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The AstraZeneca COVID-19 vaccine has been linked to a very rare blood-clotting disorder called ‘thrombosis with thrombocytopenia syndrome’ (TTS). You can read about it here. If you’re experiencing any symptoms following a COVID-19 vaccination, you can use the COVID-19 Vaccine Side Effect Checker.

Thousands of Australians develop a blood clot in their veins. Most blood clots won’t harm you, but there is a risk they will move through your body and affect your heart, lungs or brain. This can be life threatening, so it’s important to know how to recognise a blood clot.

What are blood clots?

Blood clots are when parts of your blood thicken, forming a semi-solid mass inside a vein. This can happen when:

  • the blood starts to clot more easily (for example, when you’re ill)
  • there are changes to the wall of the vein (for example, if you sit still for a long time)
  • there are changes in how the blood flows

Blood clots can form in veins anywhere in the body, including in the small veins under your skin or in the veins deep inside your body. The medical name for a blood clot is a ‘venous thromboembolism’.

Your blood naturally clots so you don’t lose too much blood if you are injured. Blood clotting becomes a problem when it blocks your blood from flowing properly.

Blood clots can be fatal if they aren’t treated. They can lead to a stroke, heart attack or pulmonary embolism. If you think you may have a blood clot, see your doctor as soon as possible.

Who is at risk of blood clots?

Usually a combination of things leads to a blood clot. You are more likely to develop a blood clot if:

  • you don’t move around for a long period of time (for example, if you are on a long-haul flight)
  • you aren’t moving because you have had surgery
  • you aren’t moving due to an injury, especially a leg injury
  • you have had a blood clot before
  • you have a blood disorder or other condition that makes clotting more likely

Other factors that increase the risk of a blood clot include:

What are the types of blood clot and their symptoms?

Deep vein thrombosis (DVT): A DVT develops when a blood clot forms in one of the veins deep inside your body. They mostly occur in the legs, but you can get a DVT anywhere in your body. The most common symptom is pain and swelling in the affected area, usually your calf or thigh. Sometimes there are no symptoms.

Blood clot in the brain: A blood clot in the brain is called a stroke. The symptoms of a stroke include weakness or drooping in the face, arm or leg, difficulty speaking or understanding, dizziness, blurred vision, severe headache and difficulty swallowing. If you or someone else experiences the signs of stroke, no matter how long they last, call triple zero (000) immediately and ask for an ambulance.

Blood clot in the heart: A blood clot in the heart leads to a heart attack. The symptoms of a heart attack can include chest pain (as though your chest is being pressed or squeezed by a heavy object), shortness of breath, feeling weak and light-headed, nausea, a cold sweat, and feeling anxious. If you have any of these symptoms, or if they get worse quickly or last longer than 10 minutes, call triple zero (000) and ask for an ambulance.

Blood clot in the lungs: If the blood clot travels to your lungs, it’s called a pulmonary embolism. Symptoms include shortness of breath, chest pain, coughing up blood, sweating, rapid heartbeat, feeling dizzy and clammy skin. A major pulmonary embolism can be fatal. If you think you may have a pulmonary embolism, go to the nearest emergency department or call triple zero (000) and ask for an ambulance.

Blood clot in the leg or arm: The most common signs of a blood clot are swelling, tenderness, redness and a warm feeling around the area of the clot. It’s more likely to be a clot if you have these symptoms in just one arm or leg.

Blood clot in the stomach: Symptoms include severe pain and swelling.

How are blood clots diagnosed?

If you think you may have a blood clot, it’s important to see a doctor right away. They will talk to you about what has happened recently and will likely order an ultrasound or a CT scan to view the clot.

You may also have a blood test to look for signs that your blood is clotting more than it should.

How are blood clots treated?

Treatment of a blood clot will depend on where the clot is located. The most common treatment for blood clots is to make your blood thinner using medicines. These medicines include warfarin to stop the blood clot from growing larger and to prevent new clots from forming. You will need to take the medicine for several months and see your doctor regularly to check that it’s working.

Sometimes blood clots are treated with a medicine or procedure to dissolve the clot or to prevent part of it from breaking up and travelling to the lungs, heart or brain.

If you have a DVT, you may be advised to wear compression stockings to help with symptoms and improve the blood flow in your legs.

If you have a heart attack, stroke or pulmonary embolism, you will need to have emergency treatment in hospital.

The Truth About Blood Clots; Warning Signs & Symptoms

What do NeNe Leeks, Tamar Braxton, and Kim Zolciak all have in common? They have all had blood clots in the past. What is a blood clot? Can you die from a blood clot?

 

When I asked what NeNe Leakes and Kim Zolciak have in common, if you’ve been watching this season of the Real Housewives of Atlanta, you’re probably thinking not much, but both of these ladies have had blood clots in the past.

 

NeNe in 2013, and Kim in 2015 while she was on Dancing with the Stars. Both Kim and NeNe are young, active, healthy-looking women, and we know at least one of them is very rich, so why would they have blood clots?

 

What is a blood clot?

 

Blood clots cause more than 60 thousand deaths in the U.S. each year, yet most people know very little about them. Today I’m going to help change that because I’m going to give you a general overview of blood clots.

 

What Causes Blood Clots?

 

A blood clot, or venous thrombosis, occurs when the blood clumps together and forms a clot in the vein. Because this clots usually blocks the flow of blood in the vein, it can cause a backup of blood, kind of like a traffic jam, and this can cause pain and swelling in the extremity, leg, or wherever the blood clot is.

 

 

What Is Deep Venous Thrombosis?

