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February 29, 2016

Medication Madness for People at Risk of Developing Blood Clots

by: Donald A. Migliori

After reading a recent Bleacher Report article highlighting “Chris Bosh’s Latest Bout with Blood Clots,” I was glad to see the underlying tone to ‘proceed with caution,’ highlighting the dangers of deep vein thrombosis (DVT) and actualizing the disease.

While it may come as a surprise to some that professional athlete and NBA All-Star Chris Bosh’s career may end early due to a blood clot in his calf, the reality is that people of all types can be affected by DVT.

DVT is a serious medical condition that does not discriminate, but instead can inflict many people, both men and women, young and old and even the active and inactive. Terrifyingly, and not commonly known, is the fact that on average, one person dies every six minutes from a blood clot and fewer than one in four people recognize any signs or symptoms of the potentially fatal condition.

Many factors can increase your risk of developing a clot including:

  • Age
  • Birth control pills and hormone therapy
  • Certain cancers
  • Genetics
  • Heart failure
  • Inflammatory bowel disease
  • Obesity
  • Pregnancy
  • Prolonged bed rest and inactivity
  • Smoking

In Bosh’s case, his size may greatly contribute to developing DVT. Bosh comes in at 6’11”, making circulation more difficult during periods of inactivity, such as long plane flights. While this may be one contributor to the cause of his developing and redeveloping blood clots, clots occurring without the cause of injury are medically referred to as idiopathic. These types of clots usually have a high rate of reoccurrence, which has proven to be true for Chris.

This time last year, Chris was diagnosed with a blood clot in his lung which knocked him out of the remaining 2014-15 season. Chris received anticoagulation therapy in the form of blood thinning medication paired with lots of rest, and was able to return to his basketball career for the 2015-16 season.

While Chris’ current condition is being closely monitored by medical professionals, who have clarified that Chris’ DVT is not life threatening. He is currently out indefinitely.

UPDATE – On May 4, 2016 the Miami Heat and Chris Bosh announced that he will not play for the remainder of the playoffs.  

Missing Key Facts about Blood Clot Treatments

The Bleacher Report article highlights potential anticoagulation therapies and accredits warfarin as the ‘gold standard’ of blood thinners. The article also mentions an “umbrella” or IVC filter as a potential option to repair and protect from blood clots, as well as the common prescription anti-coagulant Xarelto®. What the Bleacher Report fails to mention, however, is the potential risks for any of these recommended therapies.

The references of the various options, particularly ones that may carry more risk than traditional treatment options, were almost flippantly mentioned to a reach of more than 124,000 readers, without discussing any of the potential health hazards that are currently, and on an ongoing basis, being discussed.

I believe it is very important to know the risks with these and any potential treatments or potential remedies of blood clots.

Potentially Risky Remedies: IVC Filters and Xarelto

Inferior vena cava filters (IVC filters) are small, cage like devices that are implanted in the inferior vena cava or the main vessel moving blood from the lower body to the heart. However a 2013 study found that “the risks of complications start to outweigh the protective benefits of the filter at day 35 post-implantation.” This study prompted the FDA to update its initial findings and recommend that retrievable IVC filters be removed between 29 and 54 days after implantation.

The complications these studies have associated with retrievable IVC filters include migration and tilting of the device, filter fracture, IVC perforation and guide wire entrapment. While some of these devices are made to be retrievable, complications during retrieval that may require advanced techniques are increased.

It has also been alleged that C.R. Bard forged a letter to receive FDA clearance for one if its IVC filters – after the FDA previously declined approval of the filter.

In the case of Xarelto, Chris Bosh has been one of the celebrity spokespeople for the drug, along with others including NASCAR driver Brian Vickers, Arnold Palmer and Saturday Night Live’s Kevin Nealon.

In a 2014 blog post my colleague, attorney Fred Thompson, explains many of the adverse events that have been reported to the FDA after specifically taking the generic or brand forms of the drug Xarelto.

One of the most concerning issues is the current lack of antidote. If Chris were to have a major injury causing internal or external hemorrhage – there would be no way to stop the bleeding. 

Currently the FDA has not recalled either of these blood clot products, the studies and suggestions published to their website leave reason to believe that a recall may be sooner than later.

Blood Clot Treatments Can Vary

While blood clots are very dangerous, they are also unfortunately too common and treated differently depending on the location of the clot. Each person is different, so be sure to talk to your doctor if you have any signs or multiple risk factors of developing a clot.

While the Bleacher Report I’m sure is intending to help raise awareness about the concerning health issues around blood clots, even treatments that are labeled as a “gold standard” should be carefully monitored by both the patient and doctor.