Q.  My husband, 49, was referred to hospital recently by his GP, for an ultrasound scan because of a painful swollen leg. He was diagnosed with a deep vein thrombosis (DVT). Can you explain what this is? A.  DVT s are blood clots. It is the leading cause of pain and swelling in a leg and potentially fatal, according to consultant vascular surgeon, Mr John Scurr (www.jscurr.com). ‘Clots happen because of an imbalance in the make-up of the blood. If the ratio of clotting and liquefying components is upset, you develop bleeding (eg nose bleeds or bruises) or clotting, usually in the calf. The pain is due to irritation in the vein walls. The leg swells as the clot blocks the bigger veins.’

Clots in the central deeper veins of the legs (DVTs) can be very serious. If a DVT is not diagnosed and treated promptly with a blood thinning (anticoagulant) drug, a piece of the clot can break off and move via the heart to the lung (pulmonary embolism or PE ), where it may be fatal. It only takes five to seven days for a clot to develop, and it usually breaks off at seven to ten days.

Clots typically occur after a period of immobility, such as long flights or being bed-bound. Hospital-acquired clots account for one in ten deaths in hospitals, nearly 3,000 under 50. All patients undergoing major surgery should be assessed, and high-risk patients given low dose anticoagulants, with ‘squeezy boots’ (intermittent compression devices) or elastic stockings for lower risk.

Clots are also associated with conditions including cancer, kidney disease, lung problems, obesity, and sometimes heart problems. They may happen after viral illnesses when people are run down and dehydrated, also during and shortly after pregnancy. Some drugs (principally the contraceptive pill) increase the risk.

About seven per cent of the population have a predisposition to blood clots (thrombophilia), due to abnormalities in the blood, and a genetic condition called Factor V Leiden Deficiency. Clots usually occur in people over 40, so if someone in their teens or twenties develops one, they probably have a clotting abnormality. If a parent or close relative had blood clots early in their life, talk to your GP about a blood test.

You have a greater risk of a DVT if you have had one already. However, strokes are due to either a blood clot or bleeding in the brain and very rarely linked to DVT.

Varicose vein (VV) surgery may be dangerous if you have a DVT. Every VV patient should be scanned.

Exercise is helpful. Walking, or any physical activity, helps stop the blood stagnating and promotes the circulation (which helps disperse the remains of the clot).

 

WAX IS ON THE WANE

Cotton buds are ideal for keeping outer ears pristine, but they should never be inserted into the ear canal itself as they can damage the eardrum. For a gentler solution, our tester swears by Earigate Ear Cleaning System.  With a special ‘reverse flow’ nozzle that inserts into the ear, it pushes in a natural seawater solution, which flows out again before it reaches the eardrum. He found it ‘incredibly effective at getting rid of ear wax – and my hearing is better too’. Not for use on impacted wax.  £9.95 for 100 ml from Victoria Health - buy here.

 

THE TRUTH ABOUT FRUIT JUICE

Fruit contains sugar called fructose;  when it’s juiced or blended, the sugar is immediately released so when you drink it more sugar and acid comes in contact with your teeth than with whole fruit.

Fructose is often thought to be healthier than ‘ordinary’ sugar, or sucrose. But it’s just the same, and can cause tooth decay, especially if fruit juice is drunk regularly. Also, the acid damages tooth enamel. Fruit can also pile on the pounds, just like sugary soft drinks.

Fruit juice contains some healthy vitamins and minerals, although some of the nutrients and most of the fibre are usually left behind after juicing. Because of this, however much you consume, it only counts for one of the recommended five daily portions of fruit and veg.

Aim for one glass (150 ml) a day with a meal, diluted half and half with still filtered water, and drunk through a straw. Avoid ‘juice drinks’ which may only contain five per cent fruit juice and a lot of added sugar.

 

HELPLINE OF THE WEEK

Macmillan Benefit Advisers:  0808-808 0000. According to Macmillan Cancer Support (www.macmillan.org.uk), a patient’s income drops by half when they are diagnosed. Benefits are available, but the forms are incredibly complicated. Helpline advisers will go through them with patients to make sure they get what they are entitled to an average of £1,603 per person. Macmillan also campaigns to simplify the system.