 

Most blood clots occur in the larger, deeper veins in the legs. They’re called DVTs. Deep venous thrombosis. Now, the thing about these blood clots is that they can break off, and they can travel to the lungs, and to the heart. If a blood clot breaks off and travels to the lung it is called a pulmonary embolism. This is what NeNe and Tamar Braxton had.

 

What Puts You At Risk For Blood Clots?

 

The risk factors are immobility or being sedentary.  So if you’re a person who travels a lot, for example, and you’re sitting in the airplane for prolonged periods of time, or sitting in a car for a long car trip, at that time your legs are immobile or sedentary.  This puts you at risk for a blood clot.

 

Other risk factors include pregnancy, obesity, and smoking.  Also, if you’re taking birth control pills or hormone replacement therapy you’re at risk for a blood clot. Cancer also puts you at risk.

 

If you’ve had a blood clot in the past, you are at risk for a blood clot. Other risk factors are heart failure, recent surgery, and some genetic diseases will predispose you to blood clots.

 

You may also like: Heart Failure Explained Clearly 2018

 

How Do You Know If  You Have A Blood Clot?

 

Some symptoms include pain and swelling in the area of the clot. You can have swelling in both legs for example, but usually, a blood clot will occur in one leg at a time, so if you’re looking down at your legs, and one leg is swollen more than the other, you could have a blood clot.

 

Also, redness and warmth in the area of the blood clot are symptoms.  Some people even get fevers with a blood clot. If this blood clot does travel to your lung and you have a pulmonary embolism or pulmonary emboli, then you can also become short of breath, dizzy, lightheaded, fatigued, and you can get a very rapid beating of your heart.

 

How Do You Diagnose A Blood Clot?

 

If you’re having any of the symptoms I described then you need to contact your doctor immediately, or just go to the emergency room right away.

 

When you get to the doctor they can diagnose your blood clot by doing either compression ultrasonography, or they can do a Doppler to see if you have a blood clot.

 

There are other tests as well that they can do, like CAT Scans, MRIs, or even more invasive testing. If your doctor is suspicious of you having a blood clot in your lungs then they can start off with a chest x-ray, but more specifically they can do a VQ Scan or a specialized CT Scan with IV contrast to see if you have a blood clot.

 

There are also blood tests. Something called a D-dimer can be used to diagnose a blood clot.

 

How Can You Prevent A Blood Clot?

 

One thing you can do is stay active, move your body, and if you happen to be on a plane, train, or in a car for a long period of time, make sure you keep moving.

 

Even if you’re sitting down you can contract your calf muscles. You can pump those muscles, and keep those veins flowing.

 

Try to move your ankles all around and point and flex your toes. Make sure that you don’t allow yourself to be sedentary for too long.

 

Also, if you’re doing something like having a surgery then your doctor will likely give you a blood thinner.

 

Blood Clot Treatment?

 

In order to treat blood clots, most patients need anticoagulation or blood thinners. This helps to prevent future blood clots as well.

 

Depending on the type of blood clot you have you may need more invasive therapy like thrombolytic therapy, or even having a vascular surgeon go in and remove the clot.

 

Some patients just can’t take blood thinners because they may already have bleeding ulcers or something similar.  In that case, your doctor may offer you something called a filter, which will help to keep blood clots from traveling to your lung, and to other places.

 

What is a blood clot?  I hope this has given you a much better understanding of blood clots.

 

Please comment down below with any questions you have and tell me what else you’d like for me to discuss.

 

Now you know what NeNe, Kim and Tamar Braxton all have in common. As for you, I want you to prioritize yourself.

 

Go to your doctor. Find out if you’re at risk for blood clots. Pay attention to yourself, and your health.

 

The Truth About Traveling Blood Clots

Deep vein thrombosis (DVT) is a medical condition that occurs when a blood clot develops deep in a vein. These clots typically occur in a leg, a thigh, or the pelvis but may also develop in an arm.

DVT can become dangerous if the blood clot breaks off and travels through the bloodstream to the lungs. This causes a blockage called a pulmonary embolism (PE) and can be life-threatening.

The Connection Between DVT and PE

Think of pulmonary embolism as a complication of deep vein thrombosis, explains Roy Silverstein, MD, a professor and chair in the Medical College of Wisconsin’s division of hematology and oncology in Milwaukee. Important things to know about DVT and PE:

  • You can have DVT and not know it, especially if the clot is small.
  • The most common symptoms of DVT are swelling in an arm or leg, tenderness that isn’t from an injury, and skin that feels warm and is red in the area of the clot.
  • A clot usually forms in just one leg or arm, not both.
  • You’re at a greater risk for a PE if you have deep vein thrombosis or a history of DVT.

Like DVT, you can have a PE and not know it.

“With a PE, one of three things happens,” says Andrea Obi, MD, a vascular surgeon at Michigan Medicine in Ann Arbor. “Sometimes it will plug up just a very small blood vessel in the lung, and the remainder of the lung will compensate and the person may not even know it happened.”

A second scenario, she says, is that “the clot will break off and travel to the lung and block a slightly larger blood vessel that impairs the ability of the lung to exchange blood that’s returning for blood that’s oxygenated. ” This will cause oxygen saturation levels to drop.

Signs of PE might include the following:

  • Shortness of breath
  • A rapid heartbeat
  • Chest pain or discomfort that gets worse when you breathe deeply or cough
  • Coughing up blood
  • Feeling lightheaded or faint
  • Feeling anxious or sweating
  • Fever
  • Having clammy or discolored skin

“The third scenario is sudden death, and that’s really what we’re trying to prevent when we talk about making a timely diagnosis of DVT and getting patients on blood thinners right away,” Dr. Obi says.

