Phlebitis

---

Phlebitis

It's a pain in the leg--or both legs. That's how it begins, anyway. And when the pain doesn't go away, you probably want to pick up the phone and call the doctor.

Well, that's exactly the right thing to do, because anyone with the warning signs of phlebitis needs to find out as soon as possible which kind of phlebitis he has. And only a doctor can tell you that.

Phlebitis (the full name is thrombophlebitis) is an inflammation or blood clot in a vein, usually in the legs. There are two kinds. Deep-vein thrombophlebitis is the risky variety. It affects the veins that are deep beneath the skin (that explains the name), and it can be fatal if a blood clot dislodges from the vein and travels to the lungs. So doctors recommend immediate action if an exam turns up any warning signs of deep-vein phlebitis.

More often the problem is superficial thrombophlebitis, which means that you have some blockage in the superficial veins near the surface of the legs. Painful, yes--but not dangerous. Be ready to call the doctor again if you see any sign that it's getting worse. But in the meantime, there are many things you can do to ease the pain and reduce the worry associated with this problem.

The tips here should be used only by people who have been diagnosed with superficial phlebitis and are under a doctor's care. If that means you, here's what you can do to reduce your chances of another bout with pain, redness, tenderness and itching in your legs.

When to See the Doctor If you have been diagnosed with superficial phlebitis, be sure to call your doctor if there's a sudden increase in pain or swelling, if you notice any lumps or if you develop a fever, suggests Robert Ginsburg, M.D., director of the Unit for Cardiovascular Intervention at the University Hospital in Denver and professor of medicine at the University of Colorado in Boulder. Increased pain or swelling could be an indication of deep-vein thrombophlebitis, which requires immediate attention. Though it rarely happens, a blood clot could break loose and travel to the lungs. Prompt treatment may include hospitalization and medication with anticoagulants, prescribed drugs that prevent blood clots from forming. Since fever may be a sign of infection, also see the doctor if you develop a higher-than-normal temperature. Infection can usually be cleared up promptly with antibiotics, but you'll need a physician's diagnosis and prescription.

Take a load off. "Superficial phlebitis can be treated by elevating the leg and applying warm, moist heat," suggests Michael D. Dake, M.D., chief of cardiovascular and interventional radiology at Stanford University Hospital in Stanford, California. Keep legs elevated 6 to 12 inches above the level of the heart, and apply a heating pad to the affected area. In fact, it may help to keep your feet up all night long. You can elevate the foot of your bed several inches with wooden blocks.

Put the pressure on. Any kind of exercise, but especially walking, allows you to stay one step ahead of phlebitis. Muscular activity puts pressure on the veins, which helps empty them. Essentially, the walking motion helps prevent pooling of blood in the veins, says Robert Ginsburg, M.D., director of the Unit for Cardiovascular Intervention at the University Hospital in Denver and professor of medicine at the University of Colorado in Boulder.

Pop some aspirin. Besides reducing pain and easing inflammation, aspirin has blood-thinning properties, so it may reduce phlebitis by preventing rapid clot formation. For best results, take aspirin before prolonged periods of bed rest or travel, which are the times when your circulation is most sluggish. And if you're phlebitis-prone, your doctor may recommend aspirin before you have any kind of surgery.

But don't down the Pill. "If you've had a history of phlebitis or blood clots, you definitely shouldn't use oral contraceptives," says Jess R. Young, M.D., chairman of the Department of Vascular Medicine at the Cleveland Clinic Foundation in Cleveland. (The incidence of deep-vein thrombophlebitis in oral contraceptive users is estimated to be three to four times higher than in nonusers.)

And don't smoke. Another no-no is cigarettes, which can also cause recurring phlebitis in a more complicated circulatory condition called Buerger's disease.

Massage Can Be Dangerous If you have phlebitis, you might be tempted to "massage away" the pain when you have a flare-up. But that's not advisable unless you have explicit permission from your doctor, according to Robert Ginsburg, M.D., director of the Unit for Cardiovascular Intervention at the University Hospital in Denver and professor of medicine at the University of Colorado in Boulder. Massage can be dangerous for people who have superficial or deep-vein phlebitis, because you could dislodge a blood clot and cause a stroke or heart attack. So don't try hands-on healing without your doctor's blessing.

Think of zinc. If itching is a problem, a dab of zinc oxide in the bothersome areas can bring relief, according to Dr. Young. Zinc oxide is sold in most drugstores and doesn't require a prescription.

Sock it to yourself. Many phlebitis sufferers find that it helps to wear support stockings (the same kind used to treat varicose veins). The rule of thumb: If the stockings ease the discomfort, wear them. However, wearing support hose won't prevent a recurrence of phlebitis if you've had it before.

Ease your air travel. "On airplanes you tend to be confined to your seat a lot more than when traveling by car. So if you've had phlebitis, this is a case where you ought to put on your elastic stockings before boarding, then get out of your seat and walk up and down the aisle every half-hour or so after taking off," advises Dr. Young.