Published in the Lynn Haven Ledger, November 2010
DVT Awareness During the Holidays Article by: Bud Shuler, MD, FACS
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n the early spring of 2003, NBC journalist David Bloom accepted a dangerous assignment away from the comfort of the Weekend Today desk where he served as co-anchor, to become an embedded journalist with the U.S. Third Infantry Division as Operation Iraqi Freedom began. Then, suddenly, he died, not as a casualty of the expected wartime threats, but rather due to a deep vein thrombosis (DVT) and a pulmonary embolism (PE). He was 39 years old and left behind a wife and three daughters. His wife’s response when she was told of his death was not surprising, “What? He died of what?” Since that time his wife, Melanie Bloom, has become a vocal advocate and a national spokeswoman for the Coalition to Prevent DVT. Like many people, blood clots in the deep veins of the legs, is not often a common Thanksgiving table discussion, but unfortunately DVT’s affect up to 2 million Americans each year. Aside from the swollen painful limb, the possibility of the blood clot leaving the leg and traveling into the lungs (PE) occurs in approximately 600,000 people a year with up to 300,000 dying from the event. And if one happens to survive the blood clot restricting the flow of blood to the lungs, significant breathing and heart problems can lead to a severely disabled life. In addition, 20% people will develop ulcers around their ankles within the first 2 years if not treated properly. Considerably more people die each year from PE than from breast cancer and AIDS combined. So why the disconnect? David Bloom was vigorous and healthy. He had spent a year training with the Army and led an active life. But Mr. Bloom was cramped in a tank for days, dehydrated in the desert, and was later determined to have an inherited disorder that increase his risk for developing blood clots. He had complained of “leg cramps” for a few days before he died, but he was on the battlefield. Everyone “hurt” somewhere. DVT and PE are considered a silent epidemic. The diagnosis can be difficult and many people have no symptoms. Although dubbed “economy class syndrome” in the 1970’s, it is non-discriminatory. No one is immune, old or young, male or female, but risk factors can alert one to its possibility and aid in its prevention. Immobility causing stasis of blood in the legs, and damaged veins such as varicose veins can lead to development of clot formation. Obesity, heart failure, and pregnancy also increase the pooling of blood in the legs. In addition, “thickened” blood from an inherited or acquired disorder, medications such as hormone replacement and some birth control pills, cancer, and dehydration also increase the risk. Signs and symptoms of DVT often include swollen, reddened, warm, or painful leg, especially after a prolonged trip, sedentary period, or injury. PE can lead to shortness of breath, chest pain, and coughing up blood. If you think that you may have symptoms of DVT or PE, you should see your doctor or go to the emergency room. Diagnosis usually involves an ultrasound, and outpatient treatment without hospitalization is usually possible.
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However, the key is prevention. This is even more important with the upcoming holidays and season change, due to the long drives to Grandma’s house, the cramped flights and prolonged layovers, and colder weather leading to less outdoor activity. Avoiding immobility with increased exercise, frequent stops during long trips to get out of the car to walk around, walking the aisles on longer flights helps keep the blood from clotting. Drinking plenty of non-alcoholic, non-caffeinated beverages helps to hydrate the body. Using gravity to prevent swelling results from simple elevation of the legs when possible, and the use of knee-high compression stocking/socks will minimize the risks. In an attempt to turn the tide on this relatively preventable disease, the Surgeon General of the United States, Steven Galson, M.D., M.P.H., in 2008, enacted a “Call to Action” to increase awareness within the medical and lay communities. I also highly recommend visiting the website, www.preventdvt.org, to read more. So spread the word, be active, drink water, wear compression, and enjoy Grandma’s turkey over the holidays. Being aware could save your life, or the life of someone you love.