WASHINGTON, Sept. 15, 2008
Leg Blood Clots Are Silent Killers
Surgeon General Says At Least 100,000 Americans Die From Conditions Mistaken For Simple Leg Pain
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(CBS/IStockphoto)
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"It's a silent killer. It's hard to diagnose," said acting Surgeon General Dr. Steven Galson, who announced the new campaign Monday. "I don't think most people understand that this is a serious medical problem or what can be done to prevent it."
At issue are clots with cumbersome names: A deep vein thrombosis, or DVT, forms in large veins, usually a leg or the groin. It can quickly kill if it moves up to the lungs, where it goes by the name pulmonary embolism, or PE.
These clots make headlines every few years when seemingly healthy people collapse after long airplane flights or being in similarly cramped quarters. Vice President Cheney suffered one after a long trip last year. NBC correspondent David Bloom died of one in 2003 after spending days inside a tank while covering the invasion of Iraq.
But that provides a skewed vision of the problem. While there aren't good statistics, the new surgeon general's campaign estimates that every year, between 350,000 and 600,000 Americans get one of these clots - and at least 100,000 of them die.
There are a host of risk factors and triggers: Recent surgery or a broken bone; a fall or car crash; pregnancy or taking birth control pills or menopause hormones; being immobile for long periods. The risk rises with age, especially over 65, and among people who smoke or are obese.
And some people have genetic conditions that cause no other symptoms but increase their risk, making it vital to tell your doctor if a relative has ever suffered a blood clot.
People with those factors should have "a very low threshold" for calling a doctor or even going to the emergency room if they have symptoms of a clot, said Galson, who issued a "call to action" for better education of both consumers and doctors, plus more research.
Symptoms include swelling; pain, especially in the calf; or a warm spot or red or discolored skin on the leg; shortness of breath or pain when breathing deeply.
But here's the rub: Doctors are ill-informed, too. For example, studies suggest a third of patients who need protective blood thinners when they enter the hospital for major surgery don't get them. And patients can even be turned away despite telltale symptoms, like happened to Le Keisha Ruffin just weeks after the birth of her daughter, Caitlyn.
Ruffin made repeated visits to doctors and emergency rooms for growing pain in her leg and groin in December 2003 and January 2004, but was told it must be her healing Caesarean section scar.
Finally one night, Ruffin's husband ran her a really hot bath for pain relief - only to have her climb out minutes later with her leg swollen three to four times its normal size, and then pass out.
"I like to call that my miracle bath," Ruffin said, because the sudden swelling proved the tip-off for doctors.
Pieces of a giant clot in her right leg had broken off and floated to her lung. The ER doctor "said if I hadn't made it in when I did, I may not have lived through the rest of the night," recalled Ruffin, now 32, who spent a month in the hospital and required extensive physical therapy to walk normally again.
These clots "tend to fall through the cracks" because they cross so many areas of medicine, said Dr. Samuel Goldhaber, chairman of the Venous Disease Coalition and a cardiologist at Boston's Brigham & Women's Hospital.
With the surgeon general's campaign, "DVT after all these years will finally get the national spotlight like cigarette smoking did in the mid-60s," he said.
In addition to Galson's report:
For More Information On The Web:
By AP Medical Writer Lauran Neergard
© MMVIII The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.
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- I would like to say to most of these people that are writing all of this ***, I had arterial blood clots at the ripe age of 23! I am healthy, and active duty military. My problems wasn''t the fact that I didnt go to the doctor-my problem was that my doctors were IDIOTS! In one month I was sent away at least six times with purple feet that were freezing cold! I was told that I needed to "figure it out myself", amongst other stupid things. By the time I was seen by competent professionals, I could no longer walk and I had no pulses in ANY extremity. After six surgeries I am now deformed. People make fun of me walking down a sidewalk (which I cannot do well do to the drop foot I suffered because of the length of time they waited). My career is over and it was not my choosing! It makes me so *** mad that because of LAZY physicians I no longer can walk and as a women I now see myself as permenantly unattractive due to the hefty amount of scars i suffered. To these people above that say it is your fault, you won''t ever know what the other people are talking about until it is your legs that are missing!
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- So, let me get this right, every time you geta bruise, you should run to the ER, and wrack up a ew grand on tests, another boon to the medical society and the makers of blood thinners. I just read the one on the woman who had a stroke during *** over a blood clot.... geeesh.... we all have to answer to the call of when our # is up, and stop being freaked out. Longer life, yeah, nursing home having some one feed me and change my shorts because I was a health nut doesnt appeal to me at all. I will live as I want to, eat what I want, and kick off when I am supposed to. SO many chemicals in the body to keep ou going, doesnt mean your going to have any quality to your final yrs, just quantity, in some home.
