How to avoid dvt?

THURSDAY, May 3, 2018 (HealthDay News) — It’s been long known that people who sit for extended periods of time run the risk of blood clots.

In fact, the condition has been dubbed economy class syndrome because it’s believed it can be brought on by stretches of prolonged immobility on long-distance flights.

Now, a new study out of Japan found that people fleeing a natural disaster seemed to be at risk of the unexpected cause of death — life-threatening blood clots in the legs and lungs triggered by sitting in a car for a long time.

The findings highlight the importance of educating people about the clot risk, experts say.

In the study, researchers explained that following the 2016 Kumamoto earthquake in Japan, a large number of night aftershocks occurred. Many people were afraid to return home and decided to evacuate instead. While some reached a public evacuation shelter, many others had to stay in their vehicles overnight.

An analysis of hospital data following this event revealed an “epidemic” of blood clots in evacuees’ legs. In some cases, these blood clots traveled to the lungs.

Specifically, 51 evacuees were hospitalized for blood clots in the legs. Of those, 42 (82 percent) had spent the night in a vehicle. In 35 patients, blood clots in the legs traveled to the lungs, a life-threatening condition called pulmonary embolism.

The study findings were published May 3 in the Canadian Journal of Cardiology.

The findings show the need to educate people about the risk and prevention of venous thromboembolism (VTE), the study authors said in a journal news release.

“Preventive awareness activities by professional medical teams, supported by education in the media about the risk of VTEs after spending the night in a vehicle, and raising awareness of evacuation centers, could lead to a reduced number of victims of VTE,” said lead investigator Dr. Seiji Hokimoto. He’s with the department of cardiovascular medicine at Kumamoto University, in Japan.

According to Dr. Stanley Nattel, journal editor-in-chief, “This is a dramatic example of the risks inherent in spending prolonged periods immobilized in a cramped position.”

Nattel added that the report “is an important reminder of a public health point, and reinforces the need to get up and walk around regularly when on an airplane or when forced to stay in a car for a long time.”

Deep vein thrombosis – know the risks and how to avoid it

Sitting for hours in the cramped quarters of economy class: unless you’re lucky enough to be able to splash the cash for spacious seating, it’s the uncomfortable but inevitable price we pay for going overseas.

But have you ever wondered what all that confined sitting can do you to your body?

Sometimes referred to as ‘economy class syndrome’, deep vein thrombosis (DVT) is a potentially serious and often silent condition associated with long periods of immobility. What you may not realise is that you don’t need to be on a long-haul flight to get DVT. There are many situations where it can strike, and it can affect the young and old alike.

What causes deep vein thrombosis?

Deep vein thrombosis is a blood clot that occurs in a deep vein (not a vein near the skin’s surface). They are most common in the leg, but they can happen anywhere in our body.

Anything that slows down blood flow can cause deep vein thrombosis. That’s because movement helps to pump blood around our body – another great reason to stay active! When our movement is constricted, blood flow can slow down and the risk of a blood clot increases.

If a blood clot forms in the leg, it can potentially dislodge from the wall of the vein and travel to the lungs. If it’s a large clot, there’s a risk it could completely block the main artery to the lungs (known as a pulmonary embolism). This can be life-threatening.

We often associate deep vein thrombosis with long distance travel, but it’s actually more common in situations where we’re bedridden or immobile, such as after surgery or fracture, or during an illness. Understanding our risk factors is important, as this plays a big role in the likelihood of developing deep vein thrombosis.

Some of the risk factors linked with deep vein thrombosis include:

  • family history of DVT
  • blood disorders like thrombophilia (40-60% of DVT’s)
  • previous history of DVT
  • fractures of the lower limb or hip
  • heart disease
  • cancer
  • being above a healthy weight
  • smoking
  • advancing age.

Women may be at increased risk if they:

  • are pregnant
  • have recently had a baby
  • are taking a high-dose oral contraceptive pill or hormone replacement therapy containing oestrogen.

Men are at increased risk of DVT if they take testosterone supplementation.

Some people can get deep vein thrombosis without having risk factors. One-quarter of all DVT cases have no obvious cause.

How to avoid deep vein thrombosis

Compression stockings may help reduce the risk of blood clots after surgery or during long periods of travel. Speak to your doctor about whether this is appropriate for you.

Break up long periods of sitting or lying down by standing, moving, and stretching when possible and appropriate. If you’re travelling, make sure you also do regular seated exercises and stretches. You might want to try setting an alarm on your phone to remind you to get up and move around regularly. Wear loose clothes and avoid sitting with your legs crossed. Remember to keep up your fluid intake to avoid dehydration.

