My father-in-law was traveling and ended up in the emergency room. It seems he had developed a blood clot in his leg. Now he’s bedridden in the hospital until at least Sunday.
That’s all I know right now.
With that scant information as a backdrop, what can you tell me about blood clots? What kind of treatment will they be doing for him? What dangers does he face? How long will it take him to recover?
In short, blood thinners are given. Look up DVT on an internet site, as that is most likely to give you the most answers. (Deep vein/venous thrombosis).
Depending on his age and other risk factors, the doctors may want to have him tested for some genetic factors that increase the risk of DVT. There are some mutations that greatly increase the chance of getting inappropriate blood clots.
But, yeah, as has been said, the treatment is pretty much just blood thinners, like coumadin, that interfere with the formation of clots.
Blood carries oxygen from the lungs to the body. To minimize loss of blood in the case of a cut or accident, blood is designed to clot. Blood contains platelets that stick together (and to blood vessel walls) to help blood clot. For blood to clot at the proper speed (not too fast or slow), the liver also needs to be doing its job of making the many “coagulation factor” chemicals.
Blood clots can also be dangerous. They can block flow in a blood vessel, which might mean part of the body is not getting enough blood, and thus not enough oxygen. A heart attack can be caused by a clot, blocking part of the heart muscle from getting enough oxygen; an ischemic stroke might be caused by a blood clot in the brain.
In the ER, blood clots are often found in the calf or thigh. They may cause redness or swelling in one leg only. The clot can be in a vein close to the surface, as in “harmless but ugly” varicose veins. Or the clot may be a “deep venous” thrombosis (clot), DVT. This type of clot is more dangerous since blood travels from the veins back to the lung to get more oxygen. Thus, a deep venous clot has the potential to go to the lung and stop part of the lung from getting enough oxygen and working properly.
DVTs are usually diagnosed by looking at blood flow rates using ultrasound (Doppler). They can be treated with heparin or warfarin (medicines which make it harder for blood to clot, and which helps break down clots), aspirin (which interferes with the platelets) or, if the clot is in a dangerous place like the heart or lung or brain, a “thrombolytic” which breaks down clots quickly.
Risk factors for DVT include trauma, estrogen therapy, IV drug use, obesity, old age, family history, surgery, cancer, blood group A (!!), pregnancy (pregnant women bleed giving birth, and changes occur to minimize blood loss by decreasing clotting time), immobility (airplanes), surgery, infection and so forth.
Some blood clots are due to genetic reasons involving platelets, or coagulation factors (such as “Factor V Leiden”) or problems with proteins (protein C, protein S).
Superficial blood clots in the leg are no big deal (varicose veins). Deep clots are treated with six months or more of taking blood thinners.
So is there something specific about airplanes causing blood clots (pressure maybe, or is it just long flights when the passenger is sitting for 8 hours)? From time to time we hear about that in the news, but you don’t (that I know of) hear about people getting them in movie theaters or in their sleep.
Probably just the lack of movement on a 15 hour flight… no space to stretch in cattle class and risking the ire of the stewardess if you get up with the seat belt light on. People immobilized due to casts and injury also have increased chance of blood clots.
Flying at high altitudes also tends to dehydrate a person, which (correct me if I’m wrong) can be another risk factor. Yes, your passenger airline is pressurized, but not to sea level pressures, and the outside air being drawn into the airplane is extremely dry. Add in alcohol (which makes you shed water) and its one more risk factor.
So, on airplanes, move around as much as possible (ha! Yes, I know there’s no room!) and drink plenty of fluids.
**Dr. Paprika ** - type A blood is a risk factor? I had no idea… I’ve never heard that before… (I’m type A! :eek: )
I second Smeghead’s recommendation for FIL to be tested for genetic factors. I was hospitalized with a DVT about a month ago. I’ve got a blood clot in my left leg that goes from my upper thigh and extends into my mid-calf area. It’s been growing for over a year, and apparently it just recently reached critical mass and caused me problems. I was started on Coumadin, and had to take shots of Lovenox (a low molecular weight Heparin) in my abdomen 3 times a day for over 2 weeks until my clotting factors reached a therapeutic level.
