Focusing on the perils of deep vein thrombosis

Many Americans don't follow instructions from their own physicians -- those doctors already familiar with them and their predilections -- so it might seem naive to assume they're going to hit the books to learn about a particular form of blood clot simply because a honcho physician in D.C. tells them to do so.

But the problems caused by such clots are real and can be devastating, and acting Surgeon Gen.  Steven K. Galson is apparently counting on our own enlightened self-interest to help us protect ourselves -- hence his Call to Action to reduce the number of deep vein thromboses and pulmonary embolisms.

Issued today, the call is meant to raise awareness -- among consumers and healthcare workers -- about how to prevent the conditions. In it, he states:

"Estimates suggest that at least 350,000, and as many as 600,000, Americans each year contract DVT/PE, and at least 100,000 deaths are thought to be related to these diseases each year. Many of those who survive have complications that have a serious and negative impact on the quality of their lives. Without the joint efforts of all stakeholders, including clinicians and families, the problem will only worsen as the population ages."

A deep vein thrombosis is a blood clot that forms deep in the body, usually in the veins of the lower leg or thigh, leading to pain and swelling in the general area. Sometimes the clot can break loose, traveling through the bloodstream until it gets to the lungs. Then it can really do damage. The resulting pulmonary embolism blocks blood flow and can lead to death.

The condition has received increasing attention in recent years, and we now know that individuals can do much to reduce their own risk. So if you're inclined to do your homework, the Agency for Healthcare Research and Quality is here to help. It's offering a free consumer booklet, "Your Guide to Preventing and Treating Blood Clots," in English and in Spanish. For clinicians, it's offering Preventing Hospital-Acquired Venous Thromboembolism: A Guide for Effective Quality Improvement.

To prevent blood clots, the patient guide states:

* Wear loose-fitting clothes, socks or stockings.

* Raise your legs 6 inches above your heart from time to time.

* Wear special stockings (called compression stockings) if your doctor prescribes them.

* Change your position often, especially during a long trip.

* Eat less salt.

* Do not use pillows under your knees.

* Raise the bottom of your bed 4 to 6 inches with blocks or books.

More tips are available in the handy guides, the first of which is 12 pages; the second, 60. If you decide not to peruse either guide, keep these facts in mind:

People who are overweight are more at risk for the condition. So are women who use hormones. Smokers. African Americans. Whites. And people older than 50.

Prolonged inactivity (plane rides, bed rest etc.) can increase the likelihood of problems as well.

-- Tami Dennis

Photo: Long flights can increase the risk of blood clots. Doctors advise against staying in the same cramped position for extended periods.

Credit: Lucas Schifres / Bloomberg News

Comments

[Mr K]

not a bs question.. what happens if you have DVT in your penis?

[Anon]

Once while on a 1+ hour car trip I felt *something* go through my heart - very bizarre sensation, like having heartworm - it didn't occur to me until years later that it was probably a blood clot.

I'm guessing DVTs are a lot more common than is currently recognized.

[dr. x]

Mr K - DVT stands for DEEP vein thrombosis. Lucky for you the veins in the penis are superficial.

[Trae]

From what i have mostly read about this deep vein thrombosis it happens in the legs. Not your penis. Go look it up and when you don't find your answer then ask questions about your penis... wow. The article said usually in your lower leg or thigh.

[Allan]

It seems many doctors are ignorant of the risks and symptoms. I had the symptoms for years, my Dr. treated it as mild high blood pressure, and gave me drugs. Drugs didn't help the symptoms.

I was saved by a visit to an emergency room when my difficult breathing was thought to be a heart attack. The E-room doctors tested and discovered the problem -- occlusive DVT with many clots from pelvis to ankle, and three clots in my damaged lungs. I now have a new doctor - the old one almost killed me.

I think in a thousand years they will be referring to the twenty first century as part of the dark ages.

[Susan]

This is even more fun if you are part of the 25% of the population with PFO or patent foramen ovale. PFO means the clot can go to the brain without passing Go or getting $200.00

The only difference with me is that I know about it and I'm on blood thinners.

[Will]

Maybe these medical experts can figure out how to convince the airlines to let you walk up and down the aisle when they don't want you out of your seat in order to minimize the risk of terror acts.

[s]

Mr. K, I guess they'd have to amputate.

[c]

as a non-smoking, seemingly low risk woman who has suffered through DVT - it is not fun and most certainly painful. as many will attest, it can easily be overlooked or misdiagnosed - i went through weeks of pain and physical therapy before an ultrasound ultimately reveled the clot. so, if pain and swelling persists in a lower extremity ... it hurts to walk and it even hurts when you are doing absolutely nothing - get it checked out. don't wait for it get better because it will likely only get worse.

[Joe]

The makers of Lovenox and Plavix are putting out this DVT scare to increase market share. Sanofi-Aventis which makes both of these products to treat DVT (Lovenox) and atherosclerosis (Plavix) have flooded the internet with press releases about this issue. Here is a simple solution, take an aspirin before a long flight. Sanofi-Aventis stock is tanking this year - they are playing the public with this non-issue.

[Terry Oliver]

how come no one ever mentions tim russert, who within hours of returning to washington dc from italy on a very long flight, died of a clot induced heart attack?

[Paul]

Joe,

I recently had a DVT and asked my doctor if taking an aspirin every day would have prevented it. The answer I got was that aspirin would not help on vein clots.

