Your Guide to Deep Vein Thrombosis by Marcie Hoff - HTML preview

PLEASE NOTE: This is an HTML preview only and some elements such as links or page numbers may be incorrect.
Download the book in PDF, ePub, Kindle for a complete version.
index-1_1.jpg

Another eBookWholesaler Publication

Your Guide to Deep Vein Thrombosis

By Marcie Hoff

Proudly brought to you by

John Reese

Email

Recommended Resources

Web Site Hosting Service

Internet Marketing

Affiliate Program

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 2 of 63

Please Read this First

Terms of Use

This Electronic book is Copyright © 2007. All rights reserved. No part of this

book may be reproduced, stored in a retrieval system, or transmitted by any

means; electronic, mechanical, photocopying, recording, or otherwise,

without written permission from the copyright holder(s).

You do not have any right to distribute any part of this ebook in any way at

all. Members of eBookwholesaler are the sole distributors and must abide by

all the terms at http://www.ebookwholesaler.net/terms.php

Disclaimer

The advice contained in this material might not be suitable for everyone.

The author only provides the material as a broad overview by a layperson

about an important subject. The author obtained the information from

sources believed to be reliable and from his own personal experience, but he

neither implies nor intends any guarantee of accuracy.

All claims made for any product, treatment or other procedure that is

reported in this book is only the author's personal opinion. You must do you

own careful checking with your own medical advisor and other reputable

sources on any matter that concerns your health or that of others.

Research is constantly changing theories and practices in this area.

The content is not intended to be a substitute for professional medical advice,

diagnosis or treatment. Always seek the advice of your physician or other

qualified health care provider with any questions you may have regarding a

medical condition. Never disregard professional medical advice or delay in

seeking it for any reason.

The author, publisher and distributors never give legal, accounting, medical

or any other type of professional advice. The reader must always seek those

services from competent professionals that can review their own particular

circumstances.

Copyright © 2008 All right Reserved

- 2 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 3 of 63

The author, publisher and distributors particularly disclaim any liability, loss, or risk taken by individuals who directly or indirectly act on the information

contained herein. All readers must accept full responsibility for their use of

this material.

Copyright © 2008 All right Reserved

- 3 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 4 of 63

Table of Contents

Table of Contents................................................................................................2

About the Author ................................................................................................8

What is Deep Vein Thrombosis? .......................................................................9

Some Facts about Deep Vein Thrombosis ......................................................................... 9

Causes of Deep Vein Thrombosis ...................................................................10

The Risk Factors for Deep Vein Thrombosis? ..................................................................... 10

The Three Factors................................................................................................................ 12

Who is at Risk of Deep Vein Thrombosis? .....................................................13

Other Factors: ...................................................................................................................... 14

Deep Vein Thrombosis in Children .................................................................15

Occurrence............................................................................................................................... 15

Clinical Features ...................................................................................................................... 15

Central Venous Lines .......................................................................................................... 15

Deep Vein Thrombosis in Elderly People .......................................................15

Why Aging Raises the Chances of D.V.T.: ........................................................................ 15

Causes of D.V.T. in Elderly People ........................................................................................ 16

Surgery ................................................................................................................................. 16

Immobility or Lack of Movement........................................................................................ 16

How is Deep Vein Thrombosis Diagnosed? ...................................................17

Physical Examination.............................................................................................................. 17

Medical History ........................................................................................................................ 17

Diagnostic Tests ...............................................................................................18

Duplex Ultrasound............................................................................................................... 18

Venography .......................................................................................................................... 18

MRI or CT Scans .................................................................................................................. 19

A D-dimer test ...................................................................................................................... 19

Impedance plethysmography............................................................................................. 19

Venous Ultrasonography .................................................................................................... 20

Copyright © 2008 All right Reserved

- 4 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 5 of 63

Correct Diagnosis is Vital ................................................................................21

When to Seek Medical Advice..........................................................................22

Factors associated with blood clots and deep vein thrombosis........................................ 24

What Happens in Deep Vein Thrombosis? .....................................................26

Effects of Deep Vein Thrombosis....................................................................27

Postphlebitic Syndrome ..................................................................................................... 27

The blood clot over time ......................................................................................................... 27

D.V.T.’s long-term consequences.......................................................................................... 27

Side effects of D.V.T. ............................................................................................................... 29

Complications from Oral Anti-coagulants ........................................................................ 29

Bleeding Management......................................................................................................... 29

