What is Deep Vein Thrombosis and How to Guard Against It

Posted in Diabetic Complications

Deep vein thrombosis (DVT) describes a medical condition in which clots form in the deep veins of your body, typically in the legs. This condition causes swelling and pain in the legs. Each year, as many as 900,000 people suffer from DVT in the United States.

DVT can also occur if you have a specific medical condition affecting the clotting of your blood. For instance, patients can experience the onset of symptoms if they lead a sedentary lifestyle, or if they are bedridden due to physical issues. In addition, other common causes of DVT include vehicle accidents and complications with surgical procedures. That is why doctors recommend patients wear diabetes socks for men and women to improve blood circulation to the legs.

As a matter of fact, DVT can cause a life-threatening situation for many people. If a clot breaks loose in the vein, it can travel to the lungs and block or severely limit blood flow. As a result, the onset of a pulmonary embolism may occur and even death.

Symptoms

Almost 50% of all patients diagnosed with DVT do not experience the onset of any symptoms. However, in most cases, the common symptoms of the condition include swelling, as well as a throbbing or constant pain and tenderness in the legs or calve muscles.

In some cases, the clot may cause the legs to turn blue or purple, due to a lack of blood flow. These symptoms can develop suddenly over a few days, or over a few months. It depends on the patient. In general, symptoms change dramatically overnight or over a few hours if the clot breaks free and moves into the lungs.

In such a case, the patient develops a pulmonary embolism. Symptoms of a pulmonary embolism include shortness of breath, chest pain, coughing, or rapid heart rate. Moreover, the patient may also experience sweating and heightened anxiety or malaise, as well as fainting spells.

Causes

Increased blood clotting tendency

  • Certain disorders, such as cancer and other inherited disorders of blood clotting, cause blood to clot when it should not. Certain types of cancer treatments also increases the likelihood of blood clots.
  • Blood clots are five to ten times more prevalent during pregnancy. When a woman is pregnant, the amount of blood-clotting proteins builds up, and the amount of blood thinning proteins decreases. In addition, a boost in hormones, and a more moderate blood circulation from an expanding uterus causes blood to circulate back from the legs. DVT risk increases with this leg and pelvis vein pressure. As a result, the effects can last a while. Women are susceptible to blood clots up to six weeks after childbirth. Pregnancy can also lead to venous insufficiency.
  • Smoking is also a risk factor that affects blood flow and clotting.
  • Among older people, dehydration commonly causes blood to clot easier and can therefore contribute to deep vein thrombosis.
  • Family history is another factor that can increase your blood clot risk.
  • Some drugs including oral contraceptives, estrogen therapy, or other drugs that act like estrogen, can cause blood to clot more readily.

Injury to the vein

Veins damage during surgery or during an injury to an arm or leg, by the injection of irritating substances, by inflammation, or by certain disorders can lead to DVT. Also, a clot itself can cause injury, making formation of a second clot more likely.

Slowing of blood flow

During prolonged bed rest and other occasions when the legs are not moving normally, blood flow slows. This is because the calf muscles are not contracting and squeezing the blood toward the heart.

Serious disorders can cause deep vein thrombosis. Examples include a heart attack, heart failure or a stroke, lying in a hospital bed for several days without sufficiently moving the legs, and in people whose legs and lower body are paralyzed. Indeed, deep vein thrombosis can develop after major surgery, particularly pelvic, hip, or knee surgery.

Conversely, even healthy people can develop thrombosis. Those who sit for long periods of time are at risk. For example, people driving on long road trips or flying on international flights sit for an extended period of time. Nevertheless, thrombosis is extremely uncommon in these circumstances and usually occurs in people with other risk factors.

Complications

DVT is a serious condition to can lead to two pulmonary embolism and postphlebitic syndrome.

Pulmonary Embolism

A pulmonary embolism happens when there is a blood clot from another part of the body (generally the legs) and moves to your lungs. This is a severe problem that can cause fatality. Therefore, if you have any signs of pulmonary embolism, go see a doctor immediately. Here is a list of pulmonary embolism symptoms:

  • Difficulty breathing
  • Coughing up blood
  • Accelerated heart rate
  • Discomfort or pain in the chest that gets worse when coughing or taking a deep breath
  • Feeling dazed

Postphlebitic Syndrome

Another complication that commonly develops after having DVT is postthrombotic syndrome, also known as postphlebitic syndrome. Blood circulation is impaired after blood clots injure and damage the veins. This can cause constant swollen legs, sores on the skin, pain in the legs, and discoloration of the skin.

Diagnosis

In order to diagnose DVT, your doctor will examine your legs to check for swelling and tenderness. Next, he or she will ask about your symptoms and risk factors. Make sure to inform the doctor when your symptoms started and any current medications. Based on their findings, your doctor may order a blood test or an ultrasound of your legs. The blood test measures the level of a chemical called D-Dimer. For the most part, this level is always abnormally high when blood clots are actively forming in the body.

