Veins are blood vessels that carry blood back to the heart from the muscles and other body organs (compared to arteries which carry blood from the heart to the muscles).

A clot generally occurs in a vein when there is a slowing down or a blockage to the blood flow in the veins. A clot will develop when blood stops flowing normally.

A clot will develop in a veins for a number of reasons. The usual reasons involve a slowing down of blood traveling in the veins. Blood flow in the veins of the legs may slow down for a number of reasons.

Pain and swelling are usually the main symptoms of a below knee DVT. Sometimes the area around a blood clot can feel warmer than the surrounding tissues.

A blood clot is usually detected by an ultrasound. Ultrasound machines use sound waves to detect blood flow in veins and arteries. A clot can be detected because of the decreased blood flow in the veins. An ultrasound is painless and does not have any major side affects. Sometimes blood tests are also used to help in the detection of blood clots.

There are three main problems with a blood clot in the veins of the calf.

The treatment of a blood clot involves ‘thinning the blood’. This is also called anticoagulation.

Thinning the blood does two things:

1. Reduces the risk of the blood clot growing
2. Helps the body’s own blood clot dissolving system to reduce the size of the blood clot and even absorb the clot completely.

Anticoagulation medication may not always be necessary and its use will depend on the size of the clot, the symptoms associated with the clot and the risks associated with anticoagulation medication.

There are three main common problems associated with having HS:

There is another uncommon potential problem for people who have Hereditary Spherocytosis associated with a viral infection called “Slapped cheek”. Slapped cheek is caused by a virus called Parvovirus which can infect bone marrow cells and put the red cell producing cells “to sleep”. Because patients with HS need the bone marrow to be rapidly replacing the fragile red cells, this infection can cause a severe anaemia; patients can become very pale and sometimes even require blood transfusions. Fortunately this problem is uncommon.

HS is now diagnosed with a simple blood test. It is also important for a doctor to examine patients with HS to see if they are jaundiced or have an increase in the size of the spleen.

Most patients with HS do not need to do much about their condition at all. The bone marrow has the capacity to increase the number of red cells it produces many fold and is able to keep up replacing the fragile cells.

A few things may be helpful:

Removing the spleen (splenectomy) has been used a lot in the past in the treatment and management of patients with HS; it stops the red cells from breaking down and solves the problems of HS.

Removing the spleen has problems however – the spleen is an important organ in the immune system and patients who do not have a spleen may be prone to getting serious infections. This risk is higher in younger children but may be less than previously expected because of newer vaccinations. It is now generally recommended to avoid splenectomy in children younger than 6 years and to ensure that children who may need a splenectomy have all the appropriate vaccinations.

Another approach for some of these young patients is to remove only a small part of the spleen – partial splenectomy. This is done in a few hospitals and there is some experience to say this may be very helpful for some patients.