Venous+Thrombosis

=Venous Thrombosis=

Western Diagnosis Thrombophlebitis, phlebitis Presence of a thrombus in a vein Patients complain due to thrombophlebitis, DVT, chronic venous insufficiency

Etiology
1. injury to the vein 2. hypercoagulability: malignant tumors, oral contraceptives, thrombophlebitis 3. stasis ---postoperative ---postpartum ---prolonged bed rest ---ht failure ---stroke ---trauma ---long traveling with legs dependent

Signs and Symptoms
1. DVT asx often at first ---tenderness, pain, edema, warmth, skin discoloration, prominent superficial veins ---hard, palpable cord (difficult in DVT of calf veins) ---DVT of calf may have no sx at first because 3 veins drain lower leg ---soreness on standing or walking relieved by rest with leg elevated 2. superficial thrombophlebitis ---linear indurated cord ---pain, tenderness, erythema, warmth 3. chronic venous insufficiency ---edema, dilated superficial veins ---fullness, aching tiredness or no sx ---< standing, walking; > rest, leg elevation ---usually hx of previous DVT ---stasis syndrome over time: skin pigmentation increased, stasis dermatitis, stasis ulceration

Diagnosis
1. clinical 2. plethysmography a. not for calf veins 3. Doppler ultrasound 4. contrast venography

Prognosis
1. DVT may cause chronic venous insufficiency or pulmonary embolism

Treatment
1. superficial thrombophlebitis ---warm compresses ---usually resolves within 2 wks 2. DVT ---bed rest usually in hospital ---heparinization ---coumadin - antithrombotic tx ---thrombolytic tx - streptokinase ---below knee elastic stocking 3. Vitamin C, Vitamin E; bromelain 4. hydrotherapy

=
==================================================================================== IBIS:

Definition:
inflammation of a vein before the formation of a thrombus

Etiology:
injury to the venous lining (e.g. from catheterization), hypercoagulability (e.g. from oral contraceptives, hyperlipidemia), and immobility (e.g. paralysis, post-operatively)

Somatic Therapies:
• aerobic exercise: regular, to prevent • elevate feet at night • ROM exercises for foot daily

Nutrition:
eating principles: » acute with cellulitis: • eat as little as possible • increase foods rich in Vitamins C, A and E, foods rich in bioflavonoid • increase fluids • low fat diet, low sugar, high complex carbohydrates • protein 12-15% diet • low cholesterol/cholesterol foods • low sodium/sodium-restricted diet • vegetarian cleansing diet or short fasts » chronic: • elimination/rotation diet, rotation diet, rotation diet expanded

therapeutic foods: • flax seed oil, okra, hawthorn berries, millet, buckwheat, sunflower seeds, sesame seeds, bananas, potatoes, asparagus, apples, honey in small amounts (Airola, p. 101)

fresh juices: • carrot, celery, spinach, and parsley (Walker, p. 149) • carrot and spinach (Walker, p. 149) • carrot, beet, and cucumber (Walker, p. 149)

avoid: • food intolerances • meat, alcohol, hot sauces, spicy foods, fried foods, fatty foods, rich foods, salty foods, heavy protein foods, fats, meats, vinegars, shellfish, sugars

Botanicals
• Aesculus hippocastanum (toxic): internal; externally (ointment) apply to varicose veins that are liable to lead to leg ulcers (Weiss, p. 335; Felter and Lloyd, p. 992) • Anemone pulsatilla (toxic): phlebitis; limbs pale; swollen veins, hard and knotty, painful to touch (Ellingwood, p. 151; Harper-Shove, p. 145) • Atropa belladonna (toxic): phlebitis (Ellingwood, p. 184) • Citrus sinensis or nobilis or aurantium: (Bastyr College Black Book) • Crataegus oxyacantha: increase integrity of blood vessels (NCNM Botanicals) • Hamamelis virginiana: packs and p.o.: congestion, phlebitis, varicose veins (Felter and Lloyd, p. 975) • Hypericum perforatum: oil: apply frequently to varicose veins liable to lead to leg ulcers (Weiss, p. 335) • Melilotus albus or officinalis: anticoagulant: contains coumarin (Mitchell, p. 10) • Symphytum officinale (toxic): decoction of fresh root, infusion of leaves; use for wet compress (Weiss, pp. 334, 335) • Trifolium pratense: mild anticoagulant, tonic, contains coumarin (Mitchell, p. 10) • Trigonella foenum-graecum: poultice or decoction on inflamed parts (Felter and Lloyd, p. 893)

