait

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    I have survived a heart attack. Call 911 NOW!!!!
     
  5. denisd

    denisd Pre-Flight

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    Re: what does a pulmonary edema feel like?

    Not what you want to hear...911!
    My wife had shortness of breath that was caused by a pulmonary embolism from blood clot in leg.Waited for 45 minutes for our son to drive her to ER. Only later did we know what it was and how deadly it could be if another piece of the clot migrated.
     
    Last edited: Apr 9, 2013
  6. Unregistered

    Unregistered Guest

    Re: what does a pulmonary edema feel like?

    Oops I said edema I meant embolism. I do have shortness of breath but I'm at 9k elevation and live much lower.

    What mind of test for embolism?
     
  7. Allen C

    Allen C Pre-takeoff checklist

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    Re: what does a pulmonary edema feel like?

    Best case, intercostal pain that will resolve in time and you go home without fear of a lost medical. Worst case, you die.

    Don't sit this out. 911. NOW. :mad2:
     
  8. Unregistered

    Unregistered Guest

    Re: what does a pulmonary edema feel like?

    I Googled intercostal. This is front just rite side of sternum. Deep breath hurts quite a bit.
     
  9. weilke

    weilke Touchdown! Greaser! PoA Supporter

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    Re: what does a pulmonary edema feel like?

    Yeah, could be nothing........or you'll die.

    As everyone else has pointed out, none of things you have to worry about can be diagnosed via the internet. You say that you are overweight, had a history of DVT in the past:

    ----> get the the friendly people with cargo-pants give you a ride to the next suitable ER or ER with chest-pain center.

    If everything is fine, you'll have a bunch of paperwork for your next AME visit. IF things are not fine, well, you would want to have any of the things that can give you chest pain treated.

    (as I am typing this I am looking at the chest CT of someone who 'just had a little cough'........)
     
  10. weilke

    weilke Touchdown! Greaser! PoA Supporter

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    Re: what does a pulmonary edema feel like?

    What are you still on your computer ? Call ! NOW !
     
  11. bbchien

    bbchien Final Approach

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    Re: what does a pulmonary edema feel like?

    Just like my deceased father in law.
    He called. Chest pain.
    I said, call 911, have them take you to Long Island Jewish (that's his folks, and he's more comfortable there!).
    Three hours later, no news.
    I call LI-J. Never heard of him.
    I call the house. "Well I got into the car and started driving but it went away, so I when home".

    3 weeks later, 4 vessel CABG.

    Now if you have a pulmonary embolism, immediate anticoagulation is lifesaving. If you don't have it, they can tell pretty accurately.

    Hope you are able to post again in a few days. If we don't hear, we know what happened.
     
  12. weilke

    weilke Touchdown! Greaser! PoA Supporter

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    Re: what does a pulmonary edema feel like?

    Old guys can be incredibly stubborn. For some people, 'old' starts with about their 45th birthday.

    This could be anything from a pulled muscle, indigestion, intercostal nerve irritation, a cracked rib, pneumothorax (dropped lung), pneumomediastinum (air in the space around the heart), pulmonary embolus (blood-clot in lung), aortic dissection (torn lining of main blood vesssel) or a heart attack. Any ER doc will be able to rule out the big ones and get you plugged in for the further workup. The internet will not fix you.
     
  13. airheadpenguin

    airheadpenguin Pre-takeoff checklist

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    Re: what does a pulmonary edema feel like?

    This is like asking a Flight Attendant to perform Captain's duties while the FO flies the approach. It might work but wrong resource to practice CRM with.
     
  14. Unregistered

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    Re: what does a pulmonary edema feel like?

    Thanks all. Im gonna mosey over to the er. I bet i get stuck in the belly with that Loveens stuff again. I hate that shyte. Ill let you know what we find. I guess no more skiing this week and we just got some nice powder too.
     
  15. AggieMike88

    AggieMike88 Touchdown! Greaser! PoA Supporter

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    Re: what does a pulmonary edema feel like?

