Might be. If someone familiar with doesn't drop in soon, I'll try to look up as much as I can, later. Honestly curious now.
Post more!This is a post from a while back I thought I would reply to. I'm a sub-specialist that manages blood clots. There has been some other pretty good info posted on this subject by at least a couple other docs here and in the FF, but there's been some other things that haven't been totally accurate about blood clots in general.
When people talk about blood clots, they are generally talking about clots in the veins, as opposed to the arteries. Clots that occur in the arteries are approached differently than those in the veins. A few people here have mentioned clots causing strokes, but those are almost always because of an issue in the arteries and are rarely due to clots in the large veins around the brain or very rarely related to clots starting in the veins that then get into the arterial system.
When someone is diagnosed with a clot in a vein, there are two major things to think about:
A) How do I manage this clot we just found
B) How do we prevent another clot from occurring in the veins in the future
So, with regards to A: Not all blood clots require any treatment. If people have a clot that occurs in a very superficial vein or even in a deeper vein but in a non-serious location (like below the knee) we often just observe. These types of clots will often be taken care of by your body and have a low risk of causing major medical issues. So starting someone on blood thinners to treat them would result in likely more harm than benefit.
However, if someone is diagnosed with a clot in a deep vein above the knee or a more dangerous location, these essentially always require active treatment. This is because, these types of clots can lead to major problems and it is less likely that your body can take care of the clot on its own. The thing we get most concerned about occurring is embolization (breaking off of the clot and it moving through the veins). Essentially whenever a clot breaks off from the vein it 1st started in, it will then travel through a series of larger veins to the heart. Blood from the right side of the heart will all then flow into the lungs, so the clot goes with the blood flow there. Once in the lungs, the vessels then become smaller again and the clot will eventually lodge into one, or sometimes a few, vessels in the lung. This is called a pulmonary embolus and, if the clot that embolizes into the lung is large enough, people can die. This is the major problem we want to prevent with these blood clots.
So people with clots in these more dangerous positions require treatment and that essentially means blood thinners. There are a lot of different types of blood thinner out there, but almost everyone, unless there is a good reason, get placed on pill blood thinners that don't require monitoring. The most common ones are Xarelto and Eliquis. When you start these drugs, it prevents the clot from growing more, which then allows your body to take care of the clot on its own. There are other drugs out there that can actively "bust" the clot, but they have a much higher rate of bleeding are so are only used in almost like life and death scenarios. If you start a standard blood thinner, it will take a few months for the clot to resolve, in most cases. So, anyone who has a blood clot that requires treatment, they should be on one of these blood thinners for at least 3 months, because thats generally thought to be the minimum amount of time it would take to "resolve the clot" and prevent it from ever embolizing to your lungs.
The much harder question to answer is B, above. What is the likelihood this can happen again and how do we prevent this from occurring again? Even if the clot you just found is taken care of, you always need to figure out why it occurred in the first place to answer this question. If the treatment to prevent another blood clot, ie blood thinners, had few to no side effects, we would just tell people to continue them forever and that way we can be close to 100% sure you'll never develop another blood clot. However, there can be serious side effects, such as life threatening bleeding, so you really need to figure out if the benefit of preventing another blood clot with blood thinners outweighs the possible harms of the drugs. It's a very individualized decision.
Some people develop blood clots around the time of surgery, especially knee or hip surgeries. In these people if the only risk for developing a blood clot was the surgery and there is no evidence of other things playing a role, you just keep the blood thinner on for 3-6 mo because that risk factor is now, presumably, eliminated. There are a lot of other things that can increase your risk of developing another blood clot and sometimes we try to assess all of the known risk factors for people to make this decision. The toughest decision is when someone has a blood clot and you have absolutely no clue, even after a lot of testing, why they developed it (called an unprovoked clot). While this is actually a good size proportion of the people that develop blood clots, its a fairly heterogeneous group as well. There is data that shows that with people in this is group that if you stop blood thinners, about 10% of people develops another blood clot within a year and 25% of people develop a blood clot within 5 yrs. Additionally, if you were to stop blood thinners, about 1% of people will die of a blood clot that embolizes to their lungs with 5 years. So that doesn't look so good to stop the blood thinner, however continuing the blood thinner has its own risks of major bleeding, including dying during a bleeding episode. Its really a rock and a hard place situation. Considering the risk of another blood blot, a number of people will recommend life-long blood thinners for most people after having a single unprovoked blood clot. If someone has more than one unprovoked blood clot, presumably your risk of another blood clot is even higher than what I cited above. Almost everyone would recommend life-long blood thinners in anyone who has ever had more than one unprovoked blood clot.
