Deep vein thrombosis is a medical condition where a blood clot forms in one of your deep veins, commonly found in your leg. The condition affects around one in every 1000 people every year here in the United Kingdom.
Today’s blog post takes a look at the causes, symptoms and the available treatment for this condition, as well as an in-depth look at what deep vein thrombosis actually means.
What is Deep Vein Thrombosis?
Deep vein thrombosis is a blood clot which is commonly found in the leg. Blood clots that develop within a vein are also known as venous thrombosis. Deep leg veins is a larger vain which runs through the muscles of your calf and thigh.
The condition can develop at any time, however it is most common in people over the age of 40. Deep vein thrombosis can also lead to further complications, including pulmonary embolism. Thrombosis UK define this condition in the following way:
An embolism is when a part of the clot ‘breaks off’ and travels around the body eventually blocking an artery. An example of this is a pulmonary embolism when part of the clot from a deep vein thrombosis breaks off, moves up the leg, through the heart and lodges in a lung artery or pulmonary artery. This process is known as embolisation, and the piece of clot is called an embolus.”
These two conditions together are known as venous thromboembolism.
There are a number of different risk factors that can lead to deep vein thrombosis. Some of the most common include:
- Blood vessel damage.
- Inactivity for long periods – after surgery or during a long journey.
- A family history of blood clots.
- Clot-prone conditions such as cancer, heart disease and thrombophilia.
- Hormone replacement therapy.
You’re also at a higher risk if you smoke and if you’re over the age of 60, especially if you have a medical condition which has an effect on your mobility. The NHS provide a detailed explanation of how your blood can clot:
Normally, blood clotting occurs when a blood vessel is damaged and bleeds. If the blood clots when a vessel isn’t damaged, a clot can form within a vein or artery (thrombosis) and restrict the blood flow.
Although some people may no see any symptoms of deep vein thrombosis, here are the most common ones to look out for:
- Pain, swelling and tenderness in one of your legs.
- A heavy ache in the affected area.
- Red skin – particularly at the back of your leg, below the knee.
- Warm skin in the area of the clot.
- A mild fever.
The pain in your leg may also worsen when you bend your foot upward towards your knee. If you feel like any of symptoms match your current situation then you need to visit your GP. Remember that although deep vein thrombosis commonly only effects one leg – this is not always the case.
Upon a visit to your GP you may be given certain tests so that he or she can be sure the condition can be diagnosed. An example of this is the D-dimer test, which detects pieces of blood clot that have been broken down and are now loose in your blood stream. The larger the number of fragments, the more likely it is that you have a blood clot in your vain.
Other tests include an ultrasound to try and detect blood clots and a venogram if the previous two tests were unable to confirm a diagnosis. During a venogram, a special liquid known as contrast dye is injected into a vein in your foot. This then travels up your leg and can be detected by an X-ray – which will highlight a gap in the blood vessel where a clot is stopping the flow of blood.
Actual treatment, once the diagnosis is complete, usually involves anticoagulant medicines such as herparin and warfarin, which reduce the blood’s ability to clot and prevents existing clots from increasing in size. These medicines are commonly referred as “blood-thinning” medicines.
Herparin is often prescribed first as it begins working immediately to prevent clots. This medicine is available in two different forms:
- Standard (unfractioned) – Can be given as an injection straight into one of your veins or via a continuous drip, through a narrow tube into a vein in your arm. It can also be given as an injection under your skin.
- Low molecular weight – Usually given a an injection under your skin.
Both forms of the medication can lead to side affects, such as bleeding, a skin rash and the weakening of your bones if it’s taken for a long time. In rare cases, heparin can also cause an extreme reaction that makes existing blood clots worse and causes new clots to develop.
Warfarin is taken as a tablet and you may need to take it after initial treatment with heparin to prevent further blood clots occurring. Your doctor may recommend that you take warfarin for three to six months. In some cases, it may need to be taken for longer, even for life.
If you are placed on this medication, you may need to have two or three blood tests a week until your regular dose is decided. Warfarin can be affected by your diet, other medicines that you’re taking and by how well your liver is working. You should consider the following if you’re taking this medication:
- Limit your alcohol intake.
- Keep your diet consistent.
- Don’t take any herbal medicine.
- Take your dose of warfarin at the same time every day.
- Don’t start any other medicine without checking with your doctor.
Your doctor will also prescribe you with compression stockings, which you must wear every day in order to improve your symptoms and help to prevent any further complications. You will also be advised to raise your leg whenever you’re resting, as this helps to relieve the pressure in the veins of the calf and stops blood and fluid pooling in the calf itself.
When raising your leg, make sure your foot is higher than your hip. This will help the returning blood flow from your calf. Putting a cushion underneath your leg while you’re lying down should help raise your leg above the level of your hip.
If left untreated, around one in 10 people with deep vein thrombosis will develop a pulmonary embolism. This is a very serious condition which can cause a person to feel chest pains, feel out of breath and even collapse without warning.
If you’re due at hospital or are admitted to hospital your risk of developing a blood clot while your there will be assessed. Surgery and some medical treatments can increase your risk of developing deep vein thrombosis.
Before going into hospital for an operation, and you’re on the combined contraceptive pill or going through hormone replacement therapy, you’ll be advised to temporarily stop taking your medication four weeks in advance. You may also be asked to stop taking medication such as aspirin one week week before your operation.
Whilst in hospital, doctors will ensure that they reduce your risk of deep vein thrombosis. A number of medications can be used and they’ll also ensure that you’re drinking enough so that you don’t become dehydrated.
You should also take the following precautions if you’re planning a long-distance trip:
- Drink plenty of water.
- Avoid taking sleeping pills as they can cause immobility.
- Take occasional short walks when possible, either up and down the train/plane or at service stations.
- Wear elastic compression stockings.
- Perform simple leg exercises.
- Avoid drinking excessive amounts of alcohol as this can cause dehydration.
Deep vein thrombosis is a condition which qualifies you for VAT Exemption when you buy a personal alarm. HMRC state that a product which has been “designed or adapted for a disability” qualifies for VAT exemption.
For a person to qualify they must meet certain criteria set by HMRC. This criteria says that the customer must have a long-term illness, a terminal illness or a disability in order to qualify.
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