Don't add clots to your headaches!

I know what we talk about here is headaches.  But, after my recent hospitalization I want to give you all tips on not ending up where I was.

Blood clots form in veins.  Typically they begin in your legs.  You may have heard of Deep Vein Thrombosis or DVT.  These clots can break free and move.  If they move, they have a high chance of landing in your lungs.  At this point they become known as a Pulmonary Embolism or PE.  25% of people with a PE never have a chance to get to the Emergency Room.  The suffer a sudden death as the clots prevent the blood from being re-oxygenated.  PEs can injure your heart.  Your heart has to work extra hard to get blood through the lungs when the lungs have clots.

There are several factors that can increase the risk of a clot: pregnancy, flying, driving for long trips, sitting still for long periods, HRT, and oral contraception are a few of the ones that you can control.  Based on that here are some tips to keep yourself safe:

1. Know your family history.  If you have a family history of DVT, PE, clots, or miscarriages talk to your Dr.  This is especially important when looking at pregnancy, HRT, surgery, contraception and long haul plane flights.  Your Dr can recommend methods such as prophylactic blood thinners, exercises, and compression stockings to help you prevent a clot.  Choices in hormone supplementation for HRT and contraception can also be made so that you are at the least risk.

2. When going in for surgery ask the hospital what the policy is to prevent DVT during recovery.

3. When traveling get out of your seat and walk at least every hour.  Do not cross your legs.  Move in your seat as much as possible.  Drink water or electrolytic beverages.  If you have any family history look into injections of low molecular weight heparins or compression stockings.  If it is a long haul trip look into the injections and stockings even if you are low risk.

4. If your legs are swollen over a vein, red, hot, or painful after or during a drive or flight seek medical attention immediately.

5. Steer away from the newest forms of combined birth control.  The newer forms of progestins seem to cause problems when given with estrogens.  The contraceptive patch is a big culprit as well.  Look for a 2nd generation pill with very low estrogen.  You can also consider progesterone only contraception.  It has very low risk in the general population.  It is unknown if it is a risk for those with a clotting disorder or former DVT or PE.

That summarizes what I know at this point about prevention of a clot.  If you do land in the hospital with a clot and they want to do an echo cardiogram to make sure your heart is not damaged from the clot, ask for the TEE version.  It is more invasive but allows them to assess your heart for a PFO.  PFOs seem to have a tie in to migraines and can cause clots to pass more easily through the heart.

Best wishes to all!