Diagnosing DVT and PE

DVT and PE aren’t always detected for what they are. “The symptoms are quite subtle, and sometimes it’s a nagging pain in the leg that people don’t pay much attention to,” Dr. Silverstein says. “You think you pulled a muscle — you don’t think it could be a clot.”

However, because PE can lead to sudden death, it’s critical to seek medical treatment right away if you think you might be experiencing any of the telltale symptoms.

According to the Centers for Disease Control and Prevention, as many as 900,000 people in the United States develop DVT, PE, or both every year. An estimated 60,000 to 100,000 of them die, and most are sudden deaths because the fatal PE goes unrecognized.

That need not be the case, however. “As long as we make a prompt diagnosis and treat it, patients do extremely well,” Silverstein says.

Most often, DVT can be diagnosed with duplex ultrasound. A sonographer uses an ultrasound machine, sending sound waves through the leg, to observe blood flow in your veins.

To diagnose PE, doctors may order a CT scan or a specialized X-ray of your lungs, called a ventilation/perfusion scan; it can also show how much blood is getting to your lungs. During the ventilation part of the scan, you inhale a small amount of a radioactive gas. Radioisotopes are injected into your bloodstream to allow doctors to see where blood flows to your lungs.

A blood test known as D-dimer measures a substance found in your blood when a clot dissolves. High levels may suggest blood clots. If your level is normal and you have few risk factors for PE, it could indicate that you don’t have PE.

Managing DVT and PE Blood Clot Disorders

Sitting while traveling long distances in a plane or car can increase your risk for DVT and PE, and “the longer the flight, the higher the risk,” Silverstein says.

Women who take hormones, whether birth control pills or estrogen therapy, are also at an increased risk, as are pregnant women and women in the six weeks after childbirth. People who have to spend an extended amount of time in bed, most often because of hospitalization and recovery from an illness or surgery, have a heightened risk, too.

Treatment involves medications that thin your blood and slow its ability to clot. Blood thinners won’t break up clots, Silverstein says, but they will stop the clot from growing and prevent further clots. “The body has a natural way of healing itself, and eventually the clot disappears on its own,” he says.

If a pulmonary embolism is life-threatening, your doctor can administer a thrombolytic, an agent that will dissolve the clot quickly. Because thrombolytics can cause you to bleed, they’re used only when your life is in danger. “Thrombolytic therapy has to be done in a hospital setting,” notes Silverstein.

Sometimes, though not often, surgery is required to remove the blood clot.

“If the blockage is big enough where it’s causing really severe deficits in oxygen or strain on the heart, then in those patients we do try to treat them by removing the blood clot,” Obi says.

Silverstein adds that the most worrisome complication of PE is death. If you have repeated clots, over time they can damage your lungs, and that can lead to chronic heart disease. Most of the time, that doesn’t happen, he says.

Once you’ve had a PE, you are at a greater risk of having more. Other factors that could further increase your risk:

  • Being sedentary or bedridden
  • Being overweight
  • Undergoing surgery or breaking a bone
  • Having stroke, chronic heart disease, high blood pressure, or paralysis
  • Having severe symptoms of COVID-19
  • Smoking

Age is also a risk factor. “The older you are, the higher your risk,” Silverstein says, “particularly after age 55.”

Never ignore DVT or PE symptoms, thinking they will go away, especially if you have risk factors. Because the signs — if any — will be subtle, err on the side of caution.

What Are the Signs of a Blood Clot?

Depending on where in the body they occur, blood clots can cause a range of symptoms from pain to numbness, from coolness to warmth. These symptoms also won’t be the same in everyone. And sometimes, there won’t be any symptoms at all.

Blood clots in the leg can cause redness or even pale skin. Blood clots in the brain can cause difficulty walking and numbness or weakness on just one side of the body. Blood clots in the lungs can cause sudden shortness of breath, fast heartbeat, and coughing. Blood clots in the abdomen can cause abdominal pain, nausea, vomiting, and bloating. Blood clots in the heart can cause chest pain or pressure, shortness of breath, sweating, and indigestion.

Blood clots are also different depending if they develop in a vein (venous) or an artery (arterial). Venous clots may take longer to build up, while arterial clots cause symptoms immediately.

It’s important to pay attention to the signs of potential blood clots and to seek treatment as soon as possible because blood clots can be dangerous to your health.

What Are the Signs of a Blood Clot in the Leg or Arm (Deep Vein Thrombosis)?

If a blood clot in the arm or leg is small enough, you may not have any symptoms. With a large clot, your entire leg might swell. The pain may feel like a pulled muscle or a “Charlie horse.”

The most common place for blood clots is the lower leg. It’s unusual to have clots in both arms or both legs at once. So, if you experience symptoms in only one leg or arm, they may indicate a blood clot.

A clot in your arm or leg may not be dangerous there, but it poses a risk of breaking off and lodging in your lungs. This is known as a pulmonary embolism and can be fatal.

Signs of a blood clot in the arm and leg include:

  • Pain
  • Redness or bluish skin coloration
  • Swelling
  • Pale color
  • Coolness to the touch
  • Tenderness
  • Increased warmth in the part of the limb that’s swollen or hurting
  • Loss of feeling or numbness in the limb

What Are the Signs of a Blood Clot in the Brain?

A blood clot on or in the brain is diagnosed through an MRI or CT scan. A blood clot in the brain can block blood flow, causing a stroke.

But not every blood clot in the brain results in a stroke. And not all strokes are caused by blood clots. About 20 percent of strokes are caused by aneurysms, which are bulges or weakness in the wall of a blood vessel.

