DVT contraindications?

[ssssss]

So with DVT, no "rubbing" the leg is advisable. Does anyone know if percussion, either manually or with a Thumper would be okay? Any other ideas to relieve pain in legs for someone with this condition?

 

[DrLove]

With DVT the risk is that you may dislodge the clot which would then travel to other areas of the body such as lungs, heart, head etc causing a blockage there.
So no massage, including percussion. thumpers etc at all.

 

[BUDDY]

I agree with Jeff. You don't want to do anything that would increase the circulation. Energywork, however, might be helpful to ease the pain. Are you trained in Reiki?

 

[pscreamingheagle08]

That would be a high contraindication for all of the above. The thumper and percussion would be very bad for this client.

 

[John Muirs Ghost]

Okay, thanks.
She actually has a pump for her legs. It sounds like it compresses, like a bp cuff. She said part of her legs swells up and then it moves up.

 

[William Y]

Okay, thanks.
She actually has a pump for her legs. It sounds like it compresses, like a bp cuff. She said part of her legs swells up and then it moves up.

Yeah jdcan, my Mom had a pair of those legging like things while in the hospital that compress the leg when she broke her hip. It and the blood thinners were to prevent DVT. (The pump didn't come home with us though.)
They tend to compress the leg in such a rhythmic way that it moves fluid up towards the trunk of the body.
Got to admit I'd be afraid of disloding a clot. (I waited until my Mom had been cleared by the Dr and taken off the blood thinners before massaging her again.)

 

[t12_incomplete]

With DVT the risk is that you may dislodge the clot which would then travel to other areas of the body such as lungs, heart, head etc causing a blockage there.

Actually, when clots in veins break loose and become emboli, they can only end up getting stuck again in the lungs. A Pulmonary embolism.

 

[Pompal 09.]

Okay, thanks.
She actually has a pump for her legs. It sounds like it compresses, like a bp cuff. She said part of her legs swells up and then it moves up.

Thise are anti embolism/sequential stockings. They are connected to an air "compressor". The sleeves/stockings have bladders which fill then release to move blood towards the heart. We use them interoperatively to reduce the risk of embolism. Recovery room and inpatients may also be on this machine.
Ther have been home models sold....bad idea if you have risk of DVT and are not under a Drs care.

Robyn

 

[ilovemybestfriends]

Jdcan wrote: So with DVT, no "rubbing" the leg is advisable. Does anyone know if percussion, either manually or with a Thumper would be okay? Any other ideas to relieve pain in legs for someone with this condition?

Then, Jdcan added: She actually has a pump for her legs. It sounds like it compresses, like a bp cuff. She said part of her legs swells up and then it moves up.

Nybor7 wrote: Thise are anti embolism/sequential stockings. They are connected to an air "compressor". The sleeves/stockings have bladders which fill then release to move blood towards the heart.....bad idea if you have risk of DVT and are not under a Drs care.

Nybor7, that's exactly what I was thinking. Why would someone with a DVT have a mechanism that's trying to increase circulation toward the heart?

Jdcan, are you sure this person has a DVT? Is it possible she's simply under medical care designed to prevent a DVT from forming? If she has been diagnosed with DVT, the pump would seem to be a contraindication.

 

[jake long]

Jdcan, are you sure this person has a DVT? Is it possible she's simply under medical care designed to prevent a DVT from forming? If she has been diagnosed with DVT, the pump would seem to be a contraindication.

I was wondering the same thing???

Angie

 

[Kevin Davis]

I was wondering the same thing???

Angie

Me too.

That's why I added the pump information. That's also why I was wondering if I COULD do something to help her.

 

[Sandra D]

Nybor7,
Would the pump be advisable for someone after DVT has diminished and the "lump" is gone? This client is no longer on anti-coagulants. Her legs are still hard, though.
And if the pump is okay... ?


Anybody know if getting permission from a PT is similar to getting permission from an MD?

Thanks for your continued interest/help everyone.

