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Lee Kirksey, MD  
Male
Cleveland , OH

Specialties: Peripheral Arterial Disease, PAD

Interests: vascular, specialist, treatment options
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DVT Awareness Month

Mar 07, 2009 - 14 comments
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dvt

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blood clot

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leg pain

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SHORTNESS OF BREATH

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pe

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embolu

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Pulmonary

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Heart Attack

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Stroke

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Lung

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Blood

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clots

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risk factor

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March is DVT (Deep Venous Thromboses) awareness month. A time to educate and inform the public about the risk factors, prevention, identification and treatment of this preventable and potentially fatal process. DVT, simply put, is a blood clot that develops in a deep vein of the body. The most harmful consequence of the development of DVT is that pieces of the clot can break off and migrate to the heart or lungs causing acute difficulty breathing and overwhelming stress on the heart. The following lists some of the commonly asked questions

What is Deep Vein Thrombosis (DVT)?

Deep vein thrombosis, commonly referred to as "DVT", occurs when a blood clot, or thrombus, develops in the large veins of the legs or pelvic area. Some DVT’s may cause no pain, whereas others can be quite painful. With prompt diagnosis and treatment, the majority of DVT’s are not life threatening. However, a blood clot that forms in the invisible "deep veins" can be an immediate threat to your life, as compared to a clot that forms in the visible "superficial" veins, the ones beneath your skin. A clot that forms in the large, deep veins is more likely to break free and travel through the vein. It is then called an embolus. When an embolus travels from the legs or pelvic areas and lodges in a lung artery, the condition is known as a "pulmonary embolism," or PE, a potentially fatal condition if not immediately diagnosed and treated.

What are the causes of DVT?
Generally, a DVT is caused by a combination of two or three underlying conditions:

slow or sluggish blood flow through a deep vein
a tendency for a person’s blood to clot quickly
irritation or inflammation of the inner lining of the vein.
There are a variety of settings in which this clotting process can occur. First, individuals on bed rest (such as during or after a surgical procedure or medical illness, such as heart attack or stroke), or confined and unable to walk (such as during prolonged air or car travel) are common settings. It can occur in certain families in whom there is a history of parents or siblings who have suffered from prior blood clots. It can also occur in individuals whom active cancer or its treatment may predispose the blood to clotting.

Having a recent major surgical procedure, especially a hip and knee orthopedic surgeries or those requiring prolonged bed rest, predispose the blood to clotting. Irritation or inflammation occurs when a leg vein is injured by a major accident or medical procedure.

Also, there are specific medical conditions that may increase your risk of developing a DVT via these three mechanisms, such as congestive heart failure, severe obesity, chronic respiratory failure, a history of smoking, varicose veins, pregnancy and estrogen treatment. If you are concerned that you may be at risk due to any of these conditions, please consult with your physician.


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by Juana824, Mar 09, 2009
Thanks for the info. I was diagnosed with a DVT a few years ago and have been controlling it with Lovenox injections.

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by djc0619, Mar 10, 2009
I just recently started having a deep pain inside my left calf. There is no obvious signs of trauma meaning there is nothing visual that would suggest that something is wrong. I have not over exercised it in fact I do not exercise other than to walk around. The only change in my behavior would be that approx. 3 weeks ago I was layed off from my job so I have not been as mobile as I was prior to that. The only other thing that comes to mind is that towards the middle of last week I used some exfoliating scrub on my feet and later that evening my feet felt really itchy. I attributed the itching to the scrub and not to anything else. I always have really hot legs in the evening and have even tried medication for RLS but this does not feel anything like that this is a constant ache that is not going away. Since I have just been layed off from my job I do not have health insurance and am very concerned with all of the information I have found suggesting that this may be DVT. As an added side note after reading the information listed above I had 2 teeth pulled about 5 days ago and was not overly active for a couple days. I still have some pain in my mouth but for the most part I believe that this is getting better.

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by Dezdon, Mar 10, 2009
I had DVT two years ago. I was a 47 year old male. I am disabled and had just had surgery on my feet and was on bed rest most of the day. I started to notice my legs got extremely tired from walking up the basement stairs. I noticed each time I used the stairs, it got harder and harder to climb them. It got to the point I would have to stop and actualy rest half way up. My legs were extremely tired and burned inside. I also became constipated and noticed I was getting spontaneouse semi erections, for no "fun" reason. They would just happen.
  I then developed sharp pains in my adomen. They got worse and worse as the day went on. I finaly went to the ER. They did a CT scan and knew I had some kinda blockage. I had survived bacterial meningitis and sepsis six years prior and during my coma, they had put in an umbrella to stop clots from traveling up into my heart,lungs and brain.The ER suspected the filter was still in and was clogged.
  I was rushed to the major hosptal in Portland Maine by ambulance and was imediatly placed in the cath lab and had live ex rays done and it turned out I had a blockage in both legs at the groin area. I was put on a 'TPA" treatment to blast out the blockages. They were able to clear one block with the TPA, the other side, I had to have a stint installed.
  I recovered but am now on a medicine called comidine (a blood thinner) for life. I bleed alot when i get a cut and wear a med-alert bracelet to warn of the meds and and the stint. I have to have my blood tested frequently, at least monthy. If i change any meds, they have to restart the comiden therpy and adjust the levels until I am consistant again with my blood test hold a certain level.
  My poditrist knew I was on bed rest and never warned me of this posibility. It may have not been prevented from ever happening as I am on alot of bed rest due to my disability, but the major event that day could have been prevented if I was given the medicine in advance or the shots in the belly.