Precautions to Reduce D.V.T. Episodes .........................................................31

Deep Vein Thrombosis Prevention..................................................................33

Precaution is Better than Cure............................................................................................... 33

Surgery, Post Surgery and While Confined to Bed.......................................................... 34

Treatment of D.V.T. ...........................................................................................35

Deep Vein Thrombosis Medications ...............................................................35

Anticoagulants......................................................................................................................... 35

Heparin ................................................................................................................................. 36

Warfarin ................................................................................................................................ 36

Thrombolytics ...................................................................................................................... 37

Thrombin Inhibitors............................................................................................................. 37

Aspirin .................................................................................................................................. 37

Clinical Treatment of Deep Vein Thrombosis.................................................38

Clinical Management ............................................................................................................... 38

Compression Ultrasonography.......................................................................................... 38

LMWH or the Low Molecular Weight Heparin ................................................................... 39

Medicines ................................................................................................................................. 39

Anticoagulants..................................................................................................................... 39

Thrombin Inhibitors................................................................................................................. 41

Heparinoids .......................................................................................................................... 41

Copyright © 2008 All right Reserved

- 5 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 6 of 63

Thrombolytics ...................................................................................................................... 41

Other Treatments for D.V.T. .............................................................................42

Graduated Compression Stockings .................................................................................. 42

Vena Cava Filter................................................................................................................... 42

Bed Rest ............................................................................................................................... 42

Dietary Considerations ....................................................................................................... 42

Surgery ................................................................................................................................. 43

Treating D.V.T. in Children ...............................................................................44

Treatment of Newborns....................................................................................................... 44

Alternative Treatments for Deep Vein Thrombosis........................................45

Soy and Pine-bark: .............................................................................................................. 45

Garlic..................................................................................................................................... 45

Water ..................................................................................................................................... 46

Compression Stockings ..................................................................................................... 46

Exercise ................................................................................................................................ 46

Non-prescription Treatments for Deep Vein Thrombosis .............................47

Nattokinase: ......................................................................................................................... 47

Garlic..................................................................................................................................... 48

Lemon Juice......................................................................................................................... 48

Cod-liver Oil ......................................................................................................................... 48

Horse Chestnut .................................................................................................................... 48

Butcher’s Broom.................................................................................................................. 48

Ginkgo .................................................................................................................................. 48

Water ..................................................................................................................................... 48

Reduce the Risk of D.V.T. when Traveling......................................................50

Your Self-Care Plan to Reduce Deep Vein Thrombosis Risk ........................52

Living with Deep Vein Thrombosis .................................................................53

Caution with Blood Thinning Medications......................................................55

Myths and Facts about Deep Vein Thrombosis .............................................56

Deep Vein Thrombosis – Frequently Asked Questions.................................57

Copyright © 2008 All right Reserved

- 6 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 7 of 63

Glossary of Deep Vein Thrombosis Related Terms.......................................59

Copyright © 2008 All right Reserved

- 7 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 8 of 63

About the Author

Marcie Hoff has written many stories from her imagination in the last few

years but this is her first fact-based book.

Marcie wants this to help many people that, like her, thought that deep vein

thrombosis was not something she needed to be concerned about – that it

only affected “couch potatoes” and not reasonably active people like her.

But, a couple of close friends developed the illness and she realized that their

lifestyle was very similar to her own.

When she saw the devastating effect on her friends and those closest to

them, Marcie decided to put together this plain-speaking guide for the benefit

of people that could be at risk – that’s almost everyone!

She was surprised to find how much misinformation there was about D.V.T.,

the simple measures which could reduce the risks and the importance of

taking those precautions.

Marcie says that she has been as thorough as she could, but emphasizes that

research is increasing, so people need to ask their own doctor who has the

latest available information.

She believes that her guide will help people to ask the right questions of their

doctor, sort good information from bad and better manage the risk and

effects of a very serious disease, deep vein thrombosis.

Copyright © 2008 All right Reserved

- 8 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 9 of 63

What is Deep Vein Thrombosis?

D. V.T. , or Deep Vein Thrombosis is the formation of blood clots on the walls of the deep veins in the lower body and legs. The blood, when it clots,

can look a bit like a mass of jelly.

The word thrombosis means “formation of a blood clot”.

Deep vein thrombosis is not always dangerous. Some small deep vein

thromboses are fixed by our body’s natural defenses, without us being aware

of it.

