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A Lady with Painful Leg

A lady who had delivered a baby about two weeks ago was brought to my clinic by her husband complaining of severe pain and swelling in her right leg, home remedies like massage and hot water bottle applications etc. by them showed no relief.

Dr. Munawar Aziz

Examination of her leg revealed swelling of calf muscle with severe pain on light pressure, provisional diagnosis of DVT(deep vein thrombosis) was made, she was advised not to massage the area and was sent for immediate Doppler ultrasound of the leg, it showed a clot area in the vein. She was admitted in hospital for subcutaneous and subsequently oral blood thinners, after a week she was sent home fully recovered.

History revealed that after becoming pregnant she was advised by her family members to take extra rest and avoid day to day chores. Inactivity and relevant reduced water intake to avoid frequent urination (which normally occurs in pregnancy because of pressure of gravid uterus on urinary bladder) caused dehydration and clot formation.

Deep Vein Thrombosis (DVT) is a serious medical condition that occurs when a blood clot, or thrombus, forms in a deep vein, often in the legs. This condition is dangerous because the clot can block blood flow and cause pain and swelling in the affected area. If left untreated, the clot could break off and travel through the bloodstream to the lungs, leading to a life-threatening pulmonary embolism (PE).

Risk factors for DVT include prolonged immobility, surgery, pregnancy, certain medications, smoking, obesity, and a family history of blood clots. Symptoms may include swelling, warmth, tenderness, and a reddish or bluish discoloration of the skin in the affected leg. However, not everyone with DVT shows symptoms, making it challenging to detect.
Diagnosis is typically confirmed through ultrasound imaging, and treatment often involves anticoagulant medications, which prevent the clot from growing or new clots from forming. In severe cases, clot-dissolving drugs or surgery may be required. Preventive measures, such as regular movement during long periods of sitting, wearing compression stockings, and maintaining a healthy lifestyle, can reduce the risk of DVT. Early detection and treatment are crucial to prevent complications and ensure better outcomes.

Points to Note:

  1. Never recommend bed rest for prolonged periods in pregnancy, if un-avoidable then frequent sessions of physiotherapy and walks inside the room should be advised.
  2. Keep hydrated by taking abundant fluids.
  3. Never massage a leg swelling without consulting a health care provider.
  4. If bed rest is un-avoidable in any illness then passive movement of the patient or physiotherapy is recommended to avoid blood clots in veins.
  • Dr.Munawar Aziz. MCPS
    Abbottabad, (KP).
    aziz.munawar@gmail.com

1 COMMENT

  1. This is an important problem in Pakistan which requires education of the population. Unfortunately, our media is only used for political point scoring and providing spicy entertainment to the public. With a health budget of Rs11000 per person per year in Pakistan , half gets diverted to corruption and very little left for infrastructure development.

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