All your whats and whys about Deep Vein Thrombosis answered

What is Vein, Superficial Vein, Deep Vein?

A vein is a blood vessel that carries deoxygenated blood towards the heart from the tissues. There are superficial and deep veins. Superficial veins are closer to the surface of the body, under the skin. Deep veins lie deeper in the body, underneath the muscles.

What is Deep Vein Thrombosis?

It is the formation of blood clots in a deep vein. It commonly affects leg veins.

What are the symptoms of DVT?

Mostly pain in your legs. This often starts in your calf, cramps, heaviness in the legs, swelling, and warmth over the affected area.

What are the risk factors?

Prolonged bed rest due to any illness, post child birth, recent major surgery, connective tissue disorders, oral contraceptives or hormone pills, trauma/injury, thrombophilia (tendency to develop clots), cancer, long travels.

What is the treatment for DVT?

The treatments for DVT include:

  1. Hospitalization or sometimes outpatient treatment.
  2. Anticoagulation therapy (the use of blood thinners)
  3. Thrombolysis i.e., the use of clot dissolving drugs in a few)
  4. Compression Stockings.
  5. Inferior vena cava filters in very few patients.

What is anticoagulation therapy?

Anticoagulants decrease the clotting ability of the blood and therefore help to prevent harmful clots forming in the blood vessels or if they are already formed, prevent them from travelling to lungs. Initially treated with injections and then changed over to pills.

How long is the treatment?

In most case the treatment given is for 6 months to 1 year. However the duration varies on the basis of various factors.

Which are the required blood tests while on coagulation?

Blood test required is called Prothrombin Time/INR. Periodic blood tests are done to adjust the dosage of the anticoagulant required for you.

What should be my INR value?

Normal value is .0. On blood thinners it should be 2.0-3.0. Your dosage is determined by your INR value.

How frequently should I test for INR?

Initially, your Doctor monitors the Prothrombin Time & INR continuously and later advises you to follow as per the prescribed duration. In normal cases, it is done once in every 4-6 weeks while on treatment; and 7-0 days according to the change in the dosage.

Why should I have such frequent INR tests?

Your INR value is comparative to your diet, alcohol consumption, general health and your medications. It is very important to monitor your INR value regularly; since a low INR value induces clots and a high INR value increase the risk of intensifying the bleeding.

Does my medicine interact with anticoagulation?

Most of the medicines affect the INR / PT values. It is very important to inform any doctor / dentists healthcare professionals or pharmacists about your taking anticoagulants.

Why should I elevate my legs while resting?

The blood circulates back easily when you elevate you’re your legs while sleeping, sitting or resting. You can elevate your legs with the help of a pillow; care should be taken that the level should be higher than the level of your heart.

What is compression? Why should I use that?

  1. Certain stocking or crepe bandages are used for compression basically to prevent or reduce the swelling of your legs.
  2. Elastic compression bandages are to be worn as soon as you wake up in the morning, throughout the day, until you retire for sleep at night.
  3. Stocking should be worn during your routine activities.
  4. This prevents many long term complications such as wound in the legs and darkening of the skin due to DVT.
  5. Wearing stockings is an important part of your treatment.
  6. Tight compression stocking is worn preferably for 3-4 years. This has to be changed every 6months, when it loses its elasticity or is torn.
  7. These specialized stockings are not available at the usual stores, and you need a prescription to get this.

Can I become pregnant, when I am on anticoagulation?

NO. Do not become pregnant while you are on anticoagulation. If so, report to your doctor immediately. If you are planning for pregnancy you have to be off anticoagulation for at least -3 months under the guidance of your doctor.

Attention: This medication may cause birth defects and severe bleeding in the foetus during the 1st and 3rd trimester of pregnancy.

Can I breast feed my baby?

YES. A selective set of anticoagulants allows you to breast feed your baby. Consult your paediatrician regarding the precautions to be taken for your baby.

What contraceptive measures are to be taken while on coagulation?

You need to stop the oral contraceptive pills if you are taking any. You Gynaecologist can advise you to take alternative measures.

When do I need to see the doctor?

Regular follow up with the doctor along with PT / INR reports is necessary. Also in case of any unusual signs of bleeding, report immediately.

Which are the signs of unusual bleeding?

  1. Bleeding from gums while brushing teeth
  2. Nose bleeds, or blood in the urine
  3. Unusual bruises, cuts or wounds or red spots on your skin
  4. Unexpected heavy menstrual bleeding or dark coloured urine
  5. Continuous stomach upset, pain, diarrhea, fever (>100*F)
  6. Chest pain, shortness of breath, sudden weakness; especially if you have had a recent head injury, or any other injury.
  7. A feeling of fainting or weakness
  8. Report to doctor, in case of any falls, blows to the body or head or other injuries
  9. It is important to carry an ID card mentioned that you are medication

How can I avoid injury?

You need to take proper safety measures while you are at home or travelling.

Can I travel while I am on anticoagulants?

Avoid long distance travelling at the time of diagnosis. However, during anticoagulant medication, compression stockings are advised while on travelling.

Which are the other medical problems that may affect anticoagulation therapy?

Inform your doctor if you are allergic to any drugs or substances. Also inform regarding any problem with your general health conditions.

Remember: deep vein thrombosis can easily be controlled if you thoroughly follow your specialist’s advice and these measures.

Which are the specific things that affect my INR value?

DIET: Vitamin K lowers your INR. Foods rich in Vitamin K are dark green leafy vegetables, cabbage, cauliflower etc. which need to be boiled and drained; and Oats, Peas, Ground nuts, Soya Bean, Wheat bran, capsicum, garlic, liver and asafoetida. You need to take your doctor’s advice before taking a nutritional supplements or vitamin tablets.

HEALTH: Your INR value increases, if you have fever (> 101*F) or nausea, vomiting/ diarrhea for more than 2 days.

ALCOHOL: When you take alcohol while on medication, it interferes with the liver and its functions. This increases your INR considerably leading to even bleeding. DO not drink alcohol on a daily basis or exceed two drinks at a time.

OTHER HERBAL/ ALTERNATIVE MEDICINES: Chances are that these medicines may interact with the prescribed allopathic medicines.

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