There are more minutiae, but I think I've summarized the approach and treatment of these clots fairly well. I'm not going to speculate about Trey Smith's situation as I both don't have very much info and sometimes the decision making is very personalized. If you have two people in the exact same situation, one may choose one route with a certain level of risk and the other person may choose the opposite route with less risk.
I've been stalking VN for years, almost always sticking to the RF, but I think this is probably my 3rd post. I don't want to come off as a jerk, but please don't ask me for personal medical advice.
I hope you're feeling better chargervol.
Wow, that was well said. Wish I would have had someone explain it to me that well after having a clot between the pancreas and spleen then later several in the lungs. It helps with understanding the differing answers given about TS also.This is a post from a while back I thought I would reply to. I'm a sub-specialist that manages blood clots. There has been some other pretty good info posted on this subject by at least a couple other docs here and in the FF, but there's been some other things that haven't been totally accurate about blood clots in general.
When people talk about blood clots, they are generally talking about clots in the veins, as opposed to the arteries. Clots that occur in the arteries are approached differently than those in the veins. A few people here have mentioned clots causing strokes, but those are almost always because of an issue in the arteries and are rarely due to clots in the large veins around the brain or very rarely related to clots starting in the veins that then get into the arterial system.
When someone is diagnosed with a clot in a vein, there are two major things to think about:
A) How do I manage this clot we just found
B) How do we prevent another clot from occurring in the veins in the future
So, with regards to A: Not all blood clots require any treatment. If people have a clot that occurs in a very superficial vein or even in a deeper vein but in a non-serious location (like below the knee) we often just observe. These types of clots will often be taken care of by your body and have a low risk of causing major medical issues. So starting someone on blood thinners to treat them would result in likely more harm than benefit.
However, if someone is diagnosed with a clot in a deep vein above the knee or a more dangerous location, these essentially always require active treatment. This is because, these types of clots can lead to major problems and it is less likely that your body can take care of the clot on its own. The thing we get most concerned about occurring is embolization (breaking off of the clot and it moving through the veins). Essentially whenever a clot breaks off from the vein it 1st started in, it will then travel through a series of larger veins to the heart. Blood from the right side of the heart will all then flow into the lungs, so the clot goes with the blood flow there. Once in the lungs, the vessels then become smaller again and the clot will eventually lodge into one, or sometimes a few, vessels in the lung. This is called a pulmonary embolus and, if the clot that embolizes into the lung is large enough, people can die. This is the major problem we want to prevent with these blood clots.
So people with clots in these more dangerous positions require treatment and that essentially means blood thinners. There are a lot of different types of blood thinner out there, but almost everyone, unless there is a good reason, get placed on pill blood thinners that don't require monitoring. The most common ones are Xarelto and Eliquis. When you start these drugs, it prevents the clot from growing more, which then allows your body to take care of the clot on its own. There are other drugs out there that can actively "bust" the clot, but they have a much higher rate of bleeding are so are only used in almost like life and death scenarios. If you start a standard blood thinner, it will take a few months for the clot to resolve, in most cases. So, anyone who has a blood clot that requires treatment, they should be on one of these blood thinners for at least 3 months, because thats generally thought to be the minimum amount of time it would take to "resolve the clot" and prevent it from ever embolizing to your lungs.
The much harder question to answer is B, above. What is the likelihood this can happen again and how do we prevent this from occurring again? Even if the clot you just found is taken care of, you always need to figure out why it occurred in the first place to answer this question. If the treatment to prevent another blood clot, ie blood thinners, had few to no side effects, we would just tell people to continue them forever and that way we can be close to 100% sure you'll never develop another blood clot. However, there can be serious side effects, such as life threatening bleeding, so you really need to figure out if the benefit of preventing another blood clot with blood thinners outweighs the possible harms of the drugs. It's a very individualized decision.
