When we think of people people suffering from blood clots, we don’t tend to think of women in their 20s and 30s of childbearing age, or young people who are traveling abroad on their honeymoon, but unfortunately women and men of all ages are at risk for developing blood clots due to the condition deep vein thrombosis. According to renowned internist and NYU professor, Dr. Steven Lamm, deep vein thrombosis “affects 500,000 to a million individuals”, and that “90 to 100,000 people die a year of this condition.”
What can we do to prevent deep vein thrombosis? Dr. Steven Lamm was kind enough to join me for an interview this week to discuss deep vein thrombosis, prevention tips, common symptoms, risk factors and treatment options.
Candace Rose: What is deep vein thrombosis?
Dr. Steven Lamm: “Deep vein thrombosis is a condition that affects 500,000 to a million individuals. It’s a clot that primarily occurs in the veins, and primarily veins in the lower extremity, thigh, pelvic area…but it can occur anywhere.
These clots can grow, can injure the veins, can dislodge and travel up into the heart and lungs causing a pulmonary embolism. A pulmonary embolism is a clot in the pulmonary artery that injures the lung, prevents you from breathing and unfortunately causes death. 90 to 100,000 people die a year of this condition. I think the issue is a lot of people are completely unaware of it and I think the issue is can we reduce the likelihood of these things happening?
Programs such as yourself basically promoting the idea that these are common, these are preventable (although not 100% preventable) and who is at real risk. There are people who are genetically at risk, there are people who are at risk because of their obesity, because of their smoking, because of trauma, because of their lifestyle – that is they’re not moving around. If you’re not moving around the blood has a tendency to clot, and that clot then propagates and can travel to your heart and your lung.
The issue is what can you do about it? Well, if you’re sedentary, become less sedentary. That is if you’re sitting at your desk, periodically get up and walk around. I think it’s very important – you can start wearing compression stockings. Compression stockings are much more fashionable, so there’s no reason or excuse not to wear them. They improve the circulation and will improve the return of blood to your heart.
If you have a history of deep vein thrombosis, if you have a history of hypercoagulability, if you’re going to be flying and traveling for protracted hours and you’ve already had problems, it makes a lot of sense to me. Maybe a little aspirin on the days that you’re really traveling could be really useful.
The other thing is just being aware. If you get pain and swelling and redness in an extremity, go to your doctor because there’s easy ways of diagnosing it, easy ways of treating it, and you can avoid the disaster which of course is a pulmonary embolism.”
Candace Rose: Are there any other symptoms that people should watch out for?
Dr. Steven Lamm: “Well, basically the pain and swelling is one thing. Edema is, I think a really powerful symptom – maybe just a dragging feeling, a heaviness in your legs. I think from the pulmonary side, it can be as subtle as a cough. It be can be from shortness of breath and oftentimes in private practice you don’t think of pulmonary embolism. You think of a younger person coming in with a little bit of shortness of breath and a little cough and you think it’s a recent virus and you really haven’t paid attention to the fact that they’re taking birth control pills, they’re in a car for several hours every day, or they’ve recently taken Transatlantic or Transcoastal flight, and you just don’t think of that. You think of it in a hospital setting, but you might not think about it in an outpatient setting – so awareness for patients and for physicians.”
Candace Rose: I heard that deep vein thrombosis is really common among people that have just had surgery. Is there anything that people can do if they are bed-bound?
Dr. Steven Lamm: “If you’re in a hospital you’re definitely going to have compression stockings. Depending on the nature of your surgical procedure and the amount of time that you’re going to be in a sedentary state, you may be put on an anticoagulant. And then they’re going to try and mobilize you as quickly as they can. They don’t want you to be in bed very long. They realize it’s a dangerous place for patients.”
Candace Rose: Is there anything else that people can do to prevent deep vein thrombosis?
Dr. Steven Lamm: “I think that once again, not smoking, losing a small percentage of their body weight if they’re overweight (only about 65% of people are overweight), and basically mobilizing early. Being aware that you shouldn’t be sitting in a chair for hours and hours at a time. You need to really move around. Nobody knows how much you need to move around and walk around, but I think that it’s activity more than being sedentary.”
Candace Rose: Are there any other treatment options for deep vein thrombosis?
Dr. Steven Lamm: “I think that once the diagnosis is made, then you’re going to get the full-court press, where you’re going to be put on an anticoagulant, you’re going to have the prescription compression stockings, you’re going to have a program where your clots are being monitored by a ultrasound to make sure that you’re okay, and maybe to also investigate why there’s some underlying reason other than a sedentary lifestyle. For example, maybe you have an underlying malignancy such as a prostate cancer or a breast cancer or a pancreatic disease that increases your likelihood of clots.”
Candace Rose: Do you have any additional tips or information you’d like to share with us?
Dr. Steven Lamm: “I think because it’s a common condition there are plenty of really healthy and helpful websites from the NIH; NYU where I’m a professor, has a thromboembolic center. There are a lot of great places where your listeners and your readers can learn about DVT, thromboembolic phenomenon, and pulmonary embolism.”
Candace Rose: Where can we go for more information on everything you mentioned?