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The type of clot that kills. How to prevent, detect and manage it.

Being the month where a lot of emphasis is put on heart health, today I would like to share about something that is of great concern to all of us. And that is blood clots.

Blood clots are meant to help us when we bleed (usually from an injury) to help stop the bleeding and so can be very useful to the body’s defense and repair process. However sometimes clots can form in our blood vessels in places where they should not.

A clot is simply a lump of blood that has become solid. Usually clots will dissolve on their own but if it does not this can have potentially dangerous and even fatal consequences. Most clots that form in blood vessels will be small and located in one place and in such situations these clots may not be very harmful aside from the symptoms produced at the site of the clot such as pain.

However, if the clot moves and goes to the veins of your heart and lungs, it can obstruct blood flow and then it becomes very dangerous. Most people who die of clots, die of clots that have moved usually from the veins in the legs and lodge in the vessels that supply the lungs. If the clot that has moved to the lungs is large, it can cut off blood supply to the lungs and in a few minutes, someone could be dead if you don’t get good emergency care in the next few minutes. This type of clot is called a pulmonary embolism. Even in developed nations, such lung clots that are big, cause large numbers of deaths because from the onset of symptoms to death could be a few minutes unless you are in a hospital or are nearby one. But think about Uganda, what is the chance that you will get such good emergency care?

That is why we must know about this type of clot (the pulmonary embolism), learn to identify it early, know what to do and also how to prevent it. And there are warning signs that people usually get a few hours or days before such a fatal event that can be a clue and should prompt you to seek immediate care before it is too late. This is the main objective of this newsletter.

What are the early signs that can help you develop suspicion that you may develop a lung clot?

  • Pain in your limbs that is suggestive of a clot

If you get a dull, throbbing, pulsating or cramp like pain in your muscles (usually the calf muscle, but also in any other place) that is one sided, that may or may not be associated with some swelling, warmness and redness, this may be sign of a clot in that area. It is such clots that dislodge and move to the lungs that eventually kills. So, never take such a pain lightly. Common places for such pains are the calf muscle.

  • Experiencing shortness of breath

If you or someone you know experiences unusual shortness of breath even for a few seconds be suspicious. Shortness of breath is best described as a short period of a few seconds where you suddenly feel like you can’t breathe and then a few seconds later your breath is back. This could be a sign that smaller clots could have been forming that are already moving and causing small blockages in your lungs. This is the big warning sign.

Note that this shortness of breath can occur after mild exertion. Many people who have died from clots have usually experienced this a few days or hours before the clot. This is the time to get help.

In addition to the above you should be extremely concerned in the following circumstances

  1. If you or someone you know experiences both of these 2 symptoms above concurrently (i.e vague pain in the legs or limbs with some shortness of breath).

  2. If you have the above 2 symptoms and any of these risk factors for a clot;

  3. You have had recent long travel. If you have travelled long distances by road, air or otherwise then that is likely to be one of the factors that make you get a clot. Many people who get clots in the lungs get them after long journeys.

  4. You are immobile. This can be due to being hospitalized, suffering a stroke, or some form of injury that keeps you immobile. But it can also be that you sit at your desk for hours on end without getting up.

  5. Recent surgery is also a risk factor.

  6. If you have ever had any history of a clot or something called Deep Vein Thrombosis (DVT).

  7. If you have some of these additional lifestyle factors and you have any of the symptoms above then know that your risk for a clot is even higher

  8. If you smoke your risk for a clot is significantly higher.

  9. Living in a polluted city like Kampala may increase your risk. Car fumes are a big risk factor for clots. Sometimes this alone may be the big risk factor even if you are relatively healthy so keep this in mind.

  10. Being overweight. The more overweight you are the worse the risk.

  11. Using contraceptives, particularly estrogen based contraceptives increase risk.

  12. If you are either pregnant or have cancer your risk for clots goes up.

  13. Please note that people who have respiratory illnesses like asthma may miss the opportunity to detect a clot because of the similarity in shortness of breath presentation.

What I am trying to describe above is what to look out for before someone gets a clot. This is really focusing on prevention and early detection. A clot in the lungs has other symptoms once you already have it that I will describe below but for now I would like you to know how to suspect that you or someone may soon be at risk for a major clot in the lungs. If you are able to detect this, many lives will be saved.

