Thrombolysis

WHAT YOU SHOULD KNOW:

• Thrombolysis is a procedure where medicine is used to dissolve a thrombus (blood clot). A blood clot is a clump of blood that forms in your blood vessel. Blood clots more commonly form in your heart and the deep veins of your arms and legs. A blood clot that forms in the deep veins of your arms or legs is called deep vein thrombosis (DVT). A blood clot can decrease, or stop the flow of blood in the vessel it forms in. A blood clot can also break loose and travel (called an embolus) to other areas of your body. The blood clot can reach your lungs or brain, and decrease the blood supply to that organ. A blood clot can cause life-threatening conditions, such as a heart attack, pulmonary embolism, or stroke.
  
  
• Conditions, such as blood disorders, obesity, or a family history of blood clots can increase your risk for a blood clot. Being pregnant or taking hormone medicines, such as estrogen, may also increase your risk for a blood clot. Other risk factors are increasing age, smoking, long periods of time without activity, and major surgery or trauma. Thrombolytic medicine can be given through your vein, artery, or both. If you had a stroke, treatment should begin within three hours of the start of your symptoms. For some conditions, treatment should be started within 6 to 24 hours of your symptom onset. For DVTs, your caregiver will give you instruction's about when your treatment should begin. Treatment with thrombolytic medicine can dissolve the blood clot, and help your blood flow through your vessels. Treatment also can help prevent serious medical conditions, and can save your life.

AFTER YOU LEAVE:

Medicines:

• Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
  
  
• Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
  
  
• Aspirin to stop blood clots: Aspirin helps thin the blood to keep blood clots from forming. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than directed. This medicine makes it more likely for you to bleed or bruise.
  
  
• Blood thinners: This medicine helps prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. Use an electric razor and soft toothbrush to help prevent bleeding.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Blood clot and stroke prevention:

• Compression stockings: Your caregiver may have you wear compression stockings after your thrombolytic treatment. These are tight elastic stockings that put pressure on your legs. The pressure is strongest in the toes and decreases as it goes toward your thigh. Wearing compression stockings helps push blood back up to your heart, and helps to prevent clots from forming. Ask your caregiver for more information about compression stockings.
  
  
• Do not drink too much alcohol: Drinking too much alcohol, too often can increase your risk of having a stroke. Alcohol is found in beer, wine, whiskey, and other adult drinks. Men should not drink more than two alcoholic drinks each day. Women should not have more than one alcoholic drink each day. Pregnant women should not drink at all. Talk to your caregiver about how much alcohol is safe to drink. If you drink more alcohol then you should, ask your caregiver for help in finding ways to stop.
  
  
• Do not smoke: Smoking harms the heart, lungs, and the blood. Smoking can harden your blood vessels, and increase your risk for blood clots and stroke. You are also more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.
  
  
• Exercise: Exercising makes the heart stronger, lowers blood pressure, and helps keep you healthy. It is best to start exercising slowly and do more as you get stronger. Exercising for 30 minutes each day can help decrease your risk for blood clots and a stroke. Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you.
  
  
• Maintain a healthy weight: Talk to your caregiver about your ideal body weight. Weighing too much can cause serious health problems, and can increase your risk for blood clots. Ask your caregiver if you need help losing weight.
  
  
• Move your legs: Move your legs as often as possible. Standing for long periods of time can cause the blood to pool in your legs. Pooling means your blood collects in your leg veins longer then it should before returning to your heart. Avoid sitting in the same position for long periods of time. Try to walk around a few minutes for every hour you are sitting down. A short walk will keep the blood moving in your legs.
  
  
• Use your medicines exactly as ordered by your caregiver: Use all of your medicines given to control other health problems as directed by your caregiver. These conditions include diabetes, high blood pressure, and high blood cholesterol (fat).

For more information:

Contact any of the following:

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

• National Heart, Lung and Blood Institute
  Health Information Center
  P.O. Box 30105
  Bethesda , MD 20824-0105
  Phone: 1- 301 - 592-8573
  Web Address: http://www.nhlbi.nih.gov/health/infoctr/index.htm
  

• National Stroke Association
  9707 E. Easter Lane
  Centennial , CO 80112
  Phone: 1- 800 - 787-6537
  Web Address: http://www.stroke.org
  

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• You have a new skin rash and itching.
  
  
• You have new weakness, or you feel faint.
  
  
• You have new swelling around your eyes.
  
  
• You have new or worsening pain or swelling in one or both of your arms or legs.
  
  
• You have chest pain or trouble breathing that is getting worse over time.

SEEK CARE IMMEDIATELY IF:

• You cough up or vomit (throw up) blood.
  
  
• You have black tarry bowel movements.
  
  
• You have purple spots or blister like areas on your skin.
  
  
• You have swelling of your hands, face, lips, or throat.
  
  
• You suddenly feel lightheaded and have trouble breathing.
  
  
• You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
  
  
• Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  
  
• Call 911 or an ambulance if you have any signs of a heart attack:
  
  
  • Discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain, that lasts for more than a few minutes or keeps returning
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or one or both of your arms
    
    
  • Feeling sick to your stomach
    
    
  • Having trouble breathing
    
    
  • A sudden cold sweat, particularly in combination with chest discomfort or trouble breathing
    
    
  • Feeling very lightheaded or dizzy, particularly in combination with chest discomfort or trouble breathing
  
  
• You have signs of a stroke: The following signs are an emergency. Call 911 immediately if you have any of the following:
  
  
  • Weakness or numbness in your arm, leg, or face (may be on only one side of your body)
    
    
  • Confusion and problems speaking or understanding speech
    
    
  • A very bad headache that may feel like the worst headache of your life
    
    
  • Not being able to see out of one or both of your eyes
    
    
  • Feeling too dizzy to stand