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Venous thromboembolism: The deadly condition that affects more men than women

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He was then 58 years old, Kevin Wilson, paramedic, Durham, N. C., awoke on a morning in January in excruciating pain.

“I felt like my chest had imploded,” he recalled. “I said to my wife:” I’m in trouble.'”

He called 911 and when the ambulance arrived, Wilson was in deep breathing problems.

“I could talk in barely one-word-sentences. I knew that something catastrophic was happening,” he said.

When he arrived at the hospital, doctors discovered that Wilson had a massive saddle pulmonary embolism, a blood clot that blocks the main pulmonary artery from the heart, where it divides into two main arteries that lead to the lungs. Since blood was completely cut off from one side of his heart, was enlarged.

Wilson 12 hours in the resuscitation room, where the team of doctors and nurses pumped him full of blood thinners, monitored his oxygen levels and made sure the blood clot does not move.

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Although he was stabilized, his condition remained uncertain.

“I really had not thought that I would make it through the night,” he said.

For the next three days he had to stay in bed, motionless, even as tears streamed down his face.

“They were very afraid that if I moved, that I would dislodge the blood clot and it would kill me immediately,” he said.

What is a venous thromboembolism?
Venous thromboembolism (VTE) is a disease that is both deep venous thrombosis (DVT) when a blood clot forms in a deep vein, and pulmonary embolism (PE), when a blood clot breaks off and travels from the leg to the lungs.

Each year, approximately 900,000 people are diagnosed with VTE, according to the Centers for Disease Control and Prevention (CDC). Between 60,000 and 100,000 people in the U.S. die of VTE, and between 10 to 30 percent die within a month of the diagnosis.

Men and women have the same risks for a first episode of VTE. In fact, the prevalence of DVT in men was 14 percent, compared to9 percent for women, according to a study in the Journal of Thrombosis and Haemostasis.

However, in comparison with women who have no risk factors for VTE, which include pregnancy, oral contraception and in hormone replacement therapy, men are more than twice as likely to get a VTE, according to a study in the journal Circulation.

“The risk of a recurrence [to] venous thromboembolism is higher in men. In terms of annual risks, it’s about two, maybe two and a half times higher,” said Gary E. Raskob, PhD, chairman of the ISTH World Thrombosis Day steering committee.

Although it is not clear why, experts believe that it is likely there is some genetic difference between men and women, Raskob said.

Know your risk
There are several risk factors men have for FTE’s. They include:

  • A height of 6 feet or higher
  • Obesity and a larger than normal waist
  • Smoking
  • A sedentary lifestyle
  • Sitting for long periods of time or prolonged bed rest
  • A condition in which the blood clotting such as a severe infection or an autoimmune inflammatory disease
  • A family history of blood clots or a heart attack
  • Physical trauma or surgery.
  • Age: men over 40 have a higher risk

Men who have testosterone replacement therapy and a 63 percent increased risk, according to a recent study in the journal BMJ.

And simply being admitted to the hospital can increase a man’s risk. In fact, 60 percent of the Ftes occur during or within 90 days of a stay in the hospital, another study in the journal of the british medical journal found.

Symptoms of venous thromboembolism
If you suspect that you are FTE, it is important to recognize the signs early on. You can swelling, tenderness, redness, warmth or pain in your leg or calf, chest pain, shortness of breath, rapid breathing, an irregular heartbeat or palpitations, feeling light-headed or fainting.

“If someone has a clot, [it’s] usually because there is a blockage of the blood flow, and thus the symptoms are usually quite dramatically and quite quickly in the beginning,” said Dr. Amy Doneen, medical director of the heart attack and Stroke Prevention Center in Spokane (Washington), and adjunct professor for the Texas Tech Health Sciences Center. “It is a medical emergency, so people need to go and be evaluated.”

The prevention of venous thromboembolism
Although you can’t change your height, you can take steps that can reduce your risks, such as smoking cessation, exercise, stay well hydrated and avoid sitting for too long. If you are stuck on a long flight, or even on your computer for a longer period of time, consider wearing compression stockings to prevent the blood from pooling in the legs.

When you are admitted to the hospital for something, the request of a VTE risk assessment.

“Ask your doctor,” What is my risk of VTE? Do I need preventative measures to take?,'” Raskob said.

More importantly, however, is never ignore or brush off your symptoms and call your doctor immediately.

“It is a small inconvenience to your time, but it can save your life,” Raskob said.

A happy ending
For Kevin Wilson, a combination of flying more than 12,000 km in a few weeks and surgery to repair a hernia were the factors that led to his FTE.

Five days after his hospitalization, he was released and had to remain on blood thinners for 18 months. But after he stopped the medication, he had a small clot in his lungs and was put back on blood thinners for the rest of his life.

Given the line of work, Wilson said, although he never took life for granted, now he doesn’t let the little things in life bother him.

“It made me think in a more dramatic way of how precious life is,” he said. “I’m really grateful to be here.”

Julie Relevant, is a health journalist and a consultant who provides content marketing and copywriting services for the health care. She is also a mother of two. More information about Julie at revelantwriting.com.

 

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