DVT

March along with colon cancer, is Deep Vein Thrombosis awareness month (DVT). Today’s health and beauty buzz is on the causes of deep vein thrombosis. DVT is the formation of a blood clot in a deep vein usually in the leg but may occur in other areas. DVT sometimes causes pain but about half of DVT occurs without any symptoms. DVT occurs in approximately 2 million Americans each year and pulmonary embolism (a complication arising from DVT) kills 300,000 people per year.

              Causes of DVT:

• DVT can develop if you are sitting for a long time in a plane or a car. When you sit, your calf muscles do not contract which helps the blood to flow.
• If you have certain medical conditions which affect the way in which your blood clots. Some people’s blood clots more easily than others.
•  Prolonged stay in hospital lying in bed. The calf muscles not contracting can cause the formation of blood clots. Most hospitals in the US, automatically attach a compression device to the legs prior to and after surgery.
• Surgery- Injury to your veins can cause the blood flow to slow causing the formation of clots. General anesthetics can make your veins wider causing the blood to pool and then to clot
• Pregnancy increases the pressure in the veins in the legs.
• Oral birth control can increase the chance of blood clotting.
• Heart failure- The damaged heart does not pump the blood as well as a normal heart.
• Pace maker- This can irritate the walls of the blood vessels and decrease blood flow.
• Family history.
• Smoking affects blood clotting and circulation.
• Obesity- being overweight increases the pressure in your veins.
• Age-Being over 60 increases your risk.
• Cancer patients are at higher risk of developing DVT. Certain cancer drugs such as thalidomide to treat multiple myeloma and tamoxifen for breast cancer amongst many others are associated with a higher risk of blood clots.  It is thought that they cause damage to the blood vessels and reduce the production of proteins that protect us from blood clots. It is not fully understood why cancer patients are at higher risk, but it is thought that cancer leads to tissue damage and inflammation which leads to the activation of blood clots. The chemicals in tumors can lead to blood clotting.

Deep vein thrombosis is a serious condition because the blood clot which has formed in your vein can break loose, travel through your blood stream and lodge in your lungs blocking blood flow. This is called a “pulmonary embolism” and can be fatal.    

                When there are symptoms, these include:-

1.     Pain and swelling in your leg including your ankle and foot.

2.     Cramping in the calf.

3.     Feeling of warmth in the area.

4.     Changes in your skin color such as red, blue or pale color.

5.     Shortness of breath and chest pain.

6.     Sweating.

7.     Light headedness, fainting and dizziness.

8.     Coughing blood.

9.     Anxiety and nervousness.

                  Treatments may include:-

1.     Aspirin therapy.

2.     Compression stockings.

3.     Blood thinners are the most common form of medication.

                 Prevention of DVT:-

 Pneumatic leg compression device. The garment is
 connected to a pump which automatically inflates
 and deflates at a pre set pressure and cycle.
The garment works day and night. Gentle squeezing
 of one leg is felt followed by a rest period and then
 the  sequence is repeated on the other leg.

•  Walk around as soon as you can after surgery. Ask for a compression device if you have not automatically been issued one and keep legs elevated by raising the bottom of the bed.
• Take all medication prescribed to you by your doctor. 
• When traveling long distances, walk around every hour. Flex and stretch your calf muscles and wear loose clothing.
• Do not drink alcohol, but drink plenty of water and other fluids.
• Wear compression stockings whilst traveling but consult with your doctor prior to using them.
• Control your blood pressure.
• Stop smoking and lose weight.
• Maintain an active lifestyle. Include daily exercise such as walking, swimming or cycling.

Discuss your risk factors for DVT with your doctor. He or she will decide if you are at risk. Diagnosis can be difficult.

One of the most common tests is called “venography” This is done by injecting a radioactive material into the vein on top of the foot. This mixes in with the blood and flows towards the heart. An x-ray of the leg and pelvis is then taken and this will show any blockages in the calf and thigh veins. It is a costly test and cannot be repeated often, but is very accurate.

Another accurate test is called “Duplex ultrasonography”. It is non invasive and can be repeated as needed. It is less costly than venography.

The 3^rd test is called “magnetic resonance imaging” (MRI) and is useful for detecting DVT in the pelvis and thigh. It is non invasive and becoming more frequently used. It allows for visualization of both legs simultaneously.  The down side is that it is expensive, not always readily available and cannot be used on patients with pace makers. Some people may also feel claustrophobic whilst having this test.

Consult with your doctor prior to embarking on any action to treat or diagnose DVT.

Tip of the day:

Opt for twilight anesthetic if at all possible for surgery.

Stay healthy, happy and safe.

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