Disorder Magnifies Blood Clot Risk

NY Times ^ | June 10, 2008 | JANE E. BRODY

[neverdem]

When David Bloom, 39, went to Iraq in 2003 to cover the war for NBC News, his wife, Melanie, naturally feared for his safety. Would a bullet or a bomb claim him? A land mine? An ambush?

Instead it was a blood clot lodged in his lungs that ended his life. Ms. Bloom subsequently learned that her husband carried a genetic abnormality, factor V Leiden, that greatly increased his risk for developing blood clots.

Mr. Bloom had three other risk factors for clots: a long plane ride to Iraq, erratic eating habits that could have caused dehydration, and cramped sleeping space in Army vehicles. But had he not had this genetic quirk — or had he known about it and the higher risks it carried — he might have escaped his fate.

A Hidden Problem

Factor V Leiden (pronounced factor five) is the most common hereditary clotting disorder in the United States, present in 2 percent to 7 percent of Caucasians, less often in Hispanics and rarely in Asians and African-Americans.

The disorder accounts for 20 percent and to 40 percent of cases of deep vein thrombosis, or D.V.T., the clot that Mr. Bloom developed in his leg before it broke loose and traveled to his lungs, resulting in a pulmonary embolism that caused his death.

Factor V Leiden is more often than not a hidden disorder, until someone in a family — often someone like Mr. Bloom, who was athletic and healthy — develops a deep vein thrombosis or another unexpected clot. Because screening for this problem is not routine, factor V Leiden is usually not detected until several members of a family develop clots or one person develops a succession of clots.

Even then, a possible carrier of the gene defect may not be tested.

Dr. Rinah Shopnick...

[Kozak]

Those aren’t warfarin any more. They are a MUCH longer acting derivative.

[SuziQ]

ditching bottles of water and no water provided on the planes

The rules have changed. You will still have to dump any OUTSIDE food or drink when going through security. However, once you're through, you can purchase any food or drink within the secure area and bring it on board with you. I was flying once, and had finished half my burger at TGI Friday's. I took the rest in a doggie bag, and brought it on my flight, along with a bottle of water I'd bought at a newsstand. Not a problem. Most airlines still provide complimentary soda, coffee and tea, but as always, you will pay for alcoholic beverages.

[Old Professer]

“A Danish study of 9,253 adults found that in people who did not smoke, were not overweight and were younger than 40, the 10-year risk of clots and emboli was 1 percent in those with one mutated gene and 3 percent in those with two damaged genes. But the risk increased to 10 percent in people with one mutated gene and 51 percent in those with two abnormal genes if they smoked, were overweight and were older than 60.”

So, don’t smoke, lose weight and don’t pass 60.