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circulatory

Avoiding DVT
DVT, Radius Magazine On long plane rides walk the aisles every half hour or forty-five minutes

There are few things I enjoy in medicine as much as breaking down the workings of the human body and disease states that plague it into a language a patient or family can use to make good decisions regarding their health. In medicine, knowledge is power.

One such disease is deep vein thrombosis (DVT). We have heard a lot more recently about this problem because of its occurrence in long distance air travelers. The concept is this: The arteries bring the blood to your feet from the heart. They do so at a very high pressure generated by the heart (a pump) and maintained by very elastic arterial walls. The blood then traverses millions and trillions of small capillary beds giving off life and tissue sustaining oxygen, and picking up the daily “garbage” of all life carbon dioxide. The blood then needs to return to the heart. It does so through veins. The key to understanding the whole system is that in crossing that capillary bed of small vessels from artery to vein, the energy generated by the heart is spent. So, in the venous system at your feet, the blood pressure is approximately 80 mm of mercury (a measure of pressure) but in the wrong direction! It is generated by gravitational pull.

So how does blood get back to your heart? It does so because of your calf muscle. Buried within your calf muscle are veins and venous “lakes” where blood collects. When your calf muscle contracts, as in walking or exercising, blood is pushed north like a tube of toothpaste. Veins unlike arteries have one-way valves directed up, so when the calf contracts blood moves up. When the calf relaxes, the column of blood is pushed down by gravity, but valves close and support this column of blood.

If you understand this concept, I can make numerous important medical conditions clear to you, however let us stick with DVT. When you sit in a plane, car, or a cast if you break your leg, the calf muscle pump sits idle and blood while continuing to move along slowly has a tendency to stagnate. When blood stagnates or moves too slowly it tends to clot. Thrombosis means clot. And because we are talking about the deep veins in the calf and thigh combined, we describe this as “deep vein thrombosis”.

With this comes the term that sends shivers down the spine of every unsuspecting patient, “blood clot”.

There are many types of blood clots; deep vein thrombosis is just one of them. But, it is one of the most feared. If formed and left untreated, this clot can break off, return to the heart, travel into the lungs and block vessels whose job it is to extract oxygen. When blocked, these vessels no longer function, essentially suffocating a person. This is called pulmonary embolism.

The take home message is this; Mother Nature did not mean us to sit on an airplane for hours at a time, neglecting proper calf pump function. I tell patients that on long plane, train, or automobile rides they should do a “mini fire drill” and walk the isles or get out of the vehicle every half hour to forty-five minutes. Also, drink plenty of fluids to keep blood from thickening like syrup. Consider wearing some venous support stockings (knee high), they augment calf muscle pump efficiency. Your pharmacist can point them out to you. And by all means, respect your legs, keep them healthy, and walk.

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"Avoiding DVT"
   authored by:
CIRCULATORY
Dr. Southworth graduated from Boston University Medical School, completed a general surgery residency at New Rochelle Medical Center in New Rochelle, New York, and followed with a vascular surgery fellowship at St. Anthony’s Medical Center in Columbu...



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