Monday, September 22, 2008

Health Care and DVT (Deep Vein Thrombosis)

Americans were shocked a few years ago by the death of a very well-known and popular news reporter, David Bloom. He suffered a DVT (Deep Vein Thrombosis) that resulted in his untimely death. According to USA Today, far too many Americans are dying of dangerous blood clots that can masquerade as simple leg pain, says a major new government effort to get both patients and their doctors to recognize the emergency in time. These clots make headlines every few years when seemingly healthy people collapse after long airplane flights or being in similarly cramped quarters.

Vice President Cheney suffered one after a long trip last year. NBC correspondent David Bloom died of one in 2003 after spending days inside a tank while covering the invasion of Iraq. At issue are clots with cumbersome names: A deep vein thrombosis, or DVT, forms in large veins, usually a leg or the groin. It can quickly kill if it moves up to the lungs, where it goes by the name pulmonary embolism, or PE. While there aren't good statistics, the new surgeon general's campaign estimates that every year, between 350,000 and 600,000 Americans get one of these clots — and at least 100,000 of them die.

According to the National Institutes of Health (NIH), blood clots occur when blood thickens and clumps together. Most deep vein blood clots occur in the lower leg or thigh. They also can occur in other parts of the body. A blood clot in a deep vein can break off and travel through the bloodstream. The loose clot is called an embolus. PE, or Pulmonary Embolism, is a very serious condition. It can damage the lungs and other organs in the body and cause death. Blood clots in the thigh are more likely to break off and cause PE than blood clots in the lower leg or other parts of the body. Blood clots also can form in the veins closer to the skin's surface. However, these clots won't break off and cause PE. Also, according to USA Today, there are a host of risk factors and triggers: Recent surgery or a broken bone; a fall or car crash; pregnancy or taking birth control pills or menopause hormones; being immobile for long periods. The risk rises with age, especially over 65, and among people who smoke or are obese. Some people have genetic conditions that cause no other symptoms but increase their risk, making it vital to tell your doctor if a relative has ever suffered a blood clot.

According to MedicineNet.com, arteries have thin muscles within their walls to be able to withstand the pressure of the heart pumping blood to the far reaches of the body. Veins don't have a significant muscle lining, and there is nothing pumping blood back to the heart except physiology. Blood returns to the heart because the body's large muscles squeeze the veins as they contract in their normal activity of moving the body. The normal activities of moving the body returns the blood back to the heart. There are two types of veins in the leg; superficial veins and deep veins. Superficial veins lie just below the skin and are easily seen on the surface.

Information from MedicineNet.com also says that deep veins, as their name implies, are located deep within the muscles of the leg. Blood flows from the superficial veins into the deep venous system through small perforator veins. As a result, superficial and perforator veins have one-way valves within them that allow blood to flow only in the direction of the heart when the veins are squeezed. A blood clot (thrombus) in the deep venous system of the leg is not dangerous in itself. The situation becomes life-threatening when a piece of the blood clot breaks off (embolus, pleural=emboli), travels downstream through the heart into the pulmonary circulation system, and becomes lodged in the lung. Diagnosis and treatment of a deep venous thrombosis (DVT) is meant to prevent pulmonary embolism. Clots in the superficial veins do not pose a danger of causing pulmonary emboli because the perforator vein valves act as a sieve to prevent clots from entering the deep venous system. They are usually not at risk of causing pulmonary embolism.

Additionally, according to the NIH, blood clots can form in your body's deep veins when:
--Damage occurs to a vein's inner lining. This damage may result from injuries caused by physical, chemical, and biological factors. Such factors include surgery, serious injury, inflammation, or an immune response.
--Blood flow is sluggish or slow. Lack of motion can cause sluggish or slowed blood flow. This may occur after surgery, if you're ill and in bed for a long time, or if you're traveling for a long time.
--Your blood is thicker or more likely to clot than usual. Certain inherited conditions (such as factor V Leiden) increase blood's tendency to clot. This also is true of treatment with hormone replacement therapy or birth control pills.

Many factors increase your risk for deep vein thrombosis (DVT) as reported by the NIH. Your risk for DVT increases if you have more than one of the risk factors listed. They include:
--A history of DVT.
--Slow blood flow in a deep vein from lack of movement. This may occur after surgery, if you're ill and in bed for a long time, or if you're traveling for a long time.
--Pregnancy and the first 6 weeks after giving birth.
--Recent or ongoing treatment for cancer.
--A central venous catheter. This is a tube placed in vein to allow easy access to the bloodstream for medical treatment.
--Being older than 60 (although DVT can occur in any age group).
--Being overweight or obese.

USA Today reports symptoms include swelling; pain, especially in the calf; or a warm spot or red or discolored skin on the leg; shortness of breath or pain when breathing deeply. But here's the rub: Doctors are ill-informed, too. For example, studies suggest a third of patients who need protective blood thinners when they enter the hospital for major surgery don't get them. And patients can even be turned away despite telltale symptoms. The NIH says you can help prevent the condition by:
--Seeing your doctor for regular checkups.
--Taking all medicines your doctor prescribes.
--Getting out of bed and moving around as soon as possible after surgery or illness. This lowers your chance of developing a blood clot.
--Exercising your lower leg muscles during long trips. This helps prevent a blood clot from forming.
--Using compression stockings as your doctor directs to prevent swelling in your legs from DVT .

The NIH suggests that your risk of developing DVT while traveling is small. The risk increases if the travel time is longer than 4 hours, or if you have other risk factors for DVT. During long trips, it may help to:
--Walk up and down the aisles of the bus, train, or airplane. If traveling by car, stop about every hour and walk around.
--Move your legs and flex and stretch your feet to encourage blood flow in your calves.
--Wear loose and comfortable clothing.
--Drink plenty of fluids and avoid alcohol.

DVT is a dangerous health issue that should not be ignored. With over 100,000 deaths per year, recognizing DVT is an example of how simple preventive measures can help you stay safe and healthy.

Until next time. Let me know what you think.

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