Taking care of our general health – eating well, being active, and not smoking – can help reduce the risk of developing deep vein thrombosis.

DVT symptoms and when to seek help

Common symptoms of deep vein thrombosis include pain, swelling, red and warm skin, and tenderness in the affected area – usually the calf or thigh. Some people won’t experience symptoms.

Deep vein thrombosis is a serious condition, which is why early treatment is vital. If you think you have it, call 13 HEALTH (13 43 25 84) or see your doctor or Nurse Practitioner without delay. Always call Triple Zero (000) in an emergency.

Can I get a blood clot from sitting at my computer?

Guest blog post by George J. Todd, MD, Chairman of the Department of Surgery at Mount Sinai St. Luke’s and Mount Sinai Roosevelt

Question: A young co-worker of mine (age 28) developed difficulty breathing and pain in his chest. He went to the emergency department and was diagnosed with a pulmonary embolus that started in his leg. The doctors told him it was from sitting at his computer for many hours. Is this possible?

Answer: The answer is “Yes.”

Prolonged sitting without getting up to move around can lead to deep vein thrombosis (DVT). Once a clot forms in a leg vein, it can travel to the heart and lungs (pulmonary embolus or PE). A PE can cause shortness of breath, chest pain and death.

Many people are now aware that DVT can result from prolonged sitting on an airplane (sometimes called “Coach Class Syndrome”) or from being immobile in bed (after surgery, for example). Most people are also aware that obesity, taking oral contraceptives and some hereditary disorders (such a Factor V Leiden mutation, for example) can predispose a person to DVT and PE.

It may be a surprise to some however, to learn that DVT and PE have also been described in people who have sat for many hours working at a computer. There is even a report in the tabloids of a 20-year-old man who reportedly died of a PE after sitting and playing with his X-Box computer game for many hours without taking a break.

Prolonged sitting for whatever reason can lead to formation of blood clots in the legs. Once clots form in the legs, they can travel to the lungs and cause PE. In 2008, the United States Surgeon General reported that there are an estimated 350,000 to 600,000 cases of DVT in this country each year with more than 100,000 deaths resulting from PE. Other studies estimate a much higher figure for both DVT and PE.

The bottom line: It is very important when flying or sitting at a desk working, to get up and walk around at least every 60 to 90 minutes. It is also important to wear loose fitting clothing if you will be seated for prolonged periods and to maintain good hydration by drinking water.

Blood Clot Info: Risks, Symptoms, and Prevention

Blood Clot Info: Know Your Risk, Recognize Symptoms, and Prevent Blood Clots

Get all the blood clot info you need from the National Blood Clot Alliance. Here is all the main information you need to know about blood clots, all in one place.

Know Your Risk for Blood Clots

Blood clots do not discriminate. They affect people of all ages, race and gender. One of the most important things you can do to prevent blood clots is to know if you are at risk. The risk factors for blood clots include:

  • Hospitalization for illness or surgery
  • Major surgery, particularly of the pelvis, abdomen, hip, knee
  • Severe trauma, such as a car accident
  • Injury to a vein that may have been caused by a broken bone or severe muscle injury
  • Hip or knee replacement surgery
  • Cancer and cancer treatments
  • Use of birth control methods that contain estrogen, such as the pill, patch or ring
  • Pregnancy, which includes the six weeks after the baby is born
  • The use of hormone therapy, which contains estrogen
  • A family history of blood clots
  • Overweight
  • Confinement to bed or wheelchair
  • Sitting too long, especially with legs crossed
  • Smoking
  • Age 55 or older
  • Long-term diseases such as heart and lung conditions, or diabetes

Recognize Signs and Symptoms of Blood Clots

There are several important signs and symptoms of blood clots. If you can recognize these signs and symptoms, you can save your life or the life of a friend or family member.

Symptoms of a Blood Clot in the Leg or Arm (Deep Vein Thrombosis or DVT)

  • Swelling
  • Pain or tenderness not caused by injury
  • Skin that is warm to the touch
  • Redness or discoloration of the skin

If you have these signs or symptoms, alert your doctor as soon as possible.

Learn more about how DVT is diagnosed: How is DVT diagnosed?

Symptoms of a Blood Clot in the Lung (Pulmonary Embolism or PE)

  • Difficulty breathing
  • Chest pain that worsens with a deep breath or lying down
  • Coughing, or coughing up blood
  • Faster than normal or irregular heartbeat

Seek immediate attention if you experience these signs or symptoms.

Learn more about how PE is diagnosed here: How is PE diagnosed?

Prevent Blood Clots

Blood clots are preventable and can be safely treated. You can reduce your risk by learning some of the best ways to protect yourself from life-threatening blood clots.

