Deep vein thrombosis is the formation of a blood clot in one of the large veins of the body, usually in the calf and thigh, and less often in the arm or pelvis. The clots form when circulation to a particular part of the body is abnormally sluggish or when damage has been done to a blood vessel.

The danger occurs if the clot breaks free and travels through the veins where it can reach the lungs, obstructing the pulmonary artery or its branches, which supply the lungs with blood. A pulmonary embolism can cause sudden death. Therefore if you suspect you are at risk for DVT it is important to seek treatment immediately.

DVT ARTICLE INDEX:

My Personal DVT Story

In May of 2007 I began waking up in the morning with mild aching in my left leg, which I didn't pay much attention to because as soon as I got up and started moving about, it would go away.  Shortly thereafter I started waking once or twice during the night with aching in this same leg, but again it went away after moving around, so I chalked it up to old age setting in, and ignored it!  But when my ankle became swollen I decided it was time to see the doctor.  He didn't seem overly concerned, but decided to do a doppler scan just to make sure it wasn't a blood clot.  It turned out it was a DVT, and further scans showed that I also had an old DVT in my right leg, and a superficial clot in my left arm. 

Two years later I still don't know the cause of the clots.  I have been to dozens of specialists, I even went to the Mayo Clinic.  Essentially medical science still does not understand why some people form clots, and some like me form can form them even when on blood thinners.  Fortunately if I keep my blood thin enough (3-3.5) I have little or no symtpoms.  But it is frustrating to know that unless I figure this out one day, I will be on thinners for the rest of my life.

I have been doing a lot of personal research and experimentation and am currently exploring the theory that blood clots, at least in a situation like mine, may be caused by an underlying inflammatory condition in the body.  I am trying various herbs and homeopathics to see if this helps in reducing my inflammation levels, and therefore ease symptoms and clotting.  I will keep you posted.

I would also like to point out that I am very lucky - I walked around for weeks with a DVT, not everyone is so lucky.  If you suspect you may have a blood clot, or your gut instincts tell you something isn't right - get to the doctor or hospital.  Blood clots are dangerous, and it is vitally important they are diagnosed and treated promptly.

If you have any questions or comments, please email them to:  andrea@HealWithHope.com.

RISK FACTORS FOR DVT:

• pregnancy
• obesity
• recent surgery
• chemotherapy treatment
• estrogen use
• prolonged immobilization
• birth control pills
• having cancer
• genetics 

SYMPTOMS OF DVT:

• swelling of the affected leg or arm
• the area may also feel warm and look redder
• it may ache or feel tender
• although occasionally there are no symptoms at all, particularly with smaller clots

If your doctor suspects you have DVT you will probably have an ultrasound test done to measure the blood flow through your veins. If the results are still unclear the doctor will usually do an MRI or CT scan.

TREATMENT FOR DVT:
 

It is vitally important to begin immediate treatment.

Treatment involves taking blood thinners (anticoagulants) like Heparin and Warfarin (Coumadin is the brand name). Heparin is given by injection or IV and begins working immediately, and is usually discontinued when the Warfarin/Coumadin (a pill) has kicked in. Based on the cause and severity of the problem, treatment with blood thinners is usually for a period of at least 3 - 6 months to prevent existing clots from growing and preventing the formation of new clots., though people with chronic conditions or heart disease may need to be on blood thinners for life.

About Warfarin/Coumadin:

What warfarin does and how it works:

Your doctor has prescribed an anticoagulant medication. "Anti" means against and "coagulant" means causing blood clotting. Warfarin is a type of anticoagulant medication that helps prevent clots from forming in the blood.

You have been prescribed warfarin because your body may be making blood clots or you may have a medical condition known to promote unwanted blood clots. Blood clots can move to other parts of your body and cause serious medical problems. Warfarin will not dissolve a blood clot; however, over time the blood clot may dissolve on its own. Warfarin may also prevent other clots from forming or prevent clots from becoming larger.

Blood testing/INR Levels:

In order for your health care provider to determine the correct dose of warfarin, it will be necessary for you to have blood tests. The tests are performed in a laboratory or anticoagulation clinic, usually once a week to once a month, as directed by your doctor.

The prothrombin time (PT or protime) test is used to calculate your International Normalized Ratio (INR). Your INR will help your health care provider determine how fast your blood is clotting and whether your medication dose needs to be changed.

Illness, diet, medication changes, and physical activities may affect your INR. Tell your health care provider about changes in your health, medications (prescription and over-the-counter) or lifestyle so appropriate dosage adjustments can be made in your warfarin therapy.

In order to ensure you are taking the correct dose of Coumadin/Warfarin your blood clotting factor will need to be check regularly. The goal is to have the level between 2 and 3 - if it is too high (above 3) you are at an increased risk for bleeding, or too low (below 2) and you risk clotting.

How to take your Warfarin:

Take your warfarin dose as instructed once a day. Try to take it at the same time every day. Some physicians recommend taking your warfarin early in the evening (such as between 5:00 and 6:00 p.m.). Warfarin can be taken with or without food.

