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Deep Venous Thrombosis

The lesser-known medical condition in Kashmir

Post by on Sunday, November 21, 2021

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 At first, he felt a mild pain in his left leg which his parents put down to his poor eating habit. As days passed, he noticed swelling in the leg and the pain only grew unbearable. He could no longer tolerate the pain and went to see a doctor.

It was four months back when the 35-year-old Zahoor Ahmad (name changed), a spice-seller from the old city suburb of Fateh Kadal, was diagnosed with a medical condition, Deep Venous Thrombosis (DVT), of which little is known about in the Kashmir valley.
DVT is a medical condition which afflicts people who travel on long flights. Known commonly as Economy Class Syndrome or Cattle Class Syndrome, it causes a clot to form in a leg and the clot, in some instances, could travel all the way up to the lungs and could even cause death. According to a report, one in four people globally die due to conditions caused by thrombosis.
Till some time back, it was believed that only passengers travelling on long haul flights in cramped conditions were at risk of developing this medical condition but the researches have proven that the people who tend to lead sedentary lives are also at risk of developing DVT.
“I was fine and fit. I never knew that I had to face DVT. It was a different thing for me as I did not have any knowledge about it. I sometimes had difficulty walking and felt a little pain. I thought it might be weakness or tiredness. When I was diagnosed with DVT I moved outside for treatment,” said Zahoor. 
Dr Khurshid Aslam, a renowned cardiologist in Kashmir told Rising Kashmir that people who are inactive are more prone to DVT. “Since COVID-19 outbreak, people preferred staying indoors and their movement was restricted. Because of this pandemic, we have seen a surge in DVT cases in Kashmir,” Dr Aslam said.
He said people who got infected by COVID were given profolaxes (Hospitalized patients are at increased risk of Venous Thromboembolism (VTE) when compared to patients in the community. Therefore, it is imperative to consider DVT prophylaxis in every hospitalized patient) to prevent DVT. “Elderly who are frail, hypertensive and have advanced lung diseases and those who don’t move around much have a tendency of DVT,” Dr Aslam said.
According to medical studies, if a victim of DVT is not treated properly in time or mistreated due to wrong diagnosis, the blood clots accumulated in veins may travel upwards and go back to heart, from where these clots might finally end up in the lungs. This condition is called Pulmonary Embolism (P.E.), and it is life threatening. In such a situation, the patient develops breathlessness and blood pressure drops significantly. 
In some patients, there is a possibility of losing the limb if the condition worsens. In such an emergency situation, an operation called venous thrombectomy has to be performed. In this operation, blood clots are removed surgically from the large-size veins, which are then surgically connected to an artery in the thigh to get pure blood supply so that the vein does not collapse.
In 2015, Mohammad Amin Bhat, a resident of Purshyar area of Habba Kadal in Srinagar died due to Pulmonary Embolism which is the most dreaded complication of DVT.
“He was a healthy and fit person. He would consult a doctor even If he had a simple flu. Once he felt a sudden pain in his lumbar region, we consulted many doctors but none said that he has a DVT. When his condition deteriorated, we went to SKIMS hospital. We wanted to go outside for his treatment but doctors did not allow us. He died in SKIMS hospital. If doctors claim that they have all the facilities here in Kashmir then why did they fail to diagnose my husband,” said Bhat’s wife. She blamed her husband’s death on the doctors treating him, saying they were negligent in their duty to treat her husband.
Medical experts say, it sometimes could be very difficult to diagnose the condition because many times a patient might not have the symptoms that correspond with DVT.
According to the doctors, the factors that cause DVT or blood clots may include cancer or sometimes genetic conditions. The other cause of DVT is when blood flow is abnormal, such as when a person remains seated for a long time. The third factor includes injuries to the lining of blood vessels that occur through smoking or surgery. 
“Deep venous thrombosis is the formation of a blood clot in one of the veins of the body, usually leg veins. It presents as swelling of leg, ankle or foot usually on one side. Dislodgement of clot can lead to life threatening pulmonary embolism,” Dr Hamed Bashir, Consultant cardiologist at Shri Maharaja Hari Singh (SMHS) hospital told Rising Kashmir. 
He said causes of DVT include Surgery, trauma, bone fracture, a long period of bed rest or sitting for a long time (e.g., on an airplane or in a car), cancer, pregnancy, birth control pills or hormones taken for symptoms of menopause and varicose veins.
According to him there are certain measures that can prevent DVT. Quit smoking, lower your blood pressure with dietary changes, like reducing your salt and sugar intake, lose weight if you're overweight, avoid sitting for long periods of time, exercise, such as walking or swimming, every day can prevent one from DVT.
“In case of recurrent DVT, extensive evaluation is required and prolonged anticoagulation therapy may be needed,” Dr Hamed said.
How to prevent DVT? 
One should exercise regularly to prevent the attack of DVT. If you walk four to five kilometers daily in the morning and exercise your legs and feet, the possibility of pooling of deoxygenated impure blood in the leg vein becomes very less because of strengthened muscular pump of leg. The persons on prolonged bed rest due to cancer, paralyzed patients, young mothers with recent deliveries, ladies on contraceptives or hormone therapy, are at high risk of developing DVT, therefore they need to take special precaution and care.  
How can one avoid developing blood clots in deep veins?
·         Know the situations that can create blood clots in the leg.
·         If you are set for long rides which will keep you immobile, prepare well.
·         Drink lots of water and avoid excessive alcohol intake.
·         Time yourself and get up every hour or so. Choose an aisle seat, walkabout.
·         As often as possible, stretch your legs, calves or rotate your ankles.
·         If you are in bed, move your legs unless you have been advised by the doctors against it.
·         Stretch the legs, bend your knees, or point and flex your feet.
·         Don’t ignore varicose veins condition, wear compression stockings.

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