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- I vol. at a hospice,I do realize when the day comes I will want to have one more breath. I just meant that you can switch to olive oil,not eat red meat,drink decaf,ect... and when it is your time it won''t matter a lick. I am glad you have gotten to see so many more sunrises. I am sure you treasure each day.
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- We will all die one day and it won''''t matter one bit if you are a runner,swimmer,dancer,computer geek,rich poor,tall short,fat or skinny...we ALL WILL DIE of something at sometime
Lovesamerica - I have heard people say this kind of *** before! when you grow up you will realize that longivity is everything. I got sick in 1998 and I would have givin 1 million dollars for 1 more day when I thought that was the end. before that happend to me I thought alot like you! - Reply to this comment
- adt14 You may not have a blood clot but you certainly lack some brain function....like compassion for your fellow man....I am a 70 year old grandmother, if you wanna take on the grandmother''s and grandfather''s of America, bring it on!
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- We will all die one day and it won''t matter one bit if you are a runner,swimmer,dancer,computer geek,rich poor,tall short,fat or skinny...we ALL WILL DIE of something at sometime
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- This just goes to show that you can drop dead at any time without any warning for just about any reason.
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- "Doctors should not simply rely on X-rays to determine the extent of tissue and vascular damage. With 100,000 people dying a year, you%u2019d think other diagnostic tools would be used in the cases where patients have suffered from major trauma." Always interesting when laymen are telling what doctors should do. DVT diagnosis is made by ultrasound. 10 or more years ago, it was made by venogram. PE diagnosis is made by CT angiogram of pulmonary arteries. In the past, it was a nuclear medicine ventilation-perfusion scan (which is still occasionally done when patient cannot get contrast due to e.g. renal failure or prior contrast reaction). Now that you are an expert on diagnosis of DVT and PE, one more thing - these tests are EXPENSIVE, so please enligthen us out which of the millions of patients should get these tests, and who is going to pay for all the preventive screening.
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- I can understand where you are coming from dmw1167. My boyfriends grandmother, who just turned 69-years-old, was taken to the same hospital I went to almost exactly a month after me due to servere swelling of her left leg. It was almost twice the size of her right leg. She did have blood clots in her leg, although this was due to lack of circulation. She had early onset rheumatoid arthritis in her knees and has a hard time walking. She''s doing better, but not home yet.
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- It was more than a month ago. It was the very last weekend of July...
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- You are very ignorant adt14... I was admitted to the hospital last month after severe pain in my chest and back and extreme trouble breathing. I had pulmonary embolisms, 2 blood clots in each lung. This was not from lack of anything. I not only have a family history of blood clots, but I was also on a medication that has a side effect of blood clots. I was immediately put on Heparin, then put on Lovenox and Coumadin. Thankfully, the hospital I went to specializes in chest pain, so they caught it within 2 hours and had me admitted and started going to work right away. Here I am about a month and a half later, still taking Coumadin, but feeling 110% better.
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- My girlfriend died of a pulmonary embolism eight weeks after suffering a serious wound and break in her ankle. After each of her two surgeries, she was given Heparin to reduce the chance of a blood clot, but was not prescribed any follow-up blood thinners although she was essentially bed-ridden and limited to a wheel chair. Even after the site of the wound became numb, she was not given a DVT-scan that might have detected a problem. She was told the numbness would probably go away on its own. The day after her last office visit, when her doctor told her she was healing nicely, she died. Doctors should not simply rely on X-rays to determine the extent of tissue and vascular damage. With 100,000 people dying a year, you%u2019d think other diagnostic tools would be used in the cases where patients have suffered from major trauma.
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- The body was meant to be active, not sedentary. Failure to move, to exercise, is a fatal mistake.
This AP article does not address common risks of DVT, which include any long period of sitting down, such as airplane flights, extended periods of desk work, or an especially uncomfortable, circulation-pinching chair.
Soy products have been found to help with clot prevention, along with fish oil. No need for an ER to prescribe an anti-clotting agent like streptokinase, when diet can make a clot less likely in the first place. - Reply to this comment
- You don''t have to be lazy to get a blood clot. My son-in-law bumped his leg while helping a friend move some furniture upstairs.
At 5:00 the next morning, he was dead on the bathroom floor of a pulmonary embolism. - Reply to this comment
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