 Okay, welcome back. It's time for the second hot topic and want to take a look at the dangers of thrombosis and the means of prevention. I've been joined by Well, I've been joined by Dr. Heling Okoye, lecturer and consultant hematologist at the University of Nigeria, Inuku. Good morning to you, Dr. Okoye. Good morning. All right, so first of all, help us understand what thrombosis means. Okay, thrombosis is a word that describes inappropriate cloth formation within the vessel. The vessel can be the artery. It can be the vein. When cloth forms, when blood comes together in clumps, congeals within the vessel, that can be used to describe what thrombosis is. So thrombosis is a term used to describe inappropriate cloth formation, be it in the vessel, in the artery, or in the vein. All right, how dangerous is this? How is it perceived in the spot of the world? Well, you know, the normal Nigerian factor, we tend to think that some of these unexplained conditions, once it's not malaria and typhoid, they are not for Nigerians, they are not for the blacks, but it is a global problem. It occurs in everybody, no racial discrimination and no egg discrimination, no gender discrimination. So it happens in everybody. It can happen in everybody in all countries. So the one bad thing about it is that if it's not identified on time, it can progress to something that is fatal and can cause death instantly. Oh wow. So how can it be identified? There are different kinds of thrombosis. When I say that, I mean the location. Like I said previously, it can occur within the arteries or within the veins. For today, maybe we should focus on thrombosis, cloth, within the veins, which can be termed venous thromboembolism. Venous thromboembolism is comprised of Hello. and pulmonary embolism, which occurs within the lungs. So it depends on the site of the cloth that the symptoms will present. So if we have thrombosis occurring within the big veins, like the veins of the legs, the patients may come down with pains around the calf, around the thigh, with swelling, with warmth, and there may be discoloration for the fair people. All right, but for those pained people, you may not notice any discoloration in breaks off due to anything. It could progress to what is called pulmonary embolism, which is a fatal condition that is responsible for most of the sudden deaths occurring in hospitalized patients. What is the difference between these thrombosis and varicose? You know, the varicose vein. OK. Yeah, varicose vein is more superficial and most times will not lead to, it doesn't lead to pulmonary embolism. It's just a local problem, but it could be a risk factor for some kind of deep clots that's thrombosis. Again, so I would say varicose vein is benign. It's not so bad. It's a problem, but it's not the same as big vein thrombosis. OK, I would have to ask you again, what causes this thrombosis? And if you can just say it more in a layman term so that ordinary people like us can fully grasp it, how does it come about? OK, so sorry about the if I had these long big terminologies. OK, let me break it down. It depends if we are looking at arterial or venous thrombosis, but let's restrict this discussion to venous thrombosis. That's the clots forming within the veins. There are different things that could cause or predispose someone to developing clots, inappropriate clots within the veins. This could be some inherited conditions. Looking at inherited conditions, we are looking at some deficiency of some of these normal anticoagulants. The body has normal anticoagulants, natural anticoagulants within the blood vessels. So when you have deficiency of any of these proteins, someone may have a higher propensity to form clots. When I talk about anticoagulants, I mean anti clots, things that prevent clots formation. So you have a protein S, you have the antitrombin and so on. So if there is any problem, any reason someone is deficient in any of these proteins, which usually could be genetic, the person will come down with the deficiency and will have a higher risk of developing clots. Now, let's look at the common, the more common ones, which are the acquired ones. A number of factors, acquired causes can lead to thrombosis formation, inappropriate clots formation, ranging from nerve pulmonary disorders, inflammatory conditions, like you have a chest infection, like you have a cancer, like you are pregnant and about six weeks after delivery, the person is at high risk of developing clots. As a woman, if you are taking oral contraceptives or any estrogen, any hormonal therapy, be it a man or a woman, you are at higher risk of developing clots. Then when you sit as you are sitting, eating popcorn, watching television in the cinema, watching movies that we enjoy watching and you stay longer than two, three hours, you are at risk of developing clots. Long haul travels, like you are traveling from here to maybe Kaduna or any far distance or you're flying without in between exercise, having exercise in between, you are at risk of developing clots. Then if you have trauma, surgery, you are receiving chemotherapy for some conditions, the person is also at risk of developing clots. Then one more last thing, which is interesting, hospital admission, being in a hospital or whatever condition that makes you bed reading or that makes you be in bed, confined in bed for more than 48 hours, the risk of developing clots is high. And there is no age limit. No, there is no age limit. Even though it's rare, before the age of 18 in children, it's rare and the risk increases exponentially after the age of 