Blood Clots

What are blood clots?
Blood is a liquid that flows within blood vessels. It is constantly in motion as the heart pumps blood through arteries to the different organs and cells of the body. The blood is propelled back to the heart in the veins. When muscles contract, they squeeze the veins and allow the blood to be pushed back to the heart.
Blood clotting is an important mechanism to help the body repair injured blood vessels. Blood consists of:
red blood cells containing hemoglobin that carry oxygen to cells and remove carbon dioxide,
white blood cells that fight infection, and
platelets that are part of the clotting process of the body, and
blood plasma, which contains fluid, chemicals and proteins that are key to bodily functions.
Complex mechanisms exist in the bloodstream to form clots where they are needed. If the lining of the blood vessels becomes damaged, platelets are recruited to the injured area to form an initial plug. These activated platelets release chemicals that start the clotting cascade, activating a series of clotting factors. Ultimately, fibrin is formed, the protein that crosslinks with itself to form a mesh that makes up the final blood clot.
The medical term for a blood clot is a thrombus (plural= thrombi). When a thrombus is formed as part of a normal repair process of the body, there is little consequence. Unfortunately, there are times when a thrombus (blood clot) will form when it is not needed, and this can have potentially significant consequences.

What causes blood clots?
Blood clots form when there is damage to the lining of a blood vessel, either an artery or a vein. The damage may be obvious, such as a laceration, or may occur on the microscopic level. As well, blood will begin to clot if it stops moving and becomes stagnant.
Venous thrombosis or blood clots in a vein occur when a person becomes immobilized and muscles are not contracting to push blood back to the heart. This stagnant blood begins to form small clots along the lining walls of the vein that gradually grow to partially or completely occlude the vein. An analogy to this process is a slow moving river. Over time, weeds and algae start to accumulate along the banks of the river where the water flows more slowly. Gradually, as the weeds start to grow, they begin to invade the center of the river because they can withstand the pressure of the water.
Arterial thrombi (blood clots in an artery) occur by a different mechanism. For those with atherosclerotic disease, plaque deposits form along the lining of the artery and grow to cause narrowing of the vessel. This is the disease process that may cause heart attack, stroke, and peripheral artery disease. If a plaque ruptures, a blood clot can form at the site of the ruptured plaque that can completely or partially occlude the blood flow at that point.
Blood clots can also form in the heart. In atrial fibrillation, the atrium or upper chamber of the heart does not beat in an organized manner. Instead, it jiggles, and blood tends to become stagnant along the walls of the atrium. Over time, this may cause small blood clots to form. Clots can also form in the ventricle after a heart attack when part of the heart muscle is injured and unable to contract normally. Since the damaged area doesn't contract with the rest of the heart, blood can start to pool or stagnate, leading to clot formation.

Doctors

Allergy - Doctors in this field diagnose and treat immune system disorders, including asthma and rhinitis, as well as allergic reactions to substances such as food, medications and insect stings.

Anesthesiology - Anesthesiologists maintain a patient's stable condition during surgery and recovery. Long-term treatment of pain is offered, too.

Audiology - This field focuses on hearing and hearing loss, offering treatment plans that can include hearing aids.

Cardiac Anesthesiology - Anesthesiologists maintain a patient's stable condition during surgery and recovery. Long-term treatment of pain is offered, too.

Cardiology - Cardiologists diagnose and treat diseases of the heart, lungs and blood vessels. Cardiologists also give care for abnormal heart rhythms and heart attacks.

Cardiovascular Surgery - Cardiologists diagnose and treat diseases of the heart, lungs and blood vessels. Cardiologists also give care for abnormal heart rhythms and heart attacks.


Chiropractor - These are specialists in treating neuromusculoskeletal conditions by restoring misaligned vertebrae to their proper position in the spinal column. They do this manually, utilizing the chiropractic procedure known as "spinal adjustment."


Colon/Rectal Oncology - This is surgical treatment of disorders of the intestinal tract, rectum, colon, anal canal and perianal area. Disorders can include cancer, polyps, fecal incontinence, inflammatory bowel diseases and hemorrhoids.

Critical Care Medicine - Specialists in this field are to diagnose and manage the care of patients in intensive or critical care settings.

Dentistry - Dentists diagnose and treat problems affecting the teeth, surrounding tissue, tongue, lips and jaw. Dentists perform surgery, implants, tissue grafts and laser surgery.


Dermatology - Disorders of the skin, mouth, external genitalia, hair and nails is treated. Disorders can include skin cancers, moles, contact dermatitis and hair loss.

Emergency Medicine - This is the immediately evaluation, diagnosis and treatment of patients with acute illnesses and injuries.