    Interesting set of priorities there, bud...

    (I wonder if this is one of our regulars or just a random fly by. I'm not recognizing the writing style...)
     
  16. Unregistered

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    Re: what does a pulmonary edema feel like?

    D dimer? Test looks elevated. Going in for cat with contrast. Can a mod change the title to embolism pls.
     
  17. Ghery

    Ghery Final Approach

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    Re: what does a pulmonary edema feel like?

    You sound like me. 5 years ago I had three clots in my right lung that had migrated from the surgery site for my prostatectomy. Hurt like heck when I inhaled. Finally my wife and my dad talked me into letting them take me to the local ER. CT showed the clots. 4 days of quality time in their ICU. Wasn't until I got home and looked on the internet (hospital wouldn't let me connect to their network) that I found out how stupid I had been. 6 months of warfarin and all was well. I could have gotten an SI while taking it, but I just waited until I was off the rat poison, got the SI for prostate cancer and went back to flying.

    Don't wait, get help. NOW.
     
  18. gprellwitz

    gprellwitz Touchdown! Greaser!

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    Re: what does a pulmonary edema feel like?

    Wow, glad it looks like the OP finally got to the hospital. Do we REALLY need to put a notice at the top that this forum isn't for potentially life-threatening emergencies, like the robo-answerer when I call the Dr. office? IF YOU MAY BE IN NEED OF IMMEDIATE MEDICAL ASSISTANCE HANG UP NOW AND DIAL 911! Sure hope he's alright!
     
  19. Unregistered

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    Re: what does a pulmonary edema feel like?

    Well poop, the cat shows a pretty big embolism in the right upper lung and a much smaller and older one on the lower left. Just got the Lovinox stab and 10 of Coumadin. I will be in for 3 days untily pt-inr is stable.

    This really sux. From the aeromedial side since its my second time in the clot box things might be a bit dodgy getting my 3rd class back. We will see what we will see i guess.
     
  20. gprellwitz

    gprellwitz Touchdown! Greaser!

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    Re: what does a pulmonary edema feel like?

    What would have really sucked would be for you to have not gone to the hospital! Get better!
     
  21. weilke

    weilke Touchdown! Greaser! PoA Supporter

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    Re: what does a pulmonary edema feel like?

    Actually, it's really great, because you didn't wake up DEAD tomorrow morning.

    Glad they figured it out in what, 2 hrs ? It is treatable, you are being treated for it. Down the line, you may need to get worked up as to why you have the second event of thromboembolic disease.

    Btw. you may be offered at some point to be switched to pradaxa as anticoagulant (an off-label use). For some reason, the FAA really gets their panties in a wad about that one, so dont do it unless you can discuss this with a good AME first.
     
  22. bluee

    bluee Line Up and Wait

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    Re: what does a pulmonary edema feel like?

    I can't believe how stubborn some people are about seeking medical treatment. I'm glad the OP made it to the ER for treatment, but he waited how many hours?
    My father-in-law died of the flu because he refused to go to the hospital. An 84 year old man with a bad flu, how stupid.
     
  23. DeeG

    DeeG Line Up and Wait

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    Re: what does a pulmonary edema feel like?

    I would ask my mom about what a PE feels like, but it killed her, soooo......

    Glad you went and got it looked at.
     
  24. Matthew

    Matthew Touchdown! Greaser!

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    Re: what does a pulmonary edema feel like?

    Yeah, but he wouldn't have to worry about keeping his medical.
     
  25. Skylane81E

    Skylane81E Final Approach

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    Re: what does a pulmonary edema feel like?

    Bullet dodged
     
  26. jnmeade

    jnmeade Cleared for Takeoff

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    Re: what does a pulmonary edema feel like?

    I'm sure you'll think before taking the next third class, in case you want to fly as SP in LSA.

