GloucesterTimes.com, Gloucester, MA

January 4, 2013

Clinton's clot points to dangers

Senior Lookout
Anne Springer

---- — Secretary of State Hillary Clinton’s recent hospital stay due to a blood clot has focused attention on the dangers of clots and why it’s important to seek medical counsel for certain symptoms.

While Secretary Clinton has not had any recent surgery that we know of (her clot seems to be related to a fainting incident secondary to dehydration she suffered while battling a stomach bug), many people are unaware that having surgery (especially heart, orthopedic, or gynecologic) is one risk factor for developing blood clots, particularly in the veins of the legs. Other risk factors include injuries, high altitude, obesity, cancer, heart disease, prolonged sitting, recent childbirth, or advanced age. Patients are sometimes advised to elevate their legs, or wear compression stockings, after they undergo surgery to prevent swelling and clots.

Clots occur when blood turns from a liquid to a solid, and are dangerous because they can break off and travel through the bloodstream. The blockages they cause can be life-threatening. Many people do not feel symptoms when a clot forms, but when symptoms do occur they can include localized redness, pain or swelling, trouble breathing, fainting, increased heart rate, chest pain, or lowered blood pressure.

Tests which diagnose clots are painless, usually involving a simple blood test, MRI, fluoroscopy, EKG, or chest X-ray. When clots occur in the surface cardiovascular system, sometimes the treatment is as simple as warm compresses, or acetaminophen. Commonly, a blood anti-coagulant medication is used for deep vein thromboses (clots). A medication is often injected right away by the doctor, followed up with Coumadin, or warfarin, that the patient takes at home in pill form. Some clots are treated more aggressively, the object being to prevent or mitigate damage to any major organs, and prevent any long-term consequences for the patient.

Prevention strategies include staying well hydrated, keeping active, getting up and moving around every few hours when working or travelling, and following post-childbirth or post-surgical medical advice. Doctors say it’s important to pay attention to lifelong strategies for minimizing cardiovascular damage, especially if there is any family history of thrombi.

Controlling blood pressure and cholesterol levels, getting enough exercise and eating well are sensible ways in which to reduce risk.

When travelling, avoid crossing your legs or staying in your seat too long — even when you can’t get up and move around, moving your legs back and forth, even while in your seat, can help.

You may have wondered why, after surgery, the nurses come so soon to get you up and moving, or that your physician recommends that you wear compression stockings for a time. These interventions are often made so that you will be less likely to develop a clot that could set back your recovery or threaten your life.

If you would like to know more about blood clots — how they form, some of the conditions that can cause them, and how they are treated, visit WebMD online at http://www.webmd.com/a-to-z-guides/blood-clots, or see the venous filters article on this Lahey Clinic page for information on newer procedures that “trap” emboli before they do serious damage: http://www.lahey.org/Search. aspx?search text=catching%20clots.

Anne Springer is the public relations director of SeniorCare Inc., Cape Ann’s local area agency on aging. To reach SeniorCare, call 978-281-1750.