Troops Warned of Blood Clot Risk, Especially During Deployments

By Donna Miles
American Forces Press Service

Nov. 2, 2007 - The wife of an NBC News correspondent who died of a blood clot while embedded with a U.S. unit during the Iraq invasion is working to increase awareness to prevent others from sharing her husband's fate. Melanie Bloom remembers getting a call from her husband, David Bloom, who was embedded with the Army's 3rd Infantry Division as it approached Baghdad on April 4, 2003. Bloom whispered into the satellite phone, explaining that he was sleeping on the fender of his retrofitted tank and didn't want to be overheard and risk getting attacked. He was sleeping outside so he could stretch out his legs, which had been cramping up inside the confines of the tank, he told his wife.

Two days later, the award-winning journalist who brought the sights and sounds of war into America's living rooms live from his "Bloom-mobile" was dead at age 39. He died of deep-vein thrombosis, or DVT, and a related condition called a pulmonary embolism, in which a blood clot broke free from a vein in his leg and moved into his lung.

Bloom's death brought widespread attention to a killer that claims 300,000 Americans every year -- more than AIDs and breast cancer combined, said Melanie Bloom, who's become a national spokeswoman raising awareness about the affliction that claimed her husband.

Servicemembers in circumstances like Bloom's -- spending long periods in close quarters that limit their ability to move and dehydrated due to heat and failure to drink enough water -- are particularly at risk, she said. In addition, like many deployed troops, Bloom had spent many hours on long flights that limited his mobility.

An autopsy revealed that Bloom also had an undiagnosed blood disorder that increased his risk of DVT. He had no family history of blood clots and, except for his cramped legs, appeared to be the picture of health, his wife said.

Like families of troops serving in the combat zone, Melanie Bloom had fears about her husband's safety while he was in Iraq, she said during a joint interview yesterday with the Pentagon Channel and American Forces Press Service. What she hadn't expected was that he'd die from "the bomb within his own body" that would take his life so quickly, she said.

Expressing gratitude for the way the military reached out to her and her three daughters after her husband's death, Melanie said she's now dedicating herself to ensure servicemembers and others recognize the dangers of DVT and take steps to protect themselves.

She urged troops to arm themselves with information so they can be proactive in their own health care. "You are in dangerous places, and you are risking your life every day for our country," she said. "My message for the troops is: In the areas that you can, take care of your health and stay healthy and alive."

She encourages troops and everyone else whose mobility is restricted for long periods to pump their legs up and down to stimulate circulation. This works just about anywhere DVT might strike: on an airplane, in a bus or tank, or even at a computer desk, she said. "If one person hears this and lives, if one life is saved, then David's death is not in vain," she said.

Army Dr. (Col.) David Gillespie, chief of vascular surgery at Walter Reed Army Medical Center here and the Uniformed Services University of the Health Sciences, in Bethesda, Md., said there's no evidence that military people suffer from DVT at higher rates than the general population.

But U.S. troops, including those in a combat zone, have died of the disease, which strikes without warning or with symptoms that some people dismiss as temporary annoyances, he said.

Gillespie cited two military populations at the highest risk: ground troops in Iraq or Afghanistan in restricted environments, particularly in high temperatures that can lead to dehydration, and wounded troops whose mobility is restricted.

He credits strict "water discipline" within the military, in which leaders ensure their troops drink sufficient water, with helping reduce the incidence of DVT. Another factor is the stringent pre-deployment medical screening troops undergo before leaving for a combat theater, he said.

Gillespie urged troops to ensure their doctors know if they have any family history of blood clots. And he emphasized the importance of seeking medical advice quickly if they notice symptoms -- particularly swelling or discoloration in one leg, and tight, shiny, painful skin around it.

The military has state-of-the-art diagnostic equipment to diagnose DVT, even at forward locations, he said. Often it takes little more than a handheld ultrasound machine to make a diagnosis. "So we can make the diagnosis, and we treat it on the spot," Gillespie said.

Typically treatment involves a blood thinner injection to stabilize the clot while the body deploys its own clot-busting defenses, he said. And the earlier the diagnosis is made and treatment begins, the fewer complications are likely to occur, he said.

Wounded troops who are immobile for long periods and particularly susceptible to DVT should get preventative care to protect against it, he said.

Despite the emphasis on ground troops' vulnerability, Gillespie called DVT an equal-opportunity killer that doesn't discriminate between services. "All services are at risk," he said, regardless of whether the person afflicted is a shipboard sailor, a flight mechanic or a nurse operating on a vessel at sea.

"If you are traveling long distances, if you are in hot environments, you need to stay hydrated, and you need to stay mobile," he said.