Endocrinology - This is the treatment of disorders of glands such as thyroid and adrenal. Diabetes, metabolic and nutritional disorders and bone disorders such as osteoporosis are treated.


Family Practice - This general practice treats a variety of disorders in patients of all ages.

Gastroenterology - Disorders of the digestive system and its organs are treated in the field. Ulcers, irritable bowel and lactose intolerance are among the ailments treated.

General Medicine - A physician in this field is trained to recognize a variety of diseases and ailments, offering treatment plans.

General Practice - A physician in this field is trained to recognize a variety of diseases and ailments, offering treatment plans.

General Surgery - General surgeons deal with all types of surgical conditions in most areas of the body, including pre- and post-operative care.

Geriatric Medicine - Physicians in this specialty deal with the aging process and illness in the elderly. Disorders treated include Parkinson's disease, Alzheimer's disease and incontinence.

Gynecology - These physicians are trained in the care of the female reproductive system and associated disorders.

Hand and Microsurgery - Specialists deal with the hands and other areas of the body where minute dissection and manipulation, often through laser beams, is needed.

Hematology - Disorders of the blood, spleen and lymph glands, as well as all types of cancer and other benign tumors, are treated.

Hematology/Oncology - Disorders of the blood, spleen and lymph glands, as well as all types of cancer and other benign tumors, are treated.

Hypertensive Diseases - Physicians in field use diet, exercise and medication to treat hypertension.

Pharmacy

Q: My sister recently visited me with a bad cold and introduced me to echinacea. I now take it three times a day to prevent colds. What do you think about it? Are there any other natural cold remedies I can use?

A: Echinacea has been a disappointment. Although it has been the best-selling herbal remedy against the common cold, the evidence supporting it has been thin. A recent study published in the New England Journal of Medicine showed that echinacea-root extract was ineffective at preventing experimental colds. Nearly 400 volunteers had cold viruses sprayed into their noses, but those getting echinacea extract fared no better than those on a placebo.

Two other herbs that may eventually prove more promising are Andrographis paniculata (available in a standardized formulation called Kold Kare) and Astragalus membranaceus. Both are Chinese herbs.

Q: What can you tell me about red-yeast rice? My doctor recommended this cholesterol-lowering supplement instead of prescription medicine. Can I continue to eat grapefruit every morning if I decide to try it?

A: Red-yeast rice contains some lovastatin, the ingredient in the prescription drug Mevacor. There are also other statinlike compounds in this dietary supplement.

Because of such ingredients, we think you should avoid grapefruit if you take red-yeast rice. Although the fruit and juice are refreshing, they can increase blood levels of many medicines, including some statins (Lipitor, Zocor and Mevacor). When blood levels go up, there is increased risk of toxicity.

Q: I had to laugh when I saw your article on curing hiccups with a spoonful of sugar. You said it was originally published in the New England Journal of Medicine in 1971.

I had my first child in November 1947. I brought him home when he was 3 days old, and he immediately started hiccupping. I couldn't figure out how to stop it. My dad came into the kitchen and told me to put a tiny bit of sugar on the end of a spoon and give it to the baby. It worked!

I wonder where he heard that? From his mom, no doubt.

: Thanks for the history lesson. Home remedies are often passed down from generation to generation.

From Bee Staff:

A pharmacist has been arrested for allegedly stealing prescription painkiller medicine from a Sacramento County-operated pharmacy, the U.S. Drug Enforcement Administration said Friday.

Marvin G. Gibson, 61, of Folsom (photo left) allegedly stole the medication while he was employed as a pharmacist at a the county's Primary Care Center Pharmacy in the 4600 block Broadway in Sacramento, Assistant Special Agent in Charge Gordon Taylor said in a press release. Gibson surrendered at the DEA office on Friday, Taylor said.

"We are seeing an increasing trend of prescription drug abuse take hold across the country," Taylor said. "This case is a perfect example of how addiction to pain medications can affect people in all walks of life, even those working in the medical industry."

The DEA started the investigation in June 2008 with an audit of the pharmacy, Taylor said.

Investigators determined between August 2007 and January 2008, Gibson allegedly stole Hydrocodone on three occasions, Taylor said.

He said court documents show Gibson admitted to stealing approximately 60 Hydrocodone pills for his own personal use while working at the pharmacy.

Hydrocodone is commonly prescribed for moderate pain, Taylor said. Hydrocodone is one of the most frequently prescribed opiates, and the number one abused pharmaceutical drug in the United States, he said.

Hydrocodone is marketed, in its varying forms, under a number of trademarks, including Vicodin, Lorcet, Lortab and Norco, Taylor said.

The DEA's Sacramento office conducted the investigation with assistance from the Folsom Police Department and the California Board of Pharmacy, Taylor said.

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Hospitals

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