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Deep Vein Thrombosis

Q: I suffer from DVT (Deep Vein Thrombosis) for the past 19 years. It runs in the family. I also have high BP and a high pulse rate - 160/110 and 90 beats. I take medications which include : Microcid 25, Stamlo 5, Inderal 10, Zinetec 150 and Loprin 75 . I walk for 2 kms every day and exercise for 15 minutes. I keep getting a pulling sensation on my right thigh and it feels as though the problem has recurred. How I can get rid of this problem?

A:In the lower limbs we have two set of veins, one running just under the skin called the superficial set and another running deep under the muscle - deep set of veins. Both the set of veins are inter connected to each other through communicating channels. Both the set of veins are used to return the blood from the leg back to the heart. Whenever any set of vein gets damaged or thrombosed (clot formation) then the other set tries to take over and maintain the return of blood from the legs. However if the adequacy of the remaining set of veins to return the blood is not complete, then patient can have symptoms of deep vein thrombosis. These symptoms can take the form of swelling in the legs and an aching and pulling sensation and a feeling of tiredness and heaviness in the legs at the end of the day. So as far as your symptoms are concerned these are very classical symptoms of deep vein thrombosis. The advise I can give to manage DVT is:
1. Elevate the foot end of the bed whenever you are sleeping at ight or resting at the day for a long period of time.
2. Do not cross your legs as by doing that you produce further obstruction to the flow of blood in the legs and the symptoms of DVT can increase.
3. You should do exercises to build up the calf muscles so that blood-pumping action of the calf muscles is better and symptoms of DVT are ameliorated to some extent. This basically consists of standing on your toes for 10 seconds and then again back on your sole for 10 seconds and then again standing on your toes and if you do that for 10 minutes every morning and evening, you should be able to develop the calf muscles.
4. The medicines you are taking are mainly for high blood pressure and high pulse rate. Only drug, which helps in DVT, is Loprin, which keeps the blood thin and helps in the venous return. If there is any evidence of clots breaking off from the legs and going into the lungs, which I am sure you can not decide but your doctor will have to decide, then we anticoagulate a patient that give the patient blood thinning tablets by the name of Tablet Acitrom. However in your case I cannot advise you to take Acitrom till such time we have actually physically examined you and made sure that you have DVT and that you have recurrent embolism from the DVT.
5. If swelling is a problem, which you have not mentioned then one can use special stockings which are called thrombo embolism dressing or TED stockings, which are available in the Indian market also and which essentially are elastic slacks starting from the ankle on to mid thigh.
6. Other thing that you must avoid is sitting in one position for long periods of time and that is more so important for air travel and long distance train travel. When ever you have to do that then you should take adequate amount of fluid and keep moving your toes and keep walking in the aisles or in the corridors when ever feasible and possible.
7. The last thing I would advise you is to rule out secondary causes of DVT because some times DVT is a manifestation of some other primary disorder of the body and for that a thorough check up is definitely called for. I am sure you must have already undergone screening and for secondary causes for DVT must have been ruled out.

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