Feeds:
Posts
Comments

The words I am about to write have been bouncing between the walls of my skull for the past year. They never rest, though they do get quiet during periods of no travel or when I’m alone. When I’m up in the air, or under the sheets, the words scream relentlessly. You almost died for (because of?) this. And today they are screaming relentlessly. Today is the one-year anniversary of the week I was admitted to the hospital with deep vein thrombosis and a correlating pulmonary embolism.

Here’s what I know. I know that dying is easier than living. Living is a decision. It is a conscious waking pain and battling that pain all day long. It is injections of heavy-duty blood thinners self-administered directly into the fleshy bit of your abdomen, causing the area around it to turn a sexy shade of eggplant. It is the measured and struggled-for breaths of air, shallow at first and accompanied by the feeling of an invisible knife stabbing you between the ribs. It is walking with the pain of a congealed mass of what is supposed to give you life, stuck, hidden behind your knee, restricting blood flow to your lower limb, leaving it stiff and cramping. It is the blood tests, one after the other as hematologists in busy hospitals full of people who are a degree more or less fortunate than you work to determine whether you inherited this unfortunate propensity or if you brought it upon yourself. Provoked is what they call it when you have no genetic markers. You provoked this, they will say, eventually; (they will not say because you wanted too much, your sexual and metaphysical freedoms, but you will think that is what they mean when they say provoked). They will say this after the man you traveled and slept with and loved left you. Because the only way you can receive the news that you can never travel again is alone, in a hectic hospital, with needles and tubes leading blood away from your veins and water leaving trails away of your eyes, surrounded by people who are a degree more or less fortunate than you.

To say that today is a milestone is an understatement. It’s hard not to feel the weight of everything I’ve been through the past year; it’s hard not to feel incredibly sad for all I’ve lost and incredibly happy for, well, my life. I’ve never been one of those optimistic sick people. I struggle with a lot. I struggled with whether to tell this story for the past year, because (for me) there seemed to be a lot of shame attached to it. Ultimately, I think it’s extremely important for people, especially women, to know what causes DVTs and PEs, how this is related to travel, and what can be done to prevent this from happening to anyone else.

How did this happen?

The simple answer to this is: I was on hormonal birth control (the pill) and I went on a trip that involved sitting for more than 4 hours.

In late July 2013, I flew to Orange County, California, by way of Las Vegas, from Philadelphia, for my very good friend’s wedding. Since she and her now-husband live in Asia, the event would be a rare opportunity for me to see them without traveling halfway across the world. My then-boyfriend and I landed in Vegas, drove to Newport Beach for the wedding, and then spent the following days driving the long way back to Sin City by taking Route 66. All in all, the road trip totaled exactly 800 miles, so there’s actually a possibility that the clot in my leg developed in the car, not in the air.

Women who take hormonal birth control are more at risk for developing blood clots because the primary component in the pill is estrogen. Among many other things, estrogen is responsible for increasing clotting factors in blood. When I was on the pill and sitting (inactive) either on the plane or in the car for many hours at a time, this decreased my circulation and allowed the clot to form.

558789_10101468193161073_1632258758_n

What were my symptoms?

As soon as four days after arriving back in Philadelphia, I felt a cramping in my lower left leg/calf muscle. It felt almost exactly as if I had pulled a muscle, or had overworked it during exercise, only I knew I hadn’t gone running for 10 days or so and it would have been extremely unusual to develop such a delayed sports injury. After three days of gradual-to-increasing pain (which seemed only to exist when sitting in my work chair), I scheduled an appointment to speak with my primary care physician. I knew my risk factors, and I was certain something was wrong with me.

By the time I saw my doctor, a week had passed since returning home, and almost two weeks since embarking on the trip. I did not display any kind of clotting symptom externally. Usually, when someone develops a blood clot in their leg, the leg becomes red/inflamed and swollen to the touch. Mine looked and felt (externally) normal. My doctor’s theory was nerve compression, that somehow my office chair was causing a pressure on my leg to cause the pain. She recommended I get an ultrasound, despite a repeated assurance that “probably everything was okay.”

