Deep Vein Thrombosis

Deep venous thrombosis (DVT) is a condition in which a blood clot forms in a vein that is deep inside the body, usually in the legs.

Clots can form in superficial veins i.e. veins close to the skin's surface, and in deep veins. While blood clots in superficial veins rarely cause serious problems, clots in deep veins require immediate medical care. DVT is a serious condition because a blood clot that has formed in a deep vein can break loose and travel to the lungs. This is called a pulmonary (lung) embolism. In severe cases, a pulmonary embolism can be fatal.

RISK FACTORS
Many factors can increase the risk of DVT. These include:
• Sitting for long periods of time, such as when driving or flying. The same can occur with prolonged bed rest, such as during a long hospital stay, or paralysis. When the legs remain still for long periods, the calf muscles do not contract, which normally helps blood circulate. As a result, blood clots can develop.
• Inheriting a blood-clotting disorder that makes the blood clot more easily. This inherited condition may not cause problems unless combined with one or more other risk factors.
• Injury or surgery to veins can slow blood flow, increasing the risk of blood clots. General anaesthetics used during surgery can dilate (expand) veins, which can increase the risk of blood pooling and then clotting.
• Pregnancy. The risk of DVT is slightly increased for women during pregnancy and for up to 6 weeks after birth.
• Cancer may increase the amount of substances in the blood that promote clotting. In addition, some forms of cancer treatment increase the risk of blood clots.
• Heart failure increases the risk of DVT because a damaged heart does not pump blood as effectively as a normal heart does. This increases the chance that blood will pool and clot.
• Birth control pills or hormone replacement therapy (HRT) can increase the blood's ability to clot.
• A pacemaker or a thin, flexible tube (catheter) in a central vein can irritate the blood vessel wall and decrease blood flow.
• A personal or family history of DVT or pulmonary embolism.
• Being overweight or obese increases the pressure in pelvic and deep leg veins.
• Smoking adversely affects blood clotting and circulation.

SYMPTOMS
Approximately half of all cases of DVT produce no noticeable symptoms. Signs and symptoms of DVT that can occur include:
• Swelling in the affected leg; this can include swelling in the ankles and feet.
• Leg pain; this can include pain in the ankles and feet. This pain often starts in the calf muscle and can feel like cramping.
• Redness and warmth over the affected area.
• The calf or thigh may ache or feel tender to the touch or on standing and walking.
• Pain may get worse and last longer or become constant.

TREATMENT OPTIONS
DVT is a serious medical condition and requires immediate diagnosis and treatment by a medical practitioner. DVT is a potentially life-threatening condition, as the 'plug' which blocks the vein may dislodge and become stuck in veins in the heart or lungs (causing a heart attack or pulmonary embolism). DVT may also cause considerable damage to tissues around the blockage. Always consult your Doctor.

DIET HINTS
Your diet should be high in:
• Wholegrains, cereals, fresh fruit and vegetables, lean meats and low-fat dairy products.
• High-fibre foods. Eat plenty of wholemeal and wholegrain bread and cereals, legumes (kidney beans), oats, oat bran, and vegetables. These foods supply both insoluble fibre (to regulate bowel function) and soluble fibre (to help reduce blood cholesterol levels).
• Fish oil. Good dietary sources are salmon, tuna, sardines, mackerel and mullet. Fish oils help reduce the stickiness of blood, relax the walls of the arteries and reduce blood triglyceride levels.
• Vitamin E. This vitamin acts as an antioxidant to prevent the degradation of poly-unsaturated and mono-unsaturated fats. These fats, when eaten in small amounts to replace saturated fats, are beneficial in lowering blood cholesterol levels. Good dietary sources are wheat germ, sunflower seeds, sesame seeds, wholemeal flour and breads, cottonseed oil (especially if cold-pressed) and avocado.

Your diet should be low in:
• Total fat content, especially saturated fats. Saturated fats are harder, and more solid at room temperature (e.g. fat on meat, lard, dripping, butter, cream, full-cream dairy foods, hard cheese, processed meats, cooking margarine, solid white cooking fats, coconut oil, palm oil, chocolate, commercial cakes, pastries, biscuits and deep-fried snack foods).
• Refined flour and sugar. These provide energy (kilojoules or calories) with little or no fibre or nutritional value. Avoid soft drinks, flavoured mineral waters, lollies, refined cakes, biscuits, pastries and sweetened cereals.
• Dietary cholesterol. Avoid brains, liver, kidney, pate, fish roe and have no more than 3 egg yolks per week. Most cholesterol in the blood comes from the liver, not from foods in the diet. Low-fat foods and low-fat cooking techniques are preferable to 'low-cholesterol' or 'cholesterol-free foods'.

PREVENTION
Preventing DVT is far easier than treating it after it has occurred. Some common preventive measures include the following:
• Take any prescribed medications as directed. If you are having surgery, such as orthopaedic surgery, you may be given blood-thinning medication (anticoagulants) to reduce the risk of DVT.
• Have regular check-ups with your Doctor to see if your medication or treatments need to be modified.
• If you take anticoagulants, watch your intake of vitamin K, which can affect how drugs like warfarin work. Foods high in vitamin K include green leafy vegetables and canola and soybean oils.
• Exercise your lower calf muscles if you will be sitting for a long time. Whenever possible, get up and walk around.
• Movement is important. Walking as soon as possible after being confined to bed due to illness or surgery will decrease the risk of DVT.
• Make lifestyle changes. Lose weight if necessary, quit smoking and ensure your blood pressure is under control. Obesity, smoking and high blood pressure all increase the risk of DVT.
• Wear compression stockings to help prevent blood clots in the legs if your Doctor recommends them.

SUPPLEMENTS AND HERBS
• Garlic and ginger thin the blood. The recommended dose of garlic is the equivalent of a clove a day.
• The herbs ginkgo biloba and cat's claw may help reduce the stickiness of the blood. .
• Flavonoids - such as those found in grape seed extract, tea, grape skins, red wine and berry fruits - may help reduce the risk of blood clots.
• Essential fatty acids (found in certain fish and cold-pressed vegetable oils) can reduce blood stickiness by modifying levels of chemicals called prostaglandins.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice
1. Your Pharmacy has a range of compression stockings.
2. Quit smoking. Ask your MedAux Pharmacist for advice about products and services to help you stop smoking.
3. Your Doctor or Pharmacist may recommend low-dose aspirin for several days before flying, as it helps to keep the blood thin. Note: aspirin should not be given to children under 16 years of age unless specified by a doctor. Aspirin should be avoided in children aged 12 - 15 if they are feverish.