Blot that clot, keep moving. The DVT do’s and don’t’s…

English

Saroj and Naived were a young couple living in the heart of bustling Mumbai and were used to its fast-paced lifestyle. They enjoyed running their medium-sized business with its minor stresses and strains, visiting lesser-known holiday destinations and partying hard on weekdays as well as weekends. They had access to swanky gyms, the latest in organic food, athletic shoes and gadgets which meant life for them was basically a picnic and a party put together.

But Saroj wasn’t at ease. Naived had lately developed some swelling around his ankles. Naived wasn’t paying much attention because it didn’t restrict him in any way. There was no pain or discomfort of any sort so he didn’t want to “waste time going to the doctor” which rankled Saroj all the more. She knew something was amiss, but couldn’t tell what.

Finally after a month of coaxing and convincing they landed to a physician and Naived was prescribed a few pulmonary tests and others related to the working of the kidneys. The test results were normal. But the swelling wouldn’t subside. Suddenly, it hit Saroj. There had to be a clot somewhere. Could it be because of Naived’s incessant smoking or their frequent trips which necessitated them to sit for long hours without exercising their legs, particularly the ankles? She had read somewhere that Deep Vein Thrombosis (DVT) has a higher incidence among those who are immobile. For instance, those who are recuperating from surgery or frequent fliers. Smokers were certainly at high risk like they usually are with regard to all medical problems and diseases.

What exactly is Deep Vein Thrombosis (DVT)?

Vascular and Endovascular Surgeons say it’s a clot that forms in a deep vein usually in the lower limbs such as thigh, ankles and in rare instances even in the arm. If undetected, it could cause severe disability and may even result in death

The repercussions are worse, if the clot breaks or embolizes, as it can be carried through the bloodstream to the lungs and prevent blood from reaching the lungs. This blockage would certainly mean death.

For Rekha Naik, DVT was discovered accidentally. She repeatedly kept going to the municipal hospital, to be treated for her fractured toe. She bravely tried to manage as much as she could initially, without going to the hospital, but when the pain was unbearable, she took an advance from the household where she worked as a maid to seek medical advice. Understandably, she could barely touch her foot to the ground and was prescribed bed rest. Barely 3 days passed when Rekha returned to the hospital due to excruciating pain, again to be told to rest it out.

A red line seemed to have formed on the front of the led and the swelling had increased. Rekha couldn’t take this anymore. She explained that she had taken rest, but the pain and swelling had aggravated. She insisted that they examine her foot and this is when 2 clots were discovered on her calf. Was Rekha at higher risk for DVT? Yes, fractures increase DVT risk.

Other risk factors 

• Injury to muscles and limited movement due to bed confinement or a cast; reduce blood flow.
• Sitting cross-legged for long periods in offices or while traveling
• Chronic ailments such as cancer, heart and lung ailments, certain ulcers or Crohn’s disease and paralysis
• Obesity, old age, pregnancy
• Earlier incidence inherited clotting disorders
• Lifestyle factors like birth control pills
• Hormone Replacement Therapy (HRT) and treatment/medication for cancer

Avanti worked as an air hostess and had erratic mealtimes. To add to this, she had not been able to shed off those extra kilos post pregnancy and was constantly under pressure of losing her job to a younger female attendant. To guard against DVT, Avanti followed simple exercises:

Leg muscle workout:  Place heels on the floor but lift and lower your toes. Now the other way round – keep toes on the floor and raise and lower your heels. Tighten and release leg muscles.

Her colleague Sabah also suggested several ways to maintain healthy body weight. She was concerned that Avanti should not fall among the 30% who will suffer from another episode of DVT, either immediately or in the next 10-20 years.

Diagnosis and treatment

Vascular and Endovascular Surgeons use several risk stratification tools in combination with rating scores to decide whether DVT is likely. The D-dimer blood test will indicate the DVT likelihood and further course of treatment. To elaborate, the DVT likelihood is low when the D-dimer is negative.

For more information contact your nearest Vascular and Endovascular Surgeons today.