The ultrasound results = negative

It was extremely difficult to schedule a non-emergency ultrasound; the soonest the hospital would give me was two weeks, so my doctor ordered a rush. When I arrived for my appointment, the technician was nonchalant and dismissive. “Who sent you here?” she asked. I explained my situation and that my doctor wanted to check on my leg. “Usually clots don’t happen to people so young. How old is your doctor?” She squirted some jelly on my leg, had a look, and said “Nope, there’s nothing here. You’re clear.” I would later find out that she had no right to diagnose (or to talk to me so rudely), but the hospital doctor appraised the images as negative and so, my primary-care physician prescribed me some muscle relaxers and talked to me about getting a new office chair.

I continued to take the pill.

The next week = more pain, and shortness of breath

 The pain in my left leg gradually became more and more severe. I could no longer bend my foot when walking, and eventually the only way I could physically walk was to drag it behind me like a peg leg. The only way I can describe this is a cramping, a severe and unending Charlie’s Horse. I began to pop ibuprofen and other pain relievers once an hour. I took a two-and-a-half hour road trip to DC and nearly fell out of the car upon arrival, unable to support myself standing. My then-boyfriend was audibly sick of hearing me complain, so I kept quiet. I stopped walking to work because I was becoming overly-fatigued. I started to take the subway, and found myself gasping for breath walking up the steps. I joked to my coworkers that I needed to start working out again.

The weekend before I was admitted to the hospital, I had a girlfriends-trip planned to the beach. I ignored all of the signs something was severely wrong, including: not being able to carry a case of beer one-half block to my car, not being able to walk up one flight of steps to my beach motel room without pain-level-10 stabs in my right side, not being able to walk a single flat city block without stopping to catch my breath (as if I had just run ten miles), not being able to breathe while laying flat in bed, and not being able to walk on sand (at all). My best friend insisted I go to the hospital; I vehemently refused. I had an appointment to see my primary-care physician the following Monday, and I convinced everyone and myself that I could make it until then.

When I think about this weekend, I think about the wave. My two friends had left to use the bathroom, and I (not having the energy) stayed behind on the beach, to “watch our stuff.” When I saw it, I knew the wave would hit our little set-up before it even crashed. I, sitting in a low beach chair, was helpless to move out of the way. The ocean washed over our blanket and bags, swirled around my chair. I was effectively immobile, the pain in my leg prevented me from saving our things from salt-water disaster, and my lungs couldn’t have handled the rush of rising from my chair, let alone dashing up the beach, anyway. I repeat: I could not stand up from out of a chair; I let the ocean wave crash into our belongings. Something was definitely wrong.

I continued to take the pill.

Pennsylvania Hospital -- America's First Hospital. Not too shabby, as far as hospitals go.

Pennsylvania Hospital — America’s First Hospital. Not too shabby, as far as hospitals go.

The diagnosis

When she saw me unable to breathe the following morning, my doctor sent me straight to the ER. I walked the nine city blocks from her office to Pennsylvania Hospital, the last walk I would take for quite some time. Within an hour, a “massive” blood clot was found (via ultrasound, by the same technician, who could only say “Oh. There it is.”) behind my left knee and after a series of tests (including a pregnancy test, because, lol) they had discovered the network of clots in my right lung. (The clot from my leg had broken off and traveled up into my lung, and this is what is inherently dangerous about a leg clot). I officially had deep vein thrombosis (a DVT) and a pulmonary embolism (PE) and had I waited even one more day, I could have collapsed from an oxygen shortage. I very nearly could have died.

I would stay in the hospital for four days to treat the clots and anxiety (as it turns out, when you can’t breathe, you panic). I was told that if it were just a DVT, they could release me to self-administer blood thinners. Since I had a PE as well, they needed to make sure my lungs were clear and that I could breathe before releasing me.

Recovery and aftermath

The most immediate effects were on my medications and my travel. I first had to stop taking birth control. Then I had to cancel a flight to Indianapolis, and remain grounded until the knee clot cleared.

