How do I prevent blood clots?

Question: I have secondary progressive MS and have been wheelchair-bound for several years. A few years ago it was discovered that I have blood clots in my legs and I have been on a therapeutic dose of Coumadin ever since. Is this common? Are there any ways to increase blood flow without the use of medication?

Answer: Blood clots in the legs or Deep Venous Thombosis (DVT) is a common complication in anyone with decreased mobility especially those wheelchair bound. Remember, blood is pumped by your heart into arteries that supply oxygenated blood to your limbs and organs but there is no pump except your muscles to return the blood to your heart through your veins. It is the contraction of your muscles that pumps the blood back to your heart much like squeezing toothpaste out the tube. If your muscles do not move the blood sits longer in your veins and can clot. Often the first symptom is swelling of one leg below the level of the clot or pain. One of the reasons graduated pressure stockings are used is to prevent swelling of the legs and the formation of these blood clots. (Click 'read more' below...)

Once a blood clot develops, the usual rule of thumb is to treat the patient with warfarin or another new blood thinner for 6 to 9 months after a single episode and provide lifelong treatment in individuals with recurrences or other predisposing features. There are other options but all involve either using a "blood thinner” or using a mechanical device to prevent blood clots from traveling to the lung and causing a pulmonary embolus. This mechanical device of cage is usually inserted into the inferior vena cava.

If you have any specific questions on this issue, I would address them to your primary care physician. They are usually very knowledgeable in the management of DVTs.

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