Signs of a blood clot on or in the brain include:

  • Trouble speaking
  • Impaired vision
  • Numbness or weakness on one side of the body or face
  • Trouble walking
  • Inability to think clearly or confusion
  • Seizures
  • Dizziness
  • Severe headache

What Are the Signs of a Blood Clot in the Lungs (Pulmonary Embolism)?

Clots in the veins of the legs or arms can break off and travel to the lung. The resulting pulmonary embolism can cause organ damage or leave to death.

Seniors are at increased risk for pulmonary embolism. This is partly because they are less mobile.

Symptoms of a blood clot in the lungs include:

  • Chest pain that may be short and stabbing and may get worse with each breath
  • Sudden shortness of breath
  • Rapid pulse
  • Rapid breathing
  • Unexplained coughing possibly with bloody mucus

 

What Are the Signs of a Blood Clot in the Abdomen?

Blood clots in the lungs can cause sudden shortness of breath, fast heartbeat, and coughing. Blood clots in the abdomen can cause abdominal pain, nausea, vomiting, and bloating. Blood clots in the heart can cause chest pain or pressure, shortness of breath, sweating, and indigestion.

Researchers in Denmark found that certain abdominal blood clots may be a sign of undiagnosed cancer. Abdominal blood clots may also be more likely in people with medical conditions that cause fluid buildup or swelling in the abdomen.

Abdominal blood clots can cause the following symptoms:

  • Abdominal pain (especially if it gets worse after eating or over time)
  • Nausea
  • Blood in stool
  • Bloating
  • Vomiting
  • Diarrhea
  • Buildup of abdominal fluid

What Are the Signs of a Blood Clot in the Coronary Artery?

A blood clot in or near the heart can cause a heart attack, according to the World Heart Federation. Women may have different symptoms of heart attacks than men. Women’s symptoms may be less specific.

Blood clots in the coronary artery cause the following symptoms:

  • Extreme chest pain that may radiate to the left part of your jaw, shoulder and arm
  • Chest pressure or heaviness
  • Shortness of breath
  • Nausea
  • Indigestion
  • Sweating

When to Go to the Doctor for a Blood Clot

See your doctor right away whenever you think you may have symptoms a blood clot. The more quickly it is diagnosed, the better your chances of avoiding permanent harm or death. The diagnosis is usually made using a combination of symptoms, physical examination, and an imaging test.

A doctor may prescribe an anticoagulant, or blood thinner, to prevent new blood clots and keep existing clots from growing. Names of blood thinners include dabigatran (Pradaxa), warfarin (Coumadin), apixaban (Eliquis) and rivaroxaban (Xarelto).

For people who cannot take blood thinners, doctors may recommend an IVC filter. These devices are also used in patients recovering from accidents and surgeries when there is a high risk of potentially fatal lung clots.

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Blood Clots: Signs, Symptoms, and Complications

The signs and symptoms of a blood clot vary with the location of the clot—whether it’s in a vein or an artery—and its size. They can include swelling, skin tenderness and warmth, and even chest pain, shortness of breath, and dizziness. The severity of symptoms also varies depending on their cause.

Illustration by Verywell

Frequent Symptoms

It is possible to have a blood clot and not experience symptoms (as with a clot in the kidney). But more often than not, blood clots in major veins or arteries will cause symptoms, often serious ones that require immediate attention.

Blood clots can occur in different veins and arteries throughout the body, and symptoms are specific to where they are located.

Symptoms of a blood clot indicating deep vein thrombosis (DVT) include:

  • Warmth in the area of the clot
  • Swelling, possibly making one leg larger than the other
  • Tenderness when you touch the area around the clot
  • Mild to moderate pain that increases over hours or days

Symptoms of a blood clot that may suggest a heart attack:

  • Chest pain or discomfort: Most heart attacks involve discomfort in the center or left side of the chest. The discomfort usually lasts for more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, or pain. It also can feel like heartburn or indigestion.
  • Upper body discomfort: You may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach.
  • Shortness of breath: This may be your only symptom, or it may occur before or along with chest pain or discomfort. It can occur when you are resting or doing a little bit of physical activity.
  • Breaking out in a cold sweat
  • Feeling unusually tired for no reason, sometimes for days (especially women)
  • Nausea and vomiting
  • Lightheadedness or sudden dizziness

Symptoms of a blood clot that may suggest a stroke:

  • Sudden weakness or numbness in the face, arm, or leg on one side of the body
  • Sudden loss, blurring, or dimming of vision
  • Slurred speech or inability to speak
  • Sudden, severe headache
  • Dizziness, drowsiness, falling, or lack of coordination
  • Nausea or vomiting, especially if accompanied by any of the above symptoms

Complications and Sub-Groups

Blood clots can, but don’t always, cause the following complications. You may or may not experience any of the common symptoms of a clot before these occur, if they do: 

Pulmonary embolism: Sometimes a clot in the lower limbs or pelvis (due to deep vein thrombosis) breaks loose and travels to the lungs, obstructing the flow of blood to the lung. Symptoms include sudden, severe shortness of breath, rapid breathing, chest pain, profuse sweating, loss of consciousness, bluish color to the lips and fingertips, and a cough that may produce bloody sputum (mucus).

Pulmonary hypertension: It is possible to have several blood clots that block smaller pulmonary arteries yet cause no symptoms. This can lead to high blood pressure in the pulmonary arteries, which, in turn, puts extra stress on the heart, potentially resulting in heart failure. 

Several health conditions, including diabetes and atherosclerosis, increase the risk of developing a blood clot, as does being a smoker. It is especially important to be on the alert if you use birth control pills, are pregnant or postpartum, on hormone replacement therapy (HRT), or have recently had surgery. 

When to See a Healthcare Provider

If you have symptoms of DVT, call your healthcare provider right away. If symptoms suggest a heart attack, stroke, or pulmonary embolism, call 911 or go to the emergency room, as these are life-threatening conditions.

