Early Rehabilitation Following Saddle Pulmonary Embolism: Perspective From Physical Therapist as Patient

Abstract

Purpose: Pulmonary embolism (PE) is a complication associated with the condition of deep vein thrombosis (DVT). Together, DVT and PE comprise the condition of venous thromboembolism (VTE). The presence of PE is a life-threatening acute complication, with the risk of death being 18-fold higher than that in patients with DVT alone. The long-term effects of VTE may influence a patient's ability to maintain appropriate levels of physical activity, resulting in impaired functional mobility, quality of life, and overall health and wellness. Physical therapists frequently work with patients who are at risk for or have a history of VTE across all practice settings and are often responsible for mobilizing patients after VTE. However, little guidance exists regarding optimal timing for initiation and intensity of treatment to combat the negative sequalae associated with PE. Methods: This case report describes the experience of a physical therapist who suffered an unprovoked submassive saddle PE. Results: The patient self-initiated and self-administered an exercise program with successful outcomes. The case provides a unique perspective of a physical therapist who used his clinical knowledge to make decisions, while experiencing the event through the lens of a patient. Conclusion: Evidence is provided to support the role of early physical therapy–directed progressive mobility to maximize long-term outcomes following PE.

Response to the April 29, 2021, Letter to the Editor

“…My medical care did not D ear Dr Irion, First, I write to thank you for the opportunity to share my experiences and perspectives both as a patient and as physical therapist who has recently experienced a saddle pulmonary embolism (SPE) with the readers of the Journal of Acute Care Physical Therapy. 1 It was my sincere hope in writing this article that a description of what I had encountered during my acute recovery from an SPE might provide unique insights to those who also treat patients recovering from an SPE. I also hoped that by presenting my story as a case study, I might enlighten health care professionals about the dearth of foundational guidance (in guidelines) available to them, as they treat patients who have experienced an SPE.…”

“…First, I write to thank you for the opportunity to share my experiences and perspectives both as a patient and as physical therapist who has recently experienced a saddle pulmonary embolism (SPE) with the readers of the Journal of Acute Care Physical Therapy 1. It was my sincere hope in writing this article that a description of what I had encountered during my acute recovery from an SPE might provide unique insights to those who also treat patients recovering from an SPE.…”