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by kristine9190, Mar 11, 2009
I had a DVT a year ago, I suddenly began experiencing pain in my calf, almost like an intense muscle pull, but knew that I had not done anything to injure or pull a muscle. I went to my Dr. and was sent for an Ultrasound on my leg, which came back negative, but the pain continued. One place that it really bothered me was the arch of my foot, along with my calf. I was sent to a Podiatrist and give arch supports, but the pain continued to get worse, and began migrating to other places in my leg. There was a bit of swelling and discoloration, but nothing alarming, I noticed it, but trusted that the Ultrasound was negative. This started before Christmas in December of 07, after months of dealing with this pain, I finally got frustrated enough to head to the ER and get this taken care of, thinking they would get to the bottom of it, give me something for the pain, and I would be on my way, that was on Feb. 26, 2008. I was given a test called a D-dimer, which is a blood test to see if there was clotting going on in my blood, that came back not so good, I was then sent for another Ultrasound, which now found a very significant clot in my, that ran from hip to knee, it was large! Though I didn't have any major symptoms of a Pulmonary Embolism, they sent me for a CT scan and that also showed 3 clots in my lungs. I was instantly admitted and began treatments of blood thinners.

Once we got to the bottom of what caused this, after genetic testing, I was found to have Factor V Leiden, I am a Heterozygote, which means I have a slightly higher chance of clotting that most. I guess I am lucky for that, as Homeozygotes have a much greater chance for clotting and require blood thinners indefinitely. I was treated with Lovenox Shots in my Stomach for 10 days, Coumadin for 6 months, I am not able to take Birth Control, or Smoke. These are all things I can live with, as this was the scariest situation. I was told numerous times that I am lucky that I went to the ER that day, as that week would not have ended well for me otherwise.

As for djc0619, please please please get to the Dr, if this is a DVT, which is what it sounds like to me, get it treated now, before it turns into a PE.

Best Wishes to you all!
Kristine








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by uk2, Mar 13, 2009
My friends husband has had his leg in plaster for 6 weeks due to a snapped tendon in his calf, he is on his second DVT in 6 weeks and having injections the DVT is behind the knee same place each time. He does not smoke and is normaly active why does this keep happenig? and is it dangerous? he is having daily injections up at the hospital.

sam

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by DIANAJS, Mar 13, 2009
I HAVE DVTS IN MY LEGS AND A PULMINARY EMBOLISM.  I AM ON COUMIDINE.  WHAT IS HAPPENING NOW IS I HAVE A RASH, ITCHING ALL OVER MY BODY.  WHAT IS HAPPING TO ME?  PLEASE TELL ME IF YOU HAVE HAD THIS.  I HAVE BEEN ON COUMIDINE SINCE SEPT.  THE RASH AND ITCHING JUST STARTED A WEEK AGO IN MARCH.  I CAN NOT EVAN STAND TO PUT ON MY COMPRESSION STOCKINGS.  PLEASE  HELP ME I CAN NOT STOP ITCHING.    DIANA

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by thebandteacher, Mar 16, 2009
I am really scared.  I woke up two days ago with a dull achy pain in my left leg.  It is tender to the touch, located on my inner thigh.  By this point, two days later, it is now no longer just my inner upper thigh, it now radiates to my lower calf.  All of the pain is on the inner part of my leg, not the front, back, or outside.  It hurts when I walk and extend my leg fully back, and it gives me twitches/twinges of pain at night.  I have MS, and a history of cancer.  What the heck is going on?   I am planning on going to my doctor tomorrow, although I had an endoscopy today and told the nurse about it.  She poked at the area and said that it didn't feel hot or show a reddish streak down my leg, so I should be okay.  I did injure my right leg, and have been walking/limping a bit to nurse that injury.  Is there a connection?  (please say, "Of course there is!").  Thanks.  

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by imgwtw, Mar 22, 2009
I had a family member (age 42) die from DVT just two weeks ago. Please, people, if you suspect DVT, get to a doctor NOW! My family member had no symptoms (at least that he mentioned)...just didn't wake up one morning. Blessings to you all!