Frequently Asked Questions

  • What does a blood clot feel like?

    Symptoms of blood clots vary according to the area of the body in which they occur and may include chest pain and shortness of breath, or swelling, warmth, and pain or sensitivity in a specific area, such as your leg. In general, clots are an indication of a serious condition and warrant immediate medical attention.

  • Will a blood clot go away on its own?

    The body naturally forms blood clots when, for example, you get a cut or other minor injury. These do, in fact, dissolve when they’re no longer needed. However, the blood clots involved in more serious or even life-threatening conditions, such as deep vein thrombosis, stroke, or heart attack, may require medical treatment to dissolve.

  • Does Covid-19 cause blood clots?

    Yes: Blood clotting abnormalities are a relatively common complication of Covid-19. These blood clots can result from bed rest during hospitalization, inflammation related to the infection, or a rise in the levels of coagulating (blood-clot-forming) proteins in the blood.

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5 Signs of a Blood Clot: Dallas Vein Institute: Varicose Vein Specialists

Clotting is an important process that prevents you from losing too much blood if you cut or otherwise injure yourself. The platelets in the blood adhere to the edges of the cut and release chemicals that attract even more platelets to the scene, forming an aggregate that changes the liquid to a gel-like or semisolid state, thereby plugging the hole. Vitamin K also plays a role.

Clots, though, aren’t always a good thing. Sometimes a clot forms in veins deep within your body, and it won’t always dissolve on its own. If the clot remains immobile, it’s generally harmless. However, there’s a risk that it could break free and travel elsewhere in your body, quickly escalating into a life-threatening situation.

At Dallas Vein Institute in Dallas, Texas, double board-certified vascular and interventional radiologist Dr. Dev Batra has dedicated his life to diagnosing and treating vein problems. He also understands how important it is that his patients learn how to recognize the signs of a blood clot, so they can seek medical help in a timely fashion. Here’s what he wants you to know.

Types of blood clots

Your circulatory system contains vessels known as arteries and veins. Arteries transport oxygenated blood away from your heart to your tissues, and veins transport deoxygenated blood from your tissues back to your heart. Clots can form anywhere within the system.

When the clot forms in an artery, it’s referred to as an arterial clot, and it can affect the ability of oxygen to reach the tissues. Symptoms include severe pain and/or paralysis of body parts, and it can also lead to a heart attack or stroke. Symptoms appear immediately after the clot forms, and you need to get emergency medical treatment.

When a clot forms in a vein, it’s called a venous clot. This type builds up more slowly than arterial clots, and while it may be stable for a time, it still can be life-threatening.

The most common type of venous clot is called deep vein thrombosis (DVT). The clot forms in one of the major veins deep inside your legs, pelvis, or arms and can break off, traveling to the heart, lungs, or brain. The Centers for Disease Control and Prevention (CDC) estimates that DVT kills about 100,000 Americans every year.

5 signals and symptoms of a blood clot

The symptoms of a blood clot depend on where in the body it forms or travels to. Here are the five primary areas and the signs a blood clot produces:

1. Arm or leg

The most common places for blood clots to form are in your lower leg or your arm. The symptoms you have depends on the clot’s size: you may have no symptoms at all, minor swelling in the limb, or if the clot is large, major swelling with extensive pain.

The most common symptoms include:

  • Pain
  • Tenderness
  • Swelling
  • Warm sensation
  • Reddish discoloration of the skin

The National Blood Clot Alliance indicates that the pain from this type of blood clot can be similar to the sensation of a pulled muscle.

2. Lungs

A blood clot that breaks off and travels to the lungs is called a pulmonary embolism (PE). These clots can impair breathing. Symptoms of a PE include:

  • Sudden shortness of breath not following exercise
  • Chest pain
  • Rapid heart rate
  • Difficulty breathing
  • Coughing up blood

3.

Heart

The heart is less commonplace for a blood clot to form, but it’s definitely possible. Such a clot causes a heart attack.

Symptoms include:

  • Chest pain
  • Heaviness in chest
  • Lightheadedness
  • Shortness of breath
  • Nausea

4. Abdomen

A blood clot in the abdomen causes severe abdominal pain and swelling. However, these symptoms are similar to those of a stomach virus or food poisoning, so you should definitely see a medical professional for an accurate diagnosis.

5. Brain

A blood clot in the brain is referred to as a stroke. Because it cuts off necessary oxygen and nutrients, the clot can cause a sudden, severe headache, difficulty speaking, or difficulty seeing. This is a life-threatening emergency, so get to the hospital right away.

Treatment

Typical treatments for blood clots include:

  • Anticoagulants (blood thinners), which stop existing clots from growing and help prevent new ones from forming
  • Thrombolytic therapy to dissolve clots
  • Compression stockings
  • Vena cava filters, small devices surgically inserted into veins to prevent a clot from traveling to the lungs

The best defense against blood clots is educating yourself on the signs and symptoms. If you suspect you’re having clot symptoms or vein problems, contact our experts at Dallas Vein Institute, by phone at 972-646-8346, or by scheduling an appointment online.

Blood Clot Symptoms, Signs & Treatment

What Are Blood Clots?

Blood clotting is a normal process that prevents excessive bleeding when you have an injury or cut. The clot acts as a plug on an injured blood vessel to stop bleeding. But when clots form inside blood vessels, they can be dangerous and require fast diagnosis and treatment.

