Surviving AmericanSurviving
American Medicine

Hillary Clinton had a blood clot in her leg in 1998. Recently, she developed an unusual blood clot outside of her brain, and she is again on anticoagulants (blood thinners). Because she has now had two blood clots, Hillary should be evaluated for a possible hypercoagulable state, a genetic tendency towards recurrent blood clots.

Many patients get blood clots and they can be life-threatening. Because of this, knowing if you are at a high risk of getting a blood clot (in your legs, lungs, veins or arteries) can help you prevent them. Many genetic disorders, such as mutations in blood clotting proteins in the body, can predispose a person to blood clots. Various diseases, like diabetes, cancer, obesity, vascular disease can also make you susceptible to blood clots. Activities such as sitting too long, or having to stay in bed (when sick or after surgery) may increase your risk of thrombosis (clots).

Do you know your risk for blood clots? Even more, do you know how to decrease your risk for them? Here are some things to keep in mind:

• If you have had a blood clot, or any one in your family has had a clot (described as clot, thrombosis, blood clot on the lung, pulmonary embolus, or deep venous thrombosis), ask your doctor for an evaluation of your risk for recurrent clots
• If your doctor does not know how to do this evaluation, ask for a hematology consult for evaluation to see if you have hypercoagulation
• Discuss prevention of blood clots with your doctor if your risk is at all elevated (blood thinners or aspirin are the usual therapies)
• Avoid blood clots when traveling by walking at least once each hour
• If you have to be hospitalized, ask your physician for prevention of blood clots (blood thinners, anticoagulants, venous pumps on legs are all commonly used)

For more information on preventing illness and disease, see Chapter 9 Preventing Illness and Chapter 10 Predicting the Future: Genetic Testing and Disease Risk Assessment in my new book Surviving American Medicine.