Of all the symptoms and risk factors described above, if you or anyone develops a vague pain in the legs or limbs that has been associated with some level of shortness of breath in the preceding hours or day that may seem unusual and is associated with recent long travel or immobilization then think about a clot that could go to the lungs and cause a potential life-threatening clot and act immediately.

What to do if you suspect a clot

  1. Inform someone close to you about it and let them know what your suspicions are

  2. Go immediately to a qualified medical doctor preferably a physician or cardiologist and let them know what you are experiencing

  3. DO NOT downplay the symptoms as what you tell the doctor will determine the way he/she will assess the risk

  4. Specifically mention that you are concerned about a clot and want to have it evaluated. Because the symptoms I described above can be for anything else, it may not always be at the top of a health care providers mind

  5. Preferably go to a hospital that has the capability to do the required tests and advanced scans in case they are needed and one where you will have access to a physician

  6. Do not wait till the next day. Go immediately. It is better to be safe than wish you had acted sooner

  7. DO NOT go to a pharmacy and self-medicate. Many people read on the internet and then try to make their own plan

  8. DO NOT try to use natural methods until you have been evaluated by a doctor

But let me mention other symptoms of a lung clot (Pulmonary embolism) that you should be aware of

  1. Chest pain that is of sudden onset that is worse when taking a breath

  2. Shortness of breath, worse when you exert

  3. Nausea and vomiting

  4. Sweating

  5. Feeling of anxiety and being restless

  6. Coughing and sometimes coughing of blood

  7. Fainting or collapsing

If you or anyone experiences any of these, it is a MEDICAL EMERGENCY and immediate care must be sought. Call for help and if you can try and reach a hospital or health facility with emergency services.

Such information is about being prepared and knowing what to do and how to do it. I have recently had a patient of mine present with symptoms suggestive of a clot and when I referred her to a cardiologist, the doctor told her she had a massive clot that could have ended her life. Knowing what to suspect can be important and acting in a timely manner is also key.

OK so I’m thinking by this point you are feeling worried and anxious. Please don’t be. The good news is we can all take steps now to reduce our risk for clots. Here are 10 suggestions to keep your blood circulation healthy.

  1. Lose some weight. Aim to have a healthy BMI. If you need help losing weight you can contact us or sign up for our next weight management program beginning Saturday 3rd March 2018. To sign up or visit my website to learn more about weight loss

  2. Stop smoking. Make a plan to quit if you do. Smoking increases risk for clots and many other diseases

  3. Become active. Start exercising regularly

  4. Avoid being sedentary. Avoid sitting in office for long periods without moving. Point and flex your toes and make circles with your feet if you cannot move around while sitting for prolonged periods to get your blood circulating.

  5. When travelling long distances, get up every hour and stretch and move around. If travelling by road, stop and take breaks every hour. Also wear relatively loose fitting clothes when you travel long distances.

  6. If you use hormonal contraception discuss your risks with a doctor

  7. Eat foods that help to keep your blood circulation healthy and help to prevent clots. The following foods are particularly useful

  8. Ginger

  9. Cinnamon

  10. Garlic

  11. Turmeric

  12. Nuts and seeds

  13. Green tea

  14. Use an omega 3 rich supplement. Studies have shown that they are good for heart health, keep the blood at good consistency and reduce risk for clots. I recommend using Krill oil. I take krill oil almost daily and so should you.

  15. Drink enough water and stay hydrated. Being hydrated is very vital for blood health.

  16. Talk to your doctor about ways to reduce risk for clots if you are immobile due to hospitalization, physical disability or if you have risk for clots. You can discuss whether or not you could benefit from compression stockings if you are at increased risk.

In our next newsletter we will be looking at useful tips to improve our heart health. Stay tuned and please ask more people to sign up for my newsletter. Invite them to sign up. It only takes a few minutes but could make a big difference in their health and lives. You can simply share this link with them

If you have found this article useful, please share it with friends and family. Let’s join hands to spread the message of wellness to all. You could save someone’s life by sharing this information.

Also, don’t forget to stay connected on twitter @drpaulkasenene

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