Blood clots happen when the platelets and proteins in your blood work together to form a semi-solid mass. When this mass forms inside your veins or arteries and does not dissolve, it can cause serious problems. If a blood clot forms in a vein, it can keep the blood from properly returning to the heart. In this case, blood will back up into a vein and cause pain and swelling. This clot can detach and travel to the lungs, preventing blood flow, damaging the lungs and potentially causing death if treatment isn’t immediate.

If a clot forms in an artery, it can break away and lodge in the heart and cause a heart attack, or in the brain and cause a stroke.

Baptist Health is known for advanced, superior care for patients with blood clots and their diagnosis, management and treatment. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

The symptoms of a blood clot depend upon where the clot is inside the body.

Symptoms of a blood clot in the heart:

  • Chest heaviness or pain
  • Discomfort in other areas of the upper body
  • Excessive sweating
  • Fast heartbeat
  • Light-headedness
  • Nausea
  • Shortness of breath

Symptoms of a blood clot in the brain:

  • Difficulty speaking or understanding speech
  • Dizziness or lightheadedness
  • Sudden and severe headache
  • Vision problems
  • Weakness of the face, arms or legs

Symptoms of a blood clot in the arm or leg:

  • Redness and warmth
  • Sudden or gradual pain
  • Sudden weakness in the arm or leg
  • Swelling
  • Tenderness

Symptoms of a blood clot in the lung:

  • Coughing up blood
  • Difficulty breathing
  • Racing heart
  • Sharp chest pain
  • Shortness of breath
  • Sweating, fever

Symptoms of a blood clot in the abdomen:

  • Diarrhea
  • Severe abdominal pain
  • Vomiting

Diagnosis

Diagnosis of a blood clot may require one or more of the following tests:

Blood test: Blood tests check the levels of certain fats, cholesterol, sugar and protein in the blood that could indicate heart conditions.

Computed tomographic angiography (CT): This non-invasive test can show the arteries in the abdomen, pelvis and legs. This test is particularly useful in patients with pacemakers or stents.

Magnetic resonance imaging (MRI): A large magnet, radio waves and a computer are used to produce pictures of the heart and blood vessels.

Ultrasound: An ultrasound device can measure blood pressure on various points of your arm or leg, which will help the physician determine if you have any blockages and how quickly blood flows through your arteries.

Venography: This special X-ray test includes injection of a special dye into a large vein in the foot or ankle and X-rays that shows how blood flows in the legs and feet and to locate a clot.

Causes

Certain behaviors and lifestyle factors can increase your chance of developing a blood clot in veins or arteries, including:

  • Being overweight, especially if you smoke and/or have high blood pressure
  • High blood pressure or high cholesterol
  • Sitting for long periods of time
  • Smoking, especially combined with other risk factors
  • Supplementing estrogen (birth control pills, hormone replacement), especially if you smoke or are overweight

Risk Factors

Risk factors that could contribute to blood clots include:

Age: The risk of blood clots increases for people over the age of 60.

Cancer: Some cancers – like pancreatic, ovarian and lung cancer – can increase levels of substances that help blood clots form. Chemotherapy can compound that risk. Women taking tamoxifen or raloxifene for breast cancer are also at a higher risk of clots.

Diabetes: Diabetes increases the risk of plaque buildup in the blood vessels, which can cause blood clots.

Heart Disease: Cardiovascular disease, particularly heart failure, makes blood clots in the heart more likely.

Pregnancy: The baby pressing on veins in the pelvis can slow blood return from the legs, increasing a woman’s risk of clots.

Surgery: This is a major cause of clots, so medication to prevent clots may be given before and after major surgery.

Prevention

While some risk factors like age and heredity cannot be controlled, there are ways you can help to prevent a blood clot:

Keep blood flowing: If you sit for long periods of time, make efforts to get up and walk around more frequently to prevent blood from pooling and then thickening into a clot. If you are on bedrest or unable to stand, ask your doctor about appropriate leg and foot exercises.

Practice good heart health: Watch what you eat, exercise (as advised by your physician) and avoid smoking. Smoking and being overweight are two major, preventable causes of blood clots in the heart.

Take anticoagulants before/after surgery: Before and after certain types of major surgery, your physician may prescribe blood thinners. Take them as directed.

Prognosis

Prognosis for a person with a blood clot depends upon the size of the clot and where it is. Early diagnosis and timely treatment are important for better outcomes and fewer complications.

Treatment and Recovery

Depending upon where a blood clot is located, no treatment may be needed, If treatment is necessary, it may include:

Medication

  • Blood thinners: Blood thinners prevent new clots from forming. They may be prescribed before or after surgery or for a diagnosed clotting disorder.
  • Clot-dissolving medications: These medications may be used to dissolve dangerous clots, improve blood flow and prevent damage to tissues and organs.

Clot Removal

A surgeon may remove a large or life-threatening clot via a thin, flexible catheter threaded through the blood vessels.

Complications

Potential complications of blood clots can include:

Pulmonary embolism: This potentially life-threatening condition occurs when a clot breaks off and travels through the bloodstream to the lung.

Kidney failure: If a blood clot travels to the kidneys, it can cause fluid and waste to build up in the kidneys, which can cause high blood pressure, kidney damage and kidney failure.

Deep vein thrombosis (DVT): If a clot develops in the arm or leg, it can cause pain and swelling. If the clot breaks off, it can travel to the lungs.

Pregnancy complications: Blood clots can cause a pulmonary embolism as well as premature labor, miscarriage and maternal death.

Heart attack: A blood clot that breaks away in an artery can lodge in the heart and cause a heart attack.

Stroke: A blood clot that breaks away in an artery can lodge in the brain and cause a stroke.

