We used to hear about deep vein thrombosis (DVT) all the time, being associated with economy class air travel. Passengers were encouraged to get up and walk around hourly to prevent clots from forming in the legs. When things fall apart, however, we probably won’t be flying much. We’ll see DVT cases popping up in our more senior relatives and bedridden patients. Such doesn’t have to be the case if we prepare.
A common cause of death for the bedridden, DVT most frequently develops due to prolonged immobility. It is exacerbated by fractures in the lower legs, cancer, poor circulation in the legs (especially among diabetics), or a genetic predisposition to blood clotting.
Most blood clots originate in the veins of the legs, where the blood is moving more slowly. Of greatest concern is when these clots dislodge and are carried through the heart to the lungs, where they may cause chest pain, shortness of breath, or even death through pulmonary embolism. (Nothing we can do about it, it’s difficult to manage in a timely manner even with modern medicine immediately at our disposal. However, I’ve read that it is a very nice way to go. If I got to choose how to go, this is probably what I would pick.) For better or worse, most blood clots stay put.
Deep vein thrombosis (DVT) occurs when a clot forms in the deep veins of the leg, most often the thigh. Such a clot will cause swelling from the knee down, more than what is normal for that patient on a single side.[1] In other words, the swelling will be asymmetrical. DVT is most common in patients already suffering from swollen legs and poor veins. The treatment goal is not to dislodge the clot. [2] If the clot is disrupted, it may lodge in the heart or pulmonary artery and block the circulation, resulting in death.
Symptoms may develop suddenly or rapidly over a short period of time. They include:
- A feeling of heaviness or fullness, usually in the calf.
- Leg pain
- Calf muscle tenderness
- Heat
- Swelling
- Redness
- Or the leg may turn purple or blue
The only treatment available in a collapsed society will be aspirin, one 325-mg tablet per day for at least 3 months, and taken with food. The authors of Survival and Austere Medicine, 3rd Edition, suggest one 81-mg aspirin tablet per day.[3] Elevate the affected limb, apply heat, and wrap the limb in an ACE bandage.[4]
Preventative measures, particularly in patients with varicose veins, include the following:
- Exercise legs
- Avoid standing for long periods of time
- Shift weight from one foot to the other frequently
- Take short walks if sitting all day
- Lose weight to reduce strain on the legs
- Elevate legs above the heart for 30 minutes each day and while sleeping
-
Reduce salt in the diet
Especially for elderly sick patients, the benefits of bed rest must be weighed against the risks of developing clots. They need to get up a walk several times per day. They shouldn’t cross their legs in bed and legs should be massaged and stretched at least 3-4 times per day.
Herbal remedy: Horse chestnut, 300 mg of extract, 2x per day. Or create a liniment with 4 parts witch hazel to 1 part horse chestnut tincture and rub on affected varicose veins. Not for use in those with liver or kidney disease.[5]
Links to related posts:
Varicose Veins
[1] Cynthia Koelker, Armageddon Medicine, 2012, 338.
[2] Cynthia Koelker, Armageddon Medicine, 2012, 338.
[3] Survival and Austere Medicine, 3rd Edition, 2017, 434.
[4] Cynthia Koelker, Armageddon Medicine, 2012, 338.
[5] Joseph Alton, Survival Medicine Handbook, 2021, 369-70.
