The fact that our blood can clot is a good thing. If it weren’t for this important feature, we would bleed to death if we cut ourselves shaving or fell off a bike. But there are other times when blood clots form and they are harmful, even life-threatening. The medical terms for these blood clots are Deep Vein Thrombosis (DVT) when it is lodged well below the skin, or thrombophlebitis when it is closer to the surface of the skin. This column is written in honor of John D. Hutchinson, a trucker commemorated in the May 2016 edition of 10-4 because of his untimely death from a blood clot. Since truckers are especially susceptible to the harmful blood clots, please read on.
We naturally have substances in our blood and liver that help with blood clotting. The average person with normal amounts of these substances in the blood can find themselves at risk for blood clots because of certain changeable behaviors. For example, sitting for long periods of time, becoming dehydrated, binge drinking alcohol and smoking cigarettes all increase your risk for blood clots. Obesity makes it harder for blood to flow from the lower legs back to the heart. As we get older, this also occurs, and many middle-aged and older people will notice some swelling in their legs as the day goes on. Birth control pills can increase your risk of DVT (this is even riskier if you smoke and take birth control pills).
Blood is viscous – like the oil in your truck. It has a certain thickness and there is resistance to flow if it becomes too thick. The amount of viscosity varies depending on several things – the activity of the heart being one of them – and that varies with the amount of activity a person does. When one is sitting for a long time, the blood becomes more viscous, or thicker, and therefore flows more slowly. While it is flowing slower, there is a greater possibility that some of the cells floating in the blood will stick together and form a clot. The same is true for the person with high LDL (bad) cholesterol. Imagine a clump of bad cholesterol cells sitting in a blood vessel; the blood is trying to flow around it, but the space in the vessel is restricted.
Dehydration – not drinking enough fluid – also contributes to abnormal blood clotting because the blood is more concentrated and thicker when it’s not mixed with enough liquid. Drinking large amounts of alcohol (binge drinking) can also make your blood clot too much. For people who drink wine or beer in moderation (a few drinks per week), risk for blood clots may be lower. Smoking is a real devil here, too (in so many ways besides just blood clots). When a person smokes, the platelets in the blood (cells that help with normal clotting) may stick together forming a clump of cells/blood clot. Smoking also damages the lining of the blood vessels; this rough surface increases the chances that cells will get stuck, forming a blood clot.
Now the really bad news – a clot may stay in the place where it forms or it may eventually break free and travel throughout the body. When it moves to another place it is called an embolus – you may have heard the term pulmonary embolus (PE) – that’s a blood clot that has moved from the place where it originally formed (probably down in the lower limbs) to the lungs. A blood clot could get stuck in your heart or brain, as well, which could be life-threatening.
Some of the symptoms of a blood clot are swelling of one leg (or other limb, but the leg is most common); redness and heat in a leg; pain in leg; shortness of breath; coughing up blood; chest pain; and/or dizziness. If you have any of these symptoms of leg pain and/or swelling, DO NOT RUB YOUR LEG! This may actually make the clot move, and that is the most dangerous scenario. You do not want it to travel to your heart, lungs or brain. Some blood clots can cause symptoms rapidly, while others may gradually cause the symptoms noted above. If you have these symptoms, please see your healthcare provider or go to the nearest ER (emergency room) at a hospital.
So, how can you prevent a blood clot? Stick to water, coffee or tea – the low-octane stuff – to prevent dehydration. If you must sit for a long time, like when you’re driving a truck, try to take short, quick breaks during which you walk around to get the blood flow going again every few hours. In addition to short breaks, pick up compression socks at any pharmacy or big box store. They will help keep your legs from swelling and diminishing blood flow. Do whatever it takes to quit smoking. I smoked two packs a day for ten years, so I know that this is very difficult advice to follow, but take it seriously, because DVT can kill you. Make it okay for yourself and other truckers to do all these things – no making fun of the guys with the compression socks!
Compressions socks/stockings come in regular sock sizes but also have the amount of pressure noted on the label in “mmHg” or millimeters of mercury. They are usually sold in a wide range of compression – for example, “Knee Highs 15-20 mmHg” or similar. The range is anywhere from 8-40 mmHg, and, ideally, to get the best fit you should have your legs measured at a surgical supply store. If you can’t do that, however, you can start out trying low compression to see how it feels. The higher the number, the tighter the stocking/sock will be. So, if you have severe swelling in your legs, you might need a 20-30 mmHg range; if you get very little swelling but still want to prevent blood clots, you might try 10-15 mmHg. Not sexy, but having a serious blood clot isn’t particularly sexy, either.
At only 44 years old, John D. Hutchinson was way too young to pass away, which proves the point that every single day is a gift – and something we should not take for granted. And since truckers like you, reading this now, are more susceptible to blood clots, like he had, please heed this warning and take measures to prevent this ailment from happening to you. Your life could depend on it!