Athletes and blood clots

In our last post we told you about World Thrombosis Day, and before that we talked about the effect of athletic activity on veins. Now we take a look at the topic of athletes and deep vein thrombosis, or DVT.

Deep veins are located under the muscle and connective tissue layers in the legs. A blood clot in a deep vein—known as deep vein thrombosis, or DVT—can be dangerous because the high pressure in the system could cause the clot to break free from the vein wall and enter the blood stream. The DVT could then travel up through the legs into another part of the body such as the lungs, where it would become a pulmonary embolism (PE).

           

DVT or PE symptoms are often misinterpreted as something less serious. A blood clot in the leg may feel like a “Charlie horse,” shin splints, or a twisted ankle. Symptoms from PE are often attributed to a pulled muscle in the chest, asthma, or a “touch of pneumonia.”

           

In half of DVT and PE cases, no symptoms present at all—but both conditions are medical emergencies. Any of these symptoms should be regarded as a DVT or PE until proven otherwise, especially if someone is in a risk category (including whether there is a history of blood clots in your family).

Remember, being active and fit does not prevent someone from developing blood clots. Athletes, coaches, and trainers should be aware of these risk factors:

·       Traveling long distances to and from a sports competition

·       Dehydration (during and after a strenuous sporting event)

·       Significant trauma

·       Immobilization (in a brace or cast)

·       Bone fracture or major surgery

·       Family history of DVT or PE

·       Presence of an inherited or acquired clotting disorder

Treatment of blood clots depends on many variables, including your health background and the extent and location of the clot. And, of course, prevention is the best medicine. Go to our latest issue of Vein Health News to learn more.

World Thrombosis Day – October 13th

Last year we told readers about the first World Thrombosis Day. The effort continues this year with the second annual WTD scheduled to take place on October 13th (the birthday of Rudolf Virchow, the German physician who pioneered the pathophysiology of thrombosis).

The goal of this educational campaign is to raise awareness about blood clots and to reduce the number of undiagnosed cases. Community events, lectures, health fairs, and scientific meetings will help spread the word around the world about this preventable condition.

Here’s a quick review of thromboses, a.k.a. blood clots. A blood clot in a deep vein is known as deep vein thrombosis, or DVT. DVT can be dangerous because the high pressure in the system could cause the clot to break free from the vein wall and enter the blood stream. When that happens the DVT becomes a venous thromboembolism, or VTE. The embolism (a blood clot that has “broken free”) could then travel up through the legs, back to the heart and then to the lungs where it blocks some or all of the blood supply to the lungs. This is called a pulmonary embolism, or PE, and it can often be fatal.

To learn more about this common—and commonly overlooked—medical condition, go to www.worldthrombosisday.org. There you’ll find facts about VTE, as well as personal stories of blood clot survivors and their families.

Running on all cylinders

This Saturday the Vein Healthcare Center is co-sponsoring the South Portland MAINEiacs first-ever 5K run, just around the corner from the VHC offices!

We’ve had running, exercise, and athletes on our mind lately, as our latest issue of Vein Health News is hot off the press. In our cover story package, we look at how exercise affects veins (and vice versa); whether athletic compression is worth considering; and how even athletes could be affected by DVT.

Click here to read more about athletes and veins. And get out and enjoy a walk or run in the increasingly crisp autumn air!

Q&A with the newest member of the VHC team

Meet Alison Scheib, PA-C! As a certified Physician Assistant, Ali supports Dr. Cindy Asbjornsen, founder of the Vein Healthcare Center. As a trained sclerotherapist, she performs ultrasound-guided and light-assisted sclerotherapy, a procedure for treating venous insufficiency, particularly smaller “spider veins.”

In addition to spending time with her husband (a fellow PA-C at a veterans hospital) and their two children, Ali loves outdoor activities like swimming and waterskiing. Read on to learn more about Ali.

Q:  What is a Physician Assistant?

A:  A physician assistant, or PA, is a nationally certified and state-licensed medical professional. PAs practice medicine on healthcare teams with physicians and other providers and can prescribe medication. I earned my PA degree from the University of South Alabama and practiced Family Medicine for 15 years in Camden, Maine. 

Q:  How do you help patients at VHC?

A:  I perform ultrasound-guided and light assisted-sclerotherapy on patients, sometimes in follow-up to EVLA treatment. Dr. Asbjornsen and I work together as a team to treat each patient to achieve the best outcome. 

Q: What is your goal for each patient?

A: To make them feel better, both mentally and physically. After treatment, I want them to feel comfortable wearing shorts if that’s important to them. I want them to experience activities that they couldn’t do before because their legs were too sore or tired. I want them to be—and feel—healthier!

