Susan Lakoski, MD, is a cardiologist at the University of Vermont Medical Center specializing in lifestyle change for high-risk patients who have experienced a venous or arterial clot.

Susan Lakoski, MD, is a cardiologist at the University of Vermont Medical Center specializing in lifestyle change for high-risk patients who have experienced a venous or arterial clot.

March is Deep Vein Thrombosis (DVT) Awareness Month. According to the Centers for Disease Control & Prevention (CDC), 300,000-600,000 people are affected by DVT or pulmonary embolism (PE) in the United States every year. Fatal pulmonary emboli cause more deaths than breast cancer and AIDS combined.

You may not know it, but blood clots are one of the leading causes of three major cardiovascular killers – heart attack, stroke, and venous thromboembolism (VTE, for short). VTE is a blood clot that forms in a deep vein of the body, and includes both a deep venous thrombosis (DVT) and a blood clot, which can break off and migrate to the lung, potentially resulting in pulmonary embolism (PE).

Blood clots are dangerous and life threatening. After a VTE event, there is a:

  • 10% percent chance of death within the first month;
  • 33% chance of recurrence within 10 years; and
  • 50% chance of long-term complications such as swelling, pain, discoloration of affected limb.

For these reasons and more, blood clots are a growing health concern. The number of adults in the United States with VTE is projected to rise from 950,000 in 2006 to 1.82 million by 2050.

At the University of Vermont Medical Center, we recommend that patients work toward a healthy lifestyle after a VTE event. A healthy lifestyle that includes physical activity and appropriate nutritional goals is critical to manage symptoms (pain, swelling, and immobility) and maintain a desired quality of life. But, until now, there was not a funded program to support patients in doing so. That has changed.

There is a program at the University of Vermont Medical Center to help people with VTE do just that: it is called EXTEND (Exercise Therapy, Education, and Nutritional Direction after Venous Thromboembolism). EXTEND provides funding to participate in a personalized exercise training and nutritional counseling program over a 12 week period.

  • Exercise Program: The exercise program emphasizes aerobic activity with a gradual progression to longer duration, moderate- intensity exercise.  A personalized prescription will be developed to guide the initial exercise program with the goal of increasing time spent in physical activity to enhance weight loss over the 12-week program.  Exercise can be carried out in your home environment or patients have access to the cardiac rehabilitation gym at Tilley Drive in South Burlington, VT.  An exercise physiologist and a trainer are available on site at Tilley Drive to offer support in working towards your exercise goals.
  • Nutritional Counseling: Patients receive an initial one-on-one telephone consultation with a registered dietician to set personalized weight loss and calorie intake goals.  In this session individuals learn about caloric content and how to log your food intake.  After the initial session we will check in monthly to review food intake logs and discuss activities regarding behavioral aspects related to weight loss.  These include self-monitoring, goal setting, problem solving, and relapse prevention.

Patients who have experienced a VTE and have been seen by one of the Thrombosis and Hemostasis experts within the Hematology/Oncology Program at the UVM Medical Center may take part in either the exercise and nutritional counseling components, or the combination. Of the 78 patients enrolled in EXTEND, 42 have completed the 3-month program and have lost lost 229.8 pounds together!

This program is funded by the Victoria Buffum Endowment Fund.

Learn more about the Thrombosis and Hemostasis Program at the University of Vermont Medical Center.

Susan Lakoski, MD, is a cardiologist at the University of Vermont Medical Center specializing in lifestyle change for high-risk patients who have experienced a venous or arterial clot. She is also an assistant professor at the Larner College of Medicine at UVM. 

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