** I published this before spending much (any) time on editing (not really recommended) and have added some post-publishing edits and comments and embellishing, marked with two stars. **
**Not to put a spoiler alert at the beginning of post in case someone wants skip all my stream of consciousness writing and random pictures, but one friend said she was kind of worried and kept in suspense about my possibly having Deep Vein Thrombosis -because she knew someone who did – and it is a life-threatening and really serious condition. So I’ll share now that
**I did *not* have Deep Vein Thrombosis. Turns out I spent slightly more than half a day in the (easy, streamlined, professional, assuring, effective, and efficient) Danish Healthcare System, all to be diagnosed with a left calf strain/tear.
**So here’s my post about how I spent my Friday, February 7th.
About 10 days ago (right around the time I picked my run/walk training back up after a 4 week hiatus), I developed pain in my left calf (actually, both calves, but it was worse in the left one).
Like any non-hypochondriac, used to the catastrophically expensive US healthcare system, I didn’t immediately consult the web. I just stretched, rolled it out on my fabulous foam roller (that I credit with healing my years-long case of plantar fasciitis. Thank you forever Lisa M for that recommendation).
- And then the next day, I did a sprint workout.
- And the day after the sprint workout, I was feeling so good, I went and climbed up and down stairs for 20 minutes, at the place in Copenhagen with the most number of stairs (yes, googled “where are there good stairs to run in Copenhagen?”(#10 on the list). It’s 3.3km from where we live so that day I *walked* there and back. I needed to take it a little easy and not over do it.
- Then the day after that, I thought it would be a good idea to go ahead and do a “long walk/run” (long for me – 4 miles – running 6 min on 1 min off. I’m determined to do a 1/2 ironman before I’m 50 and at my current injury rate it’ll take me the next 8 years to get ready for it, so I’m not wasting any time.
- and THEN, because I was feeling SO GOOD (and also possibly because I gained a bit of weight during our travels to Italy, Munich, French Alps, and Rome between December 14th and January 25th and am trying to shed those extra pounds), I thought “why don’t I just jog on over to the Luders Running Stairs, and do one or 2, 6 minute intervals jogging up and down the stairs as part of my walk/run workout?” And then jog on home?” So I did. But my calf was still feeling a bit tight and sore. So,
- I took a rest day.
- And the next day, decided to jog back to the Luders running stairs, walk up and down those stairs for 30 minutes (137 steps up each time) and then jog home again. And in case you’re wondering, that was 1233 steps up and 1233 steps down. And for me, going down takes as long as going up because I have visions of stumbling and falling All.The.Way.Down. so I take my time.
Incidentally, one of those days I spent at the stairs was a rare and gloriously sunny day.
This whole time my left calf was staying tight. Right calf, hips, back, quads, gluts, IT band, knees, the things that have been injured on and off the last few years, were all feeling good. I have been SO DILIGENT and CONSISTENT about warming up and warming down (**except maybe after one or two workouts), stretching, and using my foam roller daily. Incidentally, never in my life have I had to spend MORE TIME warming up and warming down than actually working out.
But *sigh* then I remember that I am in my 40s (EARLY, for anyone wondering) now, and my body is enjoying reminding me of this.
**MBH is having similar muscle aches and pains challenges and wondered out loud a few weeks ago “So I wonder why that is?” Me: “Your telomeres are getting shorter” No idea if that’s true but I thought it sounded smart.**
Anyhow, the foam rolling and stretching was just not working for my left calf.
So I decided I should take a rest day. Which was yesterday, Thursday, February 7.
**Actually, Thursday was February 6th. Credit to Lisa M, my copy editor, for the catch.**
And it was SUNNY.
And I needed to hit my 12,000 step goal.
So I went out for a walk.
Some of you may recall that the determining factor for where I go for a long bike ride, is the wind direction. And after studying 8 weather apps, I plot my bike route to ensure I have:
- A tail wind the whole way, and,
- A train station at the end of the ride. So I can bike a lovely 20, 25, 30, etc miles with some help from the wind, and then take the train home. Judge all you want. ONE time I biked 25 miles with a 15 mph headwind and it pissed me off so much, I will NEVER do that again.
Well, because it’s been so wet and rainy since September, I have not been for a single bike ride (Sad, I know 🙁 ) But I do walk. A whole lot. 30 to 45 miles a week.
