Melanie Bloom:  Now, sometimes you have heard of economy class syndrome.  People on long airplane rides can develop a clot in the leg because they are just seated and the blood can pool in the lower limbs.  By the way, deep vein thrombosis (DVT) is the number one cause of preventable hospital deaths in our nation and yet there are a lot of people who are not aware at all of this condition.  The clot itself can cause significant problems. Especially, I know, with your readers, there are probably a lot of people with them who are confined to wheelchairs or are in assisted living facilities or hospitals.  And what happens is that whenever the flow of blood is restricted in those lower limbs; for example, in David's case, even though he was young and fit and healthy, he was sleeping night after night with his knees pulled up to his chin in a cramped tank and he was dehydrated.  I know a lot of caregivers find it hard to get their loved ones to remember to drink their water and stay fully hydrated, so those are two of David's risk factors.  Blocking the flow of circulation in his legs and being dehydrated. 

Deep Vein Thrombosis can cause problems in the legs just by having the clot there.  It can cause pain, discomfort, swelling, redness, tenderness to the touch. In fact, they said that when David was complaining of the leg cramps, he had a limp.  I have had DVT described to me many different ways including the fact that people say it feels like they are having a heart attack.  They can feel like they have extreme pain in the chest, or it can feel as subtle as just having difficulty getting a deep breath. One person described it as breathing in, but feeling like they are not getting enough air.  So, if you have pain in your leg and then you are having difficulty breathing, I would recommend that you call your doctor right away.

Gary Barg: If you are a caregiver who has a loved one who is immobilized, who is in bed, who has not walked in a while, is there anything you can do?

Melanie Bloom:  It is so important in any setting, whether you are in a wheelchair, hospital bed, airplane, even sitting at your desk for long periods of time, to keep moving.  The Coalition to Prevent DVT, has partnered with Marion Wilson, who has a PBS show called “Sit and Be Fit,” and it is a series of very simple and effective movements to force the blood to circulate in the legs. We have all of these demonstrated on videos on our Web site, preventdvt.org.  And for example, just taking your foot and pumping it up and down as if you are depressing a gas pedal will help. A caregiver can show their loved one that movement or do it for them, and just take their foot and bring it up and down, up and down, using both feet.  Another technique is a simple ankle circle.  You just take your ankle and circle it round and round and then go the other direction round and round.  Just doing those simple movements, once every hour or so, if you are on a flight or in a hospital bed, and keep remembering to pump those feet and circle those feet.  There are several others that are demonstrated by Marion Wilson on our Web site that are very effective also.  Something as simple as these movements can help with preventing DVT.  Some people need more aggressive preventive treatments and the doctor can determine whether blood thinners or compression stockings should be employed. There are other ways that people can prevent clots from forming; but for everyone's good health, and certainly for people who are immobile, movement is key.   

Gary Barg: Caregivers are working so hard around the clock to help a loved one dealing with whatever diseases they are living with and DVT can hit them out of the blue seemingly, so I think this is important for any caregiver to know about.