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Doctors' Answers to "Frequently Asked Questions" - Blood Clots
Hemotoma [posted 1/13/99]
Answer: Treatment for a hemotoma is usually heat to absorb the blood in the damaged tissue. As to a design fault, hemotoma is a medical name for a bruise. I'm not sure I'm answering your question.
Blood Clots and Birth Control [posted
Answer: I can give you some information, but the companies that produce them have tons.
Possibly Post Phlebitic Syndrome
Answer: Clots below the calf may embolize, but rarely, if ever, cause symptoms. This is probably due to the size of the clot and the low risk of embolization. However, they can and do cause chronic pain after the clot referred to as Post Phlebitic Syndrome. This is distension and inflammation of the veins in the leg is due to damage to the venous valve structure of the leg. This tends to be permanent since the cause is incompetent valves, which leak blood back to the leg causing chronic distension and pain. Relief centers on compression stocking, aspirin on a daily basis, elevation of the painful calf (above the heart) and heat.
In Need of a Natural Blood Clot
Medication [posted 12/10/98]
Answer: Aspirin comes from elm bark, is this natural enough?
Blood Clots [posted 10/13/98]
Answer: Yes, especially if in the deep venous system-has he been tested for Factor V Leiden activity? A newer and very common cause of clotting disorders.
Blood Clots [posted 8/11/98]
Answer: Possible, but unlikely. If he is young, he should have a work-up by a good internist or hematologist for the familial causes of hypercoagulability. This is important because it can prevent further problems in the rest of the family if found.
Answer: The physical problems caused by the accident are probably contributing to his problem but are probably not the cause. He needs to stop smoking. Occasionally, use of a drug like procardia will help peripheral vasodilation sufficiently to stop the problem.
Answer: There are two possible types of clots in the legs - arterial and venous. Arterial clots are usually due to emboli from the heart. However, some patients experience hypercoagulability with different types of cancers and can form arterial clots in different parts of the body. Few chemotherapy agents would cause this problem, and usually the reverse. Venous clots usually form in the leg and can go to the lung in severe cases. These are due to low flow in the legs or else the hypercoagable state I mentioned with different cancers. Venous clots do not usually require amputation. Arterial occasionally due if not correctable rapidly.
Answer: When blood clots occur in young people the question is why? Birth control pills, steroids trauma, inactivity and some inherited disorders could be the initiator of a clot. So, first ensure your physician has screened you for Protein C, Protein S, Lupus coagulants Antithrombin III and checked your platelet count, etc. If the above are normal, I'd recommend an aspirin a day to avoid any further clots. The damage to your arm is of no consequence. The arm has several pathways to return blood other than that one vein. Emboli from the arm are rare and never cause majorage. Continue exercising. Signs of a blood clot in the lung are either chest pain (usually pleuritic), hemoptsis (spitting up blood), or shortness of breath, but unless you develop a clot in the leg you are at minimal or no risk.
Answer: Your problem is called post-phlebitic syndrome. It occurs after damage and scarring to the venous structure of your legs caused by the clots. The best treatment is to dissolve the clot as soon as possible after it occurs with any of several drugs. Unfortunately, once the clot has been present more than a couple of days or the damage present, there is no effective treatment. Treatment centers on pressure stockings for your legs and elevation of the legs several times a day. Occasionally, anti-inflammatories (after decreasing the coumadin, ifpossible) are helpful. This is a tough problem to improve because the treatment options are very limited.
Poor blood flow
I am also curious about what may be available to permit a senior citizen of advanced years to resume sexual activity that is denied because of a lack of ability to sustain an erection of sufficient firmness. I am 72 years old and an inveterate smoker (2-4 packs a day).
Answer: This is called claudication. There are several possibilities, but generally in smokers it is due to lack of blood flow to the legs. With your decreased erections I suspect you have a major league blockage of the iliac and/or femoral arteries. Your physician will need to get arterial studies to check this. The other possibility is spinal stenosis. This is caused by pressure on the spinal cord in the lower back due to a congenitally small opening in the spinal canal. Regarding your erections, have your blood supply to your legs checked first. The lack of erections are probably due to a similar problem.
Clots In Legs
Answer: There are several reasons that a person forms clots in his/her legs. The
most common reason is trauma or inactivity. Clots following a fractured leg or
immobilization of the leg for any reason are relatively common. In a thirty year old there
are also several syndromes which are inherited in families. A complete evaluation by a
physician will be necessary to check the blood for the known causes of inherited
tendencies to clot. Also, once a person has one clot-the damage caused to the venous
system will markedly increase the tendency for a second clot.
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