After two and half years, I googled pulmonary embolism. An embolus is any mass in the bloodstream, including fat, air, blood clot and tumor. Thrombus refers specifically to a blood clots in the blood vessels. My understanding is that it is normal to always have some amount of tiny blood clots floating in the blood stream; basically, they are starters for injuries. A pulmonary embolism means that a large embolism is blocking a pulmonary artery. A pulmonary thrombo embolism means that the large embolism is a blood clot. Most people are familiar with a pulmonary embolism beginning as a deep vein thrombosis. That is, for some reason, all of the tiny emboli congregate together in a vein and eventually the larger blood clot makes its way to an artery. As far as I know there was no evidence of a DVT in Matt’s case. What I remember the doctor in the ER telling me was that he had many many, too many small emboli in his lungs.

I also looked up statistics on pulmonary embolisms. Most of the data involves pulmonary embolisms caused by DVT because there are a lot of cases that go undiagnosed. About 600,000 people in the U.S. are affected by PE each year, and maybe 100,000 die. 25% of deaths are sudden with no symptoms, but the majority of cases go more than a month with symptoms. I found that pulmonary embolism is quite common as a serious health condition and it used to go undiagnosed for a very large percentage of the people who suffered from it. With more technology, things have swung in the opposite direction and it is now considered to be over diagnosed. What makes it difficult to diagnose is that the primary symptom is shortness of breath. Supposedly 5-8% of Americans are genetically predisposed to having a pulmonary embolism.

I still find it inexplicable that Matt did not talk about suspecting a blood clot. I never googled pulmonary embolism till now, but knowing him, he must have done it at some point after his mother died of the condition. I know I thought that pulmonary embolism meant a DVT in a person’s leg. Maybe he thought the same thing. Or maybe he pushed the idea aside because he had gone to the hospital one time years before complaining of a DVT that was a false alarm. I’m not interested in studying how things might have happened differently. But I realized that I do have to come to terms with the fact that I will probably never know how and why Matt’s body declined from running 25 miles a week to such a critical condition.