1. One of the main causes of DVT is inactivity! When a person is inactive, your blood normally collects in the lower part of your body. (in your legs) This is not seen as a worry because when you start to move again then the blood flow in your body increases and travels around the body evenly. However, if a person is immobile for a long period of time (e.g. after having an operation), the blood flow in the body can decrease considerably because of non active movement. Due to the slow blood flow in the body, it can increase the chances of a blood clot forming.

2. When in hospital, patients have a higher risk of blood clots forming because DVT is more likely to happen when you are unwell, inactive or less active than normal. Patients are more at risk of developing DVT depending on the type of treatment that they are receiving. These are:- Having an operation that lasts longer than 90 minutes, or 60 minutes if an operation is performed on the leg, hip or abdomen. Having an operation for inflammatory or an abdominal condition, e.g. appendicitis. If you are confined to a bed, unable to walk or spending a large amount of time in a bed or chair for at least 3 days. A patient may also be at a higher risk of DVT if they are much less active than normal due to an operation or serious injury and having other DVT risk factors also, e.g. their family history. When being admitted into hospital, checks are thoroughly done to assess the risk of developing a blood clot……after the assessment is done, preventative treatment may be given if it is necessary.

3. About half of those who live with DVT, experience no symptoms. Although if symptoms do occur then some of these are:- Pain, swelling and tenderness in one of your legs (usually your calf). A heavy ache in the affected area. Warm skin in the area of the clot. Redness of your skin, particularly at the back of your leg below the knee. Ulcers on the calf (in severe cases)

4. DVT usually affects only one leg, but this is not always the case. The pain you suffer due to DVT may be made worse by bending your foot upward towards your knee. If DVT is not treated, a pulmonary embolism (a blood clot that becomes lodged in one of your lungs and blocks the blood supply) may occur. If you have a pulmonary embolism, you may experience more serious symptoms, such as:-  Breathlessness, which may come on gradually or suddenly.  Chest pains, which may become worse when you inhale.  Collapsing suddenly.

5. If you think you suffer from DVT, you will need to see your local GP as soon as possible. Your GP will then ask you about your medical history and your symptoms. Although, it can be difficult to diagnose DVT just from your symptoms so they may recommend that you have one of the following tests:- D-dimer test. This is a specialised blood test that is used to detect pieces of blood clot that have been broken down and are loose in your bloodstream…… The larger the number of fragments found, the more likely it is that you have a blood clot in your vein. However, this test is not always reliable. Blood clot fragments can increase after an operation or injury has occurred, or if there is an inflammation in your body. (this is when your immune system reacts to an infection or disease). This means that additional tests need to be carried out to determine if you have DVT, e.g. an ultrasound. If the D-dimer test is negative, it rules out the possibility of a DVT in up to 97% of cases.

6. An ultrasound scan. This test can be used to detect clots in your veins. A special type of ultrasound known as a Doppler ultrasound can also be used to find out how fast the blood is flowing through your blood vessel. This helps doctors to identify when blood flow is slowed or blocked, which could be caused by a blood clot. Venogram If the results from a D-dimer test and an ultrasound cannot confirm whether you have DVT, then this test may be used. A special dye is injected into a vein in your foot which travels up the blood vessels of your leg. An X-ray is then taken to view the dye. If there is a blood clot in your leg then the dye will not be able to flow around it and will show up as a gap in the blood vessel.

7. When Diagnosed with Deep Vein Thrombosis (DVT) you will need to be treated with a medicine called an anticoagulant! Anticoagulant medicines helps to prevent blood clots for getting bigger. They can also help stop part of the blood clot breaking off and becoming lodged in another part of your bloodstream (causing an embolism). Although they are often referred to as blood thinning medicines, they don’t actually thin the blood. They alter chemicals within blood which prevents clots forming so easily. There are 2 different types of anticoagulants are used to treat DVT which are:- Heparin Warfarin. Heparin is usually prescribed first as it works immediately to prevent further clotting. After this initial treatment, you may also need to take warfarin to prevent another blood clot forming.

8. Heparin:- It is available in two different forms:- Standard (unfractioned) heparin. Low molecular weight heparin (LMWH). This is usually given as a subcutaneous injection. Standard (unfractioned) heparin can be given as:- an intravenous injection – an injection straight into one of your veins an intravenous infusion – when a continuous drip of heparin is fed through a narrow tube into a vein in your arm (this must be done in hospital) a subcutaneous injection – an injection under your skin A dose of standard heparin can work differently for everyone so the dosage must be carefully monitored and adjusted where necessary. You may need to stay in hospital for 5-10 days and have frequent blood tests to ensure you have the right dose. LMWH works differently to the standard heparin. It contains small molecules and this means that it effects are more reliable and will not have to stay in hospital and be monitored. There are some side effects to both standard and LMWH, which include:- A skin rash and other allergic reactions. Bleeding. Weakening of the bones (if taken for a long time). In rare cases, heparin can also cause an extreme reactions which can cause the existing blood clots to worsen and cause new clots to form. This reaction and the weakening of the bones is less likely to occur when taking LMWH. In most cases, you will be given LMWH because it is easier to use and has less side effects.

9. Warfarin:- Warfarin is taken in a tablet form. It may have to be taken straight after an initial heparin treatment to prevent further blood clots forming. Your GP may recommend that you take this treatment for 3-6 months. Although in some cases, warfarin may need to be taken for longer or even for life. As with standard heparin, the effects of warfarin vary from person to person. You will need to be closely monitored with frequent blood tests to make sure you are taking the correct dosage. When you first take warfarin, you may need 2-3 blood tests a week until a regular dosage is prescribed for you. When the dosage is prescribed, you should only need to have a blood test every 4 weeks at an anticoagulant outpatient clinic. Warfarin can be affected by your diet and any other medicines that you may be taking and by how well you liver is working. If your taking warfarin, you should:- Have a consistent diet Limit your alcohol intake (no more than 3-4 units a day for men and 2-3 units a day for women) Take your dose of warfarin at the same time every day. Don’t take other medications without consulting your GP, pharmacist or anticoagulant specialist. Don’t take any herbal medicines.

10. Other treatments that are given are:- Rivaroxaban – which is recommended by the National Institute for Health and Care Excellence (NICE) Apixaban – which is also recommended by the National Institute for Health and Care Excellence (NICE) Compression stockings – these are given to help prevent calf pain and swelling and lower the risk of ulcers developing after having a DVT. After having a DVT, stockings should be worn every day for at least two years because symptoms of post- thrombotic syndrome may develop several months or even years after having DVT. Exercise – you will usually be advised to take part in regular exercise or activity when the compression socks have been prescribed. This can help prevent symptoms of DVT returning and may help to improve or prevent complications of DVT, such as post-thrombotic syndrome. Raising your leg – you may be advised to raise your leg when you are resting, as well as wearing the compression socks. This relieves pressure in the leg and helps to stop blood and fluid from pooling. Inferior vena cava filters – this is an alternative treatment if others don’t work.

11. NHS Choices (03.06.2014) Causes. Available at:- http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Causes.aspx http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Causes.aspx (Accessed 01.12.2015) NHS Choices (03.06.2014) Symptoms. Available at:- http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Symptoms.aspx http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Symptoms.aspx (Accessed 01.12.2015) NHS Choices (03.06.2014) Diagnosis. Available at:- http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Diagnosis.aspx http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Diagnosis.aspx (Accessed 01.12.2015) NHS Choices (03.06.2014) Treatments. Available at:- http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Treatment.aspx http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Treatment.aspx (Accessed 01.12.2015)