**Post-publishing I actually calculated these numbers and realized the “45 miles” is a bit of an exaggeration. Maybe once or twice in the last 6 months have I actually walked/run 45 miles in one week. These days I run 6 – 9 miles and walk 20 to 25 miles a week.**
And now that we’re starting to see the sun once every 2 weeks, I plot my walking routes much like I plot my biking routes – except in this case I just follow the sun. And I consult google maps to make sure I’m not too far astray from a train or metro or bus line, and when I’m ready to go home, I just hop on one of those 3 public transport options with my handy -dandy personal Rejsekort card.
So I’ve digressed a wee bit. But I’m getting to the hypochondriac piece. Promise.
So, I’ve had this tight calf after 7 to 10 days of fairly rigorous (for me, anyway) exercise after a 4 week holiday hiatus.
Rolling isn’t working. Stretching isn’t working. Something is wrong. My rest day (where I walked 6.6 miles – but remember, it’s FLAT. THERE ARE NO HILLS WITHIN A 1000km RADIUS OF THIS COUNTRY. I HAVE LOOKED AT ALL THE TOPO MAPS. I DID NOT GO TO THE LUDENS RUNNING STAIRS) DIDN’T MAKE MY CALF FEEL BETTER.
It was time to consult the internet.
Which is what I started doing this morning (Friday, 2/7/2020).
Then I looked at my left calf, and detected a very slight discoloration in the area where I felt pain. So I asked MBH. He couldn’t see any discoloration at all. But *I* saw it, and was 100% convinced of the slight discoloration (could have also been the lighting) of my left calf.
At 8:00am after everyone had left – MBH for work and the youngest and the eldest for school, I did what any health-conscious person would do, and I googled “calf pain.”
And by 8:15am, I had sent a sheepish yet also anxious google chat message to my friend Svanhildur “um, I think I might have Deep Tissue Thrombosis in my left calf, that could cause my death. I have zero risk factors, and I might have run kind of vigorously this past week, so it *could* be a calf strain. But it could also be life-threatening. I could die, like, in the next hour. Should I go see my doctor?”
And what proceeded was a 90 minute google chat with Svanhildur (God Bless her) where we went back and forth about my left calf pain being the life-threatening condition of Deep Vein Thrombosis or a simple calf muscle strain/tear.
I’ll also add that at some point during this chat,(I’d still been googling “calf pain” and “DVT”) I came to the understanding (logically, but not emotionally) that I have zero risk factors (except the overweight bit, and ONE website said being over the age of 40 was a risk factor) for DVT.
I only realized two days ago that I must now say I’m in my *early 40s.* And have a birthday coming up in less than 2 months. Egads. How did THAT happen??!??!!?
But in fact, my fairly active lifestyle (**walking/running 25 – 35 miles a week, not on birth control or other forms of hormones, non-smoker, not obese (a bit overweight, though), no recent long flights or drives, not pregnant, not immediately post partum, not recovering from surgery, not recovering from cancer treatment, no prolonged bed-rest) puts me in the category of “least likely to have DVT.”
And all that vigorous exercise after a 4 week hiatus ( did I mention there were a couple of days when I didn’t stretch or warm down at all? I just remembered) put me in the category of “most likely to have a calf strain.”
But there was still the “family history” risk factor. Which I didn’t know. We’ve got some heart and cancer and Alzheimer’s and blood pressure and a few other health issues in my family. I just wasn’t sure about blood clotting.
But by this time I was thinking “probably all those other health issues means we probably have blood clotting issues too.” I was also thinking “I really love my red wine, could that be a risk factor? Surely one website, somewhere, in Russia, says drinking red wine is a risk factor for DVT.”
Oh internet, how you enable hypochondria….
And although 9:30am in Copenhagen is 3:30am EST, I thought “I’ll just text my favorite youngest sister (who is trained as a nurse), she might be up. She’ll know.” (And for those who don’t know, I also have a favorite middle sister. Her name is Julia and she’s an incredible and amazing special Ed pre-school teacher in SC). So I texted Conoly (favorite youngest sister).
Meanwhile, Svanhildur had convinced me that I should definitely go to my doctor, who has walk-in hours from 11am – noon M-F.
To be fair, I had not shared all the details about my running and stair climbing and possibly not always stretching, with her. Because to be perfectly honest, by this point I was so convinced I might have DVT, I had suppressed all memories of the prior week’s somewhat vigorous, and calf-strain-inducing exercise. I had convinced myself that I had DVT.
So I sent a last-minute regret to my lovely French conversation group that was meeting at 10am.
Kept googling “DVT.”
Stopped googling “DVT” after Svanhildur yelled at me through google chat. (messages in all caps)
I closed all my *symptoms of DVT” browsers, I swear.
