Contrary to popular belief, DVTs are more common than we think. It's estimated that around 1-3 out of every 1000 adults will develop a DVT each year.

Importantly, DVTs are not confined to long flights. In fact, the majority of DVTs occur outside of air travel. Other significant risk factors include hospitalisation, surgery, cancer, pregnancy and childbirth, hormones (e.g., birth control pills or hormone replacement therapy), lifestyle factors (such as smoking or obesity), and even dehydration. Some people may have inherited conditions that predispose them to clotting, which they are often unaware of until they experience a DVT.

As Dr Lee, a haematologist, explains, DVT can affect nearly anyone, given the right combination of risk factors. For instance, a long car ride combined with dehydration and the use of oral birth control pills may create the perfect storm for a clot to form. Staying aware of these lesser-known risk factors can empower individuals to take preventive steps in their daily lives.

One of the challenges with DVT is that it can be subtle in its early stages, which is why it's crucial to recognise the classic warning signs when they appear. Catching a DVT early, before it breaks loose and causes a pulmonary embolism, can be lifesaving.

Some common signs and symptoms of DVT include:

• Swelling in one leg (or arm)
• Leg pain or tenderness; this may feel like a dull ache or a sense or heaviness
• Warmth and redness
• Visible leg veins

It's important to note that DVT symptoms can sometimes be mistaken for minor issues, such as a sprain or pulled muscle. However, if you notice a combination of these symptoms in one limb, especially if you have any risk factors, take it seriously and seek medical attention promptly. An ultrasound can be performed urgently to determine if a clot is present. Early treatment is critical to prevent the clot from progressing or travelling.

While experiencing a DVT can be frightening, most patients recover well with treatment. In the short term, treatment typically involves blood-thinning medications (anticoagulants) for at least 3-6 months to prevent the clot from growing and reduce the risk of new clots. It’s important to understand that blood thinners don’t actively dissolve the clot. Instead, they prevent new clots from forming and help keep the existing clot stable while your body’s natural processes break it down. In some cases, the clot may not fully disappear but will instead turn into a harmless scar within the vein over time.

Once the initial treatment phase is complete, most people can stop taking anticoagulant medications. However, if ongoing risk factors are present, anticoagulants may continue to prevent future clot formation. Recovery from a DVT can take several months, with the swelling and soreness in the leg gradually improving.

A significant number of DVT survivors may experience lasting symptoms in the affected limb, even after the clot is gone. One of the most common long-term complications is Post-Thrombotic Syndrome (PTS). PTS occurs when the blood clot damages the valves inside the leg veins that help blood flow upwards. As a result, the leg may experience chronic circulation issues, leading to symptoms such as:

• Chronic swelling in the calf or ankle
• Aching or heaviness
• Dark discolouration of the skin
• Ulcers around the ankles

Not everyone develops PTS, with many patients experiencing no lasting effects from the DVT.

Dr Lee recommends some healthy lifestyle changes to prevent recurrence:

• Stay active and avoid prolonged immobility
• Use compression stockings as directed
• Maintain a healthy weight and diet
• Quit smoking
• Stay well hydrated
• Follow up regularly with your healthcare provider and adhere to prescribed anticoagulants

With the right treatment and lifestyle adjustments, many people who have had a DVT go on to live normal, healthy lives without major limitations.

Treatment for DVTs has evolved significantly over the past decade, becoming more effective, convenient, and safe.

Two key developments have shaped modern treatment for DVT:

1. Direct Oral Anticoagulants (DOACs): This is the biggest change in DVT treatment in the past 5-10 years. Medications like Rivaroxaban, Apixaban, and Dabigatran are now available as oral options. In the past, Warfarin was the only oral medication available, and it required regular blood tests and strict adherence to a consistent diet to avoid fluctuations in vitamin K levels and anticoagulation. With DOACs, fixed doses are used, and routine lab monitoring is generally not necessary. These medications do not require patients to follow a strict diet, offering more flexibility and freedom. Additionally, DOACs have a rapid onset of action, allowing for immediate treatment of DVT with just pills, eliminating need for injections or overlap therapy. In contrast, Warfarin takes several days to become effective, and patients previously had to take injections for the first 5-7 days.
2. Advances in clot removal techniques: These innovations have helped reduce the rate of severe post-thrombotic syndrome (PTS). Techniques such as catheter-directed thrombolysis and mechanical thrombectomy are now used in some cases. In catheter-directed thrombolysis, a small catheter is inserted into the vein to deliver clot-dissolving drugs directly into the clot. In mechanical thrombectomy, devices are introduced into the vessel to break up and remove clots. These techniques are typically reserved for extensive clots, helping to rapidly restore blood flow and reduce the risk of PTS caused by a large clot burden.

In summary, the treatment of DVT has become more patient-friendly and advanced, minimising disruption to patients' lives while improving outcomes.

Dr Lee emphasises the importance of taking proactive steps if you have an inherited clotting disorder or a family history of blood clots. Knowing that you carry a genetic predisposition can be empowering. It gives you the opportunity to make lifestyle changes and take preventive measures to protect yourself.

Here are some steps you can take:

1. Follow up with a haematologist: Consult with a specialist to discuss your risk of developing a clot. Together, you can work on strategies to reduce your risk.
2. Avoid immobility: If you’re taking a long flight or car ride, be sure to move around periodically to promote blood circulation.
3. Post-surgery and hospitalisation: Always inform your doctors if you have a family history of blood clots or an inherited clotting disorder. Your physician will likely recommend DVT prophylaxis (prevention) therapy, such as low-dose blood thinners or pneumatic compression devices for your legs during periods of immobility.
4. Pregnancy and birth control: Women with pro-thrombotic tendencies need to be cautious when it comes to hormones. During pregnancy, low-dose blood thinners may be recommended to prevent clots. Additionally, some birth control methods may be preferred over others if you are prone to developing clots.
5. General health: While you can’t change your genes, you can reduce your risk by adopting healthy habits. Staying well-hydrated, engaging in regular exercise, controlling your weight, and avoiding smoking can all significantly lower your chances of developing a clot.

By taking these preventive steps, you can help protect your health and reduce the risk of complications related to blood clots.