Unprovoked PE now with worsening chest pain since treatment. Why?

[ambrocious3]

May 21st I had very subtle pings in my left chest and awoke with awful neck and back pain.  I'm a nurse and contemplated what this could be knowing some facts below:

-I had pneumonia in April and was the sickest I can recall ever being and was in bed for 5 days.  Being a nurse, I knew it wa important to move, and though I made sure to walk around my house while heating up rice packs, I was still pretty much in bed that whole time.  I continued to wheeze a few weeks after antibiotics as well.
-I had recently flown from Wisconsin to California and back, with a toddler on my lap.

In the ER, my D-Dimer was 0.61, just above normal (0.50), so they did a CT and told me they found a very small, segmental "filling defect" and were surprised I even had symptoms.  I started on apixaban.  The next day at work (yeah, I went to work so I could continue to speak with coworkers at my hospital), we checked for DVTs, but it wa negative (I had taken two doses of apixaban by then).

A week later, I had a positive pregnancy test.  I then switched to lovenox twice daily.

Throughout the first few weeks, I continued with subtle pings.  I work in a hospital and would curbside my MD colleagues about continuing symptoms, but was told it might just take some time to go away.  

Eventually, the pings went away, but evolved to some more intense pains.  This moved to the center of my chest and was more achey.  The first event occurred towards the end of my workday and not wanting to make a big thing about it, I approached a colleague who ended up calling a pulmonologist who ultimately said with the pregnancy, get checked out.  I went to the ER and everything, troponins and D-Dimers were fine.  

At 10 weeks, I miscarried.  Went back on apixaban.

This was nearing the end of my 3 month treatment course, and not feeling confident in my PCP, I made an appointment to switch providers to get a fresh perspective on everything.  Two days prior to the appointment, still on blood thinners, I was driving with my son and I developed a severe ache 8/10 pain in my left chest.  I pulled over, and had to mentally tell myself "you're on blood thinners, you're 31, your heart is (or should be fine)".  The pain decreased after several minutes, but some form of pain lasted until the next day.  I asked my new PCP who stated some people have pain for months or years after a PE.  My question was why was mine intensifying and worsening after being on treatment and why was this happening if it was so tiny to begin with?  Chest pains were less common m, but significantly more intense.

10 days ago, I saw a hematologist who thought I should be on apixaban 2.5 mg twice daily for the near future.  After telling him how heavy my periods were on blood thinners, we compromised with a repeat CT.  That showed no evidence of clot, no pleural effusion, essentially the CT looked like the chest of a healthy individual.  We decided I could switch to a daily baby aspirin.

About 4 days ago, I developed general back pain, that seems to carry through to the chest.  It's reminiscent of my initial clot pain, but more broad.  It's not worse with breathing, and has been a pretty constant dull ache.  It woke me up at 2 AM last night and I contemplated going in, but again, figured my CT was clear a week ago, the likelihood of having a new clot so quickly is low, and I'm low risk cardiac wise.  I just don't get why this pain keeps morphing.  Now it's just constant.  I'm trying to hold out another two weeks when we'll repeat a D-Dimer and then make it until the week after that when I see my hematologist again.

I do not feel this is anxiety.  I have had a lot of stress in the past few months and these flares have come at times when I've been in the best place I could be mentally.  

It's very challenging.  One minute I'm thinking I've got to go in, the next, I just feel like I need to suck it up and deal with my new normal.  I just don't know when to go in.  

Thanks if you read this far.