Doctors could not find a reason for why this happened - I’m only 28, not on birth control, physically fit, and in good health otherwise. I didn’t fit any of the risk groups - not pregnant, hadn’t traveled, no recent surgeries. Finally, they ordered genetic testing. I have a G20210A Prothrombin gene mutation (similar to Factor V Leiden but not), which causes me to clot excessively. I will be on Coumadin for the rest of my life. On my doctor’s recommendation, several family members have also been tested - we now know I inherited the bum gene from my father, who has also gifted my sister with the same problem.
Getting the genetic testing is important for your FIL’s treatment, but it’s also important for your husband/wife (don’t know your gender). If FIL has a genetic disorder that causes clotting problems, any of his children (and siblings for that matter) have a 50% chance of having it as well. Being aware of potential health issues such as this is important.
True, true. And I admit, I’m biased, because I work in a lab where testing for Factor V Leiden and the Prothrombin mutations are our bread and butter. However, there are good reasons to not get tested as well. If you’re young and healthy, do you really want to know if you have one of these mutations when there’s not really anything you can do about it? Most doctors won’t start someone on coumadin based on the presence of the mutation alone - they’ll wait until another risk factor shows up. Some people may want to know, some may not.
The official recommendation from the American College of Medical Genetics is that people get tested for these mutations only if they have an unexplained blood clot at a young age (meaning they have no obvious risk factors that could have caused it) or if they know they have a family member with one of the mutations.
OTOH, I could always use the job security, so test away! 
(Kidding!)
Among the ones mentioned already… The good thing about testing like that is it tells you yes or no about that mutation; the bad thing about testing like that is it tells you yes or no about that mutation. Only. There are other factors (pardon the pun) involved in clotting, and if you narrow the testing too much, you may miss the real cause.
Vlad/Igor
My Wife has DVT. She’s 43.
She has run two marathons with the condition.
It’s serious. But can be controlled.
I really don’t mean to frighten you, but my Mom went into the hospital and for whatever reason they decided to test for this - they found cancer. And it was at a stage where it was really too late to save her.
Maybe you want to make sure they test your father for cancer.
When Doctors look at the blood flow rates via ultrasound do they still use pressure cuffs or am I thinking of some other vascular test? The reason I ask is that at the moment I have a very sore lower leg and I don’t think I could take the pain the cuffs would cause.
When they did a venous Doppler on me a few years ago, no cuffs were involved - they basically greased up my leg with a water-based gel and used a probe-shaped thingie, as they would do for a fetal ultrasound or something. Completely non-painful and non-invasive.
And yep, they found a honking big DVT right up near my left hip joint. I was 28 and basically healthy, but had several risk factors: 2 shattered leg bones, followed by extended immobility, followed by a cast up to my hip, followed by a 1200 mile flight home with no water because I knew there was no way in Hell I’d make it to the bathroom on the plane in my condition, followed by several hours of surgery and more immobility. Oh, and I was on birth control pills at the time.
Tell your dad to ask about dietary interactions with anticoagulants. My doc (the primary doc, who was a complete idiot who could have gotten me killed by missing the DVT doagnosis, not the surgeon, who was decent) neglected to tell me that diet can have a HUGE effect on the behavior and necessary dosage of anticoagulants, which can be a terribly difficult thing to regulate properly anyway. They were drawing blood every couple of days at the beginning, and my dosage of coumadin ranged anywhere from 1 mg/day to 1 mg/day. Lots of things can affect your blood’s ability to clot: level of activity and green vegetables ingested are among them. It was very weird to have my doctor tell me not to eat green vegetables because they could interfere with the coumadin.
Good luck to your dad, and you’re doing the right thing by reading up!
:eek:
Yeah, that might do it!
D’uh! I’ve been out of the clinical lab for a while, so I forgot to mention this. I used to think of it all of the time. Vitamin K is part of the biochemical process used to create clotting factors. Coumadin blocks the use of vitamin K, so it is important not to eat large amounts of vitamin K, or more than you normally ate while the doctor was setting your dosage. Broccoli is a significant source of vitamin K, IIRC, as are vitamin supplements.
Vlad/Igor