Returning to Training from Pulmonary Embolism

student doc wrote:

good info...is this the same DocB who posts on studentdoctor.net?

No

Had a massive PE in April at age 46 - 4 hours later I ran a 5K (won age group too) because I had no idea. Wound up having 100% blockage of left p artery. Went to hospital 6 days later after the pain from the 2nd PE causing 30% necrosis of lung capacity. Completely serious - no trolling - Doctor told me I "cheated death" because of my heart's strength from running. No one still can give me a cause, despite 2 hematologist's attempts. So, it looks like I will be on the rat poison the rest of my life. From the sounds of things, you will probably be as well - and it is a small price to pay for the normalcy it brings.

Took me 2 months after to be able to run again - even though chomping at bit to do so. Then, was massively out of breath during a 5 minute run. took month before I could work up to 20 minutes at normal pace, another month before I could run decent, but then was able to run a 5K a minute a mile slower than where I was pre-PE 4 months after. Took another month before I could begin decent training.

Finally, 6 months after, I finally had a race where I was able to run the first mile at pre-PE tempo. I figure another month and I'll come back around. So, for me, that's 7 months.

Difficulties - I swear I sweat more from the coumadin - heat affects me more than usual. I did have one Pneumonia attributed to dehydration in the heat - not related to running, but a side affect I watch now carefully. And my weight ballooned since I have to limit my salad intake due to the Vitamin K restrictions - so I eat more garbage than I should. Otherwise, for me, not too bad.

You will know when you feel better - I can think of 3 days in particular where I felt I had conquered a hurdle and was getting better in my running. But, unless you have access to doctors on a regular basis, I would recommend not pushing yourself to an extreme - your INR level is a tricky wicket and it took about 4 months before I started having normalcy.

Best of health in everything you do.

mackwamba

The recovery from an acute PE is variable and difficult to predict for an individual. The initial shock to the heart and local responses in the lung improve within days (if one survives). I would suspect that you are past this point. The problem of having part of your pulmonary circulation blocked will take much longer to recover from as the clot itself can take months to disovle even on coumadin. This can will cause a particular problem with exercise as your cardiac output can increase dramatically with exercise and the limitations in your pulmonary circulation will become much more relevant physiologically. If your clot resolves normally, it should be completely gone within a six months and your exercise capacity back to normal. However, chronic problems are also common, with no return to baseline.

In any event, I agree with your doctor regarding return to activity slowly. If you are having chest pain I would completely avoid whatever causes it.

Just wanted to give an update on my condition -- in case anyone else is out there and searching for information regarding returning to exercise after PE.

Like I said, I was discharged from the hospital and told I could walk/jog as long as I "listened to my body" and did not push myself too hard. That afternoon, I tried walking/jogging and had considerable chest pain. I tried again the next day and felt the same. So I just walked for the next three days. One day I hiked for two hours... I found that as long as I kept my heart rate below ~110 bpm, I never had any shortness of breath or chest pain. I was also doing a lot of core work and even some light lower body resistance training (I lost 5 lbs while I was in the hospital).

Five days out of the hospital, I got on a spin bike and rode with my HR from 120-130 and had minimal chest discomfort. Six days out of the hospital, I tried walk/jogging again and it was much better this time. I'd jog 3:00, probably at 10:00 pace then walk for a minute and repeat for 30 minutes total. I did this, along with a couple more sessions on the spin bike, for the next week with noticeable improvement each time. I always ran with a HR monitor -- and I noticed I could get my HR a little higher each day without any discomfort.

12 days out of the hospital I went for my first run. I wasn't even planning on doing it, but walk/jogging was feeling good, so I just stopped walking and kept on going. I ran 5 miles that morning at ~8:00 pace. Not optimal training pace, I ran with the women's team, but it was absolutely magical, incredible. Since then I've been running every other day, and riding daily. My longest run, 65:00. My fastest mile, a 6:46 -- a big step back from where I was, but that doesn't bother me. I am just happy to be out there period.

Yes, I will be missing my senior cross country season, in my 5th year. But I am back to running for the pure love of running. I am still alive, I have much look forward to and to live for. Thanks again to all the kind words and advice.

Congrats on your recovery progress. You seem to have the right attitude.

Hi! I just wonder how it has gone for your running? I know it was a log time ago. I got a DVT in may left calf and after 1 moths on anticoagulant beginning to feel exertional dyspnea, could have had a PE without knowing it. ( am a doctor self)

Beatrix wrote:

Hi! I just wonder how it has gone for your running? I know it was a log time ago. I got a DVT in may left calf and after 1 moths on anticoagulant beginning to feel exertional dyspnea, could have had a PE without knowing it. ( am a doctor self)

Hope you're back on your feet 4 years down the road. I had my second DVT in 5 years early last month. Three days later diagnosed with bi lateral PE.

Five weeks in feeling great other than a cough that is lingering. Likely on the blood thinners (and BP meds) and compression socks rest of life but small price to pay.

Five years ago I was very cautious coming back. This time even though it was worse I feel more confident about being able to at least start jogging. As others mentioned, take it slow.