(instrumental music) - This is Tom Biernacki, and today I'm going over leg blood clots. There's two types of
things that I think about when it comes to leg blood clots. There's an actual blood clot that develops and blocks it almost immediately called a deep vein thrombosis. And then there's the ones
that gradually narrow, and narrow, and narrow, and narrow, and that's called arteriosclerosis. So I'm gonna go over a little bit of both, but I'm gonna focus more
on arteriosclerosis, some of the stuff that you can do. But I'm gonna give a word of caution. These can be emergencies. These are probably the most
serious things we deal with with the foot and ankle. It's not just pain, but a deep vein thrombosis
can shoot up into your lungs and cause a pulmonary embolism. And arteriosclerosis,
that's the narrowing, what that can do is
essentially clot your arteries so that you develop gangrene, and your toe can go black and dark. And this is unfortunately a reason we need to amputate people's
toes, feet, or even legs. So this is a very serious topic and probably be most serious
thing that we deal with as foot and ankle surgeons. So the disclaimer is these videos can always contain inaccuracies,
even though we do our best. So if you have a concern of a blood clot, always see your doctor. Don't mess around and try and
self-diagnose with a video because this clot can
break free in your vein and shoot up to your heart and lungs, and plug them, and cause
serious problems, even death. And also blood vessels or
arteries, in this case, can build up fat in the smooth muscle. And this could plug the blood flow causing gangrene down to your toes. So these are serious. Don't rely on this guy right here only. Go get checked out. The narrowing takes
place in your arteries. That delivers a blood flow to your toes, and the clots, which is
your deep vein thrombosis, happens on the way back up to the heart. So we're gonna get started
on how to diagnose it, what the symptoms are,
which doctors to see, what to do about it, how to
prevent it, the home remedies, the medical treatments, the medications. But first, I could use a favor from you. Guys, thank you so much
for watching this video. We appreciate your likes,
your subscribes, your comment. We really love hearing
if this stuff helps. It really makes a big difference for us. So thank you. If a clot is suspected, an venous duplex Doppler may be necessary to check where the blockage is, and these are performed
in the emergency room. So if a patient comes in here
with this type of problem, right away, we don't even mess around. Go get checked out if
you think you're worried. We consider these very serious problems because there aren't a lot
of blood vessels in the legs. And sometimes the symptoms are clear. Sometimes they're not that clear. And you can see there's a lot of arteries, a lot of veins in the
legs, the calf muscles. Especially now with medications, people are beginning
to realize how serious some of these risks are and how much you don't wanna mess around if you're concerned. So first I'm gonna start
off with the arterial supply because this is something
that sneaks up on people, especially older people. This is the commercials you see where basically plaque develops
in the smooth muscle of your arteries, just like in your heart, and it narrows, and narrows, and narrows, and a blood vessel that looks like this squeezes down to basically nothing, and the blood flow cannot get through. This is usually associated with old age. And what I mean by that
is, people are like, hey, I can't walk as much as I used to. I'm tired, and they don't
think anything is wrong, but one day they wake up, and their legs are in
severe crippling pain. So this starts with some
numbness, burning, aching. When you're walking longer distances, this is called the claudication. So your feet start spasming, and they're weak, and you
need to take a little break, then they feel better. When it gets really severe, when you're sitting on the couch, when you lift your feet up in the air, it starts to throb and ache, but when you lower them again, that's when it starts to feel better. That's when it gets most severe. That's called claudication rest pain. And that's when you really
wanna see your podiatrist. And that's the disclaimer
I always give is, come see a podiatrist for
foot and ankle problems. We work with vascular specialists, cardiologists and vascular
surgeons in our office, and we can do tests called
minimally invasive tests. So these are things where
blood pressure cuffs essentially go on your
thigh, your calf muscle, your foot, and your toe. And with a venous Doppler, it measures how much blood is flowing through those blood vessels. If there are criteria that
the blood flow is too poor, so for example, if the
blood pressure in your arm is much higher than the ones
in one leg or the other leg, then it makes sense to
go to see a cardiologist and a vascular surgeon. When I think about the
heart, it has to work hard, and everybody has a heart
with strong muscles. But when you become very large
since you were a little kid, the heart necessarily
doesn't grow proportionately. So it has to work harder,
and harder, and harder, and it needs more muscles. That's when heart attacks can happen. That's when blood vessels can narrow. And the problem is not only
is your body a lot bigger, so it has to supply more blood flow, but the blood vessels get narrowed. So this is where a cardiologist
or a vascular specialist like a vascular surgeon can come in. They could open up those blood vessels to help the heart a little bit, get the blood flow down better. So you want a strong heart and you want smooth open
vessels by a specialist. They can do something called an angiogram, and an angiogram essentially
is going down your blood vessel under imaging and seeing
where there is a blockage. Then the vascular specialist
can do one of two things. They can either balloon it
open and drop a stent in there. And that stent holds that vessel open. Or they can do, in more
severe circumstances, if it's blocked for a very
long period of time, a bypass, which is a road around. So sometimes that's a fake vessel or using a vein to go around. So the bypass is a
little bit more invasive. That's more of a surgery. Whereas a placement of a stent is something that has a little
bit of a quicker recovery time that can be done in imaging suite. So the risk factors for arterial problems, that's the narrowing, is smoking. So if you're smoking, stop smoking. That's the biggest thing we can tell you. This is no secret at this point. Number two is diabetes
