Deep Vein Thrombosis

DVTWHAT IS DVT?
DVT stands for Deep Vein Thrombosis and is a disease of the circulation. It is a medical condition where blood has clotted and caused a blockage or obstruction in the circulation within a deep vein - usually in the lower extremities i.e legs, thighs and pelvis. When a DVT occurs, it moves so slowly that it forms a solid clot which becomes wedged in the vein. The veins involved primarily deal with returning deoxygenated blood back to the heart where the quick & efficient return is crucial to the circulation system. A clot is a normal form of injury repair which can, in some instances, develop into a problem.

WHO GETS DVT?
On average, roughly 1 in 1,000 people will suffer from a DVT. Most patients are 40+, but DVT can occur in almost anyone. Factors to consider include genetics, environment or post operative (knee or hip surgery), after infection or vascular injury (Crohn's or cancers), pregnancy, oral contraception, and lack of mobility for long periods in cramped conditions, such as travelling.

SYMPTOMS
May include areas of pain, swelling, discolouration, skin warm or hot to touch, but 50% of cases have minimal or silent symptoms. Imaging study such as ultrasound with a Doppler meter to measure blood flow is an accurate way of checking symptoms, even the smallest of clots. Blood tests can also give a good indication of a thrombosis. A test that measures the levels of a by-product of clotting material called D-dimer is commonly used. BE AWARE that other conditions like muscle strains, skin infections, pleurisy, inflammation of superficial veins (phlebitis) give similar symptoms.

REPORT ALL SYMPTOMS TO YOUR MEDICAL CARE PROVIDER AT THE EARLIEST OPPORTUNITY.
Early detection can be a life saver - it will reduce the risk of contracting PE or Pulmonary Embolisms which can be fatal. 1 in 10 people die of a pulmonary embolism if it is left untreated. A piece of the clot breaks off and travels through the body, eventually lodging in the lung; this can lead to severe breathing difficulties. Rarer occurrences include part of the clot lodging in other organs, especially the brain, which can lead to strokes.

TREATMENT
Up to two thirds of DVT sufferers need to be hospitalised during the early stages, with the aim being to dissolve the clot and prevent any more forming. The main treatment for DVT and similar blood clotting problems is medicines which will thin the blood and allow it to flow easily. Usually, on diagnosis, high doses of the drug Heparin are injected. A similar drug, Warfarin, may also be given, normally in tablet form and for a number of months. Regular blood tests are needed whilst undergoing treatment to confirm that the right dose is being administered and there is no risk of a haemorrhage. To relieve the symptoms of DVT, pain killers and heat may be applied to the area affected. Patients are encouraged to move around and to wear compression stockings over the whole length of the leg.

PREVENTION
Wear comfortable, loose fitting clothes for long distance travel. Also invest in elastic support stockings or socks and use them! If possible, get up and move around on long distance travel - go the toilet or buffet area on trains, coaches and planes, take frequent breaks if driving, especially on journeys of 2 or more hours. Drink plenty of fluids and keep hydrated - alcohol and caffeine drinks are dehydrating, better to drink water or similar. When seated, shift body position - fidget - it could save your life! Whilst sat in work or travelling, do simple exercises such as leg lifts, ankle rotation, buttock and fist clenching as these may help stop the blood "pooling" in the feet- if you do these in the office environment, be aware of who or what may be behind you before you start moving yourself or your chair.

GENETICS
If there is a family history of early age (under 40) deaths from DVT or pulmonary embolism, ask your GP to refer you to your local Haematology department. A simple blood test is all that is required. If either parent carries the Prothrombin Gene Variant, you have a 50/50 chance of inheriting it. It increases your risk of a DVT from 1 in 1,000 to 1 in 10.

CONCLUSION
DVT is preventable if you take care of yourself. Keep yourself hydrated and active. Report all possible symptoms. Prevention is better than cure.
IF IN DOUBT, CHECK IT OUT!


- A Proposition carried at 2004 CWU Conference asked the Executive Council to investigate the implications of Deep Vein Thrombosis and DSE for our members, particularly if seated for prolonged periods and during DSE breaks.

A DVT, which is normally associated with long haul air travel, is a blood clot, which develops, usually in the veins of the legs, and it may cause swelling and pain in the calf. Complications from DVT can result from a clot breaking off and lodging elsewhere in the circulation, which can be life threatening.

Following conference, the T&FSE Health Safety and Environment Sub Committee contacted health professionals, which came back with the advice that they were not aware of any evidence linking DVT with sedentary work. CWU Research Department also conducted wide-ranging research for the sub committee and found considerable media references to computer use contributing to DVT. It was concluded however that references to the risk of Deep Vein Thrombosis in display screen users emanated from an article by Richard Beasley, which appeared in an issue of European Respiratory Journal, and referred to a man in New Zealand who sat in front of his PC for up to eighteen hours per day and developed a blood clot. The European Respiratory Journal reported this case of the young man from New Zealand who nearly died after developing deep vein thrombosis following long periods of physical inactivity in front of his computer.

T&FSE Health Safety and Environment Sub Committee conclude therefore, that after researching the issue raised by Proposition 53, that there is currently no conclusive evidence linking normal display screen users being at risk to DVT. The HSE and CWU advise employers and members that adequate rest breaks away from the workstation must be taken to control the potential physical and psychological health risks. Walking around and stretching during breaks exercises muscles and increases blood circulation, which relieves tension and reduces the risk of visual fatigue and musculoskeletal disorders and is encouraged. The sub committee will however continue to monitor the situation.


References
BBC News
www.dvt.org
BUPA - Factsheet
Deep Vein Thrombosis - Reducing the Risks

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