Why do some people not want the vaccine? You may wonder how this post is relevant to people with heart disease or clotting problems. And you may have heard enough about people who are opposed to mandates and vaccination. But if you have heart problems or a history of blood clots, then vaccination should be uppermost in your mind. Your biggest risk comes from the … [Read more...]
Should I be worried, doctor?
When you’re on anticoagulants, you may have concerns that you’re not quite sure about. Should you bother your doctor? My patients often bring up these concerns towards the end of a visit and start by saying, “Should I be worried, doctor?” It is essential to mention anything that bothers you rather than silently worrying. Some concerns are more important than others. In this … [Read more...]
COVID, clots and shots – Protecting the vulnerable
Part of my job is to provide Haematology services to New Plymouth Base Hospital. I visit every month to catch up with my patients. Risks of the immunosuppressed The majority of the people I see have serious blood disorders and are immunosuppressed. That means that their immune system has been damaged by their disease or chemotherapy.This causes two significant problems … [Read more...]
COVID, clots and shots – Heart Disease
I tell all my patients, "You don't want to get COVID". This is especially true if you have heart disease. Soon after the pandemic started, it became clear that people with heart problems were more likely to end up in hospital and get severe disease. So what is the risk, and why is the disease worse? Risk factors Most people think of COVID as a flu-like illness … [Read more...]
Long-term impact of venous thrombosis
I normally tell my patients that they are likely to make a full recovery from a deep vein thrombosis or a pulmonary embolus. Unfortunately some people do develop long-term complications such as post phlebitic syndrome causing chronic leg problems, but in general I do not expect long-term problems. However there is some evidence that having a DVT or PE can have an impact on day … [Read more...]
Weekend reflection: Ethics of medical trials
Berlin This week I am in Berlin about to attend the International Society of Thrombosis and Haemostasis meeting (ISTH 2017). It is a meeting where doctors and scientists present their latest research. The importance of ethics in research has been brought into sharp focus for me this week as Angela and I visited some of the historic sites in Berlin. Sachsenhausen Berlin is a … [Read more...]
Clotting: the Swiss connection
Swiss precision This week I am on my way to the International Society of Thrombosis and Haemostatsis meeting in Berlin. This is a great opportunity to catch up with all the latest developments and research in the field of blood clotting. As a stopover, Angela and I spent a couple of days in Zurich in Switzerland; what a beautiful city. I thought there must be some link … [Read more...]
Clot detectives
I attended the Haematology Society of Australia and New Zealand regional meeting in Auckland last week. Professor Barbara Bain, a highly regarded International expert from London was one of the invited speakers. She gave a really interesting talk on "Haematologists as Detectives". She highlighted some of the cases of poisoning and accidental drug errors that were picked up by … [Read more...]
Clots in Pregnancy – Treatment
A confirmed deep vein thrombosis (DVT) or pulmonary embolus (PE) should be treated with low molecular weight (LMW) heparin (enoxaparin, dalteparin or tinzaparin) immediately. Even if the diagnosis is only suspected you should start on treatment and only stop when the ultrasound scan or CTPA excludes a clot. LMW heparin is given as a subcutaneous injection. In the past … [Read more...]
Clots in Pregnancy – Symptoms
In my previous post about DVT in pregnancy I looked at the incidence of clots in Pregnancy. DVT is relatively rare but serious and should not be missed. The Royal College of Obstetricians and Gynaecologists guidelines quote that approximately 20% of DVTs can lead to a pulmonary emboli in pregnancy and these can be rapidly fatal. A suspected case of DVT should be … [Read more...]