Some people develop blood clots around the time of surgery, especially knee or hip surgeries. In these people if the only risk for developing a blood clot was the surgery and there is no evidence of other things playing a role, you just keep the blood thinner on for 3-6 mo because that risk factor is now, presumably, eliminated. There are a lot of other things that can increase your risk of developing another blood clot and sometimes we try to assess all of the known risk factors for people to make this decision. The toughest decision is when someone has a blood clot and you have absolutely no clue, even after a lot of testing, why they developed it (called an unprovoked clot). While this is actually a good size proportion of the people that develop blood clots, its a fairly heterogeneous group as well. There is data that shows that with people in this is group that if you stop blood thinners, about 10% of people develops another blood clot within a year and 25% of people develop a blood clot within 5 yrs. Additionally, if you were to stop blood thinners, about 1% of people will die of a blood clot that embolizes to their lungs with 5 years. So that doesn't look so good to stop the blood thinner, however continuing the blood thinner has its own risks of major bleeding, including dying during a bleeding episode. Its really a rock and a hard place situation. Considering the risk of another blood blot, a number of people will recommend life-long blood thinners for most people after having a single unprovoked blood clot. If someone has more than one unprovoked blood clot, presumably your risk of another blood clot is even higher than what I cited above. Almost everyone would recommend life-long blood thinners in anyone who has ever had more than one unprovoked blood clot.
There are more minutiae, but I think I've summarized the approach and treatment of these clots fairly well. I'm not going to speculate about Trey Smith's situation as I both don't have very much info and sometimes the decision making is very personalized. If you have two people in the exact same situation, one may choose one route with a certain level of risk and the other person may choose the opposite route with less risk.
I've been stalking VN for years, almost always sticking to the RF, but I think this is probably my 3rd post. I don't want to come off as a jerk, but please don't ask me for personal medical advice.
I hope you're feeling better chargervol.
Thankful to say I'm still in a much improved condition.This is a post from a while back I thought I would reply to. I'm a sub-specialist that manages blood clots. There has been some other pretty good info posted on this subject by at least a couple other docs here and in the FF, but there's been some other things that haven't been totally accurate about blood clots in general.
When people talk about blood clots, they are generally talking about clots in the veins, as opposed to the arteries. Clots that occur in the arteries are approached differently than those in the veins. A few people here have mentioned clots causing strokes, but those are almost always because of an issue in the arteries and are rarely due to clots in the large veins around the brain or very rarely related to clots starting in the veins that then get into the arterial system.
When someone is diagnosed with a clot in a vein, there are two major things to think about:
A) How do I manage this clot we just found
B) How do we prevent another clot from occurring in the veins in the future
So, with regards to A: Not all blood clots require any treatment. If people have a clot that occurs in a very superficial vein or even in a deeper vein but in a non-serious location (like below the knee) we often just observe. These types of clots will often be taken care of by your body and have a low risk of causing major medical issues. So starting someone on blood thinners to treat them would result in likely more harm than benefit.
However, if someone is diagnosed with a clot in a deep vein above the knee or a more dangerous location, these essentially always require active treatment. This is because, these types of clots can lead to major problems and it is less likely that your body can take care of the clot on its own. The thing we get most concerned about occurring is embolization (breaking off of the clot and it moving through the veins). Essentially whenever a clot breaks off from the vein it 1st started in, it will then travel through a series of larger veins to the heart. Blood from the right side of the heart will all then flow into the lungs, so the clot goes with the blood flow there. Once in the lungs, the vessels then become smaller again and the clot will eventually lodge into one, or sometimes a few, vessels in the lung. This is called a pulmonary embolus and, if the clot that embolizes into the lung is large enough, people can die. This is the major problem we want to prevent with these blood clots.
So people with clots in these more dangerous positions require treatment and that essentially means blood thinners. There are a lot of different types of blood thinner out there, but almost everyone, unless there is a good reason, get placed on pill blood thinners that don't require monitoring. The most common ones are Xarelto and Eliquis. When you start these drugs, it prevents the clot from growing more, which then allows your body to take care of the clot on its own. There are other drugs out there that can actively "bust" the clot, but they have a much higher rate of bleeding are so are only used in almost like life and death scenarios. If you start a standard blood thinner, it will take a few months for the clot to resolve, in most cases. So, anyone who has a blood clot that requires treatment, they should be on one of these blood thinners for at least 3 months, because thats generally thought to be the minimum amount of time it would take to "resolve the clot" and prevent it from ever embolizing to your lungs.
