Question: I am being treated for a blood clot in my right leg below the knee. I want to keep from having any more in the future. What is the best thing to do to prevent this from happening again?
Dr. Hibberd’s answer:
Blood clots in your leg may be superficial or deep, and usually affect the veins. Clots in arteries are very different.
Superficial clots are managed by elevation, support hose when walking, heat, anti-platelet therapy such as aspirin, pain medications, occasional antibiotics, and other conservative measures. They rarely require surgery and are associated with high pressures developing in the peripheral venous system, causing varicose veins that are often visible. Superficial clots are not life and do not require the anti-coagulant drugs that deep clots do.
Deep clots are referred to as DVT — deep venous thrombosis — and are usually in the legs. When fragments of the DVT clots break free, they can cause serious health problems. Pulmonary embolism (PE) occurs when DVT clots break free and either shower the lungs with multiple small clots or obliterate lung circulation with a huge large clot to one or both lungs. PE can be dramatically sudden and may cause sudden collapse and death without warning.
That’s why we treat DVT as a medical emergency. DVT is often caused by prolonged sitting, such as in an airline seat . Smoking, bed rest, a limb injury, fracture, surgery, prolonged swelling, inactivity, and some disorders can clotting in our bodies predispose us to DVT.
Recurrent DVT can be prevented by anticoagulants such as heparin, followed by Coumadin. In the meantime, other risk factors for DVT can be modified to reduce risks. You will be advised to stop smoking, avoid prolonged sitting, wear loose-fitting clothes, treat underlying disorders that may be contributing factors, manage your weight management, and get regular exercise.
The aim is not just to prevent DVT, but also a life-threatening PE. Sometimes DVT recurs, and extended treatment of Coumadin is needed.
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