Super-tight jeans and long drives can be a lethal combo; doctors recommend loose-fitting clothes when travelling

On 12 October, around 2 pm, a 30-year-old businessman from New Delhi was rushed to Max Super Speciality Hospital, Shalimar Bagh. He had no measurable blood pressure (BP) and his pulse was a feeble 10 to 12 beats a minute. As it turned out, a long drive and a tight pair of jeans had nearly cost him his life. [caption id=“attachment_3433096” align=“alignleft” width=“380”] Representational image. Pixabay[/caption] Sourabh Sharma had returned from a road trip to Haridwar the day before. “Actually, I was with a bunch of friends and it was a new car. I wanted to show that we could make the journey fast, without taking a single break…with friends you can get excited and carried away to prove yourself,” he said at a press conference yesterday. Sharma noticed that something was amiss with his left leg, it appeared to be swollen and it was becoming challenging for him to walk. Not thinking much of it, he applied some ointment for pain relief and went to work the next day. Within minutes of getting to work, however, he started feeling dizzy and suddenly collapsed. He was barely responsive when his colleagues tried reviving him. “I don’t remember much after that. I began seeing dark visions and completely lost control of my body,” Sharma said. Clinical suspicion The health centre he was rushed to couldn’t detect his blood pressure and he was promptly sent to Max Super Speciality Hospital in Shalimar Bagh. “This was a unique case,” Dr Naveen Bhamri explained. “We administered 45 minutes of CPR (Cardio-Pulmonary Resuscitation) to keep his heart manually pumping. This was absolutely crucial since his body was beginning to turn blue and he was very much on the brink.” When the doctors conducted a brisk ECHO test, they found that the right chambers of his heart were severely dilated. “It was a clinical suspicion that made us think of severe pulmonary embolism. Further diagnostic testing is required to confirm the condition: D-Dimer test, a CT pulmonary angiogram. But we just had no time so we decided to administer an aggressive dose of clot-busting drugs or r-tPAs,” Dr Bhamri and Dr Devendra Kumar Agarwal explained. Clinical suspicion is better than an educated guess but less sure than a diagnosis based on proper tests. In this case, however, the doctors had no time to run the tests as Sharma’s body had started to turn blue. Pulmonary embolism is a blockage in one of the arteries of the lungs. Most often, blood clots travel up from the leg, as in deep vein thrombosis (DVT), and get lodged in the lungs. Symptoms include severe shortening of breath, blood-stained sputum, and chest pain. There is also swelling in the calf and erratic heart rate. The hypothesis seemed to match Sharma’s symptoms and situation, there was the swelling in his leg, the dilation in the right chamber indicated that his heart was straining to pump blood faster due to the clot, and the long drive in the automatic car which rendered his left leg the “dead leg”, since there is no clutch, his left leg was immobile for a long period, disrupting blood flow there. “Doctors usually wait at least two hours before administering anticoagulants (drugs that thin the blood and prevent clotting, like r-tPAs), but given the gravity of the situation, we went ahead and administered them right away. If it wasn’t for that, he would most certainly not have made it,” Dr Bhamri said. Sharma regained consciousness and his BP stabilized overnight. “I had given up hope, my family thought I would die, but the nurses and caretakers there told me to fight and not give up,” Sharma said. One more complication When Sharma’s BP fell below anything a machine could measure before the treatment, his kidneys stopped functioning properly. He was not peeing at all. His creatinine levels shot up to 12, in short, he was suffering from acute kidney injury. “He was immediately put on continuous renal replacement therapy (CRRT), a continuous 24-hour dialysis therapy,” Dr Yogesh Kumar Chhabra, nephrology consultant at Max Super Speciality Shalimar Bagh, explained. “He required two additional sets of dialysis to regulate his creatinine levels. He is out of danger now. His creatinine is at 1.1.” Our body expels creatinine, a waste product, through urine. When kidney function is not 100%, creatinine starts to build up. Creatinine levels in a healthy male should not exceed 1.1. The takeaway The doctors said that Sharma did not have any pre-existing conditions that made him especially vulnerable to acute pulmonary embolism. “What we want the public to take away from this is to be mobile," Dr Agarwal said. Walk when you have the chance, stretch your legs and keep the blood flow going. If you are at a desk job, stand up and take a short walk every two hours. Also, pay attention to the signs your body is giving you, do not trivialize your symptoms,” he added. After the fact Sharma was discharged six days later and is now back at work. He lost 10 kilograms during this ordeal. But he says he feels better than ever. Facing his mortality has changed him, though. “I used to be quite a heavy drinker, I used to party. This brush with death has taught me to live a simple life and appreciate all that I have,” he said The doctors found out later that Sharma had also worn skinny pants during the drive. Doctors recommend loose-fitting clothes, especially when travelling on long-haul flights or journeys where mobility is restricted. (If you have DVT, try taking the aisle seat in aeroplanes since you are more likely to get up and walk around the cabin.) Compression socks are also recommended since they stimulate the leg and aid blood flow. “You know,” Sharma said, “I bought those jeans recently. They are very expensive and I was excited to wear them. Ironically, I had them altered to make them even skinnier and tighter.”

Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. For more information, please read our article on Pulmonary Embolism: Causes, Symptoms, Treatment and Precaution .