    I have my own thoughts on the helpfulness of telling people to go to the ER, but they are politically incorrect. Now, mind you, it helps the person doing the telling a whole lot - they can always say, "I told him so". I'm only suggesting that there are two persons in that conversation and we're only hearing the perspective of one. Those of you who have gone to an ER more than once or twice may have some glimmer of what I am saying, but I'll leave it there......
     
  27. JasonM

    JasonM Pattern Altitude

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    If something like this happens to someone with a medical certificate and it turns out that it would be something that would disqualify you from getting that medical renewed, is it possible to let your medical expire and still go the sport pilot route? or would this kind of thing need to be reported anyhow and disqualify you from the sport pilot?

    btw.. good luck to you, the original poster.
     
  28. Unregistered

    Unregistered Guest

    If the OP were to get an IVC filter, would he be able to pass a 3rd class medical?
     
  29. jnmeade

    jnmeade Cleared for Takeoff

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    You do not need to report it to anyone.
    You have to self-certify that you are fit to fly.
    61.23
    (2) A person using a U.S. driver's license to meet the requirements of this paragraph must—

    (i) Comply with each restriction and limitation imposed by that person's U.S. driver's license and any judicial or administrative order applying to the operation of a motor vehicle;

    (ii) Have been found eligible for the issuance of at least a third-class airman medical certificate at the time of his or her most recent application (if the person has applied for a medical certificate);

    (iii) Not have had his or her most recently issued medical certificate (if the person has held a medical certificate) suspended or revoked or most recent Authorization for a Special Issuance of a Medical Certificate withdrawn; and

    (iv) Not know or have reason to know of any medical condition that would make that person unable to operate a light-sport aircraft in a safe manner.

    § 61.53 Prohibition on operations during medical deficiency.

    (a) Operations that require a medical certificate. Except as provided for in paragraph (b) of this section, no person who holds a medical certificate issued under part 67 of this chapter may act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person:

    (1) Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or

    (2) Is taking medication or receiving other treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation.

    (b) Operations that do not require a medical certificate. For operations provided for in § 61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner.

    (c) Operations requiring a medical certificate or a U.S. driver's license. For operations provided for in § 61.23(c), a person must meet the provisions of—

    (1) Paragraph (a) of this section if that person holds a medical certificate issued under part 67 of this chapter and does not hold a U.S. driver's license.

    (2) Paragraph (b) of this section if that person holds a U.S. driver's license.

    If you are in doubt of or medical history would raise the question of your fitness to fly as SP in LSA, you can get your family doctor to certify if you are safe to fly with SP privileges, you don't need an AME and OK City to get involved so long as you meet all the other requirements.
     
  30. Unregistered

    Unregistered Guest

    OP here. Well, obviously I made it through the night. It wasn't very pleasant but things could be a lot worse. No news, is really no news today. More Lovinox, and monitor my vitals. Soon as my PT stabilizes where they want I'll get out, but I gotta take it easy, no strain for the next 10 weeks.

    As for the aero side of it, I asked a certain helpful doc on here for some direction. I have self grounded as of now, and I'll decide on a strategy for going back to my 3rd class or going SP once I get an idea of how hard the 3rd class will be.

    They had a confab with me a little while ago where they want to show how helpful they are to patients, and it was nice up until I asked them about their infection rates, cause I don't know squat about this facility. Lots of blank stares at that one. No one knows, no one knows how o know, and no one was going to ask to find out how to know. Maybe the state has a DB, but it should be info avail to a patient, don't you think?
     
  31. Jthamilton

    Jthamilton Line Up and Wait

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    Are you considering a IVC filter? Or did I read something wrong from Someone else? Greenfield filters are usually reserved for folks who fail anticoagulant therapy of those where taking blood thinners are contraindicated, like hx of hemorrhagic stroke or bleeding issues in past.

    I just diagnosed patient of mine with 2 PE's last week. He drives dozers for living requiring him to sit in one place for extended amounts of time. His symptoms as most present with is acute chest pain and shortness of breath. While we are working on getting him to his therapeutic INR of 2-3 he is taking lovenox. I will continue this for probably 6 months and he will do fine!