Do Not Take a Double Dose to make up for a missed dose. Also, never change your dose without first discussing the change with your doctor.

Storage conditions:
As with any medication, store your warfarin at room temperature, away from extreme cold, heat, light, or moisture. Bathroom cabinets are usually NOT suitable for storing medications because of dampness. All medications, including warfarin, should always be kept out of the reach of children and pets.

Precautions when taking Warfarin:
It is important that you follow these precautions when taking warfarin to reduce the risk of side effects and improve the effectiveness of your medication.

Medications and dietary supplements:
Many medications and dietary supplements can affect the way Warfarin works. These may include:

• Prescription medications
• Nonprescription medications such as aspirin, acetaminophen (Tylenol) nonsteroidal anti-inflammatory drugs or NSAIDs (some examples are ibuprofen, naproxen or ketoprofen), cough or cold remedies, and medications for pain or discomfort
• Herbal products, natural remedies, or nutritional supplements
• Products containing vitamin K  (see Dietary Precautions below)

Before taking any new medication, including over-the-counter medication or medication prescribed by another doctor or dentist, check with the doctor who monitors your warfarin medication. Your warfarin doctor may need to adjust your warfarin dosage or may recommend another medication less likely to interfere with warfarin.

(Thanks to the Cleveland Clinic for the information about Warfarin/Coumadin)

DIETARY PRECAUTIONS WHEN ON BLOOD THINNERS:
 

If diagnosed with DVT and you are put on Warfarin (Coumadin) and or other blood thinners, you will also be cautioned to watch your diet – it is important to try to eat a consistent amount of foods that contain Vitamin K each day. Vitamin K helps the blood to clot and can counter the effects of your medication. Vitamin K is prevalent in green leafy vegetables like broccoli, kale, spinach, brussel sprouts, lettuce, etc. Certain oils and dressings are high in vitamin K as well so watch your intake of canola and soybean oils, and don’t have more that 7 tablespoons per day. Discuss any and all herbal products that you take with your doctor as they can also impact the effectiveness of your medication.

REDUCE YOUR RISK OF DEVELOPING A DVT:

• talk to your doctor about taking anticoagulants after surgery
• exercise to improve circulation, especially when you are sitting for long periods of time – especially during long airplane flights. (try this exercise: point your toes up toward your head so that the calves of your legs are stretched, then relax)
• get out of bed as soon/as often as possible when you are ill or recovering from surgery
• talk to your doctor about compression stockings as they can help to prevent DVT if you are at risk
• Garlic has been indicated as helpful in reducing platelet aggregation and thrombosis (formation of plaque in the body) and having and anit-clogging affect on the body according to www.healthcastle.com, so you may want to discuss using garlic supplements or adding garlic to your diet on a daily basis ( the American Dietetic Association recommends 600-900 mg. or 1 fresh clove per day for general health). Garlic supplementation is not recommended if you are using apsirin or taking other blood thinners.

 GENERAL PRECAUTIONS TO TAKE WHEN ON BLOOD THINNERS:
 

It is important that you follow these precautions when taking warfarin to reduce the risk of side effects and improve the effectiveness of your medication.

Medications and dietary supplements:

Many medications and dietary supplements can affect the way warfarin works. These may include:

• Nonprescription medications such as aspirin, acetaminophen (Tylenol) nonsteroidal anti-inflammatory drugs or NSAIDs (some examples are ibuprofen, naproxen or ketoprofen), cough or cold remedies, and medications for pain or discomfort
• Herbal products, natural remedies, or nutritional supplements
• Products containing vitamin K 

Before taking any new medication, including over-the-counter medication or medication prescribed by another doctor or dentist, check with the doctor who monitors your warfarin medication. Your warfarin doctor may need to adjust your warfarin dosage or may recommend another medication less likely to interfere with warfarin.

Diet:

• Eat a sensible, well-balanced diet.
• Talk with your doctor if you are planning any major dietary changes such as following a weight-reducing diet or adding nutritional supplements.
• Large amounts of food high in vitamin K may change the way warfarin works. Try to keep the amount of these foods in your diet about the same from week to week.
• It is best to avoid alcohol while taking warfarin. Alcohol interferes with the effectiveness of warfarin.

Activities:

• Check with your doctor before starting any exercise or sports program. Your doctor may want you to avoid any activity or sport that may result in a serious fall or other injury.
• Use a soft toothbrush. Brush and floss gently to prevent bleeding from the gums.
• Be careful when using razors

Illness and emergencies:

• If you cut yourself and the cut is small, apply constant pressure over the cut until the bleeding stops. (This may take up to 10 minutes.) If the bleeding doesn't stop, continue to apply pressure and go to the nearest emergency room.
• If you cut yourself and the cut is large, apply constant pressure and get help immediately either by phone or by going to the nearest emergency room.
• Call your doctor if you have any symptoms of illness such as vomiting, diarrhea, infection or fever. Illness can change the way warfarin works.
• It is recommended that you wear or carry identification that states you are taking Warfarin.
• Avoid situations at home or at work where you may get injured. 

