Questions about deep venous thrombosis (DVT)
What are risk factors for DVT?
People whose legs are immobilized for a prolonged period of time (from paralysis or coma, surgery, a cast for a broken bone) are at risk for DVT. Long plane rides or car rides can predispose you to DVT, because the legs are inactive while you are sitting (see #4 below for precautions to take while flying). Obesity, smoking, dehydration, use of birth control pills or hormones, history of cancer, and family history of clotting disorder are other potential risk factors.
Can healthy, athletic people get DVT?
Yes. Anyone at any age with the risk factors above can get DVT. The youngest person we've treated was 17 years old and the oldest was 92 years old.
What are symptoms of DVT?
Leg discomfort and swelling. Many people will describe it as a "charley horse" feeling deep in the muscle. Any time swelling at the ankle is persistent and in one leg and not the other, DVT should be considered.
What precautions can I take on plane rides?
Any time you board a plane or go on a long car ride, wear compression socks. Keep your legs active during the flight, by pointing and flexing the toes, rotating the ankle in circles or bobbing the legs up and down in your seat-- or better yet, walking the length of the plane every hour or so. There are studies showing decreased incidence of DVT in people who get the aisle seat on the plane, probably because they are more likely to get up and move during the flight. If you are taking a long car trip, stop frequently at rest stops and get out to stretch your legs or take a short walk. Stay well hydrated on the flight. You can also take an aspirin before boarding the plane.
Do I need to worry about blood clots during surgery?
DVT can occur around the time of surgery. The incidence varies depending on your other risk factors (see#1 above) and also the type of surgery and the rehab afterwards. The highest risk operations are joint replacements (as high as 25% risk), major abdominal surgery for cancer (as high as 20% risk). Varicose vein surgery is associated with a <1% risk of DVT, less than the risk of developing a clot if your leg were splinted for an ankle sprain. For major surgery, your doctor may have you wear compression devices (SCDs) on the legs or take anticoagulants to reduce risk of DVT. Other things you can do to reduce your risk are to keep your legs moving and stay well hydrated.