Athletes and Blood Clots

Six years ago, 28-year-old Patti Kelly Niewolny woke up to hit her usual 4-mile run. 

The date was Aug. 21, and Austin’s scorching heat that summer forced her to complete her workouts inside rather than out on the Greenbelt—her favorite running trail. That morning, she opted to run inside on her apartment’s treadmill before getting ready for work. She hated the monotony of the treadmill, but she wanted to keep up with her training. This run was different though. Something felt off. 

An odd shortness of breath came over her. She abruptly stopped running. 

“I barely made it a full three minutes on the treadmill before I had to catch my breath,” Niewolny said. Her breathing was labored and shallow, and she found it impossible to breathe deeply. She was in shock. Niewolny was accustomed to running three to four miles without any problems. 

She blamed the heat. And the fact that she hadn’t slept well the night before. 

A bit unnerved, Niewolny gave the cardio a rest and completed a few sets of weights before moving forward with the day ahead. 

“I went to work with no issues, until later that afternoon,” Niewolny said. It was then that she started to feel a dull ache in her chest. “It felt like a muscular ache, aiming toward my back,” she said. Again, she brushed it off and continued on with her day.  

In the back of her mind though, Niewolny knew something wasn’t right. 

After work, she set out to have dinner with her parents. “Just before I got in my car to drive to their house, I coughed a few times,” Niewolny said. “I covered my mouth with my hand, but when I pulled my palm away, there was a small pool of blood in it—about the size of a quarter.” By this point, the aching in her chest was getting more intense and had progressed to a sharp, stabbing pain. “It was almost like someone was stabbing me in the back with a sharp object,” she said. 

As she had done previously in the day, she managed to convince herself it was nothing serious. Maybe it was some kind of chest cold or infection? “I wanted to Google ‘coughing up blood’ and yet I was almost too scared to see what it would say,” Niewolny said. 

When she described the symptoms she was experiencing to her mom, an RN, it was less than a few minutes later and she was in the car on the way to the ER.  

Once at the hospital, she was put through a series of tests—an EKG to check her heart, an X-Ray to ensure she didn’t have a collapsed lung, and a CT Scan to check for blood clots. The prognosis: massive clotting in both her lungs. The doctor told her she was lucky to be alive. 

Niewolny was admitted to the hospital for seven days and administered Lovenox shots—a blood thinner—that enabled her body to get rid of the clots. 

The chest pain she had felt was due to a lung infarction—essentially the death of lung tissue due to the blockage of blood and oxygen from the clots. “It was very painful. I felt so weak and exhausted,” Niewolny recalled of the experience. 

After making a full recovery in the hospital, Niewolny was discharged with a prescription for Warfarin, an oral blood thinner that she took every day for almost an entire year. She had to get her blood drawn once a week for testing, plan regular appointments with a pulmonary specialist and a hematologist, and change her diet to stay away from certain foods due to the medicine. Besides her normal routine, something else changed too: Niewolny started to listen to her body. 

“Athletes act differently with blood clots than the general population. They are accustomed to dealing with pain and muscular discomfort, so it’s important to know how blood clotting feels,” Selmon said. 

What originally caused Niewolny’s blood clots in the first place? Her doctors cited two things: 

1. The birth control she was on. (It had been linked to an abnormally high amount of clotting in young women, and Niewolny later joined a class action lawsuit against the drug maker.)

2. The fact that she had just flown to and from Europe a few weeks prior. (Traveling or sitting for long periods of time can put you at risk.) 

Six years removed from the incident, and Niewolny has a renewed appreciation for life and a passion for spreading awareness about blood clots to others.

“That experience completely changed my outlook on life. I treasure every day and have learned not to sweat the small stuff. I tell my loved ones I love them more often too,” Niewolny said. “To come that close to death has raised my awareness of my own health and shown me how precious life is.”

Matthew Selmon, M.D., an interventional cardiologist at Heart Hospital of Austin and Austin Heart, treats people with blood clot conditions on a daily basis. “Venous thromboembolism (VTE), or what we call blood clots, is a universal risk for everybody,” Selmon said.  

VTE is a condition that presents itself in two different forms: deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT is the formation of a blood clot in a deep vein—usually in the calf, behind the knee or pelvic veins. The most serious complication of a DVT is that the clot could dislodge and travel to the lungs, becoming a PE, as was the case for Niewolny. 

Unfortunately, VTE, or blood clots, is a leading cause of preventable hospital deaths in the United States, killing an estimated 300,000 Americans each year. The number of deaths in the U.S. caused by blood clots exceeds those caused by breast cancer, AIDS, and motor vehicle accidents combined. 

While blood clots are not commonly found in athletes, it is always a possibility, Selmon said.

“Athletes act differently with blood clots than the general population. They are accustomed to dealing with pain and muscular discomfort, so it’s important to know how blood clotting feels,” Selmon said. 

The main difference in pain, he said, is that the muscular pain from a blood clot is more constant. “It doesn’t come and go like muscular pain.”

Most athletes will feel this constant pain in their calves. As it progresses, the pain will go up higher: behind the knee and pelvis, up toward the chest. Once it’s reached the chest, the person will experience coughing and a higher heart rate.

Blood clots can affect anyone, at any time. Some people have genetic factors that put them at risk; others don’t. 

Blood Clot Risk Factors

• Long plane rides, or lengthy periods of sitting without stretching
• Birth control. “All birth control carries some risk of clotting,” Niewolny said. “Some have a higher risk than others.”
• Surgery, especially if the patient is bedridden for long periods of time
• Pregnancy, up to 6 weeks after the baby is born
• Smoking
• Family history of clotting
• Dehydration
• Cancer and/or cancer treatments
• Obesity

Symptoms of blood clotting

• Shortness of breath
• Redness or swelling in the leg (blood clots generally start in the leg)
• Constant muscular pain in the calves, behind the knees or pelvis
• Coughing up blood
• Sharp, shooting pain in the chest and/or lungs
• Increased heart rate

To learn more about blood clots and prevention, check out stoptheclot.org or join Niewolny in the Stop the Clot 5K race in Austin on May 17.