SURVIVING BLOOD CLOTTING(By Bianca Phillip)

My 47 year old aunt Dora considered herself healthy. She is a non-smoker. Two years ago she felt stabbing pains in her back on the right side under her ribs cage and the pain got worst every time she took a deep breath. She was quickly rushed to the ER. The first thought of the ER doctors was that she had pneumonia for which she was started on antibiotics, even though she had not been sick with a cold or even a fever. They did take a blood test to find out whether her symptoms might possible related to blood clot, and after seven hours in the ER, the test came back positive.

She was then send for a CAT scan, which showed definitely that she had pulmonary emboli. Multiple blot clot was detected in both her lungs. She was started on blood thinner injections and stayed in the hospital for six days.

Further testing reveled a deep vein thrombosis (DVT) in her left leg behind her knee. On top of this her heart started to race 160/180 for an hour. It was a super ventricular trachycardia, a fast heart rate she had at times all her adult life. Of course, rapid heart rate is also a symptom of pulmonary emboli.

Prior to her DVT and PEs, she flew from Florida to Washington State where she stayed for four days to help take care of her mother, so she had a quick turn around between the long coast to coast flights. She did not notice any swelling, discoloration, or any pain in her leg. A week later she did feel severe back pain while she was cleaning her house. Suddenly she was unable to breathe and her heart rate was rapid.

My aunt was also on birth control pills for more than 20 years, but immediately after her DVT and PEs was diagnosed. Apparently the combination of travel over four hours and birth control pills may have trigger her clots as it seems that there are a lot of variables that influence blood clot formation.

/

What Is DVT?

Deep vein thrombosis is a blood clot that forms inside a vein, usually deep within your leg. The danger is that part of the clot can break off and travel through your bloodstream. It could get stuck in your lungs and block blood flow, causing organ damage or death.

Symptoms

Notice how the leg on the left here is swollen below the knee. That's a common symptom of DVT. So are redness and tenderness or pain in the area of the clot. But you won't always have these. Unfortunately, about half of people with DVT get no warning signs.

Pulmonary Embolism

This is a clot that moves into your lungs and blocks the blood supply. It can cause trouble breathing, low blood pressure, fainting, a faster heart rate, chest pain, and coughing up blood. If you have any of these, call 911 and get medical care right away.

What Causes DVT?

Anything that damages the inner lining of a vein may cause DVT -- surgery, an injury, or your immune system. If your blood is thick or flows slowly, it's more likely to form a clot, especially in a vein that's already damaged. People who have certain genetic disorders or more estrogen in their system are more at risk for blood clots, too.

Who Is Likely to Get DVT?

Some people with a higher risk are those who:

• Have cancer
• Have had surgery
• Are on extended bed rest
• Are older
• Smoke
• Are overweight or obese
• Sit for long times, like on a long airplane flight

Pregnancy

Women are more likely to develop DVT during pregnancy and the 4 to 6 weeks after giving birth. That's when they have higher levels of estrogen, which may make blood clot more easily. The pressure of their expanding uterus can slow blood flow in the veins as well. Certain blood disorders can boost their risk even more.

Hormone Therapy

Like pregnancy, birth control pills and some treatments for postmenopausal symptoms raise the amount of estrogen in a woman's blood. That can increase her risk of DVT, even if she doesn't have a blood disorder.

Trapped in Your Seat

Traveling to new and faraway places can be exciting! Squishing into a coach seat for a long international flight is not. Studies show long-distance travel, a trip that lasts more than 4 hours, doubles the risk of developing DVT. It doesn't matter if you go by air, bus, train, or car. When you're in a cramped seat and don't move around, your blood flow slows.

Get a Diagnosis

Your doctor will check you for signs of DVT. He may also ask about your medical history, medications you're taking, medical problems of close relatives, and things that put you at risk. An ultrasound is the most common way to confirm a diagnosis. It uses sound waves to "see" the blood flow and reveal a clot. You might also need other tests, such as a blood test called a d-dimer.

Blood Thinners

Drugs called anticoagulants are the most common way to treat DVT. Although they're known as blood thinners, they don't really thin your blood. They make it less "sticky" to prevent new blood clots from forming. They can't break up a clot you already have, but they will give your body time to dissolve it on its own. You take these medications in a pill or by needle.

Side Effects of Blood Thinners

People who take these may get bruises often or bleed more easily. When you take certain ones, you'll need to watch what you eat. And you'll need to go to a lab regularly to get your blood checked to make sure you've got the right amount of the drug in your body. You don't have to do that for newer medications, but they make it harder to stop bleeding if you have an accident.

Let your doctor know if you bleed a lot from minor injuries.

Internal Bleeding

Blood thinners can also make it easier to bleed inside your body, where you can't see it. Bleeding in your belly can cause pain, vomit that's red or looks like coffee grounds, and bright red or black stools. Bleeding in your brain can cause severe headaches, vision changes, unnatural movements, and confusion. Call 911 and go to the emergency room if you notice any of these symptoms.

Vena Cava Filter

If you can't take blood thinners or they aren't working, your doctor may recommend putting a filter into your biggest vein, called the vena cava. This filter catches breakaway clots and stops them from getting into your lungs and heart. It won't stop new clots from forming or cure DVT, but it can help prevent a dangerous pulmonary embolism.

Clot Busters

Medications that dissolve blood clots are called thrombolytics. They can cause sudden, severe bleeding, so doctors use them only in emergencies -- to dissolve a life-threatening blood clot in your lung, for example. You get thrombolytics by IV in a hospital.

Compression Stockings

These special socks put gentle pressure on your legs to keep your blood moving. They can help prevent clots from forming as well as reduce swelling and relieve discomfort in a leg where a clot has already formed. You can get compression stockings over the counter, but your doctor will need to write a prescription for ones with more pressure. Wear them even at home.

Keep Your Feet Up

When you can, sit with your feet resting off the floor to raise your legs. You'll make it easier for the blood in your veins to flow up toward your heart. This can lessen the swelling and discomfort in the leg with DVT.

Long-Term Effects

Once a blood clot is gone, DVT sometimes leaves behind an unpleasant reminder. You may see long-term swelling or changes in skin color where the clot was. Or it could hurt. These symptoms, known as post-thrombotic syndrome, sometimes show up as much as a year after the clot.

Exercise

Use your muscles to promote blood flow. Work your lower leg muscles especially. When you're not active -- at your desk, for example -- take breaks to stretch your legs. Stand up. Step away for a bit. Regular exercise also helps keep you at a healthy weight, and that lowers your risk, too.

Travel Tips

When you travel for more than 4 hours, avoid tight clothing and drink plenty of water. Get up and walk around at least every couple of hours. If you have to stay in your seat, stretch and move your legs. Try clenching and releasing your calves and thighs, or lifting and lowering your heels with your toes on the floor. Do plenty of sightseeing by foot once you arrive!