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Circulation and SCI

Reprinted from PN June 2012

Wheelchair users must be informed about the dangers and symptoms of blood clots in their legs.

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The Centers for Disease Control and Prevention (CDC) warns that some long-distance travelers are at risk for deep vein thrombosis (DVT) and pulmonary embolism (PE).

DVT occurs when a blood clot forms in a large vein. Part of a clot may break off and travel to the lungs, causing a PE, which can be fatal.

Long-distance travelers can help prevent clot formation by walking around. But if you’re a wheelchair user, these tactics aren’t in the cards. What can you do?

Major Effects

Changes in your blood pressure and how your blood moves from your body back to your heart are spinal-cord injury’s (SCI) major effects on your circulation. Arteries in injured areas are affected because your nervous system plays a part in adjusting their diameter.

After SCI, your arteries tend to stay wide so your blood pressure stabilizes at a lower level. Usually the flexing and relaxing of your muscles helps keep your blood moving. The muscles affected by your injury can’t do that anymore.

These changes in circulation tend to increase your risk for developing edema (swelling) and thrombus/pulmonary embolus (blood clots).

Prevent Swelling

Swelling may happen in your legs because of the loss of muscle function. Muscle movement helps return blood to your heart.

To prevent swelling, routinely wear compressive stockings. These are made of tight elastic and should come up to the top of your thigh. 

Also, do range-of-motion exercises every day and make sure you move your legs from one position to another every two to three hours.

If both legs swell, try these for decreasing edema:

-         Do more range-of-motion exercises

-         Four to five times daily, elevate your legs to or above the level of your heart for 10–15 minutes.

-         Wear compressive stockings while you are in your chair.

If the swelling continues in both legs for more than a week or if you notice a sudden increase in swelling, call your physician. If the swelling is in only one leg, you may have a blood clot, so call your doctor!

Stop Blood Clots

A blood clot in the legs or lungs can be a serious medical problem. The clot can break free and travel to other parts of your
body. One that stays in one place is a thrombus; a clot that has broken free is an embolus.

Some common signs and symptoms of a clot in the leg include:

-         One leg feels warmer than the other and may also be red.

-         One calf or thigh is more swollen than the other. When a clot develops, it can cause the leg to swell quickly.

 

To prevent blood clots, proceed as for treating swelling. But if you think you have a blood clot:

-         Do not increase your activity level

-         Do not do range-of-motion exercises

-         Do not move the leg

Most people with blood clots must take anticoagulants for three to six months.

Lung Clot

One of the common places for an embolus to lodge is the lung. When this happens, it’s called a pulmonary embolus. If you have a PE, you may have one or all of the following:

-         A sudden shortness of breath, possibly with a feeling of tightness in the chest

-         Pain in your side, chest, or back that is usually worse when you inhale

-         Sudden development of a cough, often associated with sputum or phlegm that may be slightly pink or red

 

This is an emergency situation, so call 911 immediately!

Early detection and treatment can prevent death or complications.

This article is based on information at cdc.gov and in Yes! You Can, 4th Edition (5200-183), $20 for general public, $6 for members; in Spanish (5200-175). Download the order form at pva.org or contact the Distribution Center at 888-860-7244 / 301-932-7834.  

 

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