Chinese Formulae
• Hai Zao Wan (Haiodin) (patent); Salvia Shou Wu (patent): to help prevent and treat blood clots (anticoagulant) (Hai Zao Wan: Zhu, p. 82; Salvia Shou Wu: Dharmananda, 1990, p. 55) • Mao Dong Qing (patent): especially if signs of local or general heat. (Zhu, p. 242) • Tang Kuei Four C. (Si Wu Tang): Xue Yu (Blood Stasis) and Xue Xu (Blood Deficiency) (Hsu, 1980, p. 433; Dharmananda, 1986, p. 106; Yeung, p. 220; Bensky and Barolet, p. 248) • Si Miao Yong An Tang: Fire Toxin, Xue Yu (Blood Stasis): especially with ulcerations (Yeung, p. 215; Bensky and Barolet, p. 85)

Acupuncture
after assessing the person and palpating, consider these patterns: Xue Yu (Blood Stasis) and Xue Xu (Blood Deficiency)

» illustrative and related combinations: • UB-57, St-36 and Lv-3: move Xue Yu (Blood Stasis). Careful not to needle if very inflamed, use opposite side. (Eisen) • hua tuo jia ji L1 through L3 or xia jiao shu, GB-34 through to Sp-9, GB-39 through to Sp-6 (also consider shang ba xie and shang ba feng) for thromboangiitis obliterans in the lower extremities (Lee and Cheung, p. 247) • hua tuo jia ji C6 through T3, LI-11 through to PC-6 (also consider shang ba hsia and shang ba feng) for thromboangiitis obliterans in upper extremities (Lee and Cheung, p. 247)

Homeopathy
• Fluoric acid: in long-standing cases • Hamamelis: simple inflammation with much sensitiveness • Kali muriaticum: venous thrombosis; give every 10 minutes • Lachesis: for septic phlebitis • Pulsatilla: use with ham., following childbirth or when there is much pain • Pyrogenium: if lach. fails • Sulphur: if kali-m. fails

Subtle Support
• notes: A#, B, C, D#, E, G, G#

• chords: diminished 8th, C Major, D# Major, G# Major (Gimbel, p. 116)

cardiovascular: • The Barcarole • The Blue Danube • Chopin's A minor Waltz • Tango music • Humoresque • Cui's Orientale • Song of India • Donna e Mobile • Oley Speak's Sylvia (Heline, p. 18)

Mind/Body
• anger and frustration; blaming others for the limitation and lack of joy in life. Blood represents joy flowing freely in the body. (Hay, 1984, p. 156, 179) • inflammation: fear; inflamed thinking; seeing red; anger and frustration about conditions in one's life (Hay, 1984, p. 170-1) • "The blood is an expression of a person's general dynamism. It arises out of the mutual effects of the behavior of the liquid blood on the one hand and the behavior of the limiting walls of the blood vessels on the other. When considering the blood pressure we always need to bear in mind these two mutually contradictory components: the fluid and the flowing on the one hand, and the limitation and the resistance on the other. To the extent that the blood corresponds to our own inner being, the walls of the vessels correspond to the limits that the unfolding personality sets upon itself and the resistances that stand in the way of our development." In the case of thrombophlebitis, the whole circulation stagnates, thus there is resistance to fluidity. These people are literally 'unable to stand'; they cannot stand the pace, they will not stand up for anybody or anything, they lack steadfastness, and will lie down in the face of every challenge. Confinement to bed increases the risk of thrombosis, but it also shows very clearly that the mobility-pole is no longer being lived out. (Dethlefsen, p. 195, 202)

• Spleen ~ Pi governs digestion and manifests in the muscle tissues; transforms food into Qi and Xue (Blood); governs the Xue (Blood) and keeps it in the vessels; and relates to the ability to assimilate, stabilize, and feel centered and balanced. » Healthy expressions are fairness, openness, deep thinking, and reminiscence. » Spleen Xu (Deficiency) signs include slightness (deficient "form"); abundant elimination; morning fatigue; cold, wet feet (Seem, p. 28); abdomen taut and distended like a drum; craving for sweets; flatulence; nausea; mild edema; memory failure; heavy feeling in legs; pale lips; loose stools; muscular weakness; and, indirectly, obesity. » The excessive use of the mind in thinking, studying, concentrating, and memorizing over a long period of time tends to weaken the Spleen and may lead to Xue Yu (Blood Stasis). This also includes excessive pensiveness and constant brooding. (Maciocia, p. 241) Likewise, inadequate physical exercise and excess consumption of sweet and Cold foods will also deplete the Spleen. Environmentally, the Spleen is highly susceptible to attack from external Dampness and Cold.
 * Chinese psychophysiology:**

• Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; stores and cleanses the Xue (Blood); maintains smooth flow of Qi and Xue (Blood); controls the muscles, especially their contractility; and reflects emotional harmony and movement. » Healthy expressions are kindness, spontaneity, and ease of movement. » Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry eyes, skin, and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down. Liver Xue Xu (Blood Deficiency) predisposes to Xue Yu (Blood Stasis). » Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is constricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216) Xue Yu (Blood Stasis) often begins with Qi Stagnation.