It's no secret that AIDS and breast cancer take thousands of American lives each year, says Dr. Martin Evans, medical director of service quality for CJW Medical Center's Chippenham and Johnston-Willis hospitals.
But what's not broadly known, he says, is that complications from deep-vein thrombosis (DVT), a blood clot that forms in the lower limbs, are far more fatal.
"It's a very big deal," Evans says, adding that he sees DVT cases almost daily.
About 2 million people each year are affected by DVT, and the condition kills 300,000 yearly, Evans says. (In contrast, about 18,000 in the United States die of AIDS, and about 40,000 die of breast cancer.)
The first indication of DVT is usually leg pain and swelling or tenderness at the point of the clot, which could be dismissed as normal body aches.
But writing off leg cramps is what cost NBC reporter David Bloom his life in 2003. Bloom, a healthy 39-year-old who was on assignment with U.S. troops in Iraq, found himself riding and sleeping in a military tank day after day. His wife, New York resident Melanie Bloom, says he casually mentioned to her during a phone conversation that he had begun to experience pain in his legs. Two days later, he collapsed and died.
"I had never heard of [DVT], and now I know and wish I had known because I think David would be with us and alive and well," Bloom says. Her husband developed a sizable blood clot in his leg as a result of the cramped conditions. Because it was not treated, it dislodged from his vein wall and traveled to his lung — a complication that's called a pulmonary embolism.
"They call it the silent killer because when it moves to the lung, you don't know," she says, explaining that when it left his leg, his pain was gone.
Determined to spread awareness, in 2004 Bloom became the spokesperson for a national organization called the Coalition to Prevent DVT.
Richmond cardiologist Dr. Sohail Chaudhry says that immobility is the greatest risk factor for people of any age developing DVT. "Someone who is healthy and just flies to Europe is in a much more risky state," Evans says.
Another risk factor is pregnancy, which increases the risk of DVT fivefold, Evans says. Also, women on birth control or hormone therapies are at a higher risk because these medications alter the body's blood-clotting mechanisms, Bloom says. She adds that people who are overweight, older than 40 or have a history of clotting are also at risk. In addition, those who have just undergone surgery, particularly hip or knee operations, are at a much higher risk because their movement is limited, Chaudhry says.
Justin Vaughan, associate art director at Richmond magazine, developed DVT after an appendectomy in 2007. He began to experience a tightening in his chest and difficulty breathing. An ultrasound revealed a clot in his left thigh. "It was from the clotting agents given to me during the surgery," he says. Vaughan, now 31, stayed in the hospital for four days and received blood-thinning medications that included injections to eliminate the clot.
When necessary, more powerful drugs are prescribed to dissolve clots that have already formed, Evans says. In extremely serious situations, the patient's chest has to be opened or a filter is inserted to break up the clot. At times, doctors will prescribe compression stockings, which squeeze a patient's legs and help increase blood flow.
Evans and Chaudhry emphasize that prevention is important. Chaudhry says that there is "no clear time cutoff" for how long a person can safely be immobile, but risks increase with length of time. "What you do when you are ambulating [is that] your muscle works as a pump to help squeeze veins, which helps to increase the blood flow in those veins and get blood back to the heart," he says.
Before travel, Bloom says, patients should evaluate their risk factors, and if they have three or more, they should seek a doctor's advice. A free online test for evaluating your risk factors, she adds, can be found at preventdvt.org.
"I hope … other people will not have to learn the hard way, like I did," Bloom says. "DVT can be prevented."
- When traveling, stop every hour or two and walk around.
- If flying, stand up periodically and move.
- Stay hydrated and eat regularly.
- When sitting, pump your feet as if you were pressing on a gas pedal. Shift your weight from time to time.