The blood clots in my lungs dissolved when I was in the hospital. If you think about your lungs like a tree, all of the blood vessels are the branches. The clots were smaller and easier to remove here. There is no drug that “cures” clots; you must begin a regimen of blood thinners that assist your own body’s process of breaking them down. Since the one behind my knee was so large, it would take a month before I was pain-free in walking and quite some time after that until I felt the heavy blanket of fatigue pull away. Whenever I got frustrated with this process, my doctors, friends, and family would have to remind me of the trauma I’d been through.

I had to self-administer a shot of a drug called Lovenox into my abdomen twice a day while taking an oral drug called Warfarin to get my blood to a “thinness level” that was acceptable for my body to dissolve clots. I cannot understate the mental hurdle I had to clear in order to stick a needle, twice a day, into my lower stomach. I never got used to it. Then, I had to get blood drawn once a week (an INR test) and a corresponding number. Frustratingly, I never could manage to stay in range, despite eliminating what felt like the whole portfolio of green vegetables from my diet (since they would only serve to keep my blood thick and strong). Eventually I was put on another drug called Xarelto and I continued to take blood thinners until January 2014. Because I couldn’t walk and all I could eat was essentially bread and meat, I was the most physically weak I’d been in my life.

The day after getting out of the hospital, I went to my other friend's wedding!

The day after getting out of the hospital, I went to my other friend’s wedding! I couldn’t dance.

It was on the day I received a hospital bill for $30,000 and was left questioning what is the price of my life that I began the process of the breakup and a month later was told by a hematologist that I could never travel again. I cried a lot during the last half of 2013.

Phew, that’s a lot. So, what is the meaning of all this? What about travel?

It may have been the weakest part of my life, but also the strongest. It took about one minute for those words to sink in, those terrible awful words “never travel again,” before I looked the doctor straight in the eye and said “I need a different answer, because even if this kills me, I’ll never stop traveling.” It felt so satisfying, so humbling, in that moment, to know what I was willing to die for. It made me feel grateful. It made me feel alive. That moment was a gift.

Eight tests later proved that the clot was provoked (brought on, by external factors), not hereditary. The doctor’s compromise was that I could fly, but to anywhere West Coast and beyond would require a shot of Lovenox before and after every flight, because as a former clot victim, I was (and will be) more at risk to develop them in the future. A single dose of Lovenox costs upwards of $1000 before insurance, so this is no joking matter. I’ll take it. And I have taken it. I’ve taken off, and every time that plane wheel has lifted from tarmac since that day, I have felt a deep swelling of gratitude, and relief.

I cannot be on birth control, which makes dating and pregnancy prevention slightly if not wholly more stressful. I know I’m not ready to become a mother, and if I allow myself, I do feel sorry that I can never just be a normal girl. Carefree doesn’t exist anymore. A phantom ache jolts me into a compulsion to get out of my chair and walk every thirty minutes, especially on flights.

 

And here I am, one year later, and I feel like I’ve shed a skin, like I am a new person. Last week, I successfully scaled Telegraph Hill in San Francisco, and was mindful the whole time of how far I’ve come. I’ve had one of the best travel years of my life; I started the New Year (my first flight in six months!) in Charleston and then got to Chicago, Dallas, Barcelona, Madrid, Seville, Tampa, Montreal, the Finger Lakes, Memphis, and finally back to California, back to the where it all started. In this one year of life, I’ve confronted death in almost every place. I’m humbled. I’m ready to move on. I want to keep traveling, keep living, keep doing, keep being, keep learning, keep feeling. Pain so extreme can only be felt if you’re alive. And that is a beautiful thing.

Thank you, everyone who helped me get here. Everyone who lifted me up. I’m so happy I have you.

Mini victory: in April 2014, I made it on my first post-clot international trip, to Barcelona. I still have to be very careful and take medicine before and after every long flight.

Mini victory: in April 2014, I made it on my first post-clot international trip, to Barcelona. I still have to be very careful and take medicine before and after every long flight.

What can you do? If you are a woman taking birth control, and you are a traveler, please recognize the risks. It is important to stay mobile. On flights (or train/car rides) for that matter, be mindful to get up and walk around every hour in order to maintain your circulation. Flex, flex, flex. If you feel cramping or shortness of breath after a long trip, see a doctor immediately. Don’t wait. Don’t let yourself be talked out of it. Don’t be scared. Listen to your body. It’s usually right.