  • Know your risk for blood clots.
  • Recognize the signs and symptoms of blood clots.
  • Tell your doctor if you have risk factors for blood clots.
  • Before any surgery, talk with your doctor about blood clots.
  • See your doctor as soon as possible if you do have any symptoms of a blood clot. Blood clots can be safely treated.
  • Get up and move if you’ve been sitting for a long time or traveling for a long time by plane, train, or car. Stand up, walk around, and stretch your legs every two to three hours.
  • Maintain a healthy weight.
  • Don’t smoke or take steps quit smoking

Learn About Blood Clot Treatment and Care

Find a Doctor

Finding a healthcare professional who understands fully the complexities of blood clotting disorders, and who you can trust and consider a good partner in your care, is one of the most important decisions you will make if you think you may be at risk for blood clots, or if you have been diagnosed with blood clots in your legs (deep vein thrombosis or DVT) or blood clots in your lungs (pulmonary embolism or PE). If you need help finding a doctor who specializes in blood clots or blood clotting disorders visit here: Find A Doctor Resources

Blood Clot Treatment

The prevention and treatment of blood clots primarily involves the use of anticoagulant medications or, as they are commonly referred to, “blood thinners.” While these medications do not actually “thin” the blood, they do slow the body’s ability to form new clots and keep existing clots from getting bigger. Learn more about blood clot treatment here: Blood Clot Treatment.

Get More Life-Saving Information to Share

Stop the Clot, Spread the Word™

You’ll find great information, including important downloadable checklists that you can share, at Stop the Clot, Spread the Word™.

Share our infographic as a guide to information about risk factors, signs/symptoms, and prevention and watch our short video with the most important blood clot info people need to know.

Women and Blood Clots

Help women understand the blood clot risks connected to several important life stages, including birth control and family planning, pregnancy and childbirth and the treatment of menopause symptoms.

Share our Women and Blood Clots Infographic with the women you know or watch our entire Women and Blood Clots Video Series.

Your Recovery and Peer Support

Your Recovery

If you have been diagnosed with a blood clot, or clotting disorder, you may be wondering, “Now what?” While recovery from blood clots can be difficult, overwhelming, and even life-changing, most people do recover completely from blood clots and go on to resume their normal lives and activities. Get the tools to help you through blood clot recovery from NBCA’s e-Magazine dedicated to VTE recovery and lifestyle issues: Personal Perspectives: My Blood Clot, My Life.

Peer Support

If you’re feeling alone or anxious after a blood clot diagnosis, or you just want to connect with others who share your same experience, come talk with us at our Stop the Clot® Online Support Group & Discussion Community, powered by Inspire. The National Blood Clot Alliance is your community connection. For four years now, this remarkable online peer-to-peer community has grown dramatically, and demonstrated day-in and day-out the strength and inspiration that we derive from one another. Today, more than 4,000 members of this group share experiences and information in a safe and supportive space moderated 24/7 by NBCA staff. Please join us. It only takes a few minutes to learn more at the link below and then register: Peer Support

Personal Stories

Personal storytelling is one of the most successful awareness-building tools we have to improve understanding about blood clots. It’s also one of the best ways for us to come together as a community. For more than 15 years, NBCA has been telling your stories – on our website, in our educational programs, and with our day-to-day efforts to advocate for all people affected by blood clots and clotting disorders. You can read these stories here: Personal Perspectives

Connect and Share

Connect with NBCA on social media today for more information to share: Share to Stop the Clot®

Sitting for long periods doubles risk of blood clots in the lungs

The new study is the first to prove that a sedentary lifestyle increases your risk of developing a pulmonary embolism — a common cause of heart disease.

An editorial published alongside the study says that, although the risk is small — equivalent to seven extra cases per 10,000 person years, and only slightly higher than seen in users of oral contraceptives or long haul airplane travel — the findings could have major health ramifications.

Pulmonary embolism develops when part, or all, of the blood clot travels through the bloodstream from the deep veins in the leg and up into the lungs. Symptoms include difficulty breathing, chest pain and coughing.

While other studies have explored the relationship between physical activity and pulmonary embolism, few data are available linking the condition with physical inactivity.

Dr Christopher Kabrhel and colleagues studied 69,950 female nurses over an 18-year period providing detailed information about their lifestyle habits by completing biennial questionnaires.

They found that the risk of pulmonary embolism is more than two times higher in women who spend most time sitting (more than 41 hours a week outside of work) compared with those who spend least time sitting (less than 10 hours a week outside of work).

The results remained conclusive after taking account of factors such as age, body mass index and smoking, adding to the evidence that physical inactivity is a major cause of this condition.

