The wife of an elderly gentleman called me last week in a bit of a panic. Her husband had been out for a stroll, and returned with a leg so swollen he was finding it difficult to walk on. When I checked him over, the whole leg was swollen from foot to thigh, and although his skin wasn’t particularly reddened, it was quite warm compared to the other leg.
What is DVT?
There were several possibilities here, but the first to spring to mind is a blood clot in one of the leg veins. A clot (or DVT – Deep Vein Thrombosis) is a potentially serious medical condition. The clot inhibits the return of blood from the limb which results in the swelling and heat. However, the serious danger arises if the clot dislodges, and travels through the bloodstream. Venous blood from the body is on its way back to the heart and then the lungs, and a clot being carried along can easily get lodged in one of the small blood vessels here. You may then suffer with chest pain, breathlessness, a cough (usually dry, though you may cough up some blood) – although sometimes there are no symptoms. A clot can cause damage to lung tissue, and a severe one can sometimes result in a cardiac arrest (it stops the heart pumping). That’s why it’s important to treat DVT rapidly.
Who gets DVT?
The elderly gentleman was at risk for DVT, because he’d suffered twice with clots in his lower leg previously. He also spends a fair amount of time sitting in his armchair. On top of that, prostate enlargement, so common in older men, meant that he struggled to empty his bladder fully, and when sitting down the heavy bladder was pressing on the blood vessels in the pelvis. This slows down the blood flow, and increases the risk of clots forming. Pressure on the pelvis is also one of the reasons DVT occurs more commonly in pregnant ladies. Other risk factors are extended periods of immobility, such as long journeys or bed-rest. This is why hospitals are very keen for their patients to get moving again as quickly as possible after surgery.
What happens next?
A trip to the emergency doctor got our gentleman started on anti-coagulant medication as a precaution, and the following day he was sent to the hospital for an urgent ultrasound scan. A DVT was indeed found in his upper thigh. This being his third DVT, he will now continue to take medication for the rest of his life to prevent future recurrences.
If you know an elderly person who spends long periods of time sitting, encourage some movement into their daily lives. A little walking can not only help prevent clot formation, but improve strength and balance, reducing the risk of falls. Even exercise in the chair can go a long way to help maintain health. Get them bending and flexing at the ankles – working the muscles of the calf helps to get that blood moving back up the legs.
An osteopath is trained to look for problems that may require medical intervention. Unexplained swelling and warmth in the legs should be treated as DVT until it’s proven otherwise. If in doubt, dial 111 for guidance.