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Intravenous drug users can be at risk of many negative consequences as a result of their behavior. One possible complication is thrombophlebitis. This is a type of inflammation caused by a clot in the vein. This is a condition that can be treated effectively but it may take time to heal. Those who try to ignore the symptoms can risk more serious consequences. It could lead to the loss of a limb or possibly even death.
Thrombus is an ancient Greek word for blood clot and phlebitis comes from Latin and means inflammation of the vein. It most often occurs in veins of the leg, but it can also sometimes occur in the arm or neck. What often happens is that an injury to the vein leads to inflammation. As part of the inflammatory response there is an increase of blood flow to the area, and this can mean the formation of a blood clot.
There are two types of thrombophlebitis:
* A superficial thrombophlebitis involves veins near the surface of the skin. This is the type most associated with IV drug use.
* Deep Vein Thrombosis (DVT) is where the clots and inflammation appear in deeper vein. They are most likely to occur in the thigh or lower leg.
Thrombophlebitis can have a number of causes including:
* Trauma to veins. This can occur due to putting a needle into the vein for medical or recreational purposes.
* Solutions inserted via the vein that cause irritation.
* Prolonged sitting. Over a long period of inaction the blood pools and clots can form.
* Prolonged bed rest.
* Blood clotting problems. This can mean that the individual’s blood will clot more easily.
* Economy class syndrome. This occurs among people who go on long-haul airplane journeys. It is a DVT caused by prolonged sitting and changes in blood coagulability.
* Bone fractures in the legs or hips.
Symptoms can include:
* Pain in the affected part of the body
* Inflammation – the area may appear red and feel warm to the touch
* Tenderness in the area
* Throbbing sensation
* Vein is more noticeable
* A feeling of tightness in the affected limb
* There can sometimes be bruising
In most instances this condition can be managed effectively once medical treatment is commenced. Occasionally additional complications can arise such as:
* A pulmonary embolism can be a serious complication. This is where the clot becomes dislodged and travels up to the lungs. It can then block the main artery or one of the branches to the lung. This interferes with the ability to breathe. A pulmonary embolism is considered a medical emergency, and if prompt action is not taken it can easily lead to death.
* Post-phlebitic syndrome can be a long term complication of a deep vein thrombosis. It can mean that the individual is left with painful symptoms even after the original DVT has been eradicated. It can also mean permanent skin color changes to the area.
* There is a risk of infection. If the infection is severe it could lead to septic shock and this is another medical emergency.
* If people ignore superficial thrombophlebitis it can lead to much tissue death. If this gangrene is severe it may mean limb amputation is required.
The exact treatment for thrombophlebitis will depend on the type and underlying cause. The actions that need to be taken can include:
* The individual may need to take Thrombolytics. These are a type of drug that can break down clots.
* It may be necessary to commence anti-coagulant therapy. This involves taking medications that prevents the body from making more blood clots.
* Anti-inflammatory drugs may be required to reduce inflammation
* If there is any evidence of infection then antibiotics may also be needed
* Pain relief medications
* It may be necessary to keep pressure of the affected area in order to reduce pain and discomfort
There are a number of things that people can do to avoid thrombophlebitis including:
* Avoiding intravenous drug use
* Not sitting still on long haul flights. People should get up and walk and do exercises to encourage blood flow. They can also wear special stockings that reduce the risk of DVT.
* If people have an IV line that is used for medical purposes it is important that this be changed about every 72 hours.
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