Katie Shoultz awoke in the middle of the night, dripping with sweat.
It was about 1 a.m. on an early Tuesday morning, just days after the North Dakota State University softball team had won its third consecutive Summit League title on Saturday, May 14, with Shoultz going 2 for 3 at the plate. She had finished practice with the Bison earlier that Monday, followed by a team dinner.
Shoultz was able to get back to sleep, but what woke her up three hours later was what she would later describe as the "most excruciating pain in my life" in her lungs and back.
That was the beginning of a long, exhausting summer for Shoultz that eventually resulted in the 2014 Muscatine graduate deciding to end her softball career at North Dakota State prematurely.
"As much as I would love to continue playing the game, I just physically can't," Shoultz said. "From the outside, you wouldn't be able to tell, but inside it's just not something I want to push."
The intense pain sent Shoultz to the emergency room that morning, and after a series of tests, doctors found multiple blood clots in Shoultz's lungs as a result of Factor V Leiden thrombophilia. A genetic condition that can increase the chance of abnormal life-threatening blood clots, it resulted in the pulmonary embolism that caused Shoultz so much pain and can often be a life-threatening condition.
Shoultz was a five-sport athlete for most of her high school career, which included being a three-time Iowa high school state track placewinner and three-time Mississippi Athletic Conference softball player of the year in addition to being a part of successful teams in volleyball, soccer and basketball.
She had made a seamless transition to the college softball game after graduating from Muscatine and was swiping bases and scoring runs as the leadoff hitter for the Bison in addition to making plays in the outfield, and she was named first-team All-Summit League prior to the conference tournament in May.
During NDSU's run in the Summit League tourney, Shoultz said she started to mention casually to teammates how much harder it was to regain her breath after a particularly physical play on the field. She said she didn't think much of it as she often had a severe lack of stamina due to anemia that was diagnosed after an appendectomy in her senior year at Muscatine.
"I figured I might just be out of shape," Shoultz added.
Following the diagnosis, Shoultz was put on blood thinners and told to relax and go easy in the weight room, but even going up the stairs would make her tired.
On a visit with an NDSU athletic doctor, the message was straightforward.
"He said that if I was your dad, you would not be playing," Shoultz said. "And he told me that I was lucky that nothing really bad had happened to me, because not a lot of people can say that they're still here after something like that."
If Shoultz pushed herself like she did all through high school and in her two previous seasons as a Bison, she knew she could end up back in the emergency room.
"There was so much damage done to the tissue in my lungs that it could be a very long time to get back to normal, there's no saying how long," Shoultz said. "I'm just taking it day by day, honestly."
Though she won't return to the softball field for the Bison, Shoultz will continue studying her major in human development and family science, with the hopes of working in a hospital or doing something with high school counseling or coaching down the road.
She's starting a bit of that coaching now, as she's technically still a part of the Bison roster for the 2016-17 athletic year. Shoultz said she's enjoyed the help that she's offered slap hitters and outfielders on the team and will continue to travel with the Bison, which was one of her favorite parts of being with her teammates.
"The team bond is the No. 1 thing," Shoultz said of what she'll miss. "The traveling, the things behind the scenes that people don't see like practices, workouts and those big games and big wins, things like that make you know you're going to miss the game."
Those feelings may intensify once NDSU starts it season next winter, but Shoultz said she knows she made the right decision.
"I've competed my entire life, I've been a gamer and don't know anything other than that," Shoultz said. "There are moments when you get sad or emotional but you can't really complain about it. … I'm 20 years old and I've got a lot of life ahead of me."