It’s been such a long, dreary, cold winter. In western Massachusetts, April can be especially more sad and bleak when the Nor’easter persists across our towns and dumps snow and icy rain with spite. So it was with great pleasure and anticipation one sunny afternoon last week that I drove to Westfield to give a talk on vein conditions and treatments. A very lovely woman named Mary Ellen Anderson from the Westfield Woman’s Club had invited me to address their members at their monthly lunch meeting.
As Melinda and I drove up to the turn-of-the-century, stately red-brick building, my first thought was what a wonderful thing a “Woman’s Club” is. In today’s crazy, busy society where most people think only of the “next thing I gotta do,” it’s so nice to meet a group of women who gather regularly to think of citizenship, charity and community. More than anything, it was a gathering of well-accomplished women to just spend time with one another, “hanging out.” They ate, drank, smiled and talked about their kids and family, and gave ear and time to one another’s life experiences, struggles and laughter. Being a surgeon who spends 10+ hours a day in fluorescent-lit exam rooms and O.R.’s, finding myself in a room full of sunshine and happy women was just a sheer delight.
After Mary Ellen introduced me to about 30 women, I took the microphone in my hand and channeled my inner Phil Donahue. I paced the dining room back and forth in my carefully chosen black suit, enlisting questions and answering them as engagingly as I could. All about the veins. Leg pain. Leg swelling. Varicose veins. Very pleasant exchanges. Light-hearted conversation at times. Then a woman in a blue sweater asked me a question about blood clots. Apparently she knows of “someone” who had to be on Coumadin for 6 months and “just got off.” For no apparent reason. Did she have preceding surgery? No. Trauma or injury? No. Sick with an illness or cancer? No. Bed-ridden? No. Anyone else in family with blood clots? Yes, her son keeps getting phlebitis.
I zero-in like a jet pilot on her. I’m a clinician again. I tell her, your friend has what’s called an “unprovoked DVT” (deep vein thrombosis). In such a case, it’s so important to make sure that she and her physician talk about the possibility of an underlying condition that predisposes her to a heightened risk of blood clots. It’s a condition called primary hypercoagulability, or thrombophilia. Many causes can be responsible for this, including many factors that are hereditary. If you have unexplained DVT because of an underlying hypercoagulability that is genetically transmitted, your children and their children might have the same condition.
As I tell them this, their eyes widen. They are women. They are used to laughing off their own physical ailments. But they get very serious about the health of their children and their grandchildren. If you have unexplained DVT, I tell them, you’ve got to talk to your physician about getting tested for primary hypercoagulability. The result just might save your children from early heart attack, early stroke, repeat DVT’s or blood clots to the lungs—and even possible early death. About one in 20 white Americans have a particular type of genetic mutation that causes 4-8 fold increase in blood clots. That means, out of about 30 women sitting before me, one or two of them statistically have this condition.
It’s all very precarious and fragile. One tiny molecular mutation in one clotting factor gene can cause someone to lose their beloved at an early age. We have an uncle who started to have heart attacks at age 50. He died too young of congestive heart failure. We miss him every day. So much in life can be altered by such a small thing when it’s missed by not knowing. I once witnessed a 17 year old girl who dropped dead due to blood clots to her lungs. Being a parent of 20-something children, I think of that girl’s parents from time to time.
Driving back to the office, I find that the bright sunny weather has turned cold and windy with rain clouds gathering over my head. My mood turns gray. New England in April. It is…Yes, precarious. It can be so harsh to those of us who are just craving for some brightness, for some warmth. The only thing that keeps us going ‘til June is just little bits of sun shine here and there. Like the excitement and anticipation of meeting those women at noon. Today was a good day. I got to visit the lovely Westfield Woman’s Club.