• Giugi Carminati

I Nearly Died Last Week. Some Thoughts.

On October 5, 2020, I landed in Washington D.C. for a week of depositions in a civil rights case (failure to render medical care to a prisoner). I felt fine. Truly, I felt fine.


On October 6, 2020, I got up, went for a 4 mile jog in Alexandria and went back to my hotel. The run was a little harder than a 4 mile jog should have been but I figured I was just having a bad day. I then proceeded with my planned work day. At 3:00 pm on October 6, 2020, I started feeling pain in my chest. I won't go into details about the physical sensations because they are hard to explain and I don't think I would do them justice. What I can say is that the pain in my left chest got worse as time went by and breathing became more difficult. The pain spread into my shoulder and into my arm. I received a text setting dinner with colleagues so I headed there, in an Uber. As I got out of the Uber and walked towards the restaurant, I was overtaken by a sense of impending doom. Just as you can sit there and tell me the color of your shirt, I thought "I'm going to die." It was a fact. I had dinner. I held a conversation through the cloud of pain and the increasingly difficult breathing. We made it back to the hotel and I went upstairs.


The night was hard. The pain in my chest made it harder and harder to breathe. I couldn't lie down and I couldn't sit down. I couldn't stand either. Every position hurt. Every breath was agony. I eventually took an endless shower and the pain subsided enough for me to sleep some.


On October 7, 3030, the next day, I took a Tylenol, which eased the edge off the crush. I went to work and defended a deposition, as planned. As soon as it was over, I realized the Tylenol had worn off. The truck of pain that had been crushing my chest turned into a solid block of agony. I headed back to the hotel, dropped off my binders, and took another Uber to the hospital. I sat in the back taking tiny breaths, focusing on each one and on making it to the next moment. I only needed enough breath to get to the next one, so I concentrated on these tiny little sips of air. Every now and again a reflexive breath would sweep through, forcing a deep gasp, triggering a loud yelp on my part as my chest walls refused to budge without protest.


I walked into the ER and let the nice gentleman at the front desk know that I had left-side chest pain, radiating into my left arm, and difficulty breathing. I leaned on the desk. He handed me a form and I stared at it for a minute, computing what I was supposed to do with it. He asked me if I wanted a wheelchair and I let out a muffled chuckle. Could he see I was pressing into the counter in an attempt to stay upright? A wheelchair showed up. I was processed, at first quickly. Once they confirmed I wasn't having a heart attack, things slowed down. Blood draws, physical exam (picture the poor guy who came in and told me "Please take a deep breath," to which I responded, "Are you kidding me?" while still gasping for air, in pain, unable to sit or lay down comfortably), and finally the VQ Scan that confirmed my diagnosis. After about 8 hours in the ER we'd gotten to the bottom of it:


Massive bilateral pulmonary embolism.


Look it up. It's not pretty. A google search spits this out as the first finding:


As a cause of sudden death, massive pulmonary embolism is second only to sudden cardiac death. Massive pulmonary embolism is defined as presenting with a systolic arterial pressure less than 90 mm Hg. The mortality for patients with massive pulmonary embolism is between 30% and 60%, depending on the study cited.


Great.


See the dark areas? That's where blood flow was absent from my lungs because they were clotted.


So I headed out of the ER and back to my hotel where I got a few hours of sleep. When I woke up, I was okay. In the light of day I saw the fine mist of pink blood spattered on my pillow where I had coughed the night before. I had not realized it was happening. I spent some time calling a friend, easing into the day, and trying to get my bearings. I googled a bit but the results were more frustrating than helpful. I went to an office in D.C., did some work, and went to dinner with my colleagues. The pain came back, hard, turning the left side of my chest into a cement block. I couldn't breathe again, I could barely walk (I was limping), and it hurt so much. That thought "I'm going to die" came back. Just a fact. I looked at the Potomac and thought it wouldn't be so bad if it was the last thing I saw. I didn't tell anyone. I got through dinner and hobbled back to the hotel.


As soon as I made it back to my room, I threw all my clothes into the suitcase thinking I just had to get back to the hospital. I tore shirts off hangers and frantically emptied out the drawers. (In my head, I was organizing how to get the bags back to Denver. I was going to leave them at reception and email FedEx labels. Look, I guess I'm an organizer 'till the end). While throwing clothes into my bag, I took the anticoagulant (which I will keep having to take for at least six months, if not for the rest of my life) and acetaminophen. Then things slowed down, suddenly. I sat on the bed and thought, "I'm just going to sleep for a little bit." So I did, sleeping sitting upright on the side of the bed, fully dressed (coat still on!). A while later I opened my eyes and the pain wasn't so bad. I laid down on top of the suitcase, so it kept me upright, and slept a little longer, still fully dressed. When I woke up again, the pain had subsided some more. The idea of getting undressed and taking a shower wasn't so insurmountable anymore. I went to the shower, turned it on, and laid down on the floor. I slept there for quite a while, close to two hours, under the hot water. When I woke up I was ready to go to bed for the remaining two hours of my night, so I did.


