Michael Nelson had no idea that sitting in a chair in one position for too long could prove fatal.
He found out the hard way. His life was threatened by an enormous blood clot in his right leg.
The clot appears to have materialized while he worked an interim job for a call center near Lake Ozark, Mo.
Last year, on a Saturday in November, he had worked a day shift but didn't get a lunch break until 2 p.m. He'd sat for about six hours. The job required him to sit for long hours, but that day was the longest.
"I started feeling like I had a pulled muscle in my right thigh," he said.
Pain worsened the next day; he had trouble walking. Monday, he was awakened and saw that his leg was a half-size larger than normal and he was in pain.
Tests at an emergency room found a blood clot that ran from his pelvic region to his mid-calf, more than 18 inches long, Nelson said.
The ER sent him home with anticoagulant medicine, a compression stocking and instructions to keep his leg elevated.
He researched his condition online. The Society of Interventional Radiology and the American Heart Association recommend that clots the size of Nelson's be treated aggressively because blood thinners often aren't enough.
He also learned that people can die from the condition.
"Sometimes a blood clot forms in a vein that lies deep inside the body — like deep inside the thigh," said Dr. Mazen AbuAwad, an interventional radiologist at St. Anthony's Medical Center. "If it stays there too long, it can cause permanent damage."
The Heart Association warns that pieces break off and make their way to the lungs and can cause death.
The condition accounts for the occasional stories of people leaving airplanes after long flights then collapsing, even dying, in an airport for no apparent reason, AbuAwad said.
In December, says Nelson, the compression stocking wasn't working, so AbuAwad "got me in that day and removed it that day."
WHAT IS IT?
AbuAwad explained that a deep vein thrombosis is caused by slow blood flow often due to something pushing against the blood vessel. A clot forms and sometimes grows from a few inches to nearly two feet.
It's often undetected until pain and swelling signals something is wrong.
It also can be caused by a blood clotting disorder or a family history of clotting.
They're more common among older people who are bedridden or live sedentary lives.
But they're becoming more common among younger people who sit for long periods at the job or on long flights, AbuAwad said.
"That's when you see otherwise healthy people simply die for no apparent reason," AbuAwad said.
THE REMEDY
AbuAwad performed a procedure on Nelson called ultrasound assisted thrombolysis.
The physician sends an ultrasonic probe into the clot. "The waves crack the clot and make it porous," he said. Then he infuses the same type of chemical used to clear clots that cause strokes, he said.
"The patient can go home the next day," AbuAwad said.
Nelson said he was nearly back to normal in less than a week. He takes oral blood thinners and will for a few more months.
PRECAUTIONS
AbuAwad said that workplaces should be aware of the effects of long periods in chairs. Workers and travelers should be aware, too, he said.
"It's encouraged to get up every hour to make the blood move and prevent blood clots," AbuAwad said. "But definitely don't sit in one spot longer than two or three hours.
"That's just too long."
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