From Soccer Field to Surgery: Understanding Deep Vein Thrombosis (DVT)

Eighteen-year-old Simon Falcones-Sarmiento loved playing soccer and was always on the move, especially at his restaurant job. One day, he felt a strange pain in his left leg. It spread to his back and just wouldn't go away. He was used to aches from sports, but this was different. His leg started to swell and turn red. Something wasn't right.

Simon went to the emergency room, and doctors discovered he had something called a deep vein thrombosis, or DVT. As Katherine Teter, M.D., a vascular surgeon with Hackensack University Medical Center, explains, “DVT is the formation of a blood clot in a deep vein, most commonly in the legs. Think of it like a traffic jam in your circulatory system.” This "traffic jam" can not only limit mobility but also carries a serious risk: “It can put you at risk for a pulmonary embolism – a piece breaking off and traveling to the lungs.”

What is DVT?

DVT is when a blood clot forms in a deep vein, most often in the leg. Imagine your blood vessels are like roads. A DVT is like a big traffic jam blocking the road. This can cause pain, swelling and redness.

Common symptoms of DVT are:

• Leg swelling
• Achiness or cramping, especially in the calf
• Skin color changes, like red or purple
• Feeling warmth or heat in the leg

With DVT, sometimes a piece of the clot can break off and travel to your lungs. This is called a pulmonary embolism, and it can be very dangerous.

How Common is DVT in Young Adults?

DVT is more common in older adults or people who don't move around much. But even young, healthy people like athletes can get it. 

Here are some reasons why DVT can happen, especially in young athletes:

• Sitting still for too long: Long flights or bus rides, especially after exercising hard, can slow down blood flow in your legs. This can make clots more likely. Tall athletes with big leg muscles can be even more at risk in cramped seats.
• Not drinking enough water: When you don't drink enough water, your blood gets thicker, making it easier for clots to form. Athletes sweat a lot, so it's extra important for them to stay hydrated.
• Injuries: Hurt muscles, especially in the legs, can damage blood vessels and make clots more likely. A direct hit to the leg can also cause DVT.
• Surgery: Sometimes athletes need surgery for injuries. Surgery can increase the risk of DVT because you don't move around much afterwards.
• Genes: Some people are born with genes that make their blood clot more easily. This can increase their risk of DVT, even if they are healthy and active.

How is DVT Diagnosed?

If your doctor suspects DVT, there are a number of tests to confirm the presence of a blood clot, including: 

• Physical exam: First, your doctor will examine you. They'll look closely at your leg to see if it's swollen, red or warm to the touch. They'll also ask you questions about things that could make you more likely to get a DVT, like if you've had surgery recently, hurt your leg, or haven't been moving around much.
• Blood tests: When you have a blood clot, your body makes extra amounts of a protein called D-dimer. It's like your body sending out a signal that something's not quite right. A blood test checks for this signal. A high level of D-dimer can suggest a clot, but it doesn't always mean you have one. It's just one piece of the puzzle.
• Imaging: An ultrasound is the most common type of imaging used to diagnose a DVT. If the ultrasound isn't clear, other imaging tests may be used.

What are the Treatments for DVT?

If you have DVT, there are ways to treat it to help you get better and back on your feet. The main goal is to stop the clot from getting bigger, prevent it from traveling to your lungs, and reduce your chances of getting another one. 

• Medicine: The most common treatment is medicine called anticoagulants, sometimes called blood thinners. These medicines don't actually thin your blood, but they make it harder for your blood to clot. This helps your body break down the existing clot and prevents new ones from forming. You might take these medicines as a pill or a shot.

• Compression stockings: Your doctor might also suggest wearing special tight socks called compression stockings. These stockings put gentle pressure on your legs, which helps improve blood flow and reduce swelling.
  
• Staying active (when your doctor says it's okay): While you might need to rest at first, moving around is important once your doctor gives you the green light. Walking and other gentle exercises can help improve blood flow in your legs.
  
• Other treatments (in rare cases): Sometimes, if the clot is very large or causing serious problems, doctors might use other treatments, including minimally invasive procedures.
  
  

And unfortunately, Simon’s case was serious. “Simon’s case was severe enough that we thought the limb may be at risk of permanent damage if blood flow wasn't restored quickly,” says Dr. Teter. She performed a surgery called a venous thrombectomy: “Essentially, I inserted a small suction catheter and a device that looks like a butterfly net into the veins to capture and remove the clot.”

During Simon's operation, Dr. Teter found another reason why Simon had a blood clot. Using a special kind of ultrasound that goes inside the veins, Dr. Teter saw that one of Simon's veins was much narrower than it should be. This narrowing, called May-Thurner Syndrome, likely made it easier for a clot to form. 

After Dr. Teter removed the blood clots, she placed a small, springy tube called a stent in the narrow vein. The stent acts like a tiny scaffold, holding the vein open so blood can flow freely and making it less likely for another clot to form in the future.

Since the surgery, Simon shared he’s felt much better and has been able to return to his active lifestyle.

How Can You Avoid DVT?

• Stay active: Moving around helps keep your blood flowing.
• Healthy weight: Being overweight can increase your risk of DVT.
• Drink plenty of water: Staying hydrated keeps your blood from getting too thick.
• Don't sit still for too long: If you have to sit for a long time, get up and move around every hour or so.

When to Get Help

If your leg hurts, swells or turns red, it's important to see a doctor quickly to rule out DVT. 

Early diagnosis and treatment are crucial, as Dr. Teter reminds us. "If you suspect you might have DVT, seek medical attention immediately. Early diagnosis and treatment are crucial to preventing serious complications.”

Next Steps & Resources

• Meet our source: Katherine Teter, M.D.
• To make an appointment with a doctor near you, call 800-822-8905 or visit our website.
• Learn more about our vascular surgery services.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.