40. The risk is higher in the elderly but nobody is above having clots so long as you have the predisposing factors. For the elderly, you can understand they are less mobile, they have infections, they have conditions like diabetes, hypertension, which are also risk factors. So this could multiply their risk and place them in a higher place when it comes to thrombosis formation. All right, you've done a very good job at explaining it to us now. I'm sure our viewers watching who didn't know what it was would now have a better understanding of what thrombosis is about. Now let's talk about how to prevent it and how to treat it. Okay, let's start with prevention because prevention is always better. First of all, I've listed a number of risk factors. Some are modifiable, some are not modifiable. You can't modify your age. If you are 80, you are 80. But if you have diabetes, you can control it. If you have hypertension, you can control your hypertension. If you have a chest condition, chest inflammation, infection, you can treat it. If you are going to travel on a long distance, like all these long haul travels, you could in between have some kind of exercise. So it depends, you have to tackle the risk that are present in the individuals. Some people may not have any apparent risk in them. Those people who benefit from good diet watch your weight. It helps in controlling the risk of developing clots. You watch your weight, you exercise often, you eat good food and make it as a habit to move every two to three hours. If you are at work, if you are at home watching your television, pressing your phone, your social media, make it a point of duty to move around every two to three hours. Then when you get to the hospital, it is your responsibility. Take charge of your health. Ask your doctor, am I at risk of developing clots? Can you risk assess me? Your doctor would risk assess you and know whether you have risk and if you have risk, he knows what to do. At times you could replace on prophylactic therapy, that's preventive therapy, which could be in form of drugs or in form of some mechanical devices like stockings. So these are things that could help. Alright, what about, hello? Things to prevent clots. And people at risk, like cancer patients, pregnant women, people that just deliver, people that have surgery, people that have one disorder that could increase their risk of developing clots. We usually place these people on pharmacotherapeutics or we could place them on mechanical devices like the pressure stockings. We could put them on intermittent pneumatic pumps. All these are geared towards moving circulation, encouraging circulation within the vessels. So at no point would you have stasis, like stagnation within the vessel. Then the drugs in form of pills, the preventive drugs will help thin out your blood, make it not to be too sticky to come together to form a clot. So if all these things fail, then you place the patient, and the patient develops clots, you now place the patient on anticoagulants. There are different kinds of anticoagulations. You could place your patient on some aparentera, some you can give as injections, some you can give orally. So depending on the patient's choice and the condition the patient has, the patient, the doctor will now place the patient on the appropriate medications. Okay, what about making it a habit to take blood thinners, natural blood thinners like spices, turmeric, garlic, ginger? Does it also help take you off the risk zone? Does it give you some sort of insurance from ever having anything to do with it? Well, as a Nigerian, I would say it's part of the diet, your diet, watching your diet, eating the right things. But there are no controlled randomized trials on those spices and how much it can offer benefit to patients, to individuals with risk of developing, with or without risk of developing clots. So there are no studies, published studies that back up such drugs. But I mean, we go natural, we try to take the right things at the right time at the right quantity. These help in reducing your risk of developing clots. How prevalent is this thrombosis in Nigeria? Would you say? Unfortunately, we don't have a nationwide data on the frequency of thrombosis as a nation. But there are pockets of data emanating from different populations from different states. So within, generally, I would say, you have the risk of thrombosis, it's between 2.4 in Nigeria. But the risk can be higher in surgical patients, people that just came out from surgery in medically ill patients, in pregnant women, in cancer patients, the risks are higher there. And of course, they are of different proportions. But generally as a country, the risk ranges from 2.4 to 9.6%. Well, thank you so much, Dr. Heling Okoye, for this lecture. I think I can simply call it that, thrombosis and its prevention. Dr. Heling C. Okoye, thank you so much for your time. Thank you. Dr. Heling C. Okoye, lecturer and consultant, hematologist at the University of Nigeria, Enugu, has joined us this morning on our second hard topic, to take a look at thrombosis and how to prevent it. Well, that's the package we have for you today, and indeed the week. But I won't leave you without giving you a quote of the day. There is virtue in work, and there is virtue in rest. Use both, and overlook neither. That's from Ellen Cohen. And I am Maureen Menongwe-Zigui, and on behalf of the crew members, I say thank you so much for being a part of the program today, and indeed the whole week. Do join us next week for another series of The Breakfast on Plus TV Africa. Good morning.