However, there is a serious risk when the clot breaks off the vein wall and it

is large enough to hinder one of your body’s large veins, particularly the

veins that carry blood from the heart to the lungs.

D.V.T. is when clots form on the walls of these veins. Although symptoms

may not be apparent or seem significant, the potential risk of pulmonary

embolism, where a clot breaks away and is transported through the body to

the lungs or heart, causing death, means that every precaution must be

taken.

The blood clots mostly occur in the thigh or calf. However, in rare cases deep

vein thrombosis may occur in the collar bone, the armpit, the abdomen, the

upper arm or pelvic region.

Some Facts about Deep Vein Thrombosis

• In the U.S.A., deep vein thrombosis has been reported as the second

most frequent vascular (vein-related) problem.

• Around 600,000 people are affected by deep vein thrombosis every

year in the U.S.A..

• It mostly occurs in people over the age of sixty, but it can affect

anyone of any age.

• Early detection of deep vein thrombosis can prevent it escalating to

pulmonary embolism.

Copyright © 2008 All right Reserved

- 9 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 10 of 63

Causes of Deep Vein Thrombosis

Deep Vein Thrombosis is due to the clotting of the blood in the deep vein.

The veins are blood vessels spread throughout the body and carry blood in

them. At times, the blood in these vessels clot.

The Risk Factors for Deep Vein Thrombosis?

The main risk factors for D.V.T. include:

Inheritance of a blood clotting disorder: Some people inherit a rare

genetic condition, which can lead to deep vein thrombosis (D.V.T.). Factor V

Leiden is a genetic disorder that is responsible for abnormal blood clotting in the human body.

Prolonged bed rest: Any condition that involves a long bed rest; for

example, paralysis or a stay in the hospital after surgery, may lead to D.V.T.

Vein Damage: If your vein has a damaged inner lining then the chances of

your getting D.V.T. is higher. Inflammation of your vein wall (vasculitis) and

certain medications increase the chances of deep vein thrombosis, for

example chemotherapy.

Previous D.V.T. episode: A deep vein thrombosis (D.V.T.) damages the

inner lining of the veins and, as a result, it increases the chances of you

having another deep vein thrombosis in the future.

Surgery: Some medical procedures may increase the chances of developing

deep vein thrombosis (D.V.T.).

For example:

• General anesthesia given to patients during surgery may dilate the

veins and raise the chances of the blood pooling and then clotting.

• Surgeries that reduce the flow of blood to a certain part of the body

may increase the chances of developing deep vein thrombosis

(D.V.T.).

• Surgeries of the knee, leg, hip, calf, chest or abdomen.

Copyright © 2008 All right Reserved

- 10 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 11 of 63

• Orthopedic surgeries, for example hip replacement.

Surgery can increase the chances of deep vein thrombosis because there are

chances of proteins, fats, and tissue debris moving into the veins. Often,

prolonged bed rest is required after surgery. Surgery that takes longer than

thirty minutes may have a higher risk of D.V.T. occurring.

Therefore, some patients who are to undergo surgery may be injected with

heparin to lessen the chances of deep vein thrombosis.

Lack of Movement: This increases the chance of deep vein thrombosis

because the flow of blood in the vein is slowed when one is immobile. So, the

prospect of blood clotting increases.

The lack of movement also occurs in long flights or trains where the seats

have lesser leg space. This is known as Economy Class Syndrome but all

passengers have some risk where your legs are immobile and your feet may

not be on the floor or supported. In this situation, the calf muscles cannot

contract and this often results in the formation of clots.

It is advisable that passengers on long journeys walk up and down the aisle

at least once each hour.

A person that routinely has a long period of sitting in front of a computer, for

instance, is also running some risk of this condition.

Cancer: Certain forms of cancer increase the chances of blood clotting in the body, and there are some types of cancer treatments that may raise the

chances of blood clotting in the body.

Of course, doctors are well aware of these potential risks and that’s one

reason that you should keep your doctor and any specialists that are treating

you, fully informed about other treatments or conditions and your full

medical history.

Using hormone replacement therapy or contraceptive pills: These both

contain Estrogen, the female hormone which causes blood to clot easily. So,

if you are using either, your chance of developing deep vein thrombosis may

increase.

Copyright © 2008 All right Reserved

- 11 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 12 of 63

Heart problems: A person with a damaged heart has a higher risk of

developing D.V.T., because their heart has a lower ability to handle any clots

that travel from the lower parts of the body to it.