Resources:

National Blood Clot Alliance

National Heart, Lung, and Blood Institute

 

2014-07-25 19.10.11

I read a very interesting book recently that has almost nothing to do with the topic I really want to discuss, but sometimes that’s the wonderful thing about reading; expose yourself to enough ideas and you’ll find that your stimulated brain draws connections between two seemingly unrelated realms. Now, I will say that the book was about the moral life of babies, and what presses most heavily on my mind these days is war. Bear with me.

The book, Just Babies: The Origins of Good and Evil, explores a topic that is the subject of frequent debate between me and my recently-married, deciding-how-to-go-about-child-making-decisions friends. The questions tackled are: how do we as human beings know what is right and wrong? Were we born that way, or does society enforce a moral code? All murderers were babies at some point; was it nature or nurture’s fault they deviated? If you’re interested in exploring the answers to these questions, then I recommend the book. The author, Paul Bloom, is a psychologist and a lot of the book is devoted to social experiments, many of which are enlightening and thought-provoking.

Perhaps you may not be surprised to learn that is is incredibly difficult to perform experiments on babies. They are, by definition, not fully developed as human beings and therefore cannot talk to report their feelings. One thing that babies do when pressed to make a decision between two puppets (one who is “good” and one who is “bad”) is stare at the situation that confuses them. That’s how psychologists can determine the application of judgment. As it turns out, babies stare longer at puppet scenarios in which a puppet steals a ball from another puppet than when a puppet helps another puppet carry a ball up a difficult hill. It seems that a majority of babies, when faced with something wrong, at first just cannot comprehend.

Now, at the risk of comparing myself to a three-month-old, I’ve been doing a lot of staring lately. I should mention also that I consider myself well-traveled, well-read, and opinionated, generally, on global current events. I consider myself fair-minded in judgments, always bearing in mind that many of my decisions and opinions are a direct result of my identifiers: American, late-20s, woman, publisher (which roughly translates to: aware of my freedoms and privilege, relatively young, feminist, anti-Amazon). Here’s the thing. I am also a traveler. And if there’s one truth I’ve learned through my numerous border crossings it is this: for all the differences in culture and customs, in clothing and language and religion and politics, we are all basically want the same things: to pursue our happiness and to feed our children.

What have I been staring at, with the apt confusion of a baby watching an klepto-puppet? War. Check my browsing history: it seems I cannot stop reading about it. Ask my friends: it seems I cannot stop questioning it. Ask my Israeli roommate: Am I needlessly tearing our relationship apart with the word “but?” Yes, the tunnels need to be destroyed, but! Yes, it sucks that your flight out of Tel Aviv was cancelled but!

So, I’ve been reflecting on my experiences and asking myself what do I know? As a traveler, I’ve been to HIroshima, Japan. I toured and seen firsthand a city that whose civilian population and livelihood was decimated by war. I’ve been to the museum there, and I’ve encountered the melted glass, the deformed children’s bicycle, the shards of clothing.

One psychological experiment that Bloom mentions is the train-switch scenario. It asks people that if there is a track on which five tethered people are tied, and a a barreling, runaway train headed right to them, would you flip the switch that alters the train’s direction to another track where only one person lies tethered? The overwhelming result to this dilemma was “yes, flip the switch.” Subjects of this experiment nearly universally would sacrifice one for the ensured safety of a greater number. But then when you think of that experiment under the veil of war, it becomes a lot less clear. Wasn’t Hiroshima the track with one-person tethered to it?

It then becomes absolutely wrenching to read about fatality comparisons, as if the death of one person in any conflict isn’t in itself a tragedy. How absurd, to read comments that mention that a compelling reason for ceasefire is this many dead versus that many dead. Numbers instead of people. Passengers on a commercial airliner, not military transport. Villagers, not soldiers. Because it is what we do, we align ourselves on sides. Pro-this, anti-that. As if it were that easy. As if everything could be boiled down to a simple matter of right, or more right. It’s all too much. And so I stare.

Because it is wrong.

Since I last wrote you, I’ve been to Chicago, Dallas, and Tampa. All were swell times, and I hope that someday I can write about them.