And left for my doctors office at 10:37am. I had no idea how walk in hours worked, as I’d never used them before. Figured I’d better be early. And I was. Via Bike (7 minutes). I was 15 minutes early, but checked in with my fabulous Danish CPR (health) card via a machine….(CPR number is basically the equivalent of a Social Security Number)
And sat down to wait. In the waiting room there was some coughing and sniffling and hand-to-toddler-forehead motions, so of course I was thinking “I probably don’t have DVT, but am going to catch either the flu or Corona virus because of my hypochondria today. Awesome.”
11:00 AM on the dot, my doctor pops her head out and calls my name.
My doctor was great and did a quick, but thorough exam, and basically came to the same conclusion I had – I’m at very very low risk of DVT, but was symptomatic enough (calf pain) to warrant a more definitive test for DVT. Ultrasound is the #1 diagnostic tool, but there’s also a blood test for a protein that is elevated during a clot, and it can only be done at a hospital.
**My friend Robbyn, a physician, after graciously taking the time to read this post, sent me these two links:
**AND, dear readers, turns out the decisions made yesterday were exactly the right ones. I scored a *1* on the DVT Wells Criteria Test at my doctor’s office (localized tenderness along deep venous system – it wasn’t 100% definitive but enough tenderness there, the doc ordered further evaluation).
**And according to the “next steps,” that score warrants a D-dimer test (the blood test I got at the hospital). And my blood tests were perfectly normal, so my risk of DVT was then and only then deemed <1%. So to reiterate, I did *not* end up having Deep Vein Thrombosis.**
**So back to being at my doctor’s office.**
She called the hospital while I was in her office and wrote down the instructions for me to get there. I’ll just take a moment here to thank the stars, heavens, God, and Jesus that most all Danes in Copenhagen speak excellent English. Otherwise I might still be wandering around downtown Copenhagen looking for Bispebjerg Hospital (located in a nearby suburb).
I will also put in another plug for the Danish healthcare system. I was very impressed and grateful for it.
So I google how to get to the hospital. It’s either 14 minutes by bike, 41 minutes walking, or 20 minutes via public transport. I had biked to my doctors office (7 min) and was feeling super lazy about biking 14 min to the hospital. Our apartment was halfway between the doc’s office and the hospital….Plus, I should minimize vigorous exercise (biking) because it might lead to a deadly pulmonary embolism….But walking would be totally fine, of course.
So I biked 6 minutes to the bus stop nearest our apartment, locked my bike there, hopped the #12 bus, missed the nearest-to-hospital bus stop (because of my own arrogance and thinking google maps was wrong about the bus route) and walked 18 minutes to the part of Bispebjerg Hospital google was directing me to.
**A dedicated reader (Lisa) asked to see more of the raincoat. So here it is. Bonus, me in slippers with our messy kitchen in the background…
Ok, once again I’ve digressed. Back to the post…**
I’ll also add that this whole time, because my doctor had validated my “very low risk, but enough risk, of DVT, to warrant more testing,” I’m biking and on the bus, and walking, and thinking “I have DVT, I can feel it throbbing, and the blood clot is going to break up any second, and I’m going to have a Pulmonary Embolism. Right Now.”
**If my internet searches had led to the PERC Rules For Pulmonary Embolism, I probably would have been a bit calmer about my risk of this happening. My score was/is Zero.**
So I get to this entrance to the hospital and realize rather soon thereafter (as soon as I walk through that arch) that the complex is HUGE and I start following signs to the place my doctor had written down. It took another 15 minutes to find the building I needed to go to, and the throbbing in my calf was growing, and I had increasingly vivid visions of me collapsing from a pulmonary embolism. It’s ok. You can go ahead and laugh at me. I am.
But I comforted myself by thinking “It’s ok, you’re at the hospital now, you have your national health card on you, if you have a pulmonary embolism, you’ll be close to help and will have a greater-than-average-chance of not-dying…” Also, because we are in a country with socialized medicine, it won’t bankrupt us!!
I finally arrived at my floor/area and asked the first nurse-looking person I saw (white scrubs with a name tag, talking to a person that looked like a patient. He said something in Danish. I replied, apologetically with (what I hope is always) a winsome smile “I’m sorry, I don’t speak Danish.”
He switched to English immediately (one reason it’s impossible to learn Danish in Copenhagen – Danes speak wonderful English and just ain’t got time or patience for non-Danes trying to learn their language) and directed me to the sign (I should have taken a picture and I didn’t) down the hallway.
