A few weeks ago I sat in the emergency room hearing about the blood clots in my husband’s lungs and learning how lucky it was he was alive. He had a saddle pulmonary embolism, meaning that blood clots were in both lungs. Later doctors were to tell us that many pulmonary embolisms are not discovered until an autopsy, i.e., after the person who had them died. One specialist said that, due to the location and amount of blood clots, by the time my husband arrived he could have died within an hour if he hadn’t come to the hospital.
Not losing the wonderful man I married makes me grateful. It also leaves lessons for the rest of us about this illness and need to ensure all have the medical care that extends health and preserves lives.
Regarding the acute illness that befell my husband, more people should be aware of its symptoms and how to prevent it. In his case, lung clots migrated from clots in a leg. That’s not unusual.
Symptoms can be subtle but are very serious. While clots in a leg or arm, termed Deep Vein Thrombosis (DVT), may not generate any signs, the most common symptoms are swelling, unexplained pain or tenderness, and warmth and redness of the skin. Pulmonary embolisms, which can arise without DVT symptoms, can bring shortness of breath, chest pain, coughing up blood, feeling lightheaded, anxiety and faster heartbeats.
DVT often arises from long travel periods with limited movement. Although uninterrupted trips of five hours or more are most risky, recommendations are to move every two to three hours. That’s not long for those of us used to driving long distances. Even if you don’t stop and walk around that often, at least move your ankles, feet and legs. Those motions can prevent leg blood clots and thus the pulmonary embolism that can follow. But that’s not the only cause. Others develop the clots following surgery, during or after cancer treatment, during or after pregnancy, when on contraception or other medicine with estrogen, or after surgery. Up to 8 percent of the population has a genetic predisposition.
According to the Centers on Disease Control and Prevention, around 900,000 Americans get DVT and pulmonary embolisms each year, leading to up to 100,000 deaths. Survivors are at greater risk for future blood clots and are more likely to become disabled and unable to work. Having had DVT or a pulmonary embolism is a pre-existing condition for which insurance companies used to be able to deny coverage, a practice ended by the Affordable Care Act, also known as Obamacare.
Experts tell people with symptoms of DVT and pulmonary embolism to go to a hospital as soon as possible, but some may not go because they’re worried about the cost. Thus health coverage is critical for people who may not seek treatment when delay could be deadly. Coverage is also necessary for the needed follow-up care, which includes medicine, expensive scans, and visits to primary care providers and specialists. Blood thinners may be needed for months, years, or even for the rest of the person’s life.
So far President Trump and the Republican Congress have not overturned the Affordable Care Act, but more can be done to preserve its protections and cover more Americans.
First, citizens and leaders should tell Trump to stop talking about undermining the law so fewer people are covered and coverage is worse. Recently Trump threatened to stop cost-sharing payments that partially cover medical bills. Sounding like a hostage taker, Trump said, “I don’t want people to get hurt. What I think should happen — and will happen — is the Democrats will start calling me and negotiating.”
Second, rather than undermining health coverage, we should increase it. In Maine, that means supporting the referendum to expand Medicaid. Studies show that this will save lives and improve health while improving the states’ economies, helping rural hospitals, and not hurting state finances.
Even with the best health care policies, tragedies will happen. But lousier coverage for fewer people of the sort Trump and the Republican Congress seek will lead to the sort of suffering my family thankfully avoided.