Victoria A. Brownworth

by Victoria A. Brownworth

-- Part One of Two

I didn’t know I was dying.

Even as I was gasping for breath on the way to my local emergency room at Chestnut Hill Hospital, I didn’t know I was dying.

But I was.

For years my local community hospital had been the historic Women’s Medical College Hospital which had served the East Falls and Germantown neighborhoods since 1920. When it closed a decade ago, after much controversy, I had a choice of two hospitals, Einstein or Chestnut Hill, each equidistant from my home.

I chose the hospital where I wouldn’t vie with gunshot victims for my care.

On May 15, I could not have chosen better.

I’d awakened that Friday feeling unwell. It has been one of the worst allergy seasons in Philadelphia history, exacerbating the asthma I have suffered from since I was a child. But Friday is a deadline day, so I worked through, even as I started to feel sicker, even as it became harder to breathe. By evening I could no longer ignore my symptoms. I called the service for my primary care physician in Mt. Airy, and the doctor on call sent me directly to the ER.

I was lucky. So, so lucky. At Chestnut Hill ER, being a middle-aged woman gasping for breath got me taken directly to a room where I was hooked up to a heart monitor within minutes of my arrival. A doctor — young, fresh (shifts had just changed) — listened to my lungs and pronounced them clear. Yet my oxygen levels were precipitously low. Dying low. What was causing this?

A portable chest X-ray was brought in. Something was there in my left lung. The doctor made a call. The technician who does the radioactive isotope nuclear medicine testing had to drive in from New Jersey (it was now past midnight). There was one vial of the isotope left — the thing that would light up my lungs and show the doctor exactly what he was dealing with, although he already knew.

Like a reported half million (a number the Centers for Disease Control states is vastly under-reported) Americans each year, I had a pulmonary embolism. One in five people who gets one of these dies within the first 48 hours. The clock was ticking. I had already wasted precious hours at home, debating whether or not to call my doctor.

There’s no question that the ER doctor at Chestnut Hill Hospital saved my life. I had gone to the ER thinking I’d be getting IV steroids to open my lungs and some fluids to lower my heart rate, and I’d be home by morning. Instead I spent 15 days in intensive care praying not to die, with the priest from Our Mother of Consolation coming and giving me Communion at the request of one of my nurses, Maude, who had made it her personal mission to keep me alive.

What I didn’t know is that pulmonary embolism is a health crisis millions, primarily women, are at risk for every day. What I didn’t know, even though I interviewed world-renowned breast-cancer specialist Dr. Susan Love last year, in which she told me “sitting is the new smoking,” that my job as a writer — or at least how I did it, sitting for hours on end — had put me at high risk. What I didn’t know was that the sharp pain I’d had in my right leg for a week, maybe two, wasn’t the pinched nerve it seemed to be, but was a DVT, a deep vein thrombosis, that showed none of the usual signs of swelling, hotness, redness and thus was missed by me and my doctor.

It’s been a shocking few weeks since that trip in the dark to Chestnut Hill Hospital. I have an arduous recovery ahead of me. A long green cord wends its hissing way through my house from the oxygen generator that now lives in my kitchen. Twice a day I give myself a comically large syringe of a blood thinner to prevent what my pulmonologist said is the biggest risk — the second embolism. “If the first one doesn’t get you, the second one will.” Eight times a day I do a breathing treatment with a very expensive medication to keep my lungs clear. Ten times an hour I use a spirometer, a little machine that strengthens your lungs, forcing you to exercise them. My alarm is set to go off every hour, so I get up and move around, because sitting isn’t just the new smoking; it’s death in a chair. Twice a day I take a heart medication to help control the atrial fibrillation I developed as a side-effect of the pulmonary embolism.

Could I have prevented all this trauma if I hadn’t been finishing one book and starting another and meeting newspaper and magazine deadlines in between? Maybe. Maybe not. But I wish I had known at just how high a risk I had put myself with the long hours sitting at the laptop, writing, writing, writing.

The risks are manifold, yet this is a health crisis that is rarely mentioned. Young women are at risk from contraceptives. Middle-aged women are at risk from hormone replacement therapy. Pregnant women are at risk from pregnancy. Overweight women — 80 percent of American women, especially African American and Latino women — are at risk. Smokers are at risk. The elderly who move around less often or spend long hours immobile in bed are at risk.

Despite the devastation of what happened to me, including the dicey 15 days at Chestnut Hill Hospital fighting for my life, I have been lucky. Oh-so-lucky. I am still alive, thanks to a community hospital with a new ER focused on triaging patients as quickly as possible, an ER doctor who searched for an answer to a mysterious question and subsequent excellent supportive care over a very long 15 days.

But what about the next woman? What about her?

-- Next week: Why a Community Hospital Matters to the Community