I walked to that sign, poked my head in the doorway, saw it was a room with a number of desks, chairs, and computers, with one harried looking staff person right in the doorway. She said something to me in Danish. I replied (same winsome smile and apologetic tone “I’m sorry, I don’t speak Danish.”)
She replied in English (kindly, with an arm full of stuff) “What is your name? How can I help you?”
I said “my doctor sent me for an ultrasound, pain in my left calf.” She said “Do you have your CPR card?” I showed her, she said “ok, Cornelia Ellefson (everyone in Nordic countries pronounce it “A [hard A, like *ale*] -lef-son – that is how it’s pronounced in Norway, where the name originates from”) Kelley. Got it. Thank you! Just have a seat…” then she waved kind of down the hallway.
At one end of the hallway there was one table with 3 chairs. But there was also another little area with 5 tables, a few chairs, all tables filled with what I thought were patients being served lunch. It did not look like a reception area. It looked more like the patient lunchroom.
So I went to the end of the hall to wait. And I waited about an hour. gchatting on my phone with my favorite youngest sister, Conoly, who was now awake….(and shared that we had zero family history for blood clotting issues which took my risk factor of DVT to below zero).
But as I’m engrossed in my phone, I was also kind of like “hm, did they get my name? Am I in the right place? Where is reception? The staff person read my name off my CPR card but I don’t remember seeing her do anything with it. Do they know I’m here? Do they even have reception here?” These are all the thoughts running through my head.
So I left the spot at the end of the hallway and went to stand in the little area with the 5 tables and chairs. (All the chairs were full of folks being fed their lunch). And I just kind of stood there, on my phone, hoping someone would notice me there and ask me what I was doing…Otherwise I was going to wait until after lunch was over and cleared away and then I was going to just stop someone with a hospital badge.
So I waited for about 30 minutes, and the kind lunch lady finally asked (first in Danish, then in English) “Do you need any help?” And I said (with much relief, thinking “someone’s talking to me, yay!!!) “I’m here for an ultrasound for my calf, my doctor sent me.” She asked “have you checked in with our staff? And waved to the one room I’d stopped by earlier. “Oh yes, I stopped by there earlier.” She asked “and they got your name?” Me “yes, she looked at my CPR card” She said “ok, good, just wait here, then.”
**Then, “would you like some food?” Me, thinking “wait, what? What universe is this in, I’m not a patient but am being offered a free lunch? Where am I again?”**
And I’m also thinking “ok, confirmation 2 that I’m doing the things I need to be doing to be seen.”
Meanwhile, it’s clear this floor is definitely a patient floor, patients are walking up and down the hallway, with their IV bags, and I’m kind of standing around in the middle of it thinking, “I hope I”m in the right place. My left calf sure is throbbing now…At least if I throw the clot and have a pulmonary embolism I’ll get help right away and will probably not die permanently. I’ll be resuscitated!!!”
I had also updated my phone by this point to list MBH as “emergency contact.” **Prior to me reading too many websites about death from calf pain, I’d had zero emergency contacts in my phone. No time like waiting time in a hospital to update this. And I encourage anyone who doesn’t have an emergency contact list in your phone, to create one.**
I found a free chair in the small table-filled area and sat down. There was one guy, an elderly Dane (maybe 65/70) who was striking up conversation with anyone and everyone. He seems really friendly, but as I have become quite anti-social in my middle-age, I was just hoping he’d not try to talk to me. I really didn’t feel like engaging in small talk. I figured my not-speaking Danish would help my case, but then I heard him speak English [perfect with a Danish accent] and thought “ok, I must not make eye contact, I must not make eye contact, I must type on my phone continuously. This facebook post/share is critically important to world peace…”
Meanwhile, I look up to see a guy dressed in a sweater and threadbare white skivvies, with an IV bag/pole walking past the 5-table area (at first I assumed it was the cafeteria area, I came to realize it was likely reception)…He was getting his steps in! Dressed in a sweater and skivvies. Danes just don’t care about showing some skin and I have to say I admire and envy this.
At this point I was resigned to the fact that there is some system happening and I am just utterly clueless as to what it is and I will eventually be evaluated for DVT and I just have to trust the 4 people who have told me I’m doing the right thing and I’m in the right place and I need to CHILL. AND, BONUS, if I am to throw a clot and have a pulmonary embolism, again, I’m in the right place and have a fairly good chance of living to see tomorrow.
