Deep Vein Thrombosis (DVT)

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.

DESCRIPTION

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 anesthetics 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 (baked beans, 3-bean mix, kidney beans), oats,
  oatbran, 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 wheatgerm, 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 (eg. 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 orthopedic 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 Pharmacist for advice

1. Your Pharmacy has a range of compression stockings.
2. Quit smoking. Ask your 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 .