We very sadly recently lost a member, who died as a result of a deep vein thrombosis, or DVT. A DVT is a clot that forms in the leg, but then travels in the circulation and blocks off a narrower blood vessel somewhere else in the body. Our greatly missed friend was someone who could walk, with a frame, but only just. A powerful frame, tall, with a bit of weight – these things put more pressure and constriction on the veins in a seated position. On his own admission, he didn’t drink much throughout the day. He hadn’t been able to access his physio or exercise in the gym for some weeks as awaiting a wheelchair accessible vehicle, and mobilising was a struggle – he was awaiting a baclofen pump.
We wanted to get everyone thinking about their own risk factors, and please, to take the necessary steps to help avoid this sudden and possibly fatal incident.
The main cause of DVT is immobility – especially during or after surgery, but can occur without surgery. Things you can do to protect against DVT include:
- regular brisk walking – not always possible I know! But even whilst sitting,
- If possible, regularly circle your ankles, get into a ‘tiptoe’ position and then lift your toes off the floor whilst keeping your heels on the ground.
- when resting, when possible, spend some time with your feet higher than hip height.
- Stay well hydrated – this keeps the blood less sticky and less likely to clot.
- If you are not able to move your legs, consider wearing ‘travel socks’ or ‘flight socks’. These are equivalent to grade 1 thrombo-embolytic deterrent (TED), or ‘compression’ stockings.
- If your legs are swollen, or you have had thrombophelbitis, you can talk to your GP about getting grade 2 or 3 ( tighter) TEDs on prescription. You may need to first have test with a hand held Doppler scanner, done by a nurse.
- They are available in different colours, and in open or closed toe options.
- They should be removed at bedtime and put on first thing in the morning. It is important to put them on before your legs start to swell in the mornings.
- Stockings should be replaced every 3-6 months. Each time you should be measured again, just in case the size needs to be changed.
- You should always have at least two pairs prescribed so that one pair can be washed and dried while the other is worn.
- Do not tumble dry support stockings, as this may damage the elastic.
- They can be made to measure if none of the standard sizes fit you.
- Support stocking applicator aids are available if you are unable to get them on. You can discuss this with your pharmacist or nurse.
A DVT that is recognised in time can be treated to prevent further complications. So what to watch out for?
- Pain and tenderness of the calf.
- Swelling of the calf.
- Colour and temperature changes of the calf. Blood that would normally go through the blocked vein is diverted to outer veins. The calf may then become warm and red.
If you have any of these symptoms, with no other explanation, seek medical help immediately, to be safe.