But, I’m going to be in Barcelona for a few weeks, starting pretty much tomorrow. Anyone got any tips or tricks?

Going into this experience almost completely cold turkey. Ah, reminds me of my RTW months, when I hardly didn’t know which country I’d be landing in next. This trip, more than that one even, is a kind of therapy from a long, hard year (which I also hope to tell you about, someday).

It feels good to be alive.

Sometimes, like on online dating profiles, I like to throw in nifty facts about myself without context. One such fact is this: I have attended a post-Super Bowl victory riot, and lost one job as a result.

The true story is that I did go to a Super Bowl victory riot, and I wrote about it in my school’s independent newspaper. Even though my Editor passed it through, and it was syndicated (meaning, it ran in a bunch of other schools’ newspapers too), they decided after the fact that they didn’t like how I portrayed Pittsburgh. So, they let me run one more column and never published me again. Whatever, I have no hard feelings. I grew up to run my own fancytime blog instead.

Anyway, the reason I think about it now and every four years in the years since is because really it was just meant to be a love letter to the Olympics. The Winter Olympics are on now, and frankly I can’t get enough. I’m not even a sports-obsessed person. There’s no place else raw passion and human achievement and failure play out so vividly on the world stage. So in honor of Sochi 2014, I’m throwing a little love to baby Amanda Elsewhere, the Amanda Elsewhere who didn’t even have her passport yet, and her stance on the Olympics vs. the Super Bowl.

People go to New Jersey on purpose?

Frequently referred to as the “armpit of America,” New Jersey is possibly the least-liked state in the Union. It’s not helped by pop culture (The Sopranos, Boardwalk Empire), or its shitty politicians (Chris Christie, those mayors that were selling kidneys on the black market). Here to duke it out over the Garden State are Amanda Patterson of Amanda Elsewhere and Matt Hershberger of A Man Without A Country:

Hi Matt. Maybe we should talk about why we’re here. Last week on Twitter, you took offense to my taking offense that any part of America would be shocked by the idea that Chris Christie actually did know about those bridge lane closures (because, c’mon, fucking duh) and then I said that New Jersey is the worst (which, if you know me, is a pretty established stance <I woke up this way>). But I think it’s pretty established that New Jersey ranks 50 out of 50, dating back to forever and not even Bruce Springsteen can change that true fact.

Hey Amanda! Okay, to be fair, Chris Christie is a douche, and the idea he didn’t know was a bit of a stretch. That said, it’s become incredibly fashionable to shit on New Jersey, and it’s undeserved. I’ve got a theory that as soon as the show How I Met Your Mother does something, it’s passe and needs to end. They did it with the words “epic” and “legendary,” they did it with bro culture, they did it with laugh-track sitcoms, and they did it to New Jersey haters. And seriously, go to a Springsteen concert and tell me it doesn’t fix everything wrong with the world.

If it’s fashionable to hate New Jersey, then it’s fashionable in the way that denim jeans are fashionable. My sympathies to Ted Mosby. I dated a guy who lived (lives) in New Jersey and it was a deal-breaker before the first traffic circle. Did you know they charge you $0 to cross the bridge into New Jersey but charge you $5 to come back into Pennsylvania? I basically had to pay the equivalent of a Starbucks latte for the privilege to be back in Philadelphia. Are you aware of how sad that sentence is? I was so traumatized dating him that when I saw a bum peeing on a Wawa the last time I got back into Philly, I thought, “My people!” You know, try as they might – those bridge toll angels – it doesn’t even stop them from coming here on Friday nights in fleets. Fleets! You can always tell who they are, too, speaking of fashion.

Being in Philadelphia for free is traumatizing, god knows how awful it must be to have to pay to be there. And of course you can tell who they are. They don’t reek of cheesesteak and stale Yuengling. Seriously, though, I’ll give you that there are some crappy spots in Jersey, and that you happen to be quite close to two of the worst: Camden and Trenton. That said, there are crappy spots in every state (I wouldn’t want my native Ohio to be judged by Akron), and Jersey has some awesome spots, too: the Shore is awesome, and Jersey City and Hoboken are a lot of fun. And as for that Jersey Shore stereotype? Yeah, 6 of the 8 of them were from New York. So let’s give credit where it’s due: A lot of things people say suck about New Jersey are equally true of New York, and no one shits on them. Also, not everyone in New Jersey is an Italian gangster or greaseball. Some of them are Irish.

