MANY of us would have heard stories of someone travelling on a long flight only to end up spending the rest of their holiday in hospital with a deep vein thrombosis (DVT). Others may have heard of patients who have had an operation and had to stay in bed for a period of time but they ended up with one. The stories are plentiful, varied and very frightening. This article aims to give you a general overview of what the condition is, what the symptoms are, how it is treated and, most importantly, how to prevent it from happening in the first place.

A DVT is a blood clot that develops within a deep vein in the body, usually the leg. It can be a very serious condition because these clots may break away from the wall of the vein and travel through the bloodstream, lodging in the lungs, leading to a pulmonary embolism.

SYMPTOMS

In some cases of DVT there are no symptoms however, most people will have these symptoms:

1. Tenderness, pain and swelling around a specific area of the leg, usually the calf. The pain is usually more intense when the knee is bent.

2. The area may be warm or hot to the touch.

3. The skin in the area will show signs of inflammation and be red or discoloured.

4. On rare occasions both legs may be swollen.

WHAT CAUSES DVT?

These blood clots can be caused by anything that prevents the blood from circulating or clotting properly. They can occur at any age but they are more common in people over 40 years old. Those who are at risk of developing DVT are:

• People with a history of previous DVT or pulmonary embolism;

• People who have a family history of blood clots or suffer with a clotting disorder, for example Hughes disease;

• Smokers;

• People who have heart failure;

• People who have bowel diseases like Crohn’s;

• People who are pregnant;

• People who are obese;

• People who take certain types of contraceptive pill or hormone replacement therapy;

• People who are inactive for long periods of time. For example, on a long flight, car ride, or after an operation;

• People who are having chemotherapy and radiotherapy.

DIAGNOSIS

Anyone suspecting a DVT should see their general practitioner immediately or go to a hospital so that the clinical findings can be noted and blood tests done. Ultrasound examinations will also help give a clear diagnosis.

TREATMENT

Treating a DVT involves taking anti-coagulant medication, which should reduce the body’s ability to clot and stop existing clots from getting bigger.

Compression stockings should be worn every day to improve symptoms and reduce complications. Supervised exercise may be advised once the patient is wearing compression stockings. This can reduce the symptoms and again, prevent further complications.

Elevating the limb may relieve the pressure on the veins. The leg should be raised higher than the hip to aid blood flow. In some cases, small mesh devices called Inferior Vena Cava Filters may be placed in a vein to trap fragments of the clot that may be going towards the lungs and heart.

COMPLICATIONS

There are two main complications of DVT: Pulmonary embolism and post-thrombotic syndrome.

A pulmonary embolism is when the clot travels in the bloodstream to the lungs, where it blocks one of the main blood vessels. Tiny clots may not be symptomatic, but larger ones will cause chest pain and breathing difficulties. The lungs may then collapse, which can result in heart failure and death.

Post-thrombotic syndrome affects 20 to 40 per cent of people with a history of DVT. The symptoms include calf pain, ulceration and rashes.

PREVENTION TIPS

1.Do not smoke.

2.Eat a health-balanced diet.

3.Exercise regularly.

4.Lose weight if you are obese.

5.When travelling on a long journey, drink plenty of water and avoid alcohol. Do not take any sedatives when travelling as these may cause immobility. Wear compression stockings on flights, and if you are going on long car journeys, make regular stops to stretch and take a short walk.

A tip I give my patients when travelling is the “ABC” exercise. Every hour, try to form as may letters of the alphabet with each foot that you can. This will help with the blood flow.

6.When in hospital, medical staff will assess your risk factors and take appropriate precautions regarding medication, compression stockings and exercise. While in hospital too, make sure you do not become dehydrated.

7.Some general practitioners may prescribe asprin as a preventative medication.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974- 6339), Kingston (978-8392), and Savanna-la- Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.