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by mynewlife, Apr 22, 2009
I am currently in the hospital with 2 DVT's in my right calf.  I had a numb foot for 4 weeks, just woke up one morning and my foot was numb, no symptoms of DVT.  I went to Ortho, foot not broke went to my internist he was sending me for a nerve test on my foot.  I went to sleep that night no pain in leg, no discoloration, no heat, no symptoms, I woke up at 3:30
am from a deep sleep and my leg was burning and cramping, I woke my husband up and we went to emergency room, they found 2 DVT's, only because of Ddimer test and Ultrasound, I am still in hospital 7 days later trying to regulate coumadin to a level of 2.0 to 3.0 but when I eat veggies and salads the level goes down to 1.6 which puts me at risk for mor DVT's.  They tell me its dangerous and not certain if I have Factor 5

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by Annette1976, Jun 23, 2009
7 years ago, 12 weeks post natal I collapsed. I was told by my Dr a week before that I was stressed out and needed a massage! I had a sore calf, but not swelling or hot patches, but I was sweating for no reason and walking short distances ie from the lounge to the loo made me out of breath. The next thing I know I am in heart and respiratory failure and was given 20 mins to responde to a high dose of heparin IV - which came with its own set of worries ie a bleed on the brain or any other major organ, or I proably wouldnt survive. Hospital chaplin was called in!

I had massive PEs heart and lungs and shouldnt be here! I spent 10 days in the cardiac care unit and was then on warfarin for 2 years. They found no reson for the clotting otehr than pregnancy. They assumed the clot started in my right hip as scan showed nothing in calf.

Fast forward 7 years 5 weeks later! Stood up from the sofa one evening and thought I had put my righth hip out. Hobbled upstairs to bed and thougt nothing of it. Woken up next day unable to weight bare. Excruciating pain in hip groin, thigh etc. Felt like I had tight elestic bands in my hip and calf, the pressure was immense. At 5pm aftera  day oif rest and being told by Dr I had trapped a nerve, i noticed my calf was swollen and a differnt colour to my left leg.

We saw the emergency Dr who thought my back and hip pain was something different to my calf pain. The back/hip was a strain/trapped nerve/pulled muscle but calf looked like DVT. He gave me a treatment dose of clexane (low molecular weight heparin) and I was sent, the following morning, to the hospital for a doppler scan and d-dimer blood test

Turns out I havent trapped a nerve at all! I have extensive DVTs.One stretches from below my knee to my belly button on the right hand side and is completely  blocked and I have partial blockage in my groin on the left hand side.

I am now on daily clexane injections 135mgs for 10 days and then back to hospital for a follow up scan and to see where we go from here. I am on total bed rest for atleast 2 weeks, only allowed to get up to use the loo!

I am very scared, very tearful and exhausted. I have just had a baby 5 weeks ago so this was obviouslly the cause...again, even tho I was on clexane injections throughout the pregnancy. I am so frightened to go to sleep incase I dont wake up. Nightimes are worst as the pain in unbareable and I keep getting twitching in my thigh or calf! Will this pain ever go ?:-(

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by rocketsmom1693, Aug 04, 2009
I had a knee replacement done in Feb and had complications with scar tissue building up because of this I had another surgery 4 wks ago; they cut my knee open in the same incision and removed the scar tissue...I have had problems with my foot going numb all day and my left leg just aches am trying to decide if I need to go into the ER to have the problem checked out...I am 48 yrs old

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by leaannea, Nov 05, 2009
i am very interested in all your comments as each n everyone of you have different symptoms.

i had arthoscopy on my knee last year and after a few months i noticed my leg was very sore  no redness no swelling nothing i went to the docs but they said my leg was fine nothing to worry about had to go back 3 weeks later as my leg was very sore again same result few weeks later my calf was sore and cramps decided to go to er but was told i dont have symptoms of dvt do they had a feel and said as there is no swelling no redness they are happy to leave it at that.  that was 2 month ago and now the pain have moved from my calf to my groin and buttock im petrified its a dvt moving i have been referred to orthopaedics but not for a month my leg feels so strange and the pain is getting worse bt the gp is not concerned should i be concerned or will should i just trst them??

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by Siddy1, Dec 11, 2010
My symptoms were pain in groin and left leg swollen and very red. ER found dvt in left leg behind knee. Treated for one year before it dispersed. I have one copy of V-Leiden gene found out in later testing for MS. Positive for MS 2 years later.

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by drhippo, Mar 24, 2011
I had a serious DVT and PE episode about 5 years ago.  All ok now--on coumadin, forever I guess, but some slight swelling still occurs sporadically.  New ultra sounds show the remnants of a "non occlusive clot"...my question is:  what is this?  Is there reason to be concerned?
Thanks!
drhippo

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