STAY WELL & SPARKLE – Wicked Clots

My heart jumped! The moment I noticed her sister near the Ministry – Oh, the resemblance! I had admired that Nubian princess from a distance back in those youth group days. The pride of Mahaut, ‘V’ was progressive, quick-witted, with an innocent laughter that bubbled up as pure as mountain spring. After chip-chipping around Roseau all Carnival Tuesday together, I felt had died and gone to heaven!

Was it sheer coincidence, or in those days did I always ‘follow-fashion’ my big brother? Turns out he was also dating a charming young nurse from the same village. Point Michel girls had the fame, but it was these Mahaut girls who had the Christian brothers under heavy manners!

With studies, V and I went our separate ways, with different commitments. That’s life. Even so, I yearned for the opportunity to reminisce. But instead of contact information, what her sister gave me was the worst case of cold chills. Surprised, she muttered four fateful words that hit me like a ton of bricks: “Oh, didn’t you hear?!” While living overseas, V developed what seemed like a cramp in the calf. A friend referred her to an excellent massage therapist and then, suddenly…!

Deep Venous Thrombosis (DVT)

Clotting seems so common these days, some relative, or acquaintance instantly comes to mind with the mere mention of it. It is as if God covers his eyes, points a random finger at humanity and declares, “Okay, you over there – come on up!”

But actually, it is not so capricious. Blood clots (DVT) can break off from the legs and choke off the lungs with devastating swiftness, even in otherwise healthy people (pulmonary embolism/P.E). This less than 2-minute video explains clearly the science behind the final stage of the process. But why do clots form in the first place?

You see, it takes movement of the leg muscles to push blood in the veins back to the heart. After not moving around for a while, blood flow gets sluggish (stasis) and clots develop. Any general anesthesia surgery or direct injury to your leg can increase the risk of blood clots, such getting a lash with a rounders or cricket ball, football boot, accident contusion or a broken a leg. Here are some other scenarios:

• Obesity and pregnancy increase the pressure in the pelvic veins, which slows down the flow of blood. Birth control pills and hormone replacement therapy both increase clotting tendencies.
• Sitting in confined spaces for long periods of time, such as long driving trips or flights can lead to clots. South Korea seems to have the dubious reputation in the news for young men playing video games for hours and hours on end. When they finally get up, a few collapse – game over!
• Any kind of smoking affects blood clotting and circulation, which increases risk of DVT.
• Some forms of cancer / medical treatment predisposes to clotting.
• Persons over 60, those who have had clots before, or who have a family member with a clot are themselves at higher risk of themselves getting a clot.

Treatment involves days of injecting of blood thinners into the belly or thigh followed by many months of daily blood thinners by mouth (Warfarin). Patients require monthly blood tests (PT/INR) to carefully regulate their blood thinner dose. Doctors also prescribe compression or support stockings. Some patients are non-compliant as putting them on can be quite a challenge for arthritic hands. Others complain it ‘embawassay’ them, especially in hotter climes. And did anyone mention, a baby aspirin a day helps keep blood clots away?

Close to home

Ironically, something happened one Friday afternoon a couple years before that shocking encounter with V’s sister. I myself developed this deep, constant crampy pain in my left calf. Okay, don’t get too excited. But for the life of me, I could not connect at all it with any trauma or strain. In the middle of a formal dinner that evening, I said, “I’ve had enough of this!” Leaving before dessert tells you right there how much that was worrying me.

I called ahead directly to the vascular specialist at Ohio State University Hospital. He was not convinced after examining me, but ordered a Doppler/ultrasound test anyway.First thing Saturday morning, the technician (who had to be called in) kept teasing me about my ‘peace of mind’ test – until I saw her expression change…

Me?! A clot?! To the best of my knowledge, none of the aforementioned risk factors applied. It felt somewhat good proving I wasn’t wrong, but in a big, big way, I didn’t want to be right. I had dodged the bullet – for now. Nevertheless, a high risk of complications and recurrence remains.

V had so much life ahead of her.  Since then, anytime someone begins mouthing those four fateful words, I feel like corking my ears. Needless to say, if there is one thing for which I take no chances, you know what it is – not with my patients, nor myself. At the end of the day, our only defense is increased awareness of how a wicked clot is no respecter of persons. Ergo, the moment any significant calf pain arises for no good reason; do not hesitate to seek immediate medical diagnosis and treatment.

Dr. Christian operates the Urgent Care on 137 Bath Road. He serves as Medical Adviser to the Dominica Cancer Society and Grotto Home for the Homeless as well as Medical Officer for the Dominica Cadet Corps. Click here http://urgentcareda.weebly.com/ for more information.