Leg Pain can signal blood clots

WASHINGTON – Far too many Americans are dying of dangerous blood clots that can masquerade as simple leg pain, says a major new government effort to get both patients and their doctors to recognize the emergency in time.

"It's a silent killer. It's hard to diagnose," said acting Surgeon General Dr. Steven Galson, who announced the new campaign Monday. "I don't think most people understand that this is a serious medical problem or what can be done to prevent it."

At issue are clots with cumbersome names: A deep vein thrombosis, or DVT, forms in large veins, usually a leg or the groin. It can quickly kill if it moves up to the lungs, where it goes by the name pulmonary embolism, or PE.

These clots make headlines every few years when seemingly healthy people collapse after long airplane flights or being in similarly cramped quarters. Vice President Cheney suffered one after a long trip last year. NBC correspondent David Bloom died of one in 2003 after spending days inside a tank while covering the invasion of Iraq.

But that provides a skewed vision of the problem. While there aren't good statistics, the new surgeon general's campaign estimates that every year, between 350,000 and 600,000 Americans get one of these clots — and at least 100,000 of them die.

There are a host of risk factors and triggers: Recent surgery or a broken bone; a fall or car crash; pregnancy or taking birth control pills or menopause hormones; being immobile for long periods. The risk rises with age, especially over 65, and among people who smoke or are obese.

And some people have genetic conditions that cause no other symptoms but increase their risk, making it vital to tell your doctor if a relative has ever suffered a blood clot.

People with those factors should have "a very low threshold" for calling a doctor or even going to the emergency room if they have symptoms of a clot, said Galson, who issued a "call to action" for better education of both consumers and doctors, plus more research.

Symptoms include swelling; pain, especially in the calf; or a warm spot or red or discolored skin on the leg; shortness of breath or pain when breathing deeply.

But here's the rub: Doctors are ill-informed, too. For example, studies suggest a third of patients who need protective blood thinners when they enter the hospital for major surgery don't get them. And patients can even be turned away despite telltale symptoms, like happened to Le Keisha Ruffin just weeks after the birth of her daughter, Caitlyn.

Ruffin made repeated visits to doctors and emergency rooms for growing pain in her leg and groin in December 2003 and January 2004, but was told it must be her healing Caesarean section scar.

Finally one night, Ruffin's husband ran her a really hot bath for pain relief — only to have her climb out minutes later with her leg swollen three to four times its normal size, and then pass out.

"I like to call that my miracle bath," Ruffin said, because the sudden swelling proved the tip-off for doctors.

Pieces of a giant clot in her right leg had broken off and floated to her lung. The ER doctor "said if I hadn't made it in when I did, I may not have lived through the rest of the night," recalled Ruffin, now 32, who spent a month in the hospital and required extensive physical therapy to walk normally again.

These clots "tend to fall through the cracks" because they cross so many areas of medicine, said Dr. Samuel Goldhaber, chairman of the Venous Disease Coalition and a cardiologist at Boston's Brigham & Women's Hospital.

With the surgeon general's campaign, "DVT after all these years will finally get the national spotlight like cigarette smoking did in the mid-60s," he said.

In addition to Galson's report:

_The Agency for Healthcare Research and Quality is issuing a 12-page booklet to help consumers tell if they're at risk for DVTs and what to do — and a 60-page DVT treatment-and-prevention guide for doctors and hospitals.

_As a prevention incentive, starting Oct. 1 Medicare will withhold payment from hospitals when patients develop the clots after knee- or hip-replacement surgery.


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Just an FYI for everyone. I've been dealing with DVTs and pulmonary embolisms since I was 17. The first time I went to the hospital was with a pulmonary embolism. My leg had been hurting prior to going to the hospital but I put it off as a pulled muscle. A few days later it was hard to breath, hurt everytime I took a breath. I went to the ER, and they sent me home telling me it was pluerisy and would go away on it's own. Because I was 17, and because blood clots are considered "an older person's" problem, they never even considered me for it. About 2 weeks later, my calf and groin was hurting, and my calf swelled up 3 times it's normal size. I again went back to the ER, and the doctor took one look at my leg and told me that it was a clot. Back then, they could only do a dye test to test for clots (no doppler tests back then), and I passed out from the pain during the procedure. I was in the hospital for 22 days, in ICU twice, and they used 2 different kinds of clot busting drugs on me. They sent me home after the 22 days, 2 weeks later I was back at the ER with the same pain I had originally had when they dx'd me with pleurisy. This time they checked for a pulmonary embolism, and dx'd me with clots in both lungs. I was back in the hospital for another 15 days. After that, I went in and out of the hospital numerous times with pulmonary embolisms and deep vein thrombosis. Both my mother and grandmother died from blood clots, so it is hereditary with me.

The clots in my leg generally ran from my ankle up into my groin and higher, and the pain was awful. However, a smaller clot usually feels like a pulled muscle. You may or may not get swelling and redness with it. Sometimes I did, sometimes I didn't. A pulmonary embolism, when you have significant clotting in your lungs, can cause a sharp pain everytime you take a breath. It just hurts to breath. A smaller embolism in your lungs can cause a sharp pain once or twice, and then no more other symptoms. But a small clot in your lung can kill just as much as a larger clot depending upon where it gets lodged.

Blood clots kill more people than breast cancer, car accidents and Aids, and it is the most underfunded health condition for public awareness, research, etc.

To give you an idea of how serious they can be, I have been told repeatedly that if ever a large enough clot goes to my heart or lungs, I have 10 minutes left to live and there isn't anything anyone can do to save me. So I always try to live life fully, because I never know when it will be my last 10 minutes.

If you experience leg pain, or a sharp pain in your lungs when you are breathing, as the article suggests, develop a low tolerance for it and get to the emergency room (especially if you have any of the risk factors, or have had anyone in your family with blood clots ~ of if you are a female and taking hormones/birth control pills).

I rarely see an effort to educate people about clots, and saw this article and wanted to take the time to share it with others.

Interesting read TY


For you


around 11 yrs ago I helped my close friend bury her otherwise very healthy husband - a blood clot took his life in less then 3 minutes

for Judi

We miss you Sam

Some people have no warning or pain at all before disaster hits. It can come from sitting on a plane too long, or not moing around like the reporter on TV that died in Iraq from sitting in a tank without movement for hours. It's really scary.

wow! thanx for sharing this information.
I hope you live a long and happy life.

Thamk you for posting this.

Luckily I have no pain, just a possible ACL injury.

Mach said:

Interesting read TY


For you


around 11 yrs ago I helped my close friend bury her otherwise very healthy husband - a blood clot took his life in less then 3 minutes

for Judi

We miss you Sam

Dayclear said:

Shorty said:

wow! thanx for sharing this information.
I hope you live a long and happy life.

shellyevon said:

Thamk you for posting this.

MIGUELGOMEZ said:

Luckily I have no pain, just a possible ACL injury.