Friday, July 5, 2013

Are You at Risk For Blood Clots?


Summer is once again here and many of my patients are traveling on vacations, or visiting friends and relatives across the country. Before they go, however, I like to give them some pre-travel advice about a potentially serious medical condition that can occur with long periods of sitting in cars, trains, and airplanes... blood clots.

Up to 600,000 Americans develop clots every year with 1 in 3 persons developing serious medical complications from them. I'd like to share with you the same advice I give my patients about the symptoms and risk factors for developing blood clots and how you can prevent them.

What Are Blood Clots?

They are clumps of debris or fat, coagulated blood, or even surgical materials, within veins. They can start in the legs and travel within the vein system to the brain, heart or lungs and cause a heart attack, stroke, or pulmonary embolism.

What Are The Symptoms of A Blood Clot?

The symptoms of a clot are varied, depending upon their origin, but almost always include sudden and/or severe pain at the site. All require immediate medical attention. Here's a list of the common types of clots and their symptoms:

Legs: Blood clots in the legs can often be overlooked as a pulled muscle, as they can feel like a "Charlie Horse" type of cramp. Look for swelling of the leg, warmth to touch, redness or bluish discoloration, pain.

Lungs: Sudden onset of shortness of breath. A stabbing, sharp chest pain that gets worse with deep breaths, fast heart beat and/or an unexplained cough that may contain blood.

Heart: A clot that has traveled to the heart will give the symptoms of a heart attack, severe, crushing-type chest pain, and shortness of breath.

Brain: A clot that has traveled to the brain is called an ischemic stroke, which is a blockage of blood flow. Its symptoms can include severe/sudden headache, confusion, blurred vision, dizziness, weakness on one side of the body, loss of balance or coordination/inability to walk, inability to speak or understand language.

Kidneys: Not as common as leg or lung blood clots, but kidney clots do occur. The symptoms are sharp pain in the lower back, usually on one side, inability to urinate, high blood pressure, retention of fluid, swollen ankles, and shortness of breath.

What Are The Risk Factors for Blood Clots?

Anyone can get a clot at any time, but generally the risks are highest with the following:

•Recent major surgery in the abdominal or pelvic area
•Prolonged bed rest in a hospital, nursing home over 3 days
•Knee and hip joint replacement
•Major trauma to the body such as an auto accident or serious fall
•Pregnancy, or recent childbirth

Other moderate, yet still very important, risks include:

•Age - over 65
•Smoking
•Long sitting during travel in a car, plane, train, bus
•Dehydration - inadequate water intake can cause blood to coagulate
•Under going chemotherapy
•Birth control pills or hormone replacement therapy
•Genetic predisposition
•Obesity/sedentary lifestyle

What Can I Do To Prevent Blood Clots?

Avoiding a blood clot involves reducing your risk factors where possible. In general, the following guidelines can help you prevent blood clots:

•Quit smoking. Period.
•If you travel for long periods, take an "exercise" break where you get up and walk around for several minutes every 2 hours of travel. This is easier to do in car or bus travel, not so easy in a plane or train. However, you can get up from your seat and walk to the restroom, and/or the club car once in a while. Shift your position in your seat, doing leg lift exercises, or ankle rotation exercises at your seat will also help.
•If you are overweight and sedentary, make some healthy, nutritional, diet changes and get up and exercise for at least 30 minutes of aerobic exercise a day. This can be done by taking a walk, riding a bike, Wii FIT in your living room, anything that gets you up and your blood moving.
•Stay hydrated! Drinking the correct amount of water everyday is one of the healthiest things you can do for yourself for several reasons. Drink half your body weight in water every day, and a little more if you consume caffeine. Your blood needs water to stay at an optimum density which is not so thick as to form clots and not so thin as to run too freely and cause profuse bleeding if you cut yourself.
•Find out your clotting time. A simple blood test at your doctor's office can reveal if you have blood clotting issues present. You may need to make dietary changes (less vitamin K containing foods, take supplements that do not contain it) to help you prevent a clot from forming.
•Vitamin E - A low dose, 200 mg a day, can help prevent blood clots from forming.
•Hormones - if you take birth control pills and you are over the age of 35, you may want to consider another form of birth control. Similarly, if you are menopausal and on HRT, talk to your doctor about your risk for blood clots. Switch to physician-prescribed bioidentical hormones that have much lower risks for serious side effects than animal or synthetic derived hormones.

Blood clots can be scary business. Just knowing the symptoms of a blood clot can buy time in getting medical attention quickly. Though you may not be able to avoid certain high risk factors such as surgeries and/or prolonged hospital rest that may unexpectedly arise in your life, just trying your best to live a healthy lifestyle the rest of the time will help decrease your risk significantly. Happy, fun, and safe summer travels!

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