    His workup is going to include an ECHO to rule out any vegetation on his valves but I doubt this will be an the issue.

    Although PE's are very dangerous and do kill, when found early and treated properly they cause no long term issues.

    Im sure Dr. BRuce has good plan of attack for you!

    Glad to hear your well, the other options arent so good!
     
  32. bbchien

    bbchien Final Approach

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    J.T.H. I don't think he's at the Greenfield clip point just yet. But that is certifiable too :)
     
  33. weilke

    weilke Touchdown! Greaser! PoA Supporter

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    Get well !

    Is everything ok otherwise, folks travelling with you able to get home etc. ?
     
  34. Jthamilton

    Jthamilton Line Up and Wait

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    I agree he is nowhere near greenfield. Good to know I can have PE though and stil get certified since I'm taking 20 hour road trip with my son this weekend:yesnod:
     
  35. Unregistered

    Unregistered Guest

    OP here. Things are going fine. I really hate that Lovinox stuff. It burns going in. Maybe if they slow down a bit that might help.

    My breathing has clearly improved and I have less pain in chest. I can take longer breaths and even cough a little if needed. I'm using one of those inhaler testing machines and I'm up to 2000mL which is supposed to be pretty good for 8000' elevation. PT-INR is 1.4 today so it looks like I'll be out on Friday, maybe Sat.

    I'm alone up here, rest of family is back at the ranch. I've got my car, and can get around ok once discharged. Not looking forward to a 12 hour drive home. I think I'll do two 6 hour days with a nice rest in the middle somewhere.

    I wanted to address the concerns from the early part of the thread. Although it's easy to say 'go to the ER' and many times that is the right answer, I wasn't in immediate distress, and several factors were at work. I try to think about things long term when I make a decision that will have long term effects. Since I made it off the ski slope at 12k feet, and could move around pretty well, I surmised without much effort that I didn't have the really bad kind of PE that drops you like a stone. Not that the others aren't serious, but at least I could sit and cogitate for a little while.

    Also, I was pretty sure I knew what was wrong(despite first misstating it as edema). I was working hard up there, and moving fast at high alt, and for three days straight. The veins had to be expanding as other body parts do, and I figured I had some gunk in the lines that just didn't stay in the same place, added to the fact of my prev DVT. So, by going to the ER and getting an official diagnosis I was going to have to face the FAA music, and also lose some work, which is pretty important to me right now.

    What were the alternatives? Well, I could have started taking a serious dose of aspirin, get down to lower elevation, get some offshore coumadin and run a PT-inr test at home for six months. Of course, I wouldn't have the benefit of knowing where the clot was, and how dangerous it was but that could have been done. Of course, that's not the appropriate way to deal with medical issues, but with the increase in costs, and the complete hassle that the medical industry has become, I was actually considering it, as I had a very good idea that my diagnosis was correct.

    Plus, Like most active, type A people, I really hate hospitals. Not just the hassles of being hooked up to a million sensors, but the lack of privacy, getting stuck twice per day, being out of work for a while, and the threat of a hosp borne infection make them not nice places to be for any length of time. I had a temp of 99.4 yesterday and I was already thinking of some kind of weird staph bug that resists everything. Thankfully, my temp is back down to 98.5 today and I have no other symptoms.

    I guessed asking here about a PE would get the response I got. And it is, and was the right one. I'll take my medicine(literally) and get well the right way. Things could have gone a lot worse, and being in the hosp is much better than a 30 min amber-lamps ride away.
     
  36. AcroBoy

    AcroBoy Line Up and Wait

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    Actually, we typically discharge a patient on a therapeutic dose of Lovenox rather than wait until their INR comes up to the 2-3 range, which can take a while. With a history of prior PE you were already at higher risk.

    Although the current thinking is six months on Coumadin, with a prior history of DVT or PE your internist may want to keep you on it longer, if not forever. They may also want to work up your blood for some conditions that predispose you to being hypercoaguable, like factor V Leiden, or protein C or protein S deficiencies, among others.

