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  1. #1
    MembersZone Subscriber MalahatTwo7's Avatar
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    Exclamation Leg Pain Can Be Silent Killer

    Leg Pain May Signal 'Silent Killer'. Blood Clots Could Cause 100,000 Deaths A Year

    POSTED: 10:31 am EDT September 15, 2008

    WASHINGTON -- Far too many Americans die 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.

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

    Copyright 2008 by The Associated Press.


    Submitted for discussion. How many acutally know about this condition or have encountered it on the Street?


  2. #2
    MembersZone Subscriber JHR1985's Avatar
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    doesnt really affect us...

    granted, something you should think about in the back of your mind

    but unless they are having a PE, what are you going to do for it?

    And even if they are having a PE... what are you going to do for it?
    The Box. You opened it. We Came...

    "You'll take my life but I'll take your's too. You'll fire musket but I'll run you through. So when your waiting for the next attack, you'll better understand there's no turn back."

  3. #3
    MembersZone Subscriber MalahatTwo7's Avatar
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    doesnt really affect us...
    You are "Human" as in Homo Sapiens Sapiens, right? The idea of the post was more informative at the personal level, rather than in terms of patient care.

  4. #4
    Forum Member DaSharkie's Avatar
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    Quote Originally Posted by JHR1985 View Post
    doesnt really affect us...

    granted, something you should think about in the back of your mind

    but unless they are having a PE, what are you going to do for it?

    And even if they are having a PE... what are you going to do for it?
    I treat a PE or DVT at least on a monthly basis in the ED I work in - roughly 51,000 visits per year.

    It affects EVERYONE. A DVT is easily treated if found. If not it can go to the lungs - although it is exceedingly difficult for one below the knee to do so.

    If you have a PE, we treat you with medications or catheterize you to remove the clot. If it is recurrent, then you can have a IVC filter placed as well as be on Coumadin for the rest of your life.

    I have seen 18 year olds, 40 year olds, and 70 year olds with DVTs and PEs. Everyone is at risk. From obese, to marathone runners (the 40 year old), from College kids (my 18 year old) to the 70 year old with cancer. I have seen Pregnant women with them too.

    The City of Worcester, MA has a firefighter on disability right now who threw a PE while on the job. This most certainly affects you.
    "Too many people spend money they haven't earned, to buy things they don't want, to impress people they don't like." Will Rogers

    The borrower is slave to the lender. Proverbs 22:7 - Debt free since 10/5/2009.

    "No man's life, liberty, or property are safe while the legislature is in session." - New York Judge Gideon Tucker

    "As Americans we must always remember that we all have a common enemy, an enemy that is dangerous, powerful and relentless. I refer, of course, to the federal government." - Dave Barry

    www.daveramsey.com www.clarkhoward.com www.heritage.org

  5. #5
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    interesting article.
    Last edited by superchef; 09-18-2008 at 01:42 PM.

  6. #6
    MembersZone Subscriber JHR1985's Avatar
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    dumbasses....


    I was refering to how are we going to treat it in the field...

    I've had several and lost several from PE's...

    Not much we can do in the field.

    Good God sometimes I wonder if you people can read and think at the same time
    The Box. You opened it. We Came...

    "You'll take my life but I'll take your's too. You'll fire musket but I'll run you through. So when your waiting for the next attack, you'll better understand there's no turn back."

  7. #7
    MembersZone Subscriber MalahatTwo7's Avatar
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    Quote Originally Posted by JHR1985 View Post
    dumbasses....


    I was refering to how are we going to treat it in the field...

    I've had several and lost several from PE's...

    Not much we can do in the field.

    Good God sometimes I wonder if you people can read and think at the same time
    Actually, yes, I can. I can also chew bubble gum and walk, while reading and thinking, all at the same time. Just don't ask me to turn cartwheels - I have not quite mastered that yet.

  8. #8
    MembersZone Subscriber JHR1985's Avatar
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    tell you what....

    I wont ask you to do cartwheels BUT I will ask you to hop on one leg while scratching yourself with your free hand...

    But dont worry, I wont ask you to treat PE's in the prehospital setting
    The Box. You opened it. We Came...

    "You'll take my life but I'll take your's too. You'll fire musket but I'll run you through. So when your waiting for the next attack, you'll better understand there's no turn back."

  9. #9
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    Back in May when I broke my tibia plateau,I was prescribed self injected Lovenox(sp?) to keep the blood thinned out after they rolled me to the curb and tipped the wheelchair over.This was due to one of the operation I got knocked out for was to reduce the compartment syndrome that occurred when I fell.
    If you don't know what self injected Lovenox is,watch "Deadliest Catch" where Phil is crying about needles in his big ol' belly.Mine didn't hurt that much.Towboat deckhands are tough and used to hard ships.
    They also wanted me to do ankle pumps and leg flexes hourly to keep the blood flowing and any clot build up to a minimum.
    It must work because here I am listening to CBD and Three Dog Night as I post.Before I fell,I was taking 82mg aspirin to keep minor aches down as I work in a very physical environment and have to keep up with kids in their 20s.I still do since even though I am moving around and walking AMA,I still sit around the house more than I usually do.
    I don't think that telling a patient with a visibly broken leg to flex and extend said leg would be approved in any prehospital setting,though.You might check with your standing orders or on line medical control just in case I am wrong.
    Last edited by doughesson; 09-18-2008 at 01:24 PM.

  10. #10
    Forum Member DaSharkie's Avatar
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    Quote Originally Posted by JHR1985 View Post
    dumbasses....


    I was refering to how are we going to treat it in the field...

    I've had several and lost several from PE's...

    Not much we can do in the field.

    Good God sometimes I wonder if you people can read and think at the same time

    Well excuse me if I am not clarevoyant and able to discern the meaning of your post when it is not written.

    You can stop being insulting. If you read your post, you will understand that people are not going to think about what you mean.
    "Too many people spend money they haven't earned, to buy things they don't want, to impress people they don't like." Will Rogers

    The borrower is slave to the lender. Proverbs 22:7 - Debt free since 10/5/2009.

    "No man's life, liberty, or property are safe while the legislature is in session." - New York Judge Gideon Tucker

    "As Americans we must always remember that we all have a common enemy, an enemy that is dangerous, powerful and relentless. I refer, of course, to the federal government." - Dave Barry

    www.daveramsey.com www.clarkhoward.com www.heritage.org

  11. #11
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    Quote Originally Posted by DaSharkie View Post
    You can stop being insulting.
    That aint happening...
    I am now a past chief and the views, opinions, and comments are mine and mine alone. I do not speak for any department or in any official capacity. Although, they would be smart to listen to me.

    "The last thing I want to do is hurt you. But it's still on the list."

    "When tempted to fight fire with fire, remember that the Fire Department usually uses water."

  12. #12
    MembersZone Subscriber JHR1985's Avatar
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    That aint happening...
    damn right....
    The Box. You opened it. We Came...

    "You'll take my life but I'll take your's too. You'll fire musket but I'll run you through. So when your waiting for the next attack, you'll better understand there's no turn back."

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