The study also shows that physical inactivity correlated with heart disease and hypertension and could be one of the hidden mechanisms that link arterial disease and venous disease.

The authors conclude that physical inactivity is associated with incident pulmonary embolism in women, and suggest that public health campaigns that discourage physical inactivity among the general population could reduce the incidence of pulmonary embolism.

In the accompanying editorial, researchers in Canada say the study “reinforces the notion that prolonged inactivity increases the risk of venous thromboembolism, and it shows how this occurs in everyday life.” The findings also indirectly support the use of preventive interventions for at risk people with prolonged immobility, they conclude.

  • Taking caffeine during a high-intensity workout can increase the coagulation factor in your blood, making it more likely to form clots, according to a new study in the journal Medicine & Science in Sports & Exercise.
  • Increasing this coagulation factor can be dangerous in people with other risk factors for heart disease, like high blood pressure, high cholesterol, or obesity. But healthy people are not at the same risk.
  • Limiting your caffeine to no more than 400 milligrams per day is still recommended.

Using caffeine as a preworkout prep and during-exercise booster is quite common, and can offer some real performance benefits, as we’ve reported before. But, a new study throws a wrench its way, finding that the habit may be linked to higher chances of forming blood clots—which can lead to life-threatening effects in some people.

In the study, which was published in Medicine & Science in Sports & Exercise, researchers looked at 48 men, with an average age of 23, and a normal body mass index. The participants completed two sessions, a week apart, on exercise cycles that were gradually increased in speed until participant exhaustion—making it a high-intensity workout. They were given either a non-caffeinated placebo or a caffeinated drink beforehand, and their blood was drawn before and after, along with vital signs reporting.

They found that caffeine significantly increased the coagulation factor during exercise, meaning that the participants who had the caffeine drinks had a higher risk factor when it comes to what causes blood clots. That’s important, since blood clots can cause things like stroke, deep vein thrombosis, heart attack, and pulmonary embolism.

But does this mean everyone should consider ditching their caffeinated energy gels or chews? Not at all, said lead researcher Paul Nagelkirk, Ph.D., the director of the Integrative Exercise Physiology Laboratory at Ball State University.

That’s because the increase in the coagulation factor affects those with other cardiovascular risk factors—think obesity, smoking, high blood pressure, or high cholesterol. People with these risk factors are more likely to experience a cardiovascular event as a result of the increased clotting potential.

“For most people, caffeine is safe, and so is exercise,” he told Runner’s World. “Healthy adults who currently enjoy the benefits of caffeine as a preworkout or precompetition routine have little reason to worry about blood-clotting potential.”

One potential issue, though, may be lots of people don’t really know where they fall on the “healthy” scale. Although you know whether you smoke or not, or fall into the obese category, it’s the other factors that can get tricky.

“There are people who are apparently healthy, but who have an underlying pathological condition that puts them at risk,” Nagelkirk said.

That means even if you think your blood pressure and cholesterol are fine because you’re fit, it’s possible that they could high due to an inherited condition, for example. Knowing your numbers, and checking them on a regular basis, is crucial for knowing how healthy you really are.

If you’ve checked your numbers and do fall into the healthy zone for blood pressure and cholesterol, there’s still a limit when it comes to safe caffeine consumption, Nagelkirk said. The general recommendation is to get under 400 milligrams (mg) of caffeine per day.

“The amount of caffeine in most commercial products is well within these limits, and is considered safe for most people,” he said. “Dangerous levels are most likely consumed by people who use caffeine in powdered or pill form, and who ignore the dosage precautions.”

But that 400-mg max includes all your caffeine for the day, so make sure you’re including your morning cup (or cups) of coffee in your tally, as well as what you are taking in during your workout.

Plus, it’s not like taking in more caffeine will make your workout any better: Past research doesn’t show any positive performance benefits to going past recommended limits, he said.

If you do have cardiovascular risk factors? It doesn’t necessarily mean you have to shelve caffeine during your workouts entirely—you just many need to lower the intensity of your exercise when you use it.

“Lower-intensity exercise does not increase blood-clotting potential the same way vigorous-intensity exertion does,” said Nagelkirk. “Still, people who have a number of cardiovascular risk factors might want to weight the benefits of caffeine use in light of the potential increased risk.”

This blood clot story just keeps getting…more bloody.

I am not only the proud owner of blood clot in my leg. I also have pulmonary embolism. In layman’s terms, that means I also have blood clots in my lungs. Someone blast the confetti cannon.

I can’t even bury this lede because YOU GUYS BLOOD CLOTS IN MY LUNGS.