Q: Why are you a good fit for VHC?

A: I have the primary care background to see the patient as a whole person, not just the one ailment they’re seeking help for. And like the rest of the staff, I like to spend time with patients to make sure they are comfortable and understand their medical disease and treatment options. 

Q: What do you like the most about vein care?
A: I love being able to focus on one aspect of a patient's healthcare while still treating the "whole" person. I’m also excited that phlebology is still a fairly new specialty, and I’m looking forward to working with Dr. Asbjornsen on doing research that can continue to advance the field.

Environmental risks for vein disease

There are a number of risk factors for vein problems. Aging is one of the leading risk factors for the development of vein issues. Heredity is another. (If one parent has vein disease you have about a 33% chance of also developing vein problems. If both of your parents have vein issues, then your chances go up to 90 percent.)

While aging and family history are risk factors that can’t be controlled (try as we might), venous disease can be aggravated by environmental risks. It is much more common in “industrial countries” like the U.S., where riding in cars and sitting in front of a computer or television seem like a way of life.

             

We explored the risks involved in sitting in a previous post, but standing for long periods (with or without high heels) is also a risk factor. Research has shown that the more hours one stands, the more likely it is that a vein issue will develop. Likewise, lying in one position for too long can cause serious vein problems. Patients in the hospital or on bed rest, for example, may experience a slowdown in blood flow that can lead to blood pooling in the extremities.

As Dr. Asbjornsen explained in her chapter “Risk Factors and Other Causes for Vein Problems” in the book Healthy Veins…Healthy Legs, it is possible to reduce some risk factors for vein disease.

There are many treatment options today that are minimally invasive and highly successful, but education and prevention are the most important keys to vein health. Even if you are not experiencing symptoms, a venous screening can evaluate the condition of your venous system, help you avoid blood clots, and help you begin lifestyle changes that can prevent symptoms from occurring. 

The risks of…sitting?

Are you sitting down? Chances are, you are! It seems like our whole world was designed to keep us in a seated position, usually in front of a screen, whether during work or leisure time.

Earlier this year, a recent article found that this overwhelmingly sedentary behavior increases our risk of getting preventable conditions, even if we exercise. The studies showed that physical inactivity (the fourth-leading risk factor for death for people all around the world, according to the World Health Organization) can lead to premature death from cardiovascular issues and cancer, as well as cause chronic conditions such as Type 2 diabetes.

Too much sitting can also increase the risk of getting varicose veins—and if you already have vein issues, you may notice that symptoms get worse after sitting for prolonged periods of time.

Why? The heart pumps oxygen-rich blood throughout the body through the arteries. Veins then carry blood from all the extremities back up to the heart. The blood in the legs travels up against gravity, so when the valves in the veins become damaged, blood flows back into the legs which leads to a “pooling” of blood in the veins that can manifest as varicose veins or spider veins. 

When you sit (or stand) in the same position for a long time, the blood doesn’t circulate properly and, over time, this can lead to varicose veins.

There are a several ways to help reduce the risk of getting varicose veins from sitting for too long:

• Sit properly. Focus on good posture and avoid crossing your legs or sitting in ways that can compress veins for prolonged periods.

• Elevate. Occasionally, rest your legs above your heart – for as long as 30 minutes or as briefly as three minutes. (For more tips on elevation, click here.)

• Take a break. Take frequent walking breaks to avoid sitting or standing for periods of more than two hours.

• Pump it. If you can’t move around that often – or are flying on an airplane – try flexing and pointing your foot to get the blood moving in your legs. (Click here to learn more about “the foot pump.”)

Of course, the best way to reduce your risk of getting varicose veins from sitting all day is to move around more – and be aware of just how much time you spend sitting down.

Vein Health News, a resource for patients and doctors

Dr. Cindy Asbjornsen of the Vein Healthcare Center in Portland, Maine is passionate about educating people about vein health. That’s why three years ago she started Vein Health News for primary care physicians in Maine and New England. Although the magazine was originally intended for physicians, we've found that patients really like it too.

Vein Health News covers such topics as: minimally invasive treatments for varicose veins, modern compression, leg ulcers, deep vein thrombosis, and more. Plus, the regular column “One Patient’s Perspective” explores vein care from a patient’s point of view. If you’re interested in a free subscription to Vein Health News, just click here.

Are you a Physician? 

Primary care doctors are on the front lines of reducing the growing number of people suffering with symptoms of venous disease. Vein Health News serves as a resource for well-researched meaningful information that you can pass on to your patients. If you would like the publication delivered to your office, click here to subscribe.

Education is an important first step toward better vein health and an improved quality of life.