DR. STEPHAN MOLL, associate professor or medicine at the UNC cancer center, spoke June 18 to the lunch and learn group  about blood clots and their treatment.

  Blood clots subject of lunch and learn

   ” Clots of legs and lung  are the second most common cause of death in the United States,” said Dr. Stephan Moll, an associate professor of medicine in the Division of Hematology and Oncology at UNC and a member of UNC Harold R. Roberts Hemophilia and Thrombosis Center, speaking at the lunch and learn workshop held twice a month at the Cancer Resource Center located in the medical building next to The Outer Banks Hospital. He was introduced by Dr. Van Smith, president of the hospital.

  He spoke on deep vein thrombosis (DVT) located in the extremities and pulmonary embolism (PE), a blood clot which lodges in the lungs. An embolus is a blood clot that travels, he said.

    With DVT, there is swelling, pain, blue color in the extremity and it is warm. Symptoms of PE are shortness of breath, chest pain, possibly a cough, sometimes with phlegm.

  Risk factors include smoking, being overweight, having high cholesterol, high blood pressure and diabetes. The more risk factors you have, the more likely you are to develop DVT or PE.

  DVT is associated with immobility, especially after surgery, and other trauma. Heparin is the best treatment for it, Dr. Moll said, but two-thirds of  patients who need it do not get it. ”My charge to all of you is, when you are hospitalized, ask your physician, `Do I need heparin?’ Be proactive.”’

  Exercise is essential to avoid DVT if you have risk factors, he said. Blood thinners like Coumaden (warfarin) are used for this condition.  A risk of bleeding is present with this drug, and a patient has stop taking it for a time before surgery. A meter similar to those used for diabetes testing is available to show Coumadin levels , and anyone on long-term use of this drug should have one, he said. A new blood thinner which is out of the system in 24 hours is being tested and is available in Europe and Canada and will probably be approved for use in this country in 1-3 years, he said. He advised patients to become acquainted with the numbers and values associated with Coumadin and if they are out of line, to ask their physician about it. Again, be proactive.

  Plavix, a blood thinner commonly used to battle high cholesterol, is used for arterial disease.

  Spider veins are not indicative of blood clots, but varicose veins can be if the area affected worsens and swells.

  The test for DVT is a Doppler ultrasound, and a CT scahnis needed to diagnose PE, not a chest x-ray.

  “Know the symptoms,” he said in closing, ”know the risk factors, lose weight, stop smoking, be active, and in the hospital, ask if you should get DVT prophpylaxis.”