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CLOT-BUSTING PILL CUTS HEART RISK

Singer Gene Pitney had a heart attack, believed to be caused by a blood clot

Tuesday March 9,2010

By Dr Rosemary Leonard

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Q Several months ago I was diagnosed with a blood clot in my leg, for which I have been prescribed warfarin. As yet, there is no sign of the swelling going down. I am worried about taking this medication unnecessarily and wish there was an alternative. Will my leg eventually return to normal?

A When one of the veins in the legs is blocked by a clot there is a build up of blood lower down the leg. The fluid is pushed out into the tissues, leading to swelling or oedema as the medics call it.

The warfarin you have been given thins the blood and gradually the clot will dissolve but it may be a long time before the circulation in your leg returns to normal.

At the moment there is no alternative to warfarin for this type of problem. However new drugs are now being used to prevent clots after surgery and it is hoped these will become available to treat them in the near future. As you have found, taking warfarin is far from simple. You need to have regular blood tests to check the dose is correct and that your blood is thinned to exactly the right amount. You need to be careful about how much alcohol you drink and also watch that you keep the amount of green vegetables in your diet fairly constant, as this too can affect the action of warfarin.

Despite all this it is important you continue taking warfarin for as long as your doctor recommends.

Without it there is a risk of a piece of the clot breaking off and travelling around your circulation, where it could either block one of the blood vessels in your lungs – a pulmonary embolism – or in your brain, where it could lead to a stroke.

Q Ihave the constant sensation of having a lump in my throat, which I have been informed is called globus pharyngeus. I have seen a specialist but was advised only to drink more fluid and carry out neck exercises. Although the feeling isn’t as bad three months on, it is still there. Will it eventually disappear or will I have to live with it?

A Globus pharyngeus is a feeling that you have something stuck in your throat but there is actually nothing there.

When we swallow a piece of cartilage in the throat at the top of the food pipe tightens to stop food regurgitating back up to the mouth. It is thought that constant tightening of this sphincter gives rise to the symptoms of globus pharyngeus.

Sometimes this is due to reflux of acid from the stomach and if you suffer from heartburn you would probably benefit from taking drugs to reduce the amount of acid produced by your stomach. However in many people the tightening appears to be due to underlying stress.

Look at your lifestyle and see if there are ways in which you can give yourself more time to relax and unwind.

You should also try some exercises to stretch and relax the muscles of your neck and shoulders. Yawning can also stretch the back of the throat and can be helpful even when you are not tired.

Try to avoid clearing your throat all the time as this will make the symptoms worse and also drink plenty of water to keep your throat moist.

If you have a health question for Dr Rosemary please write to her in confidence at The Northern & Shell Building, 10 Lower Thames Street, London EC3R 6EN, or e-mail health@express.co.uk Dr Rosemary’s reply will appear in this column. She regrets that she cannot enter into personal correspondence and that, due to the volume of letters, she cannot reply to everyone.

READERS RESPOND:

With reference to your reader who suffered from ulcers caused by Helicobacter pylori (February 23).

I suffered for some time with pains in my duodenal area. I took one teaspoon of Manuka honey 15+ three times a day, 30 minutes before food. A few months later I had an endoscopy which confirmed the scarring was healing.

This would appear a less aggressive and more natural cure than three types of antibiotics.

Graham Wye, by e-mail

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