90,000 Thrombosis symptoms – how to diagnose thrombosis

There are two main forms of venous thrombosis: deep vein thrombosis (DVT) and superficial vein thrombosis or thrombophlebitis. The first form is the most dangerous. Deep vein thrombosis in the initial periods may be asymptomatic. Blood clots can break off and enter the pulmonary bloodstream and block the pulmonary arteries – then pulmonary embolism develops, sometimes this is the first sign of DVT. TELA is a life-threatening condition.[1]

Symptoms of venous thrombosis of the lower extremities are often nonspecific, but may differ depending on how much the vein is thrombosed, where the thrombus is located, and the duration of the disease. [1]

Thrombosis symptoms [1,2]
Superficial veins of the lower extremities Deep veins
Feels heavy in the legs Feeling of fullness and heaviness in the limb [2]
Pain along the thrombosed veins, limiting limb movement [1] Pain spreads along the inner side of the foot, lower leg and thigh [1]
There may be swelling of the nearby part of the limb Edema of the entire limb or part of it [1]
Skin reddening appears along the course of the thickened vein [2] The skin of the affected leg becomes pale and cyanotic in places [2]
Skin hypersensitivity [1] The temperature of the affected limb is 1. 5–2 ° C higher than that of the healthy one [2]
Possible deterioration in general health, manifested by symptoms of a general inflammatory reaction – weakness, malaise, chills, fever [2] Bursting pain in the limb [1]

If thrombophlebitis is suspected, both legs should be examined, since bilateral damage to both superficial and deep veins is possible.In many patients, the transition of the process of thrombus formation from superficial veins to deep veins can proceed without obvious clinical symptoms. [1]

For an accurate diagnosis, it is additionally required to carry out special laboratory and instrumental diagnostic methods. [2]

If you suspect you have any symptoms of thrombosis, immediately consult a doctor for advice.

SARU.ENO.16.05.0678 (1)

  1. Russian clinical guidelines for the diagnosis, treatment and prevention of venous thromboembolic complications (VTEC). Phlebology, 2015: 4 (2): 3-52
  2. Givirovskaya N.E., Mikhalskiy V.V. Thrombosis and thrombophlebitis of the veins of the lower extremities: etiology, diagnosis and treatment. Russian medical journal, 2009. No. 25: p. 1663.

SARU.ENO.19.02.0227

90,000 Why blood clots form and come off

In recent months, several Russian celebrities have died from a ruptured blood clot. Among them is the actor Dmitry Maryanov, who died on the way to the hospital. What are the risk factors for the development of thrombosis and what happens when a blood clot breaks off, says “Gazeta.Ru “.

On October 15, actor Dmitry Maryanov died. Even in the morning of that day, the actor complained of poor health, he was worried about pain in his back and leg. After lunch, he passed out. Maryanov’s friends tried to take him to the hospital on their own, but on the way the actor died. The cause of death, according to preliminary data, was a detached blood clot.

Other recent victims of thromboembolism are footballer Alexei Arifullin and Zenit sports director Konstantin Sarsania. Although Sarsania was taken to the hospital, he was in a coma for three hours and died without regaining consciousness.

A thrombus is a blood clot formed during the patient’s life in the lumen of a blood vessel or in the heart cavity.

There are several reasons for the formation of blood clots. The first of them is a blood clotting disorder, which can be caused by genetic defects or autoimmune diseases, for example, antiphospholipid syndrome. Operations on large veins also contribute to clotting disorders.

The second reason is damage to the endothelium, the cells lining the inner surface of the vessels.Damage can occur during operations, due to injury or infection.

Disruption of blood flow also contributes to the formation of blood clots. Its main cause is blood stasis, often due to injury or a sedentary lifestyle. Congestion can also be caused by atrial fibrillation and heart failure. Other risk factors are cancer: the growth of the tumor leads to compression of blood vessels, or metastases grow in them. Chemotherapy and radiotherapy increase the risk of hypercoagulability.

After the formation of a thrombus, it gradually increases in size as the thrombotic masses are layered. In 2015, a group of biophysicists, with the participation of specialists from the Moscow Institute of Physics and Technology, developed a mathematical model for the formation of an arterial thrombus. They described the platelet aggregation process as similar to the stacking of blocks in Tetris. The results were published in the journal PLOS ONE .

Platelets, like blocks in the game, either fall down onto a flat surface or stick to the protrusions on the sides of a growing blood clot.The difference is that the completely filled layer does not disappear, therefore, over time, the thrombus is able to block all the space available to it.

A logical continuation is the separation of a thrombus from the vessel wall, which can lead to thromboembolism – clogging of a blood vessel by a thrombus.

As a result, the blood flow in the vessel stops, often leading to ischemic infarction.

Thromboembolism of cerebral vessels leads to ischemic stroke, spinal cord vessels – to paralysis and sensory disorders, renal or spleen vessels – to infarctions of these organs, coronary arteries – to myocardial infarction, peripheral arteries – to tissue ischemia with the threat of gangrene of the limb.

Thromboembolism requires immediate hospitalization.

An anticoagulant is administered to the patient as an emergency.

As a preventive measure, however, anticoagulants are not suitable – although they reduce the risk of pulmonary embolism and deep vein thrombosis, they increase the risk of bleeding. If blood clots are detected, the patient is prescribed statins, nicotinic acid, a low-cholesterol diet is recommended.

To reduce the risk of blood clots, doctors recommend not neglecting physical activity – 30 minutes of cardio workout per day accelerates blood circulation, strengthens the heart muscle and reduces blood clotting. You should also limit your intake of saturated fat. During pregnancy and childbirth, as well as during operations, it is recommended to use anti-embolic stockings.

Prevention of thrombosis should not be neglected even by young people. In Russia, about 1000 people suffer from strokes alone every day. Two out of three survivors remain disabled. The disease affects not only the elderly – one in eight turns out to be younger than 45 years old.

