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Millions die of blood clots

Beware of leg pains, as clots form deep in the veins, usually in the legs.  These clots can then move to the lungs, blocking blood flow.  This condition, a pulmonary embolism, can easily be fatal.

Risk in people who :

Are immobile for a long period, as your veins require muscle movement to push blood back to the heart.  If you have been in an accident, where you are to stay in a hospital without any movement, the blood tends to pool in the veins and then gets “cruddy” .

You are also a risk, when you have cancer or when your on chemotherapy.  Cancer and cancer treatments , promote clot-forming substances in the blood and increase levels of procoagulants.

Have n inherited blood-clotting disorder that causes the blood to clot more easily.

Have a personal history or family history  of deep vein thrombosis ( formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system) or pulmonary embolism (a blockage of the main artery of the lung).

Medications

Patients with deep vein thrombosis always are treated with an anticlotting medication, such as heparin or warfarin. (Heparin is given as an injection and acts quickly. Warfarin is a pill that takes two to three days to start working.) The drugs prevent a clot from getting larger while the body’s anticlotting mechanisms slowly break it down.

Anticlotting medication also may be given as a preventive measure. Patients undergoing an orthopedic procedure, such as knee or hip replacement, are routinely given anticlotting medication prior to surgery. (In the past, before anticlotting drugs, between 50% and 70% of patients would develop clots after surgery.)

Patients taking anticlotting medications should limit their consumption of foods high in vitamin K, which can affect how drugs such as warfarin work. Foods high in vitamin K include leafy green vegetables and canola and soybean oils.

Other medications your doctor might prescribe…

Low-dose aspirin. Two recent studies in The New England Journal of Medicine found that patients with deep vein thrombosis who were treated for three to six months with anticlotting medication could be started on 100 milligrams of aspirin after these medications were stopped. This prevented recurrent clots.

Rivaroxaban (Xarelto). This is a new oral blood thinner approved by the Food and Drug Administration for the treatment of blood clots. It also reduces the recurrence of clots.

Your doctor may recommend compression stockings, which usually are worn from your foot to about knee level. These exert pressure on the legs and cause less pooling of blood. They are recommended for patients who have had a blood clot in the legs.

Different patients require different amounts of leg pressure. I usually recommend stockings with a pressure of 20 to 30 mmHg (millimeters of mercury). These are available at pharmacies for about $20 a pair—much less than prescription stockings.

The power of Prevention

Even if you have never had a blood clot, you still need to take measures to prevent one…

Flex and extend feet and knees. It’s among the best ways to prevent clots from forming in the leg veins. When you’re sitting or lying down for more than two hours—in the hospital, on an airplane—rotate your ankles and flex your toes at least three times an hour. If you’re able to stand, flex the calf muscles by rising up and down on your toes. It pushes blood out of the veins.

Drink more water. Dehydration is a common cause of clots because it decreases blood volume and makes blood “sticky.” It’s particularly important to drink more water during airplane flights because the dry air increases dehydration. Drink a large glass of water before getting on a plane, and have several glasses during your flight.

Lose weight. Patients with a body mass index (BMI) of 40 or higher have an elevated risk for clots when they are immobile or have surgery. Those who lose weight and lower their BMI can reduce their blood clot risk. In addition, quit smoking and control your blood pressure—these measures also can lower your risk.

Symptoms of Pulmonary embolism

A pulmonary embolism can be fatal. It’s important to seek medical attention if you…

• Have sudden, unexplained shortness of breath.

• Experience chest pain or discomfort that worsens when you take a deep breath or cough.

• Feel dizzy, faint.

• Have a rapid pulse.

• Cough up blood.

Source: Geno J. Merli, MD, FACP, FHM, FSVM, an internist and a leading specialist in vascular medicine. He is a professor of medicine and codirector of Jefferson Vascular Center, part of Thomas Jefferson University Hospitals in Philadelphia. He specializes in the treatment and prevention of deep vein thrombosis and pulmonary embolism.

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