Catheter: When a pacemaker or flexible, thin tube (called a catheter) is

placed in a central vein, blood vessels can be irritated and this may decrease

blood flow and the body’s ability to handle clots floating in the blood.

A history of D.V.T.: If you have had D.V.T. before, there is a greater chance of you suffering from the condition in the future.

Family history: If there is a family history of D.V.T., then you have a higher than average risk of developing the condition.

Obesity: Being obese or overweight increases the chances of deep vein

thrombosis.

Smoking: Smoking increases the chances of blood clotting and this may

increase the seriousness of a D.V.T. episode.

The Three Factors

Some studies report that there are 3 principal factors that influence the

occurrence of deep vein thrombosis:

1. Venostasis, a condition where there is stagnant or reduced flow of blood in

deep veins.

2. Injury to the walls of the blood vessel.

3. Hyper-coagulability, a condition where there is increased activity of the

substance in the blood that controls the blood clotting mechanism.

Copyright © 2008 All right Reserved

- 12 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 13 of 63

Who is at Risk of Deep Vein Thrombosis?

D.V.T. may strike anyone of any age.

Some people have an increased chance of being affected by deep vein

thrombosis:

• People with a history of deep vein thrombosis

• People with factors or disorders that make their blood thicken sooner

than normal or people whose blood is thick.

There are certain inherited blood disorders, for example V Leiden

factor, that clots the blood sooner than most other people.

• People that are undergoing hormone replacement therapy.

• People that are using contraceptive pills.

• People who have injured to a deep vein during surgery, or because of

a fracture or other trauma.

• People who are immobile for a great length of time, whether it is bed

rest after surgery, or because their movement is restricted while they

travel a long-distance or for a long time.

• Pregnant women and those who are in the first six weeks after

childbirth.

• People who are having, or recently had, treatment for cancer such as

chemotherapy.

• People who have a central venous catheter, a tube that is placed in the

vein during medical treatment for easy access to their bloodstream.

• People who are older that forty have an increased level of risk but,

please remember, that D.V.T. may also occur at any age.

• People who use seats that keep their feet off the ground and below

their hips when seated.

• People who are obese.

• People who smoke.

Copyright © 2008 All right Reserved

- 13 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 14 of 63

• Previous D.V.T. Episodes. If you have had D.V.T. before, there is a

greater chance of developing it again if there are other causal factors.

Other Factors:

• Smokers are considered at a higher risk.

• If you are above the recommended weight, you are more likely to

develop deep vein thrombosis.

• If you are traveling and your feet do not touch the ground while you

are sitting.

Copyright © 2008 All right Reserved

- 14 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 15 of 63

Deep Vein Thrombosis in Children

Occurrence

Occurrence of deep vein thrombosis in the pediatric population is

approximately 0.07/10,000 and 5.3/10,000 hospital admissions. Other

studies and comparisons show a <1% deep vein thrombosis during childhood

in cases after lower limb surgery and a relative absence of deep vein

thrombosis in children having congenital thrombophilias.

Clinical Features

About 95% of deep vein thrombosis in children occurs as a signal of serious

disease such as cancer, prematurity, surgery, trauma, or congenital heart

disease. However, congenital prethrombotic disorders are found in <10% of

deep vein thrombosis in children.

However, children are at the risk of developing deep vein thrombosis either

at the age younger than one or in their teens. D.V.T. presents a similar

clinical presentation in children as it does in adults.

Central Venous Lines

Forty percent of deep vein thrombosis in children and up to eighty percent in

newborn babies occurs in the upper venous system. This is secondary to the

use of central venous lines that are used for a short time or long-term

supportive system in children who require total therapy for cancer. This

needs anesthesia with each replacement and can be complicated because of

pulmonary embolism. This may also cause the syndrome of superior vena

cava and chylothorax. This condition can destroy the upper venous system

and lead to a severe postthrombotic syndrome.

Deep Vein Thrombosis in Elderly People

Deep vein thrombosis is common in elderly people.

There is some evidence that people over forty years of age have a greater

chance of getting D.V.T.

Why Aging Raises the Chances of D.V.T.:

• The blood of the human body tends to thicken as we become older.

• Elderly people tend to sit in a particular place for a long period. This

increases their risk of developing deep vein thrombosis.

Copyright © 2008 All right Reserved

- 15 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 16 of 63

• Elderly people have a slower rate of healing - they do not heal as

quickly after an injury and may require more rest.

