Surgeon General Focuses on DVT: How not to die from a blood clot in your leg–a doctor’s take

by James Hubbard, M.D., M.P.H.

For 2008 the U.S. Surgeon General’s call to action (the thing he or she wants to publicize nationwide, ie, his or her pet project) is to prevent deep vein thrombosis (DVT) and pulmonary embolism. From the press release:

Deep vein thrombosis is a blood clot in a deep vein, most commonly in the lower leg or thigh.  The clot can block blood flow and cause pain, swelling, and skin discoloration.

DVT can be a problem in itself.  Due to damaged veins, your leg may be chronically swollen for life, causing all sorts of problems.  But the big risk is that sometimes, a piece of this clot can break off and go directly into the lung (pulmonary embolism) to cause serious damage or even death.

According to the surgeon general, each year there are 350,000 to 600,00 cases of DVT, with as many as 100,000 deaths.

DVT is not to be confused with superficial thrombophlebitis, which is inflammation of the veins near the skin surface.  Varicose veins are prone to this condition, which is not susceptible to a pulmonary embolus.  But how can you tell the difference if your leg is red and swollen? Well, you can’t.  You will need to see a physician ASAP.

Obviously, you want prevent DVT.  And you really, really want to prevent a pulmonary embolus, but how?


RISK FACTORS FOR DVT

Anyone can get DVT, but according to the surgeon general, the following increases your risk.

  • Certain inherited blood disorders or factors that make your blood thicker or more likely to clot, as well as a family history of previous deep vein thrombosis or pulmonary embolism
  • Overweight and obesity
  • Cancer and its treatment
  • Pregnancy and childbirth
  • In women, hormone use for birth control or menopause
  • Smoking
  • Age (50 or older)
  • Ethnicity: African Americans and Whites are more likely than other groups to develop deep vein thrombosis

I would add that prolonged bed rest or standing, and surgery (some types more than others), increase your risk.


HOW TO PREVENT DVT

  • Don’t smoke.
  • Stay active.
  • Try not to stand in one place for long periods without walking or flexing your feet several times to exercise your calf muscles.
  • Consider support hose if you are at increased risk.
  • Maintain a healthy weight.
  • Follow doctor’s orders in getting out of bed to exercise after surgery.
  • If you are traveling, get up and exercise your calf muscles every couple of hours, and stay hydrated.


HOW TO PREVENT A PULMONARY EMBOLISM

Get evaluated ASAP if you:

  • have increased warmth, swelling or pain in your leg.
  • have unexplained shortness of breath, or cough up blood, even without the leg symptoms.  Sometimes DVT is silent, with no symptoms until a piece of the clot damages your lung.


DVT TREATMENT

If you develop DVT, you may be admitted to the hospital and placed on heparin (an injectable blood thinner) until an oral blood thinner like Coumadin can get into your system in a sufficient quantity.  Your blood  will be regularly tested to make sure it’s not too thin or thick.  The potential complications of blood thinners would require another blog entirely.

Does anyone have any experience with these diseases? Will you be doing anything differently?

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2 Responses to “Surgeon General Focuses on DVT: How not to die from a blood clot in your leg–a doctor’s take”

  1. cathy Says:

    This post is so timely as I have a friend whose husband just threw some blood clots in his legs resulting in pulmonary emboli. Scary, scary stuff. He’s fine now, but it’s been a long road and much recovery ahead.

    So, thanks for this post! Good stuff to know and follow!

    cathys last blog post..Bear with me!

  2. James Hubbard, M.D., M.P.H. Says:

    Thanks Cathy,

    It is Very scary. I’m glad he’s ok.

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