Running with Crohn’s: Blood clots

Many people suffer from blood clots (aka thrombosis), however, like many of the other issues that I’ve written about if you suffer from IBD, you are more likely to experience these than normal, healthy people.  To make matters worse, runners (and other athletes) suffer from clots more frequently than normal healthy people.  If you run and have IBS this is a condition that you need to be looking for.

Thrombosis in Crohn's patients

Runners are more susceptible to clots in their legs.

I experienced two of these but both of them occurred in the late 1990s at a time that my daily commute was an hour or more each way. 

If you think you have a blood clot, seek medical attention immediately!  Deep Vein Blood clots (called deep vein thrombosis – DVT) are an immediately life threatening condition!

Both of my blood clots were in my legs and both were in “superficial” veins.  Blood clots in your deep veins are much more worrisome than those in the superficial veins.  Regardless of where you think your blood clot resides, you should seek medical attention if you suspect one.

Symptoms

Both of my blood clots presented as pain, swelling, numbness, and stiffness in my lower leg.

In one case, the clot occurred in my calf and the site looked extremely bruised.  Since I almost never get bruises, my discovery of a baseball sized bruise on my calf along with the stiffness, swelling, and pain in my leg caused me to seek medical attention.

My first blood clot looked like this - a bruise and swelling in my calf

In the other case, I didn’t see any sign of bruising around the area with pain and swelling.  However, since the rest of the symptoms mimicked those of my earlier clot, I sought medical attention again.

My symptoms:

• Swelling
• Pain
• Stiffness
• Warm skin
• Bruise (in only one case)

I never discovered whether the bruise caused the clot or the clot caused the bruise.

The Mayo Clinic lists additional symptoms of thrombosis

The Mayo clinic states that about half of blood clots sufferers (even those suffering from deep vein clots) do not observe symptoms.

Diagnosis

The two types of clots are “superficial” and “deep vein”.  Since the deep veins are larger, doctors worry much more about clots in those veins.  In both of my blood clot cases, my doctor directed me to get an ultrasound of the affected site.  The ultrasound revealed in both cases that my clot occurred in a “superficial vein” (the first one in my calf, the second in my knee).

Other tests are available (including blood tests, MRI, and CT scans).  Of these the blood tests can only show whether you have a clot and not where the clot is located (e.g. superficial or deep vein)

Concerns

In most cases, the clot in your arm or leg does not concern your physician.  It is the possibility that the clot will break loose and lodge in your heart, brain, lungs, or other critical location that concerns them. 

If you suspect you have a blood clot, regardless of how you feel, you should seek medical attention immediately.

Treatment

Once my doctors discovered that my blood clots were in superficial veins, they never expressed much concern about them.  They asked me to monitor them while the symptoms persisted and report to the doctor when the symptoms resolved.  In both cases for me, the symptoms lasted a couple of days and disappeared spontaneously.

If you suffer from the more severe deep vein clots, then expect your medical professionals to monitor your condition more closely.  Furthermore, they will likely administer one or more blood thinners to help break up the clot and prevent your blood from reclotting.  Follow your doctors advice closely as deep vein clots are immediately life threatening and the treatments for resolving them also possess potentially life threatening side-effects.

Prevention

Many aspects of my life increase the likelihood of developing blood clots.  These include:

• Long commutes
• Long airplane flights
• Dehydration (from running and from diarrhea)
• Long periods of sitting at the office
• Chronic bleeding
• High concentrations of hemoglobin when healthy

One aspect of me preventing blood clots is to reduce those factors.

• When I am sitting (at the office, on a plane or in my car), I now frequently flex my legs to help prevent the blood from pooling.  I try to stand and walk around at least once per hour.
• When commuting on a road with rest areas, this often means stopping at every rest area for a short walk.
• When I’m on a plane, it means getting up and walking back to the bathroom whether I need to use it or not.
• When I’m on a plane, I always accept complimentary drinks.  Since my recent reading indicates that orange juice is better at preventing clots than water, I take orange juice.
• When I’ll be flying, I always bring a bottle of water (for hydration) and drink water whether I’m thirsty or not.
• When I’m running, I always hydrate before a run and I always hydrate when running for 30 minutes or more.
• I sometimes take a baby aspirin to help, however, I have a history of GI tract bleeding and I frequently take ibuprofen so I do not take an 81 mg aspirin all that often (speak to your doctor about this before starting).