Healthy Me - At Home and Away: Deep vein thrombosis

Showing posts with label Deep vein thrombosis. Show all posts

Wednesday, May 27, 2009

Stockings 'useless in reducing clots' after stroke

Time is GMT + 8 hours
Posted: 27-May-2009 19:59 hrs

A file photo of an IRM machine at a hospital in 2007. Special stockings designed to prevent dangerous blood clots among stroke patients are no better than routine care, according to a study published on Wednesday by The Lancet.

Special stockings designed to prevent dangerous blood clots among stroke patients are no better than routine care, according to a study published on Wednesday by The Lancet.

Millions of these thigh-length, graduated stockings are given out each year to stroke victims in the belief the garment curbs the risk of deep vein thrombosis (DVT), a potentially life-threatening clot that forms in the leg.

DVT is notorious in so-called economy-class syndrome, in which airline passengers, hunched in cramped seating for long flights, develop the clot because of poor blood circulation in their legs.

But the condition can occur in any position where an individual is sedentary for long periods, and is particularly a risk for hospitalised stroke patients.

British doctors carried out a study among 2,500 patients who had been admitted to hospitals in Australia, Britain and Italy within a week of a stroke and were bedridden.

Half of the patients received normal care only for hospitalised stroke victims, and the other half received normal care plus the compression stockings. The patients were twice checked for clots by ultrasound scanner.

In the stockings group, 10.0 percent suffered a DVT, while in the normal-care group the figure was 10.5 percent, a difference that was statistically insignificant.

In addition, five times as many patients wearing the stockings suffered skin breaks, blisters and skin ulcers as their counterparts.

"Abandoning this ineffective and sometimes uncomfortable treatment will free up significant health resources -- both funding and nurse time -- which might be better used to help stroke patients," said lead researcher Martin Dennis of the University of Edinburgh. — AFP

From TODAYOnline.com, Health – Wednesday, 27-May-2009; see the source article here.

----------
Looking for safe and sound but effective alternatives?

Tuesday, May 26, 2009

Varicose veins not just cosmetic Prevent varicose veins

LEG WATCH
They could lead to serious medical complications. Your love for skyscraper heels and leg-crossing may increase your risk of getting varicose veins.

Eveline Gan, eveline@mediacorp.com.sg

The 50-year-old man had gone to see Dr Imran Nawaz about a chronic ulcer in half of his leg. He had lived with the condition for about a decade.

Instead of treating the ulcer first, the consultant vascular surgeon at the Singapore Vein Centre (SVC) turned his attention to the unsightly varicose veins above it. The man's ulcer healed in three months.

"Many people think varicose veins are just a cosmetic problem but it's not true," said Dr Nawaz, who is also the director of SVC.

Hard-to-heal ulcers, which the 50-year-old patient suffered from, are just one of the painful complications caused by severe varicose veins.

About one in five adults in Singapore suffers from this condition in varying degrees, added Dr Nawaz.

Varicose veins — which often appear as blue or dark purple linear bulges on the legs or lower body — occur when faulty valves in the veins impair blood circulation.

"When blood is unable to flow back to the heart properly, it pools in the veins, causing them to swell and bulge," said Dr Nawaz.

People at risk include those who have had multiple pregnancies or whose work requires them to stand for long periods of time. Genes also play a major role.

According to Dr John Tan, a consultant vascular surgeon at Paragon's The Vein Clinic, about 40 to 50 per cent of people with varicose veins may experience symptoms such as swollen ankles or cramps and aches after long periods on their feet.

While most people can live with minor vein problems with no mishaps, a minority — one to three per cent — may experience more serious medical complications over time, said Dr Tan.

Severe varicose veins, which are also "high pressure veins", may sometimes rupture and bleed, he added.

In addition, those with varicose veins are at an increased risk for deep vein thrombosis, the blood vessel specialists said.

Deep vein thrombosis occurs when blood circulation in the leg's deeper veins is blocked, causing blood clots.

