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February 08, 2012  
VEIN NEWS: Feature Story

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  • Thrombosis Strands Americans on Malta

    Thrombosis Strands Americans on Malta


    May 15, 2008

    By: Jean Johnson for Veins1

    John Rupp and his wife Beverly think Malta is sublime. They just hadn’t planed on spending two weeks on the island.

    Although Malta – off the boot of Italy just beyond Sicily – is stunning against the flat expanse of the Mediterranean Sea, this island is only 10 miles across at its widest point and 17 miles long. More, while Malta’s ancient fortresses and Romanesque spires can shine a brilliant gold against the dazzling blue of the sea, when you’re sequestered in a hospital room nursing a thrombosis that has your leg swollen to twice its normal size, the ambience can be difficult to appreciate.

    Learn More About Thrombosis
  • Deep venous thrombosis affects mainly the veins in the lower leg and the thigh. It involves the formation of a clot or thrombus in the larger veins of the area. This clot may interfere with circulation, and it may break off and travel through the bloodstream. A resulting embolus can lodge in the brain, lungs, heart, or other area, causing severe damage to that organ.
  • Risks include prolonged sitting, bed rest, or immobilization such as on long plane or car trips, recent surgery or trauma (especially hip, knee or gynecological surgery), fractures, childbirth within the last six months and the use of medications such as estrogen and birth control pills.
  • Risks also include a malignant (cancerous) tumor and inherited or acquired hypercoagulability (a condition where the blood is more likely to clot).
  • It is important for people taking the blood thinner Warfarin to know that vitamin K or foods containing vitamin K may reduce the effectiveness of this medication. Ask your healthcare provider before increasing intake or for advice on maintaining proper levels of vitamin K if you are taking Warfarin.
  • That said Rupp, a retired English teacher – and one that I credit for formative college instruction and unfailing encouragement – is known for his sanguine nature. “It’s hard to get upset when you have so little control over your situation. Besides, they made a very good crème brûlée as well as a sherry trifle in the hospital,” he said upon arriving back at the couple’s home in Sandy, Oregon.

    Clearly, Rupp knows how to take his pleasure where he finds it. The day on the Holland American cruise ship when he was wheel-chaired to the ship’s physician, however, challenged even his amiable faculties. “My leg was quite swollen and reddened. What I had was a deep thrombosis in one of the veins in my right leg,” said 69 year old Rupp. Rupp explained that the thrombosis started three or four days prior with a small lump in his right calf. “I thought I’d pulled a muscle. At that point we were several days into our cruise, and we had done quite a bit of walking.” The diagnosis was clear, however: thrombosis (a blood clot).

    Rupp received antibiotics and blood thinners during the ensuing two days it took for the ship to reach Malta. “Beverly was majorly overwrought. She loves to hover over dying husbands,” said Rupp, with his wicked sense of humor.

    Nonetheless, Beverly took solace in the first-class care her husband had. While the architecture on Malta ranges through the century and includes a 5,000-year-old pagan temple, St. James Hospital where Rupp was taken is just seven years old. The ultra-modern facility has state-of-the-art equipment and attending physicians trained in Germany and England. Everyone there speaks English to some degree.

    Rupp said of his clot, “it was four inches long so if it had broken loose while I was stomping around on the ship, the end would have been quick!” The end that we’ll all meet some day did not come for Rupp on Malta, of course, and all concerned are grateful for that. After eight days in the hospital watching the BBC and reading the Maltese newspaper, he was able to get around enough to leave the hospital. Even at that point, however, his physicians did not think flying was wise. So the Rupps checked into the lovely old Imperial Hotel where they remained another week while his blood was monitored.

    Now, Rupp goes in twice a week to have his blood checked to make sure the Warfarin, the blood thinner he’s on, is at the correct dosage. Also he has to avoid green leafy foods high in vitamin K, the vitamin that the National Institutes of Health describes as “the clotting vitamin.”

    “They weren’t quite sure,” he added, “but once the Warfarin is stabilized in my system, I’ll only have to go once a week. After that, I’ll probably have to take it for six months.” A question on future travel plans gets the biggest laugh from Rupp yet. “No,” he said. No! I haven’t been too lucky lately. And one thing they always worry about long plane flights is all the sitting and not being able to get up and down too much.”

    So John and Beverly Rupp will be at home for the holiday season. I’m sure they’ll reminisce about sparkling sunlit water, venerable architecture, great local food – as well as how nice it is to be together, to be alive, and to be well.

    Last updated: 15-May-08

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