    Just a few thoughts, but I have had literally thousands of patients on a variety of anti coagulants through the years and also did an NIH biochemistry fellowship in blood coagulation proteins during my medical training. Good luck.
     
  37. Unregistered

    Unregistered Guest

    OP here. Jim, thanks for the info, that's great stuff. I will be going out with the Lovinox kit tomorrow at a value of 1.5 or higher. I'll be getting with my internal guy to keep it in the right range. I looked at that Greenfield thing and would like to avoid that for a while.

    Now on to the interim situation:

    61.53 Prohibition on operations during medical deficiency.

    (a) Operations that require a medical certificate. Except as provided for in paragraph (b) of this section, no person who holds a medical certificate issued under part 67 of this chapter may act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person:

    (1) Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or

    (2) Is taking medication or receiving other treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation.

    As above, I will be wanting to act as pilot in command before a new medical issuance. I will be taking Coumadin for control of my blood clot. Here's the 64 billion dollar question.

    Since this is qualified or approved or whatever medical situation, can I still fly once I consider myself safe while on my medication? I don't know, nor do I have reason to know that this would be unable to meet the requirements(I'm not an expert on medical FAA req) for the ops, and the medicine I will be prescribed is supposedly 'approvable'?

    This is one of those gray areas that I'd like to see defined better. From my perspective, I will interpret this as liberally as possible. However, the rest of the community may not be as charitable. Again, I was flying prev on a Coumadin prescription, so my thinking is that if I feel fit, I fly. If I feel unfit, I don't fly.

    What say you?
     
  38. Ghery

    Ghery Final Approach

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    I'll leave it to Bruce for the current definitive answer, but back when I was on the rat poison for 6 months following my PE I would have had to get an SI to keep flying. Keep the INR in the 2-3 range. As part of that time was the no-fly time after the prostatectomy I just self-grounded until I was off the rat poison, then got the SI for PC. I sent all the PE data to the regional medical folks along with the PC information and all they cared about (seeing as I was off the warfarin) was the PC stuff. That SI came back in the mail 8 days after I mailed the package. I can't say enough about the service I got from the FAA folks here in the northwest. Of course, following Bruce's instructions didn't hurt, either. :D
     
  39. comanchepilot

    comanchepilot En-Route

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    I like that, get some offshore coumadin and go get some off the books INR tests . . .

    please - don't fly near me.

    It's kind of harsh but that is not type A its type S for stupid. For even considering it. What is a lower altitude going to do? The whole rant just shows such a **** poor thought process - even if you did not do it this time, then we all know you did it other times with other conditions.

    I'm am glad you took advice and went to the ER because your condition is life threatening. Forget medical cert threatening. And that you are getting better.

    My mother had a 'nagging' discomfort in her side for 2 years - and woke up one day with a bowel obstruction due to stage III colon cancer. Did not want to go to the doc because she did not want to know if it was something bad. same exact attitude.

    My wife told me about being short of breath going up stairs and of discomfort in her leg - you got it - a DVT and PE. Hers put her in the hospital for 3 days. If she'd gotten to the doc a little earlier she might have not had the blockage be in both legs and both pulmonary arteries . . .

    Whatever.
     
  40. bbchien

    bbchien Final Approach

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    Read 67.313 and get back to me. The medical officers will say you have some 'splaining to do if you went flying without their blessing.

    When you have four out of five consequitive INRs in the 2.0 to 3.0 range, you send your current status letter (you DO have a treating doc who isn't YOU, no?) telling the story, the results of the Protein A and C assays, and the INR values and ask for a Special.

    Or you you could let someone who knows if it's going to go well at the agency look at it before sending anything to the agency, tell you whether to just step down to LSA and say the heck with it, rather than risk a denial. 'Lotta variables here.

    Hey I'm just glad you didn't have the "big one" while waiting, procrastinating.....the other night.
     
    Last edited: Apr 11, 2013
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