To read the thrilling conclusion, follow this link over to Matt’s blog…

 

This post is a response to “Don’t date a girl who travels.”

If you are like me (and by “like me,” I mean on the internet last week), you saw the “Don’t date a girl who travels” link pop up and be shared enthusiastically. While it may be true that I am unimpressed  with (or rather, indifferent to) your expensive watch, the rest of it is a jumble of unforgiving, amateur generalizations. The troubling thing about “Don’t date a girl who travels” is that it says “Don’t date A Girl Who Travels. Because A Girl Who Travels  is generally better (more socially engaged, independent, creative, interesting, etc.) than you (if you don’t like to travel) and you should actually really want to date her (if you do like to travel). ” But people who travel aren’t better than people who don’t. The travel community itself is rife with one-upping culture. “Don’t date a girl who travels” is just another example of this.

If you really must know, please just don’t date A Girl Who Travels if the idea of interacting with people, cultures, and foods different from your own truly offends you. Please don’t date A Girl Who Travels if you can’t roll with the punches, or if changes in “The Plans” disrupt your ability to retain your cool. Don’t date A Girl Who Travels if you cannot at least pretend to have a good time, for her sake, when she tries to share her love of travel with you. It will actually be heartbreaking for her when you can’t hide your blatant disdain for brass bands in New Orleans, or when you exclaim “Thank God!” when your plane lands back in your home city. It’s not that A Girl Who Travels cannot truly enjoy her time collecting experiences in her hometown (that includes holding a steady job and/or going out to dinner and to the movies between travels, by the way). It’s also not a requisite that you must love every place you to which you travel. A Girl Who Travels knows that a love for travel is not necessarily a love for place, for A Girl Who Travels know you can travel to the same place twice and come away with two completely different stories. But please, don’t date A Girl Who Travels if you can’t see the magic in the story that you together create, because it will cut her to the core, and every attempt to be rational and not take your blindness to her passion personally will fail. Creating stories is her truest happiness.

My guess is that these real reasons for not dating A Girl Who Travels won’t go viral. Don’t don’t date A Girl Who Travels because some thoughtlessly written and shared article claims A Girl Who Travels doesn’t need you and will be bored with you. That girl sounds like kind of a psychopath. Trust me when I say A Girl Who Travels wants you to go with her. Nobody needs to be with another person, but life sure is more fun when you get to share experiences with people you love.

Here’s a piece of dating advice: Date a girl whose face you want to kiss. If she happens to be A Girl Who Travels, congratulations. You’ll probably have a few cool adventures together. If you happen to be a Dude Who is Ambivalent About Travel (but are otherwise kind and compassionate), never fear. Let her leave without you from time to time, because she’ll get to come home to you. And travel or no travel, isn’t that what this whole dumb dating thing is all about?

IMG_3178

beer glasses india bag p135778_2

Hey guys! I have a $75 gift code for NOVICA to give to a reader! In conjunction with National Geographic, NOVICA hosts an online fair trade marketplace that showcases thousands (literally thousands!) of hand-crafted gifts from around the world, offering artisans a free platform to develop their businesses and connect to savvy consumers like you and me (who may very well prefer a shopping jaunt to Nepal than to a chain store in the mall, but alas).

Seriously, how cool are those beer glasses? The products above are all offered on NOVICA’s website (and are my picks for under $75!). It is the perfect place to shop for gifts for your gal or fella who loves to travel, and to make it even easier, you can shop by personality (or by hobby, wink wink).

To enter, leave a comment (tell me your favorite place in the world!) and share this post by 11:59pm, 1 February. Be sure input your email address when you comment; I will contact the winner via email. One-time-use promo code must be used by 5 February, and does not include shipping costs (although you may purchase a lower value item and apply the code toward shipping). Please contact me with any questions.

Comments are now closed. Congratulations to Christina for winning the giveaway. Thanks to all who participated.

Follow

Get every new post delivered to your Inbox.

Join 838 other followers

%d bloggers like this: