Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
This weekend, as I drove
the 5 hours to the north Wisconsin woods, I reminded myself of advice I give to
my patients: remember to get out of the car and move around. It's also why,
buried deep in the recesses of the in flight magazine, somewhere between the
movie grid and the duty free opportunities, hides a warning that staying still
in an airplane seat for a prolonged time can cause
blood clots. And while the
magazine recommends moving around the cabin and stretching, the flight
attendants tend to want to keep you in your seat.
Blood does wonderful things like carrying oxygen, cleaning waste products,
and delivering cells and chemicals to fight infection. But mess up its
environment and blood can cause all sorts of problems. Blood cells get pushed by
the heart to the far recesses of the body, but returns from the fingers, toes,
arms and legs in veins that are milked by the routine contractions of the
muscles that surround them. As you walk, blood gets pushed back to the heart; as
you type, the muscles of your fingers and hands do the work to get the blood
back.
Without that muscle movement, blood stagnates and has a tendency to clot...
Arteries have thin muscles within their walls to be able to withstand
the pressure of the heart pumping blood to the far reaches of the body.
Veins don't have a significant muscle lining, and there is nothing pumping blood
back to the heart except physiology. Blood returns to the heart because
the body's large muscles squeeze the veins as they contract in their
normal activity of moving the body. The normal activities of moving the
body returns the blood back to the heart.
There are two types of veins in the leg; superficial veins and deep veins. Superficial veins lie just below the skin and are easily seen on the surface.
Deep veins, as their name implies, are located deep within the muscles of
the leg. Blood flows from the superficial veins into the deep venous system through
small perforator veins. Superficial and perforator veins have one-way valves
within them that allow blood to flow only in the direction of the heart when the
veins are squeezed.
A blood clot (thrombus) in the deep venous system of the leg is not dangerous in
itself. The situation becomes life-threatening when a piece of the blood clot breaks off
(embolus, pleural=emboli), travels downstream through the heart into the
pulmonary circulation system, and becomes lodged in the lung. Diagnosis and
treatment of a deep venous thrombosis (DVT) is meant to prevent pulmonary embolism.
Clots in the superficial veins do not pose a danger of causing pulmonary
emboli because the perforator vein valves act as a sieve to prevent clots from
entering the deep venous system. They are usually not at risk of causing pulmonary
embolism.
Picture of a blood clot is formed
What are the causes of deep vein thrombosis?
Blood is meant to flow; if it becomes stagnant there is a potential for it to
clot. The blood in veins is constantly forming microscopic clots that are
routinely broken down by the body. If the balance of clot formation and
resolution is altered, significant clotting can occur. A thrombus can form if
one, or a combination of the following situations is present.
Immobility
Prolonged travel and sitting, such as long airplane flights ("economy
class syndrome"), car, or train travel
Hospitalization
Surgery
Trauma to the lower leg with or without surgery or casting
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, or even fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
Blood clots can occur in the venous and arterial vascular system. Blood clots can form in the heart, legs, arteries, veins, bladder, urinary tract and uterus. Risk factors for blood clots include high blood pressure and cholesterol, diabetes, smoking, and family history. Symptoms of a blood clot depend on the location of the clot. Some blood clots are a medical emergency. Blood clots are treated depending upon the cause of the clot. Blood clots can be prevented by lowering the risk factors for developing blood clots.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
A pulmonary embolism occurs when a piece of a blood clot from deep vein thrombosis (DVT) breaks off and travels to an artery in the lung where it blocks the artery and damages the lung. The most common symptoms of a pulmonary embolism are shortness of breath, chest pain, and a rapid heart rate.
Edema is the swelling of tissues as a result of excess water accumulations. Peripheral edema occurs in the feet and legs. There are two types of edema, non-pitting edema and pitting edema. Causes of pitting edema is caused by systemic diseases, most commonly involving the heart, liver, and kidneys. Local conditions that cause edema are thrombophlebitis and varicose veins. Edema is generally treated with medication.
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Varicose vein: A dilated (widened) tortuous (twisting) vein, usually involving a superficial vein in the leg, often associated with incompetency of the valves in the vein. These visible and bulging veins are often associated with symptoms such as tired, heavy, or aching limbs. Spider veins are a group of widened veins that can be seen through the surface of the skin.
Jet lag (desynchonosis) is a temporary disorder that results from travel across time zones. Symptoms include anxiety, constipation, headache, nausea, dehydration, diarrhea, confusion, sweating, irritability, and even memory loss.
Sudden cardiac arrest is an unexpected, sudden death caused by sudden cardiac arrest (loss of heart function). Causes and risk factors of sudden cardiac arrest include (not inclusive): abnormal heart rhythms (arrhythmias), previous heart attack, coronary artery disease, smoking, high cholesterol, Wolff-Parkinson-White Syndrome, ventricular tachycardia or ventricular fibrillation after a heart attack, congenital heart defects, history of fainting, and heart failure, obesity, diabetes, and drug abuse. Treatment of sudden cardiac arrest is an emergency, and action must be taken immediately.
Phlebitis is the inflammation of a vein. Thrombophlebitis is when a blood clot causes the inflammation. Phlebitis can be superficial or deeper in the veins. A blood clot deep in a vein is deep vein thrombosis (DVT). Some of the common causes of phlebitis include prolonged inactivity, varicose veins, trauma to a vein, underlying cancers, clotting disorders, etc. Symptoms of phlebitis may be mild (pain, tenderness, redness, or bulging of a vein. Treatment of phlebitis depends on the cause.
Antiphospholipid syndrome (phospholipid antibody syndrome or Hughes syndrome) is an immune system disorder characterized by excessive blood clotting and/or pregnancy complications (premature miscarriages, unexplained fetal death, or premature birth) and the presence of antiphospholipid antibodies (cardiolipin or lupus anticoagulant antibodies) in the blood. Treatment focuses on preventing clotting by thinning the blood with the use of anticoagulants and aspirin.
Smoker's lung photo essay is a collection of pictures and microscopic slides of lung disease caused by cigarette smoking. Smoker's lung refers to the diseases and structural abnormalities in the lung caused by cigarette smoking.
Lymphedema is a common chronic, debilitating condition in which excess fluid called lymph collects in tissues and causes swelling in them. It is common after a mastectomy, lumpectomy or breast cancer surgery and radiation therapy.
Jet lag, also called desynchronosis and flight fatigue, is a temporary disorder that causes fatigue, insomnia, and
other symptoms as a result of air travel across time zones. It is considered a circadian rhythm sleep disorder, which is a disruption of the internal body clock.
What are other symptoms and signs of jet lag?
Besides fatigue and insomnia, a jet lag sufferer may experience a number of physical and emotional symptoms including anxiety, constipation, diarrhea, confusion, dehydration, headache,
irritability, nausea, sweating, coordination problems,
dizziness, and even memory loss. Some
individuals report additional symptoms, such as heartbeat
irregularities and increased susceptibility to illness.
Children can also suffer the same jet lag symptoms as adults.
What is a time zone?
A time zone is a geographical region which has the same time everywhere w...