In addition, an ultrasound of your legs detects blood flow problems in your veins. This procedure is called a lower extremity non-invasive test. If the test shows evidence of a blood clot, your doctor will diagnose DVT. On the other hand, if the initial test is negative, it does not mean that there is no clot. It may be too early to see the full effect of the clot. As a result, your doctor may ask that you return in three to four days to repeat the test.

Prevention

Diabetic Socks

If you have had surgery or are at risk for DVT, the may doctor may prescribe diabetes socks for you when you return home.

Men's and ladies diabetes socks help promote circulation of blood in the blood vessels and prevent blood from pooling in the legs and causing blood clots. Diabetic socks are socks with wide tops that do not bind to the legs. At the same time, they are not so loose that they sag down the leg either. Also, they feature extra cushioning on the soles to soothe sore feet. If you are wearing diabetes socks, they should feel snug but not too tight. Talk to your doctor and getting the right size is important.

These socks also feature moisture wicking material that keep the feet dry to protect against infections. Most diabetics wear these socks just below the knee, although there are also crew, ankle, and low cut lengths available. Some people with diabetic neuropathy may not be able to tolerate socks with seams. Look for ones that are seamless or have flat seams.

Exercise

Lack of exercise is unhealthy for many reasons, but it is certainly a major risk factor for DVT. In fact, almost any kind of exercise can reduce your risk. For instance, a great way to start is by simply walking 30 minutes a day. Even if you have a job where you have to sit all day or if you are just habitually sitting, get up and move around every hour or so.

Weight Control

Because of the added pressure that extra pounds can put on the veins in your pelvis and legs, it's important to maintain a healthy weight, especially if you know that you're already at risk for DVT.

Thus, if you are overweight or obese, talk to your doctor about making improvements in your diet (low glucose foods for diabetics), starting a fitness regimen, and find support to help with your weight loss.

On the positive side, even losing just a small amount, such as 5 to 10 percent of your current weight, can help reduce your risk for health problems.

Medication

Take medicine as directed. Your healthcare provider may recommend blood thinners and other medicines to help prevent blood clots. It is important not to skip a dose. The medicine may not be able to prevent blood clots if the amount in your blood gets too low.

Treatment

Deep vein thrombosis treatment prevents clots from getting bigger, breaking loose, and causing a pulmonary embolism. Therefore, the goal is to reduce your chances of deep vein thrombosis happening again.

Blood thinners

The most common way to treat deep vein thrombosis is with anticoagulants, also called blood thinners. These drugs, through injections or taken orally, decrease your blood's ability to clot. Rather than breaking up existing blood clots, blood thinners prevent clots from getting bigger and reduce the risk of developing more clots. Blood thinners do not remove clots. Your body automatically does this with time. Sometimes the clot is completely gone and other times only partially. In general, you need to take blood thinner pills for three months or longer. It is vital to take them exactly as your doctor instructs because taking too much or too little can cause serious side effects.

Are there risks and side effects with blood thinner drugs?

Anyone making a choice to take these drugs must weigh the pros and cons. Is the benefit of preventing blood clots worth the potential harm it causes? In some cases, taking these drugs can be harmful. People who take anti-coagulation medications are at risk for bleeding. Those with increased risk include people with brain bleeding, recent major surgery, or significant injury. If there is bleeding, stop taking the drug. In addition, doctors can take steps to stop the anti-coagulation effects.

Clot busters

If you have a more serious type of deep vein thrombosis or pulmonary embolism, or if other medications aren't working, your doctor might prescribe drugs that break up clots quickly, called clot busters. These drugs are either given through an IV line to break up blood clots or through a catheter placed directly into the clot. However, these drugs can cause serious bleeding, so they're generally only for severe cases of blood clots.

Filters

If you can't take medicine to thin your blood, you might have a small metal filter inserted into the large vein in your abdomen called inferior vena cava (IVC). The filter prevents clots that break loose from lodging into your lungs. A filter prevents pulmonary embolisms. These filters may be helpful, but the downside is that they may potentially cause a new clot to form if left in too long. However, it does not protect against nor does it treat DVT.

Surgery

In certain circumstances, when a clot is very big, the doctor may recommend dvt surgery to get rid of the clot. However, this is only done in extreme cases when a clot causes serious problems such as tissue damage.

During surgical procedure, the doctor cuts into the blood vessel. Next, they must find and remove the clot. Lastly, they fix the incision on the blood vessel.

Sometimes, the surgeon uses a small medical balloon to open the blood vessel and clear away the clot. The balloon is lifted once the clot is seen and eliminated.

Surgery has its perils, so surgeons only use it as a last resort. Complications can include blood vessel damage, infections, and excessive bleeding.

Deep vein thrombosis is a common blood clot in the legs that can lead to serious health problems. It is vital to know the signs of DVT and catch it during the early stages to prevent further complications. There are many ways to prevent and treat DVT including wearing diabetic socks, exercising, taking medication, and maintaining your weight. Check with your doctor to find the best solution for your situation.

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