The clots restrict blood circulation and are potentially fatal if they move towards the heart or lungs, said Dr Nawaz.

IT CAN BE FIXED
Traditionally, affected veins are treated using an invasive, surgical method called vein stripping, said the specialists. The treatment is performed under general or regional anaesthesia, and hospitalisation is often required.

"Some people neglect their vein problem because they think it's purely a cosmetic concern, and wonder why they should through the hassle of an operation," said Dr Nawaz.

But treatment for varicose veins has evolved.

A newer, less invasive alternative includes Endovenous Laser Treatment (EVLT).

Patients can also opt for injection sclerotherapy. Unlike the traditional method where the vein is removed surgically, these treatments "seal off" the veins, which then shrink and disappear over time, said Dr Tan.

Injection sclerotherapy involves injecting a chemical solution into the vein, and usually requires multiple injections.

In EVLT, a fibre optic wire is inserted into the vein, which is heated up with laser energy. The vein then shrinks and disappears over time.

"Many people wonder if it's bad to close up a vein. But bear in mind that a leaking vein is a liability. Paradoxically, sealing off the vein improves circulation instead," said Dr Tan.

Consultant vascular surgeon Dr John Tan of The Vein Clinic gives tips on how you can reduce your risk of developing varicose veins.

Wearing graduated compression stockings may help, especially for those at risk of the condition.

If you need to stand or sit for long periods of time, make sure you get up and walk around every half hour to work out your calf muscles.

If you must stand for long hours, tip-toe around to help improve circulation.

Tight clothing, especially those that constrict the thighs, is bad for circulation. So are high heels.

But if you can't bear to give up your heels, wear them only for special occasions instead of all the time.

Try not to cross your legs too much when sitting.

A lifestyle involving regular exercise and a balanced diet will help.

From TODAY, Health – Tuesday, 26-May-2009

----------
Here are alternatives: in liquid form or in caplets, your choice

Saturday, May 2, 2009

ASK THE DOC: Birthmark Removal

English: birthmark commonly known as "stork bite" or "angels kiss" Deutsch: sogenannter "Storchenbiss"; Geburtsmahl im Nacken eines wenige Tage alten Babys (Photo credit: Wikipedia)

QUESTION BY MDM KIM TEO

I was delighted to read “Don’t let the brown get you down”, an article about birthmarks in Today early this year.

My 10-year-old daughter has a brownish, coffee-cream birthmark about the size of a 50-cent coin on her face. The birthmark is getting more noticeable and people are starting to be curious about it.

I consulted a dermatologist last year and he suggested that my daughter wait for a sharper contrast between the colour of the birthmark and the surrounding skin before undergoing laser treatment. However, I’d like to find out if it’s possible to get rid of the birthmark before it bothers her further. Can the prescription cream Tri-Luma be used on the birthmark and is there any technology — IPL, laser treatment — that can remove the birthmark?

REPLY BY DR DERRICK AW
Dermatologist, University Medicine Cluster,
National University Hospital

I suspect your daughter may have a café-au-lait spot and am afraid that Tri-Luma is not the appropriate treatment for it.

Tri-Luma is more suitable for certain acquired conditions than hereditary conditions such as birthmarks.

Tri-Luma also contains a medium-strength steroid , which may not be suitable for a child as it may cause the skin to thin. Already, a child’s facial skin tends to be thinner than that of an adult.

The cream also contains a retinoid that will cause redness, dryness and irritation to a child’s face.

From my knowledge, QS ND: YAG laser treatment — a type of pigment laser — is the only treatment in Singapore for café-au-lait spots.

The treatment may require several sessions, separated by at least two months’ interval. Your daughter may need about 5 to 10 sessions. The treatment aims for a 60 to 80 per cent reduction in pigmentation.

The risks of laser treatment for café-au- lait spots are pigmentation (darkening), as well as recurrence and persistence of pigmentation.

The information provided above is for your general knowledge only. You should seek medical advice or treatment for your condition. Email questions to health@newstoday.com.sg.

From TODAY, Health – Tuesday, 28-April-2009