The much harder question to answer is B, above. What is the likelihood this can happen again and how do we prevent this from occurring again? Even if the clot you just found is taken care of, you always need to figure out why it occurred in the first place to answer this question. If the treatment to prevent another blood clot, ie blood thinners, had few to no side effects, we would just tell people to continue them forever and that way we can be close to 100% sure you'll never develop another blood clot. However, there can be serious side effects, such as life threatening bleeding, so you really need to figure out if the benefit of preventing another blood clot with blood thinners outweighs the possible harms of the drugs. It's a very individualized decision.
Some people develop blood clots around the time of surgery, especially knee or hip surgeries. In these people if the only risk for developing a blood clot was the surgery and there is no evidence of other things playing a role, you just keep the blood thinner on for 3-6 mo because that risk factor is now, presumably, eliminated. There are a lot of other things that can increase your risk of developing another blood clot and sometimes we try to assess all of the known risk factors for people to make this decision. The toughest decision is when someone has a blood clot and you have absolutely no clue, even after a lot of testing, why they developed it (called an unprovoked clot). While this is actually a good size proportion of the people that develop blood clots, its a fairly heterogeneous group as well. There is data that shows that with people in this is group that if you stop blood thinners, about 10% of people develops another blood clot within a year and 25% of people develop a blood clot within 5 yrs. Additionally, if you were to stop blood thinners, about 1% of people will die of a blood clot that embolizes to their lungs with 5 years. So that doesn't look so good to stop the blood thinner, however continuing the blood thinner has its own risks of major bleeding, including dying during a bleeding episode. Its really a rock and a hard place situation. Considering the risk of another blood blot, a number of people will recommend life-long blood thinners for most people after having a single unprovoked blood clot. If someone has more than one unprovoked blood clot, presumably your risk of another blood clot is even higher than what I cited above. Almost everyone would recommend life-long blood thinners in anyone who has ever had more than one unprovoked blood clot.
There are more minutiae, but I think I've summarized the approach and treatment of these clots fairly well. I'm not going to speculate about Trey Smith's situation as I both don't have very much info and sometimes the decision making is very personalized. If you have two people in the exact same situation, one may choose one route with a certain level of risk and the other person may choose the opposite route with less risk.
I've been stalking VN for years, almost always sticking to the RF, but I think this is probably my 3rd post. I don't want to come off as a jerk, but please don't ask me for personal medical advice.
I hope you're feeling better chargervol.
This is a post from a while back I thought I would reply to. I'm a sub-specialist that manages blood clots. There has been some other pretty good info posted on this subject by at least a couple other docs here and in the FF, but there's been some other things that haven't been totally accurate about blood clots in general.
When people talk about blood clots, they are generally talking about clots in the veins, as opposed to the arteries. Clots that occur in the arteries are approached differently than those in the veins. A few people here have mentioned clots causing strokes, but those are almost always because of an issue in the arteries and are rarely due to clots in the large veins around the brain or very rarely related to clots starting in the veins that then get into the arterial system.
When someone is diagnosed with a clot in a vein, there are two major things to think about:
A) How do I manage this clot we just found
B) How do we prevent another clot from occurring in the veins in the future
So, with regards to A: Not all blood clots require any treatment. If people have a clot that occurs in a very superficial vein or even in a deeper vein but in a non-serious location (like below the knee) we often just observe. These types of clots will often be taken care of by your body and have a low risk of causing major medical issues. So starting someone on blood thinners to treat them would result in likely more harm than benefit.
However, if someone is diagnosed with a clot in a deep vein above the knee or a more dangerous location, these essentially always require active treatment. This is because, these types of clots can lead to major problems and it is less likely that your body can take care of the clot on its own. The thing we get most concerned about occurring is embolization (breaking off of the clot and it moving through the veins). Essentially whenever a clot breaks off from the vein it 1st started in, it will then travel through a series of larger veins to the heart. Blood from the right side of the heart will all then flow into the lungs, so the clot goes with the blood flow there. Once in the lungs, the vessels then become smaller again and the clot will eventually lodge into one, or sometimes a few, vessels in the lung. This is called a pulmonary embolus and, if the clot that embolizes into the lung is large enough, people can die. This is the major problem we want to prevent with these blood clots.