Causes of D.V.T. in Elderly People

Surgery

When surgery is performed on people over forty, the possibility of clots

forming is greater because their blood is starting to become thicker than it

was in their earlier years. This surgery may reduce the blood flow to the part

of the body that was operated on.

During surgery, there is some chance that proteins, fats, and debris move

into the veins of an elderly person.

They may have to rest in bed for a significant period and, if suitable exercise

is not done, this can also increase the risk of D.V.T.

Immobility or Lack of Movement

With age, some people become less active. This may increases the chance of

D.V.T.

Copyright © 2008 All right Reserved

- 16 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 17 of 63

How is Deep Vein Thrombosis Diagnosed?

The diagnosis of deep vein thrombosis is based on your physical

examination, the results from the tests that your doctor performed or

ordered and your medical history. Your doctor will take account of your

medical condition, history and symptoms, and then consider the risk factors

and advise you what treatment, if any, he believes is best for you.

Physical Examination

During your physical examination, the doctor will look for signs and

symptoms of deep vein thrombosis while considering the possibility of other

conditions. He or she will carefully check your legs, your heart, lungs and

your blood pressure.

Medical History

The doctor will ask you about:

• Your overall health

• Your past medical conditions

• If you are on any prescribed medicines at the time of the check up

• Any recent injury or surgeries you might have had

• Whether you have or have ever been treated for cancer

Copyright © 2008 All right Reserved

- 17 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 18 of 63

Diagnostic Tests

Duplex Ultrasound

Duplex ultrasound, or Doppler ultrasonography, is a test that is commonly

used to diagnose deep vein thrombosis. In this test, sound waves define the

blood flow in your veins. Duplex ultrasound uses Doppler echo signals and

echo sound to make pictures which your doctor can evaluate.

Duplex ultrasound involves these steps:

• A gel is applied to the leg where D.V.T. is suspected.

• The doctor passes a handheld device back and forth over the affected

area of your leg. This device sends sound waves to the ultrasound

machine.

• The computer then turns the sound waves into a picture of the inside

of your leg.

• There is a monitor, which displays this picture. Your doctor can see the

flow of blood in your leg through this picture and find out if there is a

significant problem.

Venography

Sometimes, ultrasound does not provide good enough results from the veins

in the calves. The doctor may use venography for such cases.

Venography is claimed to be the most accurate test, but venography is not

commonly used because the process is relatively expensive and painful.

Also, the patient is exposed to radiation, which might further complicate the

problem and cause other reactions.

Venography can identify:

• The extent of the problem

• The degree of the blood clot’s attachment

• Location of the blood clot, and

• More information to help the doctor assess your deep veins.

Copyright © 2008 All right Reserved

- 18 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 19 of 63

A contrast solution is injected into the vein of the foot through the catheter.

The dye travels with the blood to the veins of the thigh, leg and pelvis.

Then the X-ray of the leg is taken.

Movement of the solution reveals the condition of the blood clot in the vein.

The obstructing blood clot in the vein can be seen as a dye-free area in the

X-ray.

The entire process takes around thirty to forty-five minutes and may be

performed in the hospital, laboratory, or in the physician’s office.

Specialist skills are needed to perform venography and care is required to

correctly interpret the results accurately.

Venography examines veins through an X-ray called the venogram.

You may need other tests to confirm whether or not you have D.V.T.

Other common tests used to diagnose D.V.T. include:

MRI or CT Scans

Both MRI (magnetic resonance imaging) and CT (computerized tomography)

scans provide visual images of the veins and can show if any clot is present.

Sometimes, while performing these scans in relation to other medical

conditions and procedures, a blood clot is detected in the patient’s veins.

A D-dimer test

The blood releases a substance when a blood clot dissolves. If this test

reveals a high-level of that substance, it is an indication of you having a deep

vein thrombosis.

Impedance plethysmography

In this process, the physician wraps the blood pressure cuff around the leg

just above the knee. This process records the blood vessel resistance and

changes in blood volume.

There are four electrodes, which are placed around the ankle and the knee,

after which the physician inflates the cuffs. This process checks how

Copyright © 2008 All right Reserved

- 19 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 20 of 63

efficiently your vein returns to normal. This process may take your physician

fifteen to twenty minutes.

Venous Ultrasonography

Because of problems sometimes associated with venography when used for

the diagnosis of D.V.T., it is replaced by venous ultrasonography.

