Deep vein thrombosis doesn’t sound like something that should strike fear in your mind or even be a serious condition…
…unless you or a loved one have faced it head-on.
Doctor’s warn that we, as family caregivers, should know the signs of deep vein thrombosis (DVT), or blood clots in veins in the lower extremities of our senior loved ones — and what to do if you encounter them.
DVTs can be dangerous, especially if the clot breaks off and finds its way into the lungs, where it becomes a pulmonary embolism (PE).
The clot could even be fatal.
DVTs do not lead to strokes or heart attacks as many might think since they occur in veins. Arterial blood clots however can lead to heart attack or stroke as the clot occurs in an artery in the heart or brain.
Unfortunately, DVTs are not an uncommon occurrence. Blood clots can happen in the legs, pelvis or arms and often create pain. Usually seniors recover from DVTs with the correct treatment and catching them quickly.
According to the Centers for Disease Control and Prevention (CDC), 300,000 to 600,000 Americans have DVTs each year. It is estimated that one half of the people with a DVT will have long term complications such as discoloration or pain in the affected limb. One third of people with a DVT will suffer from a recurrence within ten years.
Unfortunately, 60,000 to 100,000 people die from a DVT each year. Yes, it is that serious.
Risk Factors And Symptoms
An estimated 5% to 8% of us have a genetic factor increasing the risk for blood clotting. Far more, however, who develop a DVT exhibit one or more of these risk factors.
- Age – over 40
- Obesity – body mass index over 30
- Surgery – within the past three months
- Injury – fractures, muscle injury
- Hormone replacement therapy or estrogen containing contraceptive use
- History of prior blood clot
- Mobility limitations – leg cast, ambulation impairment, confined to bed
- Cancer or cancer treatment
- Family history of clots
Many seniors don’t realize that they have a blood clot because about half will have no symptoms. Fortunately, there are common symptoms that can be found in the affected area of the body for many seniors.
- Warm to touch skin
DVTs are diagnosed through a variety of procedures including ultrasound, venography or a blood test called D-dimer. An MRI is used less frequently but useful for diagnosing DVT.
Some type of test is needed to make a diagnosis because other conditions, including swelling of veins or muscle strains, can cause the same symptoms.
Treatments for DVT
There are several treatments that your senior will find helpful that his doctor will recommend. As with any treatment, they will best be effective when used according to the instructions of your healthcare team.
1) Compression stockings
Your senior’s doctor may recommend special hosiery called compression stockings. They are made of special elastic fabric that squeezes muscles and vein walls. Stockings will help blood flow in the legs or affected area.
Your doctor will prescribe the type that your senior needs, as they come in different tightness or millimeters of mercury (mmHg). Ask the doctor when to put on and take off and how long your senior will be expected to wear them.
There are different sizes so be sure your senior is fitted for the most appropriate treatment. They also come in different styles such as knee high, thigh high or full length. Usually knee high are used because they are easier to put on and will provide good relief even when the clot is above the knee.
Be sure your senior wears these special stockings if prescribed. He or she usually needs to put them on in the morning before the swelling makes it more painful or difficult. Your senior will probably not need to wear them in bed but verify this with your senior’s doctor.
The heel should be in the correct position and then smooth the stocking over the leg. They should not be rolled up, especially behind a need or ankle. Don’t roll at the top if it is too long, you may need to be measured for a different size.
Caution your senior loved one to be careful when putting on compression hose not to get jewelry caught on the fabric, as it might tear the hose and cause it to lose effectiveness. Avoid lotion or wait until it is completely dry before putting on compression hose. Talk with your senior’s doctor if their leg is too swollen to get the stockings on.
Most compression hose are sold in pairs but only the affected leg needs this special hosiery. Some people wear them as long as two years after a DVT so your senior may need to have several so one is always available. Order extras when you know the size that fits correctly. Most should be replaced after being used for four to six months as the elastic will lose its effectiveness.
Special care is needed when cleaning compression hosiery. Use warm water and a mild soap, either by hand or in the washing machine on gentle. Air dry the stockings or dry by rolling in a towel.
Medications that help keep the blood thin are called anticoagulants and are used to prevent DVTs. They don’t actually thin the blood, but instead work to prevent a clot from forming. Anticoagulants include heparin and warfarin (Coumadin).
If taking warfarin your senior needs to take certain precautions since it can interact with food and other medications. Being careful to prevent bleeding is very important and includes steps such as using an electric razor instead of blades, using soft bristled toothbrush to avoid gum bleeding, always wearing shoes to avoid inadvertent food/toe injury, caution when cutting finger and toe nails and any other activity that can leading to bleeding.
There are newer oral medications that can help prevent blood clots, such as Pradaxa, Xarelto and Eliquis. There are specific considerations when taking these medications such as history of atrial fibrillation so be sure to talk with your senior’s doctor to understand all the risks and benefits.
3) Improved Circulation
Legs should be moved frequently and sitting too long in one position should be avoided.
Encourage your senior loved ones to get up and walk around every two to three hours, stretch their legs, and extend their legs out straight and flex their ankles.
Movement will help improve the circulation in your senior’s lower legs. Suggest they avoid crossing legs for extended periods, which will also help keep circulation flowing. Avoid tight fitting clothes (excluding compression stockings) to maintain adequate blood flow.
Pain Killers & Blood Clots – A Link?
If your senior has a history of using non-steroidal anti-inflammatory pain killers (NSAIDs), including naproxen, ibuprofen and aspirin, they could be at increased risk for developing blood clots such as DVTs and pulmonary embolism, which is a blood clot in the lung, according to a new study.
This study showed an association between NSAID use and blood clots, but not a direct cause and effect. The association was found in the analysis of six studies of more than 21,000 cases of blood clots pointing to an 80% increased risk of venous clots in users of NSAIDs. Because it is unclear if one particular NSAID increases risk, researchers warn our seniors to be careful when using NSAIDs in general especially if seniors are already at risk for clots.
Due to the seriousness and prevalence of DVTs in our senior loved ones, it is important to be on the lookout for symptoms, especially for those who might be at greater risk. If you suspect a problem, contact your senior’s doctor and seek treatment quickly.