So people with clots in these more dangerous positions require treatment and that essentially means blood thinners. There are a lot of different types of blood thinner out there, but almost everyone, unless there is a good reason, get placed on pill blood thinners that don't require monitoring. The most common ones are Xarelto and Eliquis. When you start these drugs, it prevents the clot from growing more, which then allows your body to take care of the clot on its own. There are other drugs out there that can actively "bust" the clot, but they have a much higher rate of bleeding are so are only used in almost like life and death scenarios. If you start a standard blood thinner, it will take a few months for the clot to resolve, in most cases. So, anyone who has a blood clot that requires treatment, they should be on one of these blood thinners for at least 3 months, because thats generally thought to be the minimum amount of time it would take to "resolve the clot" and prevent it from ever embolizing to your lungs.
The much harder question to answer is B, above. What is the likelihood this can happen again and how do we prevent this from occurring again? Even if the clot you just found is taken care of, you always need to figure out why it occurred in the first place to answer this question. If the treatment to prevent another blood clot, ie blood thinners, had few to no side effects, we would just tell people to continue them forever and that way we can be close to 100% sure you'll never develop another blood clot. However, there can be serious side effects, such as life threatening bleeding, so you really need to figure out if the benefit of preventing another blood clot with blood thinners outweighs the possible harms of the drugs. It's a very individualized decision.
Some people develop blood clots around the time of surgery, especially knee or hip surgeries. In these people if the only risk for developing a blood clot was the surgery and there is no evidence of other things playing a role, you just keep the blood thinner on for 3-6 mo because that risk factor is now, presumably, eliminated. There are a lot of other things that can increase your risk of developing another blood clot and sometimes we try to assess all of the known risk factors for people to make this decision. The toughest decision is when someone has a blood clot and you have absolutely no clue, even after a lot of testing, why they developed it (called an unprovoked clot). While this is actually a good size proportion of the people that develop blood clots, its a fairly heterogeneous group as well. There is data that shows that with people in this is group that if you stop blood thinners, about 10% of people develops another blood clot within a year and 25% of people develop a blood clot within 5 yrs. Additionally, if you were to stop blood thinners, about 1% of people will die of a blood clot that embolizes to their lungs with 5 years. So that doesn't look so good to stop the blood thinner, however continuing the blood thinner has its own risks of major bleeding, including dying during a bleeding episode. Its really a rock and a hard place situation. Considering the risk of another blood blot, a number of people will recommend life-long blood thinners for most people after having a single unprovoked blood clot. If someone has more than one unprovoked blood clot, presumably your risk of another blood clot is even higher than what I cited above. Almost everyone would recommend life-long blood thinners in anyone who has ever had more than one unprovoked blood clot.
There are more minutiae, but I think I've summarized the approach and treatment of these clots fairly well. I'm not going to speculate about Trey Smith's situation as I both don't have very much info and sometimes the decision making is very personalized. If you have two people in the exact same situation, one may choose one route with a certain level of risk and the other person may choose the opposite route with less risk.
I've been stalking VN for years, almost always sticking to the RF, but I think this is probably my 3rd post. I don't want to come off as a jerk, but please don't ask me for personal medical advice.
I hope you're feeling better chargervol.
Thanks for providing the most informative post I have seen about clots. I did not realize there were arterial vs vein type clots. Also, always thought DVT’s were more from veins in the calf, not mostly from above the knee. Thanks for taking the time to make such a detailed post. Now as we hear about TS maybe we will have a better understanding of what is reported.
@ChattaTNVol since school isn’t in session the normal 20hr a week and a off day rules don’t apply as when school is in session
Yep, you're right. Thanks for pointing that out.
View attachment 216152
https://www.ncaa.org/sites/default/files/20-Hour-Rule-Document.pdf
Seen a lot of JJP bust talk. Let me give you my two cents there.
1. The coaching staff as of this evening is still very high on him. He has the raw talent and athleticism to be truly great..
2. That being said he isn’t the sharpest tool in the shed and will need more coaching and time based on what i know to get ready
3, He will see playing time this year and should get progressively better as the year goes on. Next year will be the oh **** moment though IMO when he lives up to the hype.
Makes you worry if he can survive on the academic side of college.
Appreciate your insightSeen a lot of JJP bust talk. Let me give you my two cents there.
1. The coaching staff as of this evening is still very high on him. He has the raw talent and athleticism to be truly great..
2. That being said he isn’t the sharpest tool in the shed and will need more coaching and time based on what i know to get ready
3, He will see playing time this year and should get progressively better as the year goes on. Next year will be the oh **** moment though IMO when he lives up to the hype.
Yep, you're right. Thanks for pointing that out.
View attachment 216152
https://www.ncaa.org/sites/default/files/20-Hour-Rule-Document.pdf