Over the last few years, blood clots have become an increasingly common diagnosis amongst high-level athletes, and one of the rare medical conditions that has shut down the careers of star players in their primes.
Abnormal blood clots in the legs, known as deep vein thrombosis, can break free and travel to the lungs, where they can present as a life-threatening condition called a pulmonary embolism.
The standard treatment to prevent such blood clots is for patients to go on blood thinners, a regimen that has had a lot of success over the years.
But it’s not one that works well for athletes. Blood thinners prevent the blood from clotting when it’s useful, such as after a cut or other injury. Individuals on blood thinners need to do everything they can to minimize the risk of bleeding, meaning sports are out for those undergoing that treatment.
It’s led to the diagnosis being a scary one for athletes. Miami Heat forward Chris Bosh never played again after his 2016 diagnosis. Pittsburgh Penguins forward Pascal Dupuis retired in 2015 after an unsuccessful comeback bid when his blood clots returned for a second time.
Some athletes have been able to return to competition, notably tennis star Serena Williams, Tampa Bay Lightning forward Steven Stamkos and New York Mets closer Jeurys Familia. What has allowed those athletes to remain in competition seems to be mostly a matter of luck. After taking steps to change their routines in order to minimize clots, they weaned themselves off the blood thinners and returned to play.
The uncertainty, and the potential to end careers makes it a scary diagnosis for an athlete to receive, and even a successful course of treatment will leave with it the specter of reoccurrence throughout the athlete’s career.
Pitt senior guard Aysia Bugg didn’t know any of that last fall, when she noticed a swelling and pain that wouldn’t go away after the Panthers lost to Georgetown on Nov. 19, 2018.
In the ensuing eight months, Bugg has found out all about the process that will determine whether or not she’s able to complete her college career and pursue her dream of playing in the WNBA.
The early part of Bugg’s tenure at Pitt was not without its own trials and tribulations. The 5-foot-7 guard joined the Panthers in 2014 out of Bollingbrook High School in Chicago. She started 29 of 32 games as the Panthers advanced to the second round of the NCAA Tournament.
But the team started to fall apart around her. Graduations and high-profile transfers mined the Panthers of their elite talent, and over the next two seasons, Pitt posted back-to-back 13-win seasons with 4-12 marks in ACC play.
In what was supposed to be her senior year, Bugg missed the entirety of the 2017-18 season with a knee injury. Pitt went 10-20 with just two conference wins, followed by more transfers and the firing of head coach Suzie McConnell-Serio.
It was no sure thing that Bugg would even come back to play with the Panthers for her redshirt senior season. Having already graduated from Pitt, she could pursue a free transfer — even to another ACC school. But Bugg felt an immediate connection with new Pitt head coach Lance White, and wanted to be part of the rebuilding process.
That all changed in November.
Suddenly, Bugg went from worrying about how a young team — her teammates had taken to calling her “the grandma” of the group — would fare in ACC play, to whether she’d ever be able to play the sport she loved again.
“We were playing Georgetown,” Bugg said in an exclusive interview with Pittsburgh Sports Now. “We actually drove there, played and drove back the same night. I was experiencing some discomfort the following day.”
The following day was a Tuesday, and Wednesday, Pitt was flying to Nashville to play in a three-game tournament. Bugg didn’t play while Pitt won two of three in Nashville. Before the Panthers could take the floor again, Bugg was in the hospital with a pulmonary embolism.
It was not a diagnosis she was familiar with.
“I didn’t know anything,” she said. “We went to the doctor’s and they said, ‘She has blood clots’ and everyone is looking at me like I’m crazy, because I was like, ‘I’ve got a game tomorrow. Let’s wrap this up.’”
Instead of the quick course of treatment she was hoping for, Bugg was prescribed blood thinners for a minimum of four to six months.
“There goes the season.”
Six months is not a long time over the course of a human’s existence. But six months for a 23-year-old athlete, at the prime of her collegiate career, restricted to not only not playing basketball, but not even working out, not even raising her heart rate — it was a literal and metaphorical tough pill to swallow.
“It was just a real stagnant six months,” she said. “I didn’t feel like myself.”
She wasn’t even sure that a return to basketball would ever be in the cards.
“After I received my diagnosis, I wasn’t sure what my options were,” Bugg said.
She found other ways to fuel her basketball passion, though, and she remained closely engaged with the team, which was made even younger by her absence. Bugg served as a de facto assistant coach for the remainer of the season, one that saw Pitt limp to another 2-14 conference record.
“Sometimes you look at them and it’s like, ‘You don’t realize how good you guys are.’ I feel like when I got hurt it was just a downward domino effect. It sucks, because we have so much talent. All we have to do is believe in ourselves.”
Bugg said that the time away from the court — she’s played five games in over the last two seasons — has helped her in some ways.
“I’ve just grown mentally,” she said. “I’ve progressed as a person, outside of basketball.”
Finally, after consulting with her doctors, she was eventually given the green-light to begin to prepare her body to come off the blood thinners in an attempt to return to play.
In May, the pieces started to come together to facilitate Bugg’s return. The NCAA approved a waiver for a sixth year of competition, and more importantly, she was given the go-ahead to fully come off the blood thinners and return to practice.
“Her health is our No. 1 priority, but it’s all looking good so far in her progress toward being back on the floor,” White said.
That doesn’t mean that her saga is over. At any moment, Bugg’s blood clots could return and end her career in an instant. She’s taken steps to prevent that from happening, from different stretching and cool-down routines, to exercises she’ll do on long trips and flights and more. But largely, the fate of her career lies outside of her hands.
“It worries me, which they say you shouldn’t think about it, but if something like that were to happen again, there it goes — my career,” Bugg said. “I would have to take blood thinners forever if I have another blood clot.”
Bugg said that the positivity and energy brought by White and the new coaching staff has helped her through the mental stress of the situation.
“People can be negative,” she said. “We try to eliminate that, especially when we’re on the court, around each other.”
Bugg’s hope is to have to a normal 2019-20 season, and to make an impact in her sixth and final go-around with the Panthers. She’s not letting her diagnosis stop her from having high expectations, either.
“Postseason,” she said. “I think there’s no reason we shouldn’t. Probably have one of the best seasons since I’ve been here and we can do that.”
“I couldn’t be more excited to have her lead this group, being older and wiser and knowing
what it takes,” White added.
At the end of it, Bugg hopes that there will be a way for her to continue her playing career beyond her six years at Pitt. But perhaps more importantly, she wants to be known as someone that stayed and fought through the tough times, and helped make the Pitt program better for it.
“I never gave up. No matter what obstacle I was faced with, I stayed optimistic, I stayed positive. I just always had a vision for where I wanted to be.”