Frequently Asked Questions

Excerpted from recent VDF's Live "Ask the Doctor" Chat with Drs. Rathbun and Cherry, Transcripts of all chats may be found online at www.vdf.org.

Question: After starting anticoagulant drug treatments, under what circumstances does the body naturally break down a blood clot? Are there statistics with regard to the success rate? How soon would you expect to see symptoms reduced or eliminated? Also, is it dependent on the location or size of the clot?

Answer: The most important job of blood thinners, such as heparin, low-molecular-weight heparin, and warfarin (Coumadin¨), is to prevent new clots from forming on top of an existing clot. Over time, the body's own clot-busting system will break down clots, but it is not uncommon to see some evidence of residual clot even months to years after the initial blood clot. In general, more extensive clots will require a longer time to resolve. There are some medications available which can dissolve clots more quickly. These are known as thrombolytic agents or "clot busters" and are given in special circumstances when the burden of clot is very high and the symptoms are severe. There are also mechanical devices that are used in some cases to remove or break apart clot.

Question: I am experiencing pain in my toes. This may be pain from gout, which I take medicine for, or decreasing circulation. How can I know the cause and what can I do about it?

Answer: Sometimes pain due to abnormal circulation can mimic or be confused with pain due to other causes. A doctor's physical examination and a simple test called the anklebrachial index (ABI) are important to rule out a circulation problem, such as peripheral arterial disease, or PAD. Ask your doctor if your foot pain could be due to PAD, rather than gout, and if you should be tested.

Question: What should I do if I have a swollen and painful leg?

Answer: First of all, it is key to make sure that this is not a blood clot, or DVT. This is a medical emergency that requires evaluation by your doctor right away. Once a DVT has been ruled out, other causes of leg swelling can be considered, such as varicose veins, venous insufficiency, medications, lymphedema, or other medical conditions.

Question: How can you prevent PAD?

Answer: The most important thing you can do to prevent PAD is NOT SMOKE or QUIT SMOKING IF YOU DO SMOKE. Diabetes is also a very strong risk factor for PAD. High blood pressure and high cholesterol contribute as well. Regular exercise, maintaining normal blood pressure and cholesterol, and maintaining a healthy body weight can also help.