 

[kelvin S]

Nybor7,
Would the pump be advisable for someone after DVT has diminished and the "lump" is gone? This client is no longer on anti-coagulants. Her legs are still hard, though.
And if the pump is okay... ?


Anybody know if getting permission from a PT is similar to getting permission from an MD?

Thanks for your continued interest/help everyone.

I'd skip getting permission from the PT and require a signed consent from the MD. I don't think the PT is qualified to give permission.

 

[Sergio]

OK. At this point, I'm thinking that client herself doesn't really know what's going on with her body, which is why the information she's giving you seems to be conflicting. Many clients hear medical terms, and since they don't understand them, they don't remember them very well either. If she had a DVT, she would be on anti-coagulants and she would not be on the pump. Also, DVT's don't cause the legs to get hard. That sounds more like lymphedema. If I were her MT, I would want a signed release to actually talk with her doctor to find out what her medical history accurately has been, and what her condition is now. If she has Lymphedema, she should really be referred on to a lymphedema specialist. That's very sensitive work.

 

[Pompal 09.]

At this point I think a call to her doctor is advisable.
I have no idea or experience if people use sequentials if they are stabilized with Coumadin et. al.
Get her permission to ask her doctor a few questions, you may gain a lifelong client when she sees what a professional interest you have in her....and that you care enough to do the right thing.

Robyn

 

[Cochise]

I am going to try to talk to her doctor.

Thank you.

 

[Visions of Codeine]

having had several DVTS I can speak from experience...I am a thrombofeliac.
Its no fun to have a DVT, THEY HURT LIKE HELL...feels like your leg is gonna blow off from back pressure....wicked pain.

The DVT and the extremety is a local and regional CI for three months and you need a MD's approval after that time.
The clot is not dissolved by blood thinners, only by Heprin which you only get for two weeks, via stomach injections....I do those my self when I had the last DVT.

So the clot may be there as a partial blockage for the rest of the patients life like the one in my left common femoral...that means it will aways be a local caution.
The therapist needs to indentify and treat S/S of course. The pain is due to the back pressure in the vein, something we cannot help with other then good advice like elevation, rest, stockings, follow MD orders and medications pre three months DVT...and getting a balance on their INR with blood thinners is often a crazy balancing act.
I know that my leg pain was most helped with the injectable Heprin and with also anti inflammatories as the inflammation is triggering the nocireceptors like crazy, so we need to drain the leg, decrease the stretch receptors overload with elevation, stockings, that pump which is not dangerous if MD advised.

After three months we can approach the leg with Lymphatic drainage and John Barnes Myofasacial Release techniqe, also Active Isolated Stretching.

Usually you end up with Post Thrombotic Syndrome due to valve damage post DVT back pressure which occurs by the third day....why they don't take those suckers out I am not sure, in Europe they do...but here they do not so you are left with constant backpressure with damage valves and you need stockings for life. Make sure they get prescribed stockings BEFORE Post Thrombotic Syndrome starts.

 

[~just me~]

UPDATE:
I dropped off a signed by client paper saying "permission to contact" (Dr's name.)
I also dropped off a Physician's Permission form. I did this last Tuesday, Dec. 12th. Today is Wednesday, Dec. 20th.

I haven't heard anything from the doctor yet.

 

[8 In the corner]

UPDATE:
I dropped off a signed by client paper saying "permission to contact" (Dr's name.)
I also dropped off a Physician's Permission form. I did this last Tuesday, Dec. 12th. Today is Wednesday, Dec. 20th.

I haven't heard anything from the doctor yet.

Around here, the doctors may very well sign it, but they won't contact you or the client to pick it back up. Have you called to ask about it?

A good majority of doctors are the extremely arrogant variety, and wouldn't dream of simply communicating.

 

[sucounnilync]

UPDATE:
I called after the previous post. This was on Thursday, 12/21. I talked to the person who answered the phone. She had left the papers, no response yet.
And as of now; the following Wednesday, still no response.