This will be something of a long read but I hope I can get some help/advice/answers/ thanks in advance for all who read this.

My story starts in late 2015. I was a production operator in a factory. I applied for and got the job or rail yard operator with the same company but at a different facility. Upon taking the job, I noticed that I did not have the physical stamina I once had. I also noted that my legs became VERY heavy and achy. The job was considerably more physical than the production job so I chalked it up to that. Through 16 and 17 the condition worsened and the varicose veins in my left leg literally blew up. My doctor was at a loss for my fatigue and lack of energy. My varicose veins were dismissed as mainly cosmetic. 2018 saw my condition worsen and by August I could work a shift (12 hours) and only sleep after that. I work 2 on 2 off and would sleep pretty much the entire 48 hours then all of my off time. In late August we went on vacation and where we stayed had a lazy river I was too weak and exhausted to enjoy it. I went back to the house and slept. Returning from vacation I worked two days. On the first day I was non functional. On the second day halfway through my shift I called the boss and told him I wasn't well and needed to go home. He was ok with it and I parked the locomotive, and took a shower (late August in the South is very hot and the job is dirty). I went home and slept three days solid. On Sunday evening I woke up and went into the kitchen. My wife was making her dinner (my appetite was gone for months) I spoke to her and picked up our new kitten. I went into the den and sat down with the kitten on the loveseat. Then everything went cold and dark. I do not remember hitting the floor.

What followed was a whirlwind. I could breathe but it hurt, and trying to walk made me pass out. My mother in law who lives with us still had a few oxygen tanks from a recent hospitalization. I put myself on 2lpm... then 4, then 6 to try to catch my breath. An ambulance came to get me, the EMT asked if I could walk to the ambulance. Halfway to the door I passed out again. On the ambulance the EMT told me I wasn't having a heart attack but the right side of my heart was really stressed. Once at the ER (where I used to work years before) i had another IV inserted. When the nurse pulled out a third IV for me I knew I was in serious trouble.(Only patients in danger of coding out get three) I asked the nurse what was going on she told me I was going for an emergency CT.  

Bilateral Pulmonary Embolism submassive on the right, massive on the left.

I spent three days in the ICU. On my first night in ICU I had just drifted off to sleep when the door blasted open and every nurse on the unit charged in - I had gone into afib. I told the nurses I had felt like that many times before. After a week I was sent home with a heart monitor and home oxygen. I was 45, and had the set up of a very unhealthy 75 year old. I could only walk from my room to the nurses station about 60 feet away before becoming fatigued. My work's nurse put me out on short term disability. The company paid me 2 months 100% pay . I went to physical therapy to recondition myself. I was on a blood thinner for life.

When I returnd to work I did ok for a while. I felt better than I had in a long while.. Early 2019 was better than any recent year before. I was hopeful that I had put everything behind me. Then the legs started to bother me and fatigue crept in, over the course of 2019.One morning after a night shift I took a picture of my swollen and red leg and sent it to my wife. Unknown to me she forwarded it to a nurse at a vascular surgeon.I had to go that day. A CT and an ultrasound was ordered. "Why were you not reffered to us out of the hospital?" I was asked. I began listing my symptoms... A cardiologist was called, and a pulmonologist. Over the next two months I had 2 CTs, a chemical stress test (dont reccomend), ECG, a regular stress test, a massive blood panel, a right heart cath, and two ultrasounds.

The pulmonologist was convinced I had CTEPH. That scared the hell out of me. Turns out I didn't have CTEPH. Notice I had two ultrasounds, one was in my legs the other was done in my lower abdomen pretty much at my insistence. Turns out I have/had severe veinous reflux. Doctor tells me I am 10-12 seconds off where I should be. In my lower abdomen on the left side was a cluster of really bad veins. In November 2020 I had an ablation done and many of the bad veins were removed. For a while, I felt better. In the last few months I have felt worse and worse.. Last week I had an ultrasound, no clots but the tech could tell I had some massive event.

Throughout all of this there has been a dull ache deep in my body that never goes away. The shadow of fatigue is always there. Sometimes it is painful to take a deep breath. I lost the lower half of my left lung. After the PE any varicosity I had before got worse, including the varicole. I developed Peyronnies disease. Next week I am going to a urologist for the varicole and peyronnies. From all the testing that was done i was told I have tons of scarring. My legs burn. I just do not have energy anymore. I am tired . 

So three years out and I feel awful anyone else have a similar story? What happened?