Pregnancy:

If you are a woman who is taking warfarin and are planning to become pregnant, talk with your doctor about the possible risks and ways to reduce those risks. Tell your doctor right away if you become pregnant or think you might be pregnant.

Surgery and dental work:
Before any treatment is provided, tell all your doctors and dentists that you are taking warfarin. Before having a surgical or dental procedure, you may need to have a blood test, and you may need to stop taking warfarin for a few days. Do not stop warfarin without conferring with the doctor who monitors your INR.

Travel:
Check with your doctor before you travel. Before you go on vacation, you may need to have a blood test and your warfarin dose may need to be adjusted. While traveling, carry your medications with you at all times. Do not put medications in checked baggage, and do not leave your medications in the car.

Taking Supplements/Other Medications:
Do not start taking the following unless specifically approved by your physician:

• Any vitamin supplement that provides more than 100 percent of the Recommended Daily Intake (RDI) for vitamins A, E, and C
• Fish oil supplements
• Garlic oil supplements
• Ginger supplements
• Onion extract pills

 Do NOT stop or start taking any medications, herbal products, natural remedies, or nutritional supplements without first talking to the doctor who monitors your warfarin medication.

Some medications may increase or decrease the anticoagulant effect of Warfarin and therefore, may increase your risk for side effects. If you take any of the medications listed, your Warfarin dosage may need to be adjusted.

You may need to get blood tests more often when you stop, start, or increase the dose of medications that are likely to affect the way warfarin works. Talk to your doctor about any changes in your medications.

WHEN TO CALL YOUR DOCTOR:

Call your doctor if you notice any of the following signs of bleeding or illness that can affect the way your Warfarin works:

• Feeling more weak or tired than usual or looking pale (symptoms of anemia)
• Bleeding from cuts that won't stop after applying pressure for 10 minutes
• Coughing or vomiting blood (which may look like coffee grounds)
• Bleeding from the nose, gums, or ears
• Unusual color of the urine or stool (including dark brown urine, or red or black, tarry stools)
• Unusual bruising (black-and-blue marks on your skin) for unknown reasons
• Menstrual bleeding that is heavier or lasts longer than normal
• A fever or illness that gets worse
• A serious fall or a blow to the head
• Unusual pain or swelling
• Unusual headache
• Dizziness
• Difficulty breathing

If you notice any of these symptoms, your doctor may want to do a blood test, stop the warfarin, or prescribe medication to stop the bleeding.

ALTERNATIVE BLOOD THINNERS: 

There are other alternative products that show some potential for treating/preventing clotting disorders like DVT, but they are unproven and therefore not currently recommended substitutes for conventional medicines. If you are predisposed to clotting and are searching for alternative treatments to prevent the onset of a problem, I would strongly suggest you discuss any type of alternative treatment as clotting is a serious and potentially life-threatening problem that requires treatment by a qualified health professional.

Ginkgo biloba, which is believed to improve blood flow to the brain by thinning the blood, also reducing inflammation and act as an antioxidant to fight cell damage. "Because of this, ginkgo has been used in the treatment of a variety of conditions including blood flow disorders like thrombosis and Raynaud's phenomenon, and in the treatment of problems associated with memory and concentration, likely caused by decreased blood flow to the brain," says Nicole Nisly, MD, UI Hospitals and Clinics Complementary and Alternative Medicine Clinic. Ginkgo also has been useful in treating asthma and allergies causing inflammation in the respiratory system.

If you are interested in taking ginkgo, be sure to check with your doctor. "Because of its ability to thin the blood, people who are already taking medications to thin the blood, such as aspirin or warfarin, should not take ginkgo without recommendation from their physician," Nisly says.

Nattokinase is an enzyme isolated from the vegetable cheese, Natto – a typical and popular soybean food in the Japanese diet. It has been found to have blood clot dissolving abilities and preventing the aggregation of red blood cells. But no clinical trials have been to done on humans to determine its effectiveness and or potential side effects, so speak with your physician before taking this product.Nattokinase is an enzyme isolated from the vegetable cheese, Natto – a typical and popular soybean food in the Japanese diet. It has been found to have blood clot dissolving abilities and preventing the aggregation of red blood cells. But no clinical trials have been to done on humans to determine its effectiveness and or potential side effects, so speak with your physician before taking this product.

According to a doctor I spoke with at the Mayo Clinic, they are currently working on a drug that will have the same benefits as Warfarin/Coumadin, without the same dietary complications.  They are also conducting research to see if natural supplements and foods can benefit those in hypercoatulative states, such as mangosteen (a fruit) and green tea.

SOURCES OF INFORMATION: 

http://www.clevelandclinic.org/health/health-info/docs/0800/0835.asp?index=4713
http://www.webmd.com/heart-disease/tc/Deep-Vein-Thrombosis-Topic-Overview
http://familydoctor.org/online/famdocen/home/common/blood/244.html
http://www.raysahelian.com/nattokinase.html
http://www.drweil.com/drw/u/QA/QA33112/
http://www.uihealthcare.com/
http://www.mayoclinic.com/health/thrombophlebitis/DS00223/DSECTION=1

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Questions?  Comments?  Email me:  Andrea@HealWithHope.com