In this process, sound waves are used to detect the blood clot. The probe is

placed over the deep veins of the leg and gentle pressure is applied to check

if the veins will shut on a gentle squeeze.

It is easy to squeeze a normal vein, but a vein with a clot is more difficult to

compress.

Copyright © 2008 All right Reserved

- 20 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 21 of 63

Correct Diagnosis is Vital

If you are diagnosed with deep vein thrombosis, then your physician will

start will the treatment fairly quickly with anticoagulant drugs.

These drugs may sometimes cause internal bleeding for some patients, so

physicians only start the treatment after the tests prove that you have deep

vein thrombosis.

Sometimes, another test may also be carried out; a pulmonary arteriogram

or lung perfusion scan. In this, a dye is injected to the artery, and it flows

through the lungs. If there is any obstruction by the clot, it will be easily

seen.

Copyright © 2008 All right Reserved

- 21 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 22 of 63

When to Seek Medical Advice

Deep vein thrombosis either causes minimal symptoms or may not cause

any obvious symptoms at all. Only forty to fifty percent cases of D.V.T. show

some obvious signs and symptoms, and the condition most of the time goes

unrecognized.

The signs and symptoms may also vary according to the severity of your

condition.

But, these symptoms or conditions might indicate a serious, even critical

situation.

• Acute pain in the leg, ankle and feet followed by cramping, mostly

while you are walking or standing

• Tenderness of the leg

• Tenderness in the calf region

• Swelling of the leg, ankle or feet

• Increase in temperature of the affected area

• Skin discoloration mostly bluish and redness

• Discomfort in the upward movement of the foot

• Leg fatigue

• Visible surface veins

• Pain or swelling in the arms or neck. It can occur because of the blood

clot formed in your neck or arms

If you see any of the following conditions, you should seek immediate

medical assistance:

Copyright © 2008 All right Reserved

- 22 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 23 of 63

Please note: Some of the examples may actually be a sign of other serious

medical conditions in some instances instead of signs of D.V.T. They always

should be checked to reduce the chance of your problem becoming an

emergency.

You have discomfort in your chest or an acute pain while

coughing or taking a deep breath

You feel dizzy or light-headed

You faint suddenly without apparent reason

You cough and bring up some blood

You feel a sense of anxiety and nervousness for no apparent

reason

You have an unexpected shortness of breath

Copyright © 2008 All right Reserved

- 23 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 24 of 63

Deep vein thrombosis may cause swelling and pain in either one or both the

legs, or, rarely, in the arms.

Sometimes, the affected area is tender and may have an increased

temperature compared to the unaffected portion of the body.

Clinical diagnosis for deep vein thrombosis can be difficult. Often, only a

specialist can confirm the case.

This is because many conditions have similar symptoms.

The symptoms which should be checked include:

• Muscle tears and aches

• Superficial thrombophlebitis, a condition where blood clots in the

inflamed part of the vein near the body surface

• Varicose veins or blood vessels that are twisted and swollen

abnormally

• Arthritis

• Blood clotting inside the arteries

• Cellulites, an infection of tissue under the skin

• Fracture of the bone

• Swelling in the hands and the feet

Sometimes, the most obvious sign of deep vein thrombosis may be chest

pain, which might also be a sign of various other conditions.

Factors associated with blood clots and deep vein thrombosis

• Hormonal Factors

• Varicose Veins

• Poor circulation due to conditions such heart disease, recent

heart attack or stroke.

• Long-term inactivity

• An extended bed rest

Copyright © 2008 All right Reserved

- 24 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 25 of 63

• Deep vein thrombosis occurs during long flight sessions, where

the passenger has very limited space to move the legs.

• A vein injury can result in deep vein thrombosis. Vein injury

may occur due to a blow to the legs, radiation treatments in

cancer patients or surgery. Often, such injuries cause blockage

or narrowing in the vein where the blood gathers and clots.

• Pregnancy increases the chances of deep vein thrombosis as the

body has the natural tendency to preventing excessive bleeding

at childbirth.

• Severe infection, some forms of cancer and liver disease may

also cause deep vein thrombosis.

Copyright © 2008 All right Reserved

- 25 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 26 of 63

What Happens in Deep Vein Thrombosis?

If your doctor believes that your symptoms indicate you may be suffering

from deep vein thrombosis then he will conduct or order tests to help confirm

whether there is a problem with blood clots in your leg(s).

