“Sudden death – robbing the world of pacesetters”

An elderly obese lady who has recently had surgery for a broken hip and has been staying in bed against her doctor’s advice or such a lady is in bed without adequate blood thinning; this is the stereotype most of us have of someone who forms clots and may die suddenly from a pulmonary embolism.

….But wait a minute! We hear of young active males and females alike dying from pulmonary embolism and the message is clear, we are all at risk but the following may make matters worse:

• People born with blood that clots easily and quickly

• Being inactive for long periods such as being in bed after surgery or during an illness. Sitting for long hours on a flight or in a car.

• Recent surgery especially those involving the legs, hips, belly or brain.

• Some diseases such as cancer, heart failure, stroke or severe infection.

• Pregnancy and childbirth especially if through a caesarean section.

• Taking birth control pills or hormone therapy.

• Smoking

• Being Obese

• Elderly

The human body has its way of coping with diverse situations but sometimes it may be faced with a condition that may appear trivial yet if this condition is not diagnosed and managed quickly it can result in death. One of such conditions is Pulmonary Embolism. This is the sudden blockage of a major blood vessel in the lung usually by a blood clot. A large clot can stop blood flow to the lungs and could cause sudden death. Fortunately for us the clots are often small and may only result in various degrees of lung damage and reduced oxygen supply to body tissues.

I hope we can discuss more causes of SUDDEN DEATH over the next few months and we should all take steps to modify our lifestyle as well as spread the WORD. No life should be lost in vain and if the living can modify our lives appropriately, our maker will take care of the rest.

These blood clots that cause the blockage of vessels in the lungs commonly originate from the deep veins of the legs but may also come from other parts of the body. This condition is referred to as deep vein thrombosis (DVT). When the clot moves from its origin then it is referred to as an embolus. Though blood clots commonly cause the vessel blockage other causes include; fat from a broken long bone, parts of a tumour, air bubbles and even amniotic fluid.

Pulmonary Embolism (PE) may present with general symptoms such as anxiety, increased sweating, faintness or lightheadedness and sometimes the heart begins to beat faster. Classically we may experience one or more of the following:

• Severe Chest Pain that gets worse when you breathe deeply, cough, eat or bend over. The pain worsens when you exert yourself but does not go away with rest.

• A Cough that may produce bloody or blood streaked sputum.

• Shortness of Breath that appears suddenly and worsens with activity.

Pulmonary Embolism can be any doctor’s nightmare since it can mimic equally serious conditions such as a heart attack, panic attack and pneumonia. A doctor after examining you may order blood tests as well as one or more of the following; Chest X-ray, Ultrasound, Spiral CT scan, electrocardiogram (ECG) and MRI.

Treatment is based on drugs often referred to as blood thinners. These medications do not actually thin blood but they help prevent new clots and keep existing clots from growing. When the symptoms are life-threatening and if available, you may be put on a “clot-busting” drug. However in most cases your doctor may start you immediately on a shot of heparin, which is a fast acting blood thinner and later convert you to a pill such as warfarin or newer medication. It is essential that everyone on warfarin consults a dietician to modify their diet to ensure that warfarin remains effective. Vitamin K rich products may reduce the effectiveness of warfarin and hence increase your risk of forming clots. While on warfarin beware of Vitamin K containing greens including Kontomire and other green components of salad as well as green tea. Beware of onions and garlic as well; keep them on the low. Alcohol and cranberry juice can enhance the activity of warfarin leading to bleeding; minimize their consumption or better still avoid.

Once you have had a DVT or Pulmonary Embolism, your risk of having another is high. Remember that the “blood thinners” may be protective but they also increase your risk of bleeding. Your doctor may keep you on the blood thinner for a few to several months and in some cases for life.

HOW TO REDUCE YOUR RISK OF FORMING CLOTS

In general stay healthy and try the following frequently;

• Avoid a sedentary lifestyle. At the top of each hour walk for a minute or two. Wriggle your toes and flex your feet as you sit

o Walk often while on a plane and even while in your chair move your feet regularly

o Break your journey by road and walk around briefly.

• Move as soon as you can after surgery

• While travelling drink a lot of water but avoid alcohol and caffeine

• If you are at high risk wear compression stockings

• If you are on blood thinning medication take it exactly as your doctor and pharmacist have advised.

We can never become immortals, neither can we fully explain all conditions but enjoy life and let us all avoid excesses.

AS ALWAYS LAUGH OFTEN, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)

Dr. Kojo Cobba Essel

Moms’ Health Club/Health Essentials

(dressel@healthclubsgh.com)

*Dr Essel is a medical doctor, holds an MBA and is ISSA certified in exercise therapy and fitness nutrition.

Thought for the week – “When many innovative, hardworking middle aged people die suddenly then our healthcare system is failing us. We need such pacesetters to help the world develop. Acquiring appropriate knowledge is the START POINT!”

References:

• Pulmonary Embolism – WebMD

• Pulmonary Embolism by Mayo Clinic Staff