My sister has a blood clot in her leg. The doctor says the clot runs from just above her knee to near her ankle. Is that possible? I’ve never heard of such a thing. It seems really bad! Does anyone have any experience with blood clots? My mind is blown.
Yes, this is called a deep venous thrombosis (DVT) and must be taken seriously. The risk is that the clot breaks off and travels to the lungs where it can even be fatal.
Some people are born with a genetic tendency for such clots, but most people acquire the risk. Things like birth control pills and other estrogen containing preparations triple a woman’s risk. Prolonged immobilization, broken legs and hips, surgery (esp. on the knee or hip), cancer, obesity are some other major risk factors.
Treatment ususally consists of blood thinners. The duration of treatment will depend on whether the cause has been rectified or is expected to disappear (eg. broken hip) or whether the cause is likely going to remain forever (eg. genetic tendency or cnacer).
Well, she is obese. I don’t think she’s on the pill. I just can’t believe the size of it! I thought blood clots were like the size of a pea or something. This is three feet long (and hasn’t changed in the three weeks she’s been on Coumadin. She was also giving herself injections of something for a week. This was supposed to slow the growth of the clot. Is a clot this size normal? By the way, KarlGauss, you seem very informed. Are you a doctor?
“Are you a doctor?” - Well, I play one at medical school 
Sorry, I forgot to answer your other questions.
The injections were probably a form of heparin (likely low-molecular-weight heparin). This is given until the effect of the Coumadin (oral blood thinner) builds up.
Clots can be quite long, as you’ve seen. Sometimes they form a complete cast of the affected vein.
I would expect that the risk of your sister’s clot breaking off is quite small by now. After a while, the clot becomes “organized” and completely adherent to the vein. Still, she needs the blood thinners (to prevent new clots if nothing else).
Will the vein die, requiring it to be removed or something? And yes, they did say she’ll need the blood thinners for around 6 months. I feel very sorry for her. She’s only 42 and having these problems already. Yikes!
My wifes mother has to take Rat Poison (or some more nicely named variant of it) as she is prone to blood clots.
My wife (he daughter, duh) will no longer take the pill as her Dr cautioned her not to as the estrogen can make her more likely to get one as her mother now has a history (or something like that).
I have no idea how “big” MILs clot was.
The conceptual problem with a clot this size is that you may be envisioning a hard, dry, pellet-like clot (like a scab). Internal clots don’t dry out, so they remain soft and gelatinous. A clot is composed of blood cells and some plasma trapped in a matrix of clotting proteins, so it’s very much like Jell-o.
Bernse: The “rat poison” IS coumadin. See Cecil’s column a few months ago about imported vanilla flavor. Sometimes the difference between poison and medicine is a thin line.
If the rats eat too much “blood thinner” tainted bait, their blood thins right out of their bodies and they die back in their sickbeds. It’s not instant, so you as Joe Consumer don’t have dead rats lying all over your home (where you can see them, anyway). This kind of rat poison is popular for its out-of-sight-out-of-mind feature.
Is it really based on rat poison (which I think is arsenic or something similar)? Kewel!
My wife also has DVT. Threw us for a loop. Very active healthy 40 year old. It was originally diagnosed as tendonitis so she did not get the proper treatment right away. The test they used to test for DVT (d-dimer) was wrong. The physical therapist she went to would not touch her until she had an ultra-sound. The ultra sound found the clot.
She is on coumadin and wears a knee high stocking. I know it’s a bummer for her but she has kept her chin up. All in all, no real life-style change other the medication and stocking.
I don’t believe the vein dies, but there are one way check valves in the vein that help the heart pump the blood back to the heart. Even if the vein is cleared out, there is a good chance that these valves will not function as well, or at all, making the vein much less effective. As I under stand it, other existing veins take over the duty of the clogged vein. I think that the ‘new’ veins become more robust.
As I said, while not fun, my wife is doing quite well. She has even run a marathon since this happened.
I just did a presentation at work on a genetic mutation called Factor V Leiden, which increases the risk of DVT for people that have it. (I work for a lab, and we do a lot of FacV tests) The American College of Medical Genetics recommends that anyone under the age of 50 with a DVT be tested for it. You may want to ask your doctor about it.
Allow me to throw in a little local Wisconsin color.
To paraphrase an old SNL commercial: Hold on kids, it’s a rat poison AND a blood thinner!
The connection between the two is called Warfarin. One might think the term is derived from warfare. In fact, it is derived from the Wisconsin Alumni Research Foundation, which funded the creation of the drug. This is the same organization that “owns” most of the stem cell lines currenly used in genetic research.
Carry on.
Ian Anderson of Jethro Tull fame has also dealt with this particular affliction (might be all the one-legged flute playing). You can read his experience with it here.
Wow! The Ian Anderson thing was great! Thank you all for all the information and personal stories. I’m a bit of a worrier when it comes to my little sister. I feel somewhat better now.
Thanks yojimboguy, though you beat me to it. I believe the guy that developed warfarin got money from WARF (they hold onto 80% of patent licensing revenues to cover costs associated with patenting and to fund further research). And how did WARF get started? It was started from revenues from a patent to add vitamin D to foods, such as milk.
I’m working in a student design group trying to get a patent through WARF, though I learned that stuff in my biochem class.
[/Wisconsin hijack]