Many people with D.V.T. do not show any significant symptoms of this

disease. Testing is important because early diagnosis and treatment can help

reduce the risk of a loose clot traveling to the lungs or heart and causing

pulmonary embolism which causes a significant number of deaths each year.

What happens after the clot forms?

Blood clots occur in veins of the calf and thigh muscles when you are inactive

for a long duration.

When you stand up suddenly, your blood flow rate will increase within the

vein and the clot may break away from the wall of the large vein. The

dislodged clot may move towards your heart, with the chance of being

pumped into the lungs where pulmonary embolism may occur.

This condition may obstruct flow of blood through the lungs and cause death.

Copyright © 2008 All right Reserved

- 26 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 27 of 63

Effects of Deep Vein Thrombosis

The most important cause of concern associated with deep vein thrombosis is

pulmonary embolism. Pulmonary embolism is a condition where the arteries

are blocked due to a blood clot or thrombus, which has traveled to the lung

or heart from your body part, most often from a leg.

If not treated immediately, pulmonary embolism can prove fatal. Therefore,

you have to be on guard when signs and symptoms of D.V.T. or pulmonary

embolism occur.

Postphlebitic Syndrome

In about ten percent of people suffering from deep vein thrombosis, post-

phlebitic syndrome, also called the post-thrombotic syndrome, occurs due to

the damage done to your veins by the blood clot. This syndrome may show

as skin discoloration and pain, or edema in the leg.

The blood clot over time

Treatment makes the clot stabilize and attach tightly to the inner wall of the

vein. Therefore, the chances of the clot to dislodge and travel to the lungs

diminish over time. In addition, our body also can produce blood factors that

help the clot to dissolve. If the clot is located in the calf vein or in the

superficial leg vein, the clot frequently dissolves totally.

However, ninety percent of large deep vein thrombosis patients with clots in

the groin or thigh may end up with abnormal veins, despite careful

treatment.

D.V.T.’s long-term consequences

A significant percentage of people that had D.V.T. may develop a long lasting

(chronic) pain, swelling, scaling, and pigmentation in the affected leg.

A few patients may suffer from pulmonary hypertension, a condition that

may disrupt the functions of the heart. The severity of the condition decides

which medication is used to address the condition.

Some may need complicated surgery to remove blood clots attached to the

inner lining or pulmonary artery.

Copyright © 2008 All right Reserved

- 27 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 28 of 63

In some severe cases, venous ulcers may develop.

Other possible complications may include eczematoid reaction, ulceration,

purpura, dermatitis and pruritis.

Deep vein thrombosis may have fatal consequences if not detected and

treated in a timely manner.

On the other hand, if it is diagnosed early, then deep vein thrombosis

(D.V.T.) can be treated successfully in many people.

If the patient is regularly taking anticoagulants, the risk of D.V.T. is reduced.

More than twenty percent of patients have their D.V.T. recur within five

years.

The chances of D.V.T. are greater when the patient has certain risk factors,

such as:

• certain defects of blood coagulation in the body,

• cancer or

• if the person undergoes surgery.

Untreated D.V.T. (deep vein thrombosis) may be associated with ten percent

incidence of symptomatic PE (Pulmonary Embolism).

With older patients, the casualty rate estimation for Pulmonary Embolism is

between 1 to 5%.

If the person is treated with anticoagulants, then the chances of the person,

developing Pulmonary Embolism following deep vein thrombosis may be

lower.

Copyright © 2008 All right Reserved

- 28 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 29 of 63

Side effects of D.V.T.

Complications from Oral Anti-coagulants

Bleeding is the most common complication from oral anticoagulant drugs.

This bleeding may be due to the strength of the anticoagulation.

Some studies seem to indicate that the risk of bleeding reduces when the

drug strength or amount is reduced.

Some other studies indicate that anticoagulant bleeding may be linked with

concurrent administering of aspirin, which may impair the platelet function

and produces gastric erosions.

The risk of bleeding may be heightened because of underlying clinical

disorders and some studies advise that the risk of bleeding increased

according to the patient’s age. If a person is sixty-five years and above, has

a history of gastrointestinal bleeding or stroke, and presence of a comoroid

condition (for example, anemia or renal insufficiency), then the person may

be at higher risk of significant bleeding.

If the drugs used include Coumadin® or are related to warfarin, usage and

effects must be closely monitored.