and being overweight. If you're eating sugar,
if you're a diabetic, go see your primary care doctor, get on the right medications,
get that swelling down, get that feeling a whole lot better. If you're overweight, so if you're weighing a lot,
clearly being healthier, having more muscle mass, less
weight makes you healthier. If you can exercise more,
if you can ride a bike, if you can swim, that will help
your blood flow quite a bit. If you have high blood pressure, get that blood pressure down. That could really help out. See your primary care doctor. Family history. If you have a family
history of blood clots or heart problems, go
get that checked out, get that taken care of as well. On the other hand, you
have your venous supply. This is what returns
blood flow to your heart. This is where you could develop a clot, which blocks that vein. In itself, that's not dangerous because you have a lot of different ways that your veins can go
and return the blood flow. What the danger with this
venous blood clot is, that this blood clot can break free and shoot up to your heart, and this can be a
life-threatening emergency. This is called a pulmonary embolism. This can get stuck in your
lung and plug up the lung. And you could, there's a, I think it's a 50% chance of dying. That's what I've always been taught, but nonetheless, it's very serious. If you have a deep vein thrombosis, what happens is it's usually
one leg compared to the other. It's usually in the calf. It could be in the thigh
or in the hamstring, but most of the time
it's in the calf muscle. It's gonna be big, red. What the difference is compared
to other causes of swelling is it's usually just one
leg compared to the other. Theoretically, you could have
two clots, one in each leg, but that's extremely rare. So if you squeeze your calf,
and it hurts, and it's red, and it's sore, and it's swollen, that's going to cause a lot
of problems in that leg, and then eventually it can shoot up. There's that risk factor. So what you wanna do is
go see your podiatrist or primary care doctor. If they think that it's a blood clot, they will order something
called a duplex Doppler. So what happens with
the duplex Doppler is, they will scan your vein. This is done at the hospital. And they will see, is
there a blood clot there? So if it is an emergency, and you're like, hey, this
is 99% chance I have one, go to the emergency room. That's kind of the warning. And a venous Doppler can be performed. There's other tests like a
D dimer or some blood tests, but realistically go
get the venous Doppler. That's kind of the standard treatment, diagnosis, I should say, not
treatment, for a vein problem. And what could happen is, then you're referred to
a blood flow specialist. So you're put on a couple
of different medications in this case. If it's very severe, you could
be admitted into the hospital for something called a thrombolytic, which is an IV medication, which essentially breaks up the clot. But these can be dangerous, and you have to be in the hospital. What generally happens is
you're put on a blood thinner for three months or six months, depending on what the
criteria are on your area. And again, as a pediatrist, I'm not the one prescribing these, but we diagnose these quite a bit and send them to our vascular surgery and cardiology colleagues, because these are serious
blood vessel disorders. So how do you prevent vein problems? So this is when people sit
for long periods of time. So when you're on long car
trips, long plane rides, what you wanna do is you
want to use your feet. Bend your feet up and down 10 times, lift your legs, do some toe rises. What I'm a big fan of
his compression socks. So the tricky part is you don't need medical grade compression socks. So in my opinion, insurance
doesn't cover stuff well anyway. Like even if you think they're covered, they're not really covered. Buy some ones online. They're dirt cheap. You can get a great pair
of socks for like $10. Start with the lower strength, like 10 millimeters of mercury, and then if you feel you
need more, work your way up. But in my opinion, when people
get the medical grade ones, they never wear them because
they're so hard to put on. But the standard athletic
ones that are like 10 millimeters of mercury, people are much more likely to wear. That will help with venous flow because your veins won't engorge as much. Number two, everybody works from home now, especially in the era of COVID. Get yourself some leg compression pumps. So what these do is they're on a pump, and they go around your legs. And when you're sitting,
every couple of seconds, they pump, and they push the blood flow. So it stimulates you walking, and it's stimulating the blood flow. Personally, when I use these, not only does it prevent blood clots, but it makes you have less headache. You're less tired. I talked to people who, 'cause I give these to
people all the time. And what happens is people
who sit at their desk all day tell me they feel sick. But with these leg pumps, they
say they have more energy, they feel a lot better, their brain's working a lot better because your blood's
cycling a whole lot more. Is there studies that prove this? Not that I know of personally, but this makes a big difference. And hopefully even if you
get a benefit out of that, this is a huge benefit for me. I wear those leg pumps
when I'm on the computer for a long period of time, and I feel a million times better. And then the keys, same
thing for arteriosclerosis, get healthy, stop smoking,
cure your diabetes, start exercising, start losing weight, stop drinking alcohol, take
great care of yourself. If you're sitting in a car or a plane for long periods of time,
compression stockings, pumps, start doing exercises
every 20, 30 minutes, pump up your legs up and down,
stretch your calf muscle, lift your legs, flex your thighs
if you can't wear leg pumps because that's kind of the
standard now in the hospital. You should be wearing leg
pumps if you're in a hospital because the risk is very high. Not only in the hospital do
they give you those leg pumps, but they put you on blood
thinners as a precaution because the risks can be so high. So if you have a DVT or arteriosclerosis, and you're in Michigan, come see us. We'd love to take care of you, but otherwise go see your local podiatrist or primary care doctor. If that helped at all,
please give us a thumbs like. Give us a comment. Tell us if we suck or
if we did a great job and give us ideas on future videos. Let us help.