Okay, so the clot is actually pretty thin because Eliquis, but “the clot thickens” has a sort of poetry, right? I almost titled this post “Two Needles. One Vein.” Also sort of poetic.

Monday I met with a hematologist and together we decided that since I don’t know half of my medical history, we’d go ahead and do a work-up to rule out any genetic factors which may have caused the blood clots in my legs.

The end result of that decision was a butterfly needle in the one and only great vein in my left arm and TWELVE VIALS OF BLOOD.

The children were with me. They were the most stressful part. Between Joshua saying “Mom, that is…like…REALLY ACTUALLY BLOOD…” and Emma’s repeated attempts to touch everything (and the impending OMG of it all) Monday night ended in half a Xanax and going to bed early.

She also wanted me to see radiology for a chest CT the very next day. When I say I knew the results of this test before it happened, I’m not joking. I have known that they would find pulmonary embolism because OF COURSE they would.

Also this:

That was two days before we discovered the blood clots in my legs. I know I’m out of shape, and yes, I had recently battled the flu and bronchitis, or what I thought was bronchitis, and sure, my allergies are always haywire this time of year. But there was something about that particular instance that was just…not normal.

I messaged Dan and told him about it nearly immediately while I was trying to regain my breath and we both shrugged it off as being a sign my body just wasn’t ready for exercise again. We never, ever thought at that moment that it was a sign my airways were being constricted by pulmonary embolism.

(Fun fact: coughing is a sign of both pulmonary embolism AND bronchitis, so now I’m wondering if I’ve had these clots in my legs for longer than just a few weeks.)

Anyway. I got a call at about 10:30 in the morning that my CT scan was scheduled for 2:00 p.m. that same day and oh by the way don’t eat or drink anything for four hours beforehand. If you ever want to make yourself really, really thirsty, have someone officially tell you that you can’t have anything to drink. Works like a charm.

I got myself over there, filled out all of my paperwork (again), handed it over and heard “that’ll be $578, cash, check, or charge.”

I’m sorry. Are we saving my life here or am I buying a handbag?

I have a whole ‘nother post about the health insurance side of this, but I really need to keep myself from getting too worked up. I threw down our HSA card, which I’m really, really glad we have, and paid for the pleasure of being stuck in the same vein for the second day in a row.

The radiologist hooked up an IV to my arm and warned me that the contrast dye would make me feel like I was peeing myself, but that I wouldn’t actually be peeing myself. Probably. I peed beforehand anyway because actually peeing myself was the last thing I needed.

That IV was definitely unpleasant. It was a larger needle. It hurt. It was in an already tender vein, but that’s the best one I’ve got, so winner winner chicken dinner. The scan was done in a matter of minutes and I was on my way back home.

The hematologist told me not to expect answers until Friday, but about five minutes after walking in the door following having the scan done, she called to tell me that there were, in fact, blood clots in my lungs. The good news is that I’m already undergoing treatment.

We’re still pretty sure hormonal birth control caused this, but either way, the treatment for pulmonary embolism is the same. Blood thinners to prevent more clots while my body reabsorbs the existing ones.

This probably means I’ll be on the blood thinners for a longer period of time, a minimum of 6 months as opposed to 3. It also means I have to monitor whether or not I feel short of breath and how hard I feel like my heart is working.

If either of those things feel abnormal, I am to go directly to the emergency room. Do not pass Starbucks. Do not collect 200 Stars.

Swell.

But I’m alive. I could be not alive and that would be definitely worse than this.

Daily coffee ‘lowers stroke risk’

Dr Yoshihiro Kokubo, lead author of the study, published in the journal Stroke, said: “The regular action of drinking tea, coffee, largely benefits cardiovascular health because it partly keeps blood clots from forming.”

Their results for coffee were similar to that of ‘study of studies’, presented at a European conference last May, which found that one to three cups a daily was associated with a 14 per cent reduction.

For three to six cups, there appeared to be a similar although weaker association, but there was no benefit from drinking six or more.

Exactly why coffee and green tea appears to lower stroke risk is unclear, although antioxidants are thought to be at work.

However, the science is by no means cut and dried. Caffeine raises blood pressure, and there have been indications that too much coffee can raise stroke risk because of this.

Dr Dale Webb, from the Stroke Association said: “We welcome this study which suggests that the benefits of antioxidants in coffee and green tea may offset the potential harm from caffeine.

“The results demonstrate higher consumption of green tea and coffee might reduce the risks for stroke, especially for inter-cerebral haemorrhage.

“We would like to see further research to understand the underlying biological mechanisms for these findings.”

Every year about 150,000 people in Britain have a stroke.

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