Bleeding Management

If there is bleeding during treatment with an oral anticoagulant, the medical

response will depend on three factors:

1. the severity of the condition,

2. INR (International Normalized Ratio – a mathematical way of

standardizing results from the Prothrombin Time test, which shows

how long the patient’s blood takes to clot) during the bleeding period,

and

3. the course of the prescribed anticoagulant therapy.

If the INR range is above the usual therapeutic range then the treatment is

not continued.

Copyright © 2008 All right Reserved

- 29 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 30 of 63

The doctor will decide if that treatment should be resumed after the bleeding

stops completely, maybe with a lower strength preparation.

If the INR is below, or within, the therapeutic range then the bleeding source

will be investigated, especially if the bleeding is likely to be from the urinary tract or a gastrointestinal source.

Copyright © 2008 All right Reserved

- 30 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 31 of 63

Precautions to Reduce D.V.T. Episodes

Treatment of D.V.T. begins with self-help techniques that you can

incorporate into your daily routine at home. They include:

Be as active as possible: If bed rest is unavoidable, such as after surgery or because of medical conditions or pregnancy, it is strongly recommended

that you look for ways to keep your legs as active as possible.

You may try swinging your legs over the sides of the bed a few times a day.

You may also be able to push your knees up and down briefly from time to

time.

Reduce or quit smoking: Smoking increases the possibility of deep vein

thrombosis in people who are at risk. If you do not smoke then do not start.

If you do, it is highly advisable that you quit.

Exercise: Exercising regularly is a good way to reduce the chances of blood clotting in your legs. Ask for advice from your physician about the kind of

exercise that suits you and will reduce the chance of deep vein thrombosis.

Be active while traveling: The risk of developing blood clots while you are on a long trip may be lowered by taking simple precautions and being aware

of those factors which could increase your risk.

When you have to travel for a long duration, see you doctor first and ask for

advice about reasonable precautions you should take, medicines you might

carry etc.

You should try to get up and walk about as often as possible so that the

blood in your legs does not slow its travel.

If you are traveling by air, at least flex your ankles and wiggle your toes.

There are also devices which claim to enable you to exercise even in the

confines of your plane seat. Be sure to check for testimonials and

independent reports about any device that you consider buying.

Do not cross your legs for too long.

Drink small amounts of water regularly.

Many airlines serve alcohol but it is best to avoid that because alcohol tends

to dehydrate your body and may raise the risk of deep vein thrombosis.

Copyright © 2008 All right Reserved

- 31 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 32 of 63

Caffeine drinks (tea and coffee etc) and carbonated soft drinks also cause the

body to excrete water. This can affect your level of brain function as well as

increasing your risk of D.V.T.

Copyright © 2008 All right Reserved

- 32 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 33 of 63

Deep Vein Thrombosis Prevention

Precaution is Better than Cure

You can reduce the chances of developing deep vein thrombosis by:

9 keeping a check over your health regime

9 exercising regularly

9 quitting smoking and

9 taking measures to keep your blood pressure in check.

If you are in good shape, it is likely that you enjoy yourself more while on a

holiday.

Prevention of deep vein thrombosis means preventing blood clots forming in

the deep veins of your lower body and is very important. This is because the

blood clot, which may form in your thigh or calf muscle, can break away,

travel and clog a vital blood vessel in your heart or lungs.

Each year, many Americans are diagnosed with deep vein thrombosis. Out of

every hundred people identified, about one will die from the effects of their

D.V.T.

If you are at risk, take steps to prevent it affecting you.

Get regular checkups and adopt a healthy lifestyle.

• Exercise - you may indulge in bicycling, swimming and walking.

• Maintain a healthy diet and keep your weight in check

• If you are a smoker, consider reducing or quitting. You might try

chewing gum. A nicotine patch or spray could make quitting easier for

you

• Keep your blood pressure under control. If it fluctuates, get it checked

and follow your doctor’s advice.

• If you have any personal or family history regarding blood clotting, tell

your doctor

• You might ask for suggestions on possible alternatives to hormone

replacement therapy or your current birth control pill from your doctor

• If you are pregnant or planning a baby, ask your doctor about DVT

preventive measures

Copyright © 2008 All right Reserved

- 33 -

"Your Guide to Deep Vein Thrombosis" By Marcie Hoff

Page 34 of 63

Surgery, Post Surgery and While Confined to Bed

Your surgeon will assess your medical history, explain to you the risk of DVT,