So I scroll NYTimes.com, Washingtonpost.com, slate.com, sighthoundunderground.org ( I miss my greyhounds so much and take great comfort in the fact that they are being very well cared for by my favorite youngest sister, West Point Grad BIL, and niece), my FB feed, chat with my favorite youngest sister, chat with Svanhildur, look up, and see Mr. Skivvies walk past again…Bless his heart….
Then my name is called!!!! yay!!!!!!!!!!!! Confirmation they know I’m here!!!! woohooo!!!!
And a lovely and kind nurse proceeds to ensure all my personal information is accurate. She then takes a few test tubes of my blood. I do not like having my blood drawn, but work hard to tap into my ability to take slow deep breaths. As a result, I don’t break out into a cold sweat or pass out while 3 test tubes of my blood get drawn.
She then tells me I should get up, get a cup of coffee, walk around, they are quite busy today and I should settle in, it’s going to be awhile. This makes me chuckle and I’m grateful she told me. I went to get a diet coke and some peanuts (it’s close to 2:30 pm and I hadn’t eaten since breakfast. I should have accepted the offer of food from the nurse…
Then realize there is complimentary tea and coffee and water in the hallway of the floor where I’m waiting to get an ultrasound for (what I have convinced myself by now is) DVT.
It’s another hour or so, when another woman in a lab coat calls my name. “A-lef-son?” “Cor-ne-l-i-a?”
**My Irish [married] last name sometimes gets dropped in Denmark, apparently. That’s cool. Always happy and proud to claim my Norwegian roots, but especially fun and gratifying to do so while living in Scandinavia.
Turns out, she was the doctor. And she spends a good 20 minutes with me, and in hindsight, I am very grateful she didn’t spend the whole time just laughing at me and my foolish-internet-induced-anxiety-about-having-DVT. She was very thoughtful, and thorough and direct “I am 100% confident you do not have DVT. I am near 100% certain what you have is a calf-strain and not DVT.” We went down the whole list of risk factors again. Zero. Zilch, for me.
The one piece of additional information added to this whole internet-caused-hypochondriac drama-regarding-life-threatening-calf-pain was bloodwork. There is a protein that is elevated with blood clots – but the doc said all my blood work came back 100% normal (the word *perfect* keeps coming to my mind, but I don’t think she actually used that word. I’m just projecting.)
So given the bloodwork, my recent running, the utter lack of risk factors, she concluded, and kindly told me, that I have a calf strain/tear. And that I could probably still run – but just pain attention to pain and stop/rest if it gets worse.
Did I need to check out? Get a bill?
No. She would tell the nurses I was checking out, and if I had chest pains or trouble breathing or other symptoms this weekend, I needed to call the emergency number.
No bill. We are 100% covered with our health card.
**And yes, we pay higher taxes in Denmark (the research scientist rate, though, not the full Danish Citizen Rate, because we will also pay taxes in the US) but I am happy to pay those taxes for such high quality health care coverage for myself and the rest of the country. Denmark does not have tens of thousands of deaths annually caused my lack of access to health care. The US does. We must do better. **
So I headed home.
And on my walk home, I took many deep breaths and I was able to [more objectively] think through the last 10 days or so of my workouts. And laugh at how worried I was about DVT. And feel quite sheepish at my getting worked up over this.
I was home by 4:30.
If I’m going to be completely honest I would say I just wanted to justify going to see medical professionals to rule out DVT. To continue in this vein of honesty, I’m also glad I took the time to get it checked out. Now I can enjoy my weekend and breathe a whole lot easier.
**If I were to do it over again, I’d still go get checked out. DVT is absolutely serious enough to warrant it.
**Also, after re-reading this post, I realized that my flippant and sarcastic commentary about DVT could come across as making light of the condition. I am not at all. It is a serious and life-threatening condition – which is why all the websites say “if you suspect you have DVT, see your doctor immediately.”
My flippancy and sarcasm is 100% self-directed – because of the panicky thoughts running through my head and because of my inability to think at all rationally about my calf pain once I started reading that it could possibly be life-threatening.
Throughout the day, the likelihood my calf pain was due to DVT went from “very low to less than 0” but after reading about calf pain on the internet for a few hours, I had convinced myself I had it.**
Huge props to my favorite youngest sister Conoly for suggesting I write a blog post about this. I otherwise would have simply added it to my increasingly longer list of “future blog posts” that have an approximately 1 in 100 chance of getting written…
And just for more fun, and for those who read all the way to the end of the post. and for everyone very tired of all the selfies of just me (Like I am), here are a few pictures from our trip to Rome two weeks ago.