Does your blood clot frequently inside your veins? (Blood Clotting Disorders) - Let's be aware of this!

Have you ever had a small cut and a little blood, and then it stopped on its own? It's an amazing defense mechanism in our body. To stop the bleeding, a blood clot forms inside our body. This is a very important, normal process. But, imagine what would happen if this blood clot formed without any injury, just inside your body, inside your blood vessels . That's what we simply call a blood clotting disorder, or in medical terms `(Hypercoagulable State)` or `( Thrombophilia )`.

Simply put, what is this blood clotting disease?

This is when your blood clots more easily than normal. A blood clot is formed when proteins made by our liver ( clotting factors ) and platelets in our blood come together. This is essential to stop bleeding when there is an injury. But if this process becomes too active, it can be a problem.

We call unwanted blood clots that form inside veins a ``thrombus'' or ``embolus''.

Is this situation really dangerous?

Yes, this can be dangerous if left untreated. This is because blood clots can form anywhere in our body. They can mainly form in the arteries that carry blood from the heart to other parts of the body and in the veins that carry blood from the body to the heart.

If blood clots form in the veins...

A blood clot that forms in a vein can break free and travel with the blood, causing two main problems:

• Deep Vein Thrombosis (DVT): This is when a blood clot forms in a deep vein, especially in the legs, pelvis, arms, liver, intestines, or kidneys. Imagine you're on a plane for hours at a time. Keeping your legs in one position can cause blood flow to be restricted, and a blood clot can form in a vein in your leg. This is called DVT.
• Pulmonary Embolus: This is an emergency. This condition occurs when a blood clot that has formed in the leg, like a DVT, breaks loose and lodges in a vein in the lungs. This can be life-threatening.

If blood clots form in the arteries...

Arteries are the blood vessels that supply oxygenated blood to our brain, heart, and limbs. If a blood clot forms in one of these, it can cause serious damage.

• Stroke: If a blood clot blocks an artery that supplies blood to the brain.
• Heart Attack: If a blood clot blocks a coronary artery that supplies blood to the heart.
• Severe leg pain and difficulty walking.
• In some cases, it may even be necessary to remove an arm or leg.

How do you know if you have this disease? What are the symptoms?

Symptoms depend on where in the body the blood clot has formed. Symptoms can vary from person to person.

Why do these diseases occur? What are the causes?

Blood clotting disorders can be divided into two main categories: congenital (genetic) causes and acquired causes.

How do doctors diagnose this disease?

Just because you have a blood clot doesn't mean you have a genetic condition, so your doctor will take a careful look at your personal and family medical history.

Typically, people with the following risk factors are referred for such tests:

• If anyone in the family has a history of this type of blood clot.
• If a young person under the age of 50 develops a blood clot.
• If blood clots form in unusual places, such as the arms, liver, or brain.
• If blood clots form for no particular reason.
• If you have recurrent blood clots.
• If miscarriages occur frequently.
• If you have a stroke at a young age.

What tests are performed?

Several blood tests will be performed to assess your condition.

• PT-INR: If you are taking the drug `Warfarin`, this test is done to check how quickly your blood clots.
• aPTT: This test is done to see how the blood responds to the drug `Heparin` if you are taking it.
• Complete Blood Count (CBC): A complete blood count.
• Fibrinogen test

Specific genetic tests are performed to identify congenital conditions. They also perform tests to check protein levels such as `Protein C`, `Protein S`, and `Antithrombin`.

How is it treated?

Most of the time, treatment is only needed if a blood clot forms inside a vein. The main goal of treatment is to prevent further blood clots from forming and to stop existing blood clots from getting bigger.

This is done using blood-thinning medications. In medical terms, we call these `Anticoagulants`.

Mainly used medications:

• Aspirin
• Warfarin (a type of oral pill)
• Heparin (an injection given into a vein or under the skin in the hospital)
• Low-molecular weight heparin (an injection that can be injected under the skin at home once or twice a day)
• Fondaparinux (injection)
• Direct oral anticoagulants (DOACs) - these are the new generation of oral pills (e.g. Rivaroxaban, Apixaban)

Your doctor will decide which medication is best for you, how long you should take it, and what kind of follow -up monitoring is needed.

Do I need to be careful about what I eat and drink when taking Warfarin?

Yes. Foods rich in vitamin K, in particular, can affect the effectiveness of Warfarin. Therefore, it is very important to follow the dietary instructions given by your doctor when taking this medication.

Some foods rich in vitamin K

• Brussels sprouts
• Spinach
• Broccoli

This isn't to say you shouldn't eat these foods, but it's important to keep your daily intake consistent. Talk to your doctor about this.

If you have this condition, how do you take care of yourself?

• If you are taking medication like Warfarin, wearing a medical identification bracelet that states this will help you receive proper treatment in an emergency.
• Some over-the-counter medications, such as painkillers, can interact with this blood thinner. So talk to your doctor before taking any other medication.
• Get regular blood tests (such as PT-INR) done. Your medication dosage may need to be adjusted based on the results.
• If you are going to have surgery or are planning to become pregnant, inform your doctor in advance.

When should I see the doctor?

When you take blood thinners, even a small cut may cause a little more bleeding, or you may develop bruises. This is normal.

However, if you are bleeding unusually heavily or see large blood spots, call your doctor immediately.

Also, if you think you have symptoms of DVT (leg swelling, pain), seek medical advice immediately.

When should you go to the Emergency Treatment Unit (ETU)?

Living with this condition can be challenging. But with the right medication and the right doctor's advice, you can live a completely normal life. Your doctor is there to help you. So don't hesitate to talk to him or her about any questions or concerns you may have.