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Lifestyle Questions - PSD and not on Blood Thinner


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Hi - been doing a bunch of internet searching asking docs etc over the past year, but really don't get any solid answers on the following lifestyle questions. Just wondering if anyone else had and info (opinion is fine, but would like to understand both opinion and medically/scientificially documented guidance on the following:

FYI - otherwise healthy 35 year old male, DVT in left leg and asymptomatic PE in both lungs May 2013 (multiple test confirm PSD). Recently had superficial thrombophebitus in same leg (ankle - greater sapheous vein etc).

1. Only lifestyle guidance I have been given by medical professionals is don't become obese, smoke or become dehydrated. Top notch cardiologist advised take one baby asprin per day. Hematologist indicades that it was a good idea, but it is NOT supported by any medical research to date (i.e. no direct evidence that it will help prevent DVT).

2. Impact of diet - does a "clean" diet help prevent DVT?

3. Alcohol - assuming the normal range is fine (no more than 1 or 2 drinks - of std size). What about drinking too much - risk here other than dehydration. My thoughts tend to lean towards the liver is stressed and may not make the "already low" amount of Protein S etc?

4. Travel - Should I always get blood thinners when traveling greater than 4 hours by air?

5. Stress - Thoughts here?

6. D-dimer test - can I buy/administer these myself????

A lot of this ties into my recent clotting in superficial veins. Has been extremely painful, but feel like I dodged a bullet as it happened not too long after a 9+ hour flight.

The long and short of this is I really don't want to have another DVT and/or PE. This runs in my family and my dad has extreme leg damage as well as a lifelong requirement to take blood thinner. If BT is required, so be it I will deal with it....

Thank for any feedback on the above!

Jim

Edited by hlands_jim
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Hope this helps...

1/ aspirin helps prevent faster moving arterial clotting. warfarin helps prevent slower moving venous clotting

2/ dosage response to warfarin is susceptible to diet, a balanced diet will help to keep INR stable

3/ your INR increases when you have alcohol. so does your risk of an accident. not a good mix.

4/ I have a history of dvt/pe and am on warfarin. when I fly I still take my normal warfarin dosage (including long haul)

5/ psd has a role in inflammation, so there may be a general susceptibility to some other health conditions aggravated by stress (my own thoughts, nothing to back this up yet), it is normal to feel some kind of depression with long term health conditions, if this affects you ask for some support

6/ no point, these are readily available and only a starting point for diagnosis. if you suspect a clot see a doctor

with a history of multiple clots I believe your best course of action is warfarin, plus the usual advice on reducing risk factors

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After my extensive DVT and PE's I took warfarin for 6 months then came off it. I was then seen by the consultants at the RVI in Newcastle who decided that one of the biggest issues with clotting is age, combine that with PSD means at some point in your life you will have another clot weather that be in a year or in 10 years time. I've now been put on blood thinners for life.

All your points are valid loosing weight helped improve my damaged legs, appropriate exercise has improved circulation, drinking less is always a good idea. However I was 22 when I had my clots and I will not let PSD control all aspects of my life and I intend to enjoy it. You clearly have a strong family history, (I'm the same) and that also played a minor part in me being put on blood thinners long term.

When I was younger I always took three doses of heprin the day before I traveled, the day I traveled and the day after, then the same on return. I also still get made to measure pressure stockings each time I traveled.

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When you have damaged legs (post thrombotic syndrome) it's often a good idea to wear compression stockings on a regular basis. They aren't too different from tight fitting socks. They can help to avoid longer term deterioration which can lead to dry skin, sores and ulcers. You can get them on prescription too.

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