The answer was kind of a relief. The lecture from my dad reminding me how he said to take aspirin every day would have been terminal.

[Ritchie Christianson MPH]

Even though these blood clots are the leading cause of US hospital deaths, and one of the leading causes of death outside a hospital setting, there are 2 things anyone can do to greatly reduce the formation of emboli. Drink enough water to avoid being clinically dehydrated (which most Americans are) and exercise those legs, even when sitting or lying down.

[Ransome]

You are probably more susceptible when sitting at a computer all day.

[Judith deP.]

Yes, Bill, walking around in an airplane is discouraged, and is difficult if beverage carts block the way. Another thing is that now it's hard to stay hydrated. No longer can I bring my own water, and with no free drinks, consuming adequate fluids can be very expensive.

[RH]

Two of the genetic factors that influence the risk of DVT are Factor V and Factor II. Tests for these markers are now available through 23andMe and other personal genetic testing services. (full disclosure: my spouse works for 23andMe) My data show that I have approximately average risk for venous thrombolism. Several members of my family have also been tested, all showing an average risk.

[Bonnie]

I have chronic DVT and am on Warfarin, probably for the rest of my life. Am I in as much danger of getting more blood clots? I have never been told what to do to take care of my leg as it is now. Does anyone have any suggestions?

[jhgap]

Having had a DVT, I can testify to the deep seated pain it causes. My first one was in the middle of the night, I got up to use the Bathrooom, and couldn't stand to walk. The DVT at that time went from my knee to my groin. I was hospitalized, treated and adjusted on Coumadin. Two weeks later, I again had severe and excruciating pain, and the DVT had extended and now went from my knee to my iliac crest (hip). I was off my job, (nurse) unable to walk, and after 8 months, was finally released to return to work. I can thank all of this to Estrogen ! Birth Control Pills, which I wasn't even taking for that purpose. Seems they had this wild idea that Estrogen helped you if you had a history of heart attack in your family. The pain I endured could have CAUSED a heart attack !!! No estorgen. NO ESTROGEN !!!

[El Guido]

Another easy prophy is to take a baby aspirin every morning. Amazed this "expert" didn't mention it.... Makes me wonder what the pharmaceutical companies are paying him....

[Howard]

These quacks know nothing...

[Dr. B]

Women on the pill or those with a family history of clots should have a test to see if they are fast clotters. I had a pulmonary embolism out of the blue and it turned out that was the cause. Its called factor five leiden and its not uncommon. Women with factor five leiden on the pill have a much higher incidence of DVT and pulmonary emboli.

[Frank Stallone]

Unfortunately, the treatment can be almost as bad as the cure. A therapeutic level of warfarin results in about a 10% mortality risk due to internal hemorrhaging from ulcers, cranial contusions, etc. Still, 10% is less than 30%.

[peter smiley]

My Doc told me to get compression stockings and to wear them if I was flying or driving a long distance, etc.. You can get them at a drug store but the best selection is on the web at places like www.brightliediect.com and www.compressionstore.com
Pete Smiey

[pete smiley]

In my previous post for a compression hosiery resource I misspelled the url... it is www.BrightLifeDirect.com

[Dr Trugli Vartna]

The Surgeon General's comments are typical of the high level of ignorance rampant in the entire medical profession today ... particularly in the Halls Of learningdom (medical Schools) where instruction is done by doctors who have either rejected private practice because of the ineffectiveness of drugs in producing health, or have never had a private practice where they cared one iota about the results their prescribing produced. With research funded primarily by private interest groups (medical as well as drug-related) it is no wonder that health-producing procedures and remedies are lost in the gargantuan amount of trivial, unimportant side issues and half truths.

Deep vein thrombosis is a function of the condition of the blood and the condition of the entire vascular system. Clots form because of the viscosity and sluggish nature of the blood. Vessels swell and form pools because they have lost their vascular muscle integrity. Cholesterol is a natural remedy secreted by the liver to plug arteries and veins whose supply of collagen is severely depleted. Where you put your legs; the clothing you wear-- and eating less salt -- are all trivial, unimportant half-truths that purposefully (or in total ignorance) avoid the primary issues.

The solution lies in diet, nutrition, PURIFICATION OF THE BLOOD, and exercise. Learn about these things from the few THINKING physicians who put out information designed to empower you ... not keep you in the position of drug-dependant victim. Here are some suggestions to start you on your way:
1. Subscribe to the monthly newsletter called: Dr. Brownstein's Natual Way To Health which you'll find at http://drbrownstein.newsmax.com ... and buy his books.
2. Spend a few hours on Dr. Garry Gordon's website www.gordonresearch.com researching your own particular problems. Purchase his products at http://www.longevityplus.net/store/home.php ... particularly his Beyond Chelation Improved and his Essential Daily Defense ... all of which condition the blood.
3.Subscribe to Dr. Bruce West's educational publications at his website http://www.healthalert.com/

I have no relation or vested interest in any of the products or people mentioned above, except that I purchase and daily use many of the products and procedures these men recommend thus resolving and eliminating all my personal heart and health problems. I am 73 years old, but should have died years ago but for my own efforts at educating myself.

There is a thin line between a hero and a fool, but the true hero always first acknowledges his status as a fool. Educate yourself using orthodox as well as unorthodox information. Use the men mentioned above as your guides. They will not fail you ... and take the hero's path despite your fears.

Trugli Vartna