“In August 2017, aged 23, I went on a trip to see my sister in New York. I had a whole row to myself on the plane, both there and back. I made the most of the opportunity and spent both flights stretched out and even had the chance to lie down. I was wearing flight compression socks and got up a few times for the loo.

Around 10 days after I got back on my way into work one morning I stood on a nail which puncture through into my toe. It didn’t prevent me being mobile, I had a tetanus jab, started a course of antibiotics and went back to work the same day.

The day after I started to experience lower pack pain- nothing unusual. I thought perhaps I hadn’t drunk enough water the day before. Other than that I felt fine. Later that evening I was extremely tired and couldn’t keep my eyes open, again nothing too unusual for a newly qualified teacher.

The next day I woke up and felt fine other than the back pain which was still there. Around 20 minutes after I woke up I took my antibiotic and almost immediately without any prior warning signs I suddenly felt my heart racing, faster than it ever had before. So fast it felt like I could feel two separate heartbeats. Along with this I had the most excruciating chest pain. It felt like my chest was being ripped apart. I also began to feel hot, sick and dizzy all at once, worse than I’ve ever felt before. Naively, not expecting it to be anything serious I had a nap to try and ‘sleep it off’. When I woke up hours later I still felt unwell and still had chest pain, like there was huge pressure on my chest. I also felt so out of breath just walking to the toilet, like I’d been at the gym.

Around 8 hours after the initial symptoms I rang 111 who sent an ambulance. The paramedics took my resting heart rate which was 140 bpm- way above what it should be. They took me to hospital and I spent the evening in Resus, put on a drip, had several ECGs and blood tests and had my oxygen levels monitored. That evening Doctors told me the only thing they couldn’t rule out was Pulmonary Embolism and gave me a low molecular weight heparin (LMWH) injection in my stomach. I was so confused. I had never heard of Pulmonary Embolisms before and never realised I was at risk. The next day I had a VQ scan and saw about 5 different doctors who confirmed multiple bilateral pulmonary embolisms. Everyone I encountered in hospital asked me why I left it so long before ringing 111 because of the risks of leaving it undiagnosed. But I literally had no idea I was at risk of an illness I knew nothing about! I thought it happened to older people.

After 6 months of an anticoagulant (that made me anaemic and made my hair really thin), probably hundreds of blood tests, a 24 hour heart monitor, an Echocardiogram and countless trips to hospital throughout the last year I am fortunate enough to not have any underlying conditions that makes me prone to blood clotting. I was tested for everything from Lupus to Factor V and all tests results came back negative, which makes it even more of a mystery. Doctors speculate it was a combination of the long-haul flight to New York, being on the combined oral contraceptive pill and the minor foot injury that happened within the space of a few weeks- incidents that seemed unrelated. When you take the pill you get told of the small risk of blood clots and never think that it will happen to you.

I will never know exactly what caused my PE but it has definitely made me aware of the risks of long-haul travel, something I had previously taken for granted.

I feel extremely lucky to have no long term health impacts. While I now have an increased risk of having a reoccurrence the only time I have to be referred back the haematologist is if I decide to have a baby in the future. Also, every time I take a trip longer than 4 hours I have to inject myself in the stomach with a blood thinner injection and I can never have any form of artificial hormone again- a small price to pay compare to some.

Advice I have been given and wanted to share is:

• to make sure I get up and walk every hour when flying
• to sit on an aisle seat so I can get up and stretch
• wear flight compression socks on every flight
• drink 2 litres of water before flying and stay hydrated.

I am so grateful to have survived this and really hope this post will be of some help to those who previously never knew anything about Thrombosis (like me)”.

Charlotte