The flight home was uneventful on the surface but both my parents and my husband were tracking me. My husband said he followed the flight expecting it to be diverted any moment. On my end, I wore compression socks, I took my medication just before boarding, and I got up every 15-20 minutes, pacing the aisle. I had the first seat on the flight but I made it a point to use the restroom at the back of the plane to make myself walk. I made it home. I was okay. I am now working on finding doctors and undergoing tests to figure out why this happened but that's for another post. The "Why" and "Why me" is constant.


But I wasn't done. The week had just begun. I landed on Friday. On Sunday my eldest was hospitalized for an infection in his knee. He had to be operated and spent three nights at the hospital. I switched off with my husband, alternating which one of us spent the night at the hospital. I also had to conduct three trials and one hearing. I further received very bad news at work which made me further dislike how attorneys treat each other.


I have spent days thinking and these days have likely altered the trajectory of my life in very fundamental ways. So here are some preliminary thoughts.


Without insurance, this week would have devastated us.


In the span of six days, my family had to undergo an Emergency Room visit which included all sorts of tests, a second trip to the ER, surgery, and a three-night stay at the hospital. There was no way we could have planned for any of these events. Without insurance, this week would have bankrupted us. Which brings me to this thought: Health insurance, and access to healthcare, is a human right. Our country is unconscionable in its refusal to accept this fact. We must have Medicare for all and we must decouple employment from health insurance.


Even with insurance, this is going to hurt.


I haven't seen the bills yet but I know they're going to be rough. Between deductibles and copays, we're bracing for impact, while trying to put the pieces back together. So even the insurance products we do have need improvement.


What I do know is that my life-saving medication, my anticoagulant, is $300/month with insurance. This is untenable. At a minimum wage of $15.00 (which is not minimum wage, I know) it's 20 hours of work, gross. This is insanity. We need affordable medication.


Wear your frigging mask.


The entire time I was in the back of the Uber, at the Emergency Room, in the VQ Scan, and getting driven back I wore my N95. My husband says it's not fair to compare, because everyone has their own physical capabilities. And it is true that this event underscored the fact I have tremendous cardiac reserves. Despite having no blood flow to large parts of my lungs, my oxygenation never went under 97%, my heart rate didn't go over 80 bpm, and my blood pressure stayed really steady and normal. If you read up on this, you'll find this is uncommon. I also wore my mask the entire time because I owed it to my healthcare providers to keep them safe.


For better or for worse, this experience has made me even less patient about people not wearing masks "for medical reasons," when they don't actually have such medical reasons.


Working out probably saved my life, regardless of the fact I didn't lose weight doing it.


I jog 5-6 times a week, jogging close to 20-25 miles a week. When I don't jog, I do indoor cycling. I've been trying to lose 15-20 lbs for about two years and the weight will not come off. It has frustrated the crap out of me. But all the while I was annoyed at the lack of weight loss, I also reminded myself that working out is not just for "looks" but also because it's good for me. I tell the kids I work out because it's "healthy." Depending on the day, I may have absolute belief in this statement or be bullshitting myself. As it turns out, working out probably saved my life.


I made it to the hospital. I stayed oxygenated at the hospital (without supplemental oxygen). I had enough reserves to not panic and focus on my breathing. I made it home. I'm still here today. I canvassed for the Democratic Party, I held my kids, I handed out literature to volunteers, I kissed my daughter, I held my husband, I cooked them dinner and finished the laundry. I'm here. I'm alive. I can't help feeling grateful and like I cashed in a whole bunch of "work out chips."


And this 180 lbs body that I get mad at saved itself, regardless of how ungrateful I have been to it. So the voice that tells my ego to STFU has only become stronger and more self-assured.


We need medical leave.


I should live in a society where I could have thrown on the brakes and taken a breather (ha!). I should live in a country that would have allowed me the time & space to deal with the blows that kept landing on me and my family. But I don't. Americans are resilient. We soldier on, no matter what. We show up to work, no matter the cost.


This is not healthy. This is not normal. This is not okay.


We should have family leave.


I know this is legislation that has been worked on in Colorado, and I am grateful for it. We need it at a national level though. We need to do better.


In conclusion...


Life changing decisions are happening. I am filled with gratitude. I feel both heavier and lighter. I am resolved to finish my run for office because change is necessary. I hug my children just a bit tighter and my husband hugs me just a bit longer. I'm still here.


I quit social media several weeks ago and am no longer active on any platform. Feel free to leave comments below or email me directly. Feel free to share this with others on social media if you wish to do so.

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