90,000 Feel the blood clot. Expert – on the dangerous symptoms of vascular diseases | Treatment Methods | HEALTH

What are the first signs of vascular diseases and how does varicose veins differ from thrombosis? The questions of AiF-Kazan readers are answered by Head of the Department of Vascular Surgery of the Interregional Clinical Diagnostic Center, Doctor of Medical Sciences, Cardiovascular Surgeon of the Highest Category, Associate Professor of the Department of Cardiovascular Surgery of Kazan Medical University Roman Bredikhin.

When should you operate the stars?

– How to understand if I have internal varicose veins? Nadezhda, Kazan

– Signs of varicose veins are always there: either the so-called vascular “spiders”, “stars” appear on the legs, or larger veins that look like worms wriggling under the skin. If “stars” appear, you need to contact a phlebologist – a specialist in vein diseases or an even more general doctor – a vascular surgeon.To determine which type of treatment is right for you, you need to perform an ultrasound scan of the veins.

So, isolated vascular “stars” are a purely cosmetological problem, they can be removed on an outpatient basis by sclerotherapy. But if they are the result of varicose changes in the saphenous veins, then such changes usually require surgical intervention. Drug therapy is often necessary.

Roman Bredikhin during the operation. Photo: From the personal archive of Roman Bredikhin

– My son is 33 years old, diagnosed with varicose veins. Can the operation be performed free of charge? Alfiya Zufarovna, Leninogorsk

– Varicose veins are curable. In our department, about 500 such free operations are performed annually. Usually in 1-2 weeks a person can already go to work.

To receive free help, you need to come to our clinic’s office, where your son will be examined and put on a waiting list for a free operation.

– Is it possible to operate on varicose veins at 70? Zulfiya, Kazan

– There are two most effective treatments: surgery and compression hosiery, and they usually complement each other.Modern medicine does not consider age as a contraindication to surgery and allows you to cure varicose veins at any stage and at almost any age, if there are no serious complications. Modern operations are minimally invasive. They can even be performed under local anesthesia.

– In 2004, there was an operation for varicose veins. But varicose veins appeared again. Alfinur, Buinsk

– The recurrence rate reaches 30-40%. Often, varicose veins occur as a result of the progression of the disease, sometimes due to an inadequately performed first operation.It is possible to recover, but, unfortunately, not with stockings, pills or ointments, but only with a second operation. According to the current recommendations, such operations can only be performed in expert-level hospitals (in Kazan, this is the ICDTs or RCH). First, you need to do an ultrasound scan and take a referral from the surgeon for a consultation with the ultrasound data. If you contact us, we will examine you, show you what needs to be done in terms of diagnostics and put you in a queue for a free operation. According to the state guarantees program, this queue lasts no more than 1 month.

How to feel a blood clot?

– My leg hurts. Is it possible to identify the first signs of thrombus formation on your own? Vera Leonidovna, Kazan

– Thrombus is a blood clot formed in a vessel. If it is formed in a vessel, then its narrowing or complete blockage leads to impaired blood circulation in the organ that feeds this vessel. The signs of thrombosis are always bright, but different, since there are a lot of vessels and they supply blood to different organs.Thrombosis is always an acute condition. If a blood clot forms in the vessels supplying the brain, the person is paralyzed, speech is impaired, there are signs of a stroke. If a blood clot forms in the heart, then a heart attack occurs, its signal is severe chest pain.

If a blood clot forms in the leg, the leg becomes cold, sharp pains appear in it, comparable to an electric shock, gangrene develops. With a blood clot in the venous system, the outflow of blood is impaired. If the vein is subcutaneous, then the place where the blood clot formed begins to ache, the skin over the vein turns red, palpation of the vein becomes like a lace or a pencil.In order not to bring oneself to such a state, one must try to prevent the formation of a blood clot.

To do this, you need to understand if you have vasoconstriction – to undergo an ultrasound of the vessels and heart, to take an ECG. For example, a blood clot forms in the arteries when it is narrowed by 70% or more. In the cavity of the heart, thrombi are formed during its uneven work (arrhythmias). In the veins – with their varicose transformation.

It is necessary to make a coagulogram – an analysis that allows you to find out how the blood coagulation system works, an analysis for D-dimer and homocysteine.If the coagulogram, homocysteine ​​and D-dimer are normal, then the risk of blood clot formation in you is the same as in all healthy people.

Shunt or stent?

– Is an operation always necessary if an ultrasound scan showed changes in the vessels? And what is the difference between bypass surgery and stenting? Rifkat, Kazan

– Operation on vessels is done only for certain indications. The degree of narrowing of the arteries on ultrasound (usually the question of the operation is raised if the narrowing has reached 60-70 %%) – only one of them. The clinical picture and localization of the lesion are very important. In any case, the patient is prescribed specialized medications in the hope that the vessels will stop narrowing. That is, in most cases, not an operation is needed, but conservative therapy.

There are two main types of treatment: open or endovascular. It is possible, for example, to restore blood circulation using open surgery methods – to let blood bypass a narrowed or closed vessel – that is, to sew an artificial vessel. This is called bypass surgery.The bypass vessel is sutured through a surgical incision. The second way is to restore the permeability of the vessel from the inside. In this case, a stent is inserted into the vessel – a “frame”, which expands the lumen of the vessel.

This type of operation is performed through a puncture in the vessel, without its incision (usually the punctured artery on the arm or on the thigh). Almost any artery can be stiffened. Most often, puncture of the femoral artery or radial artery is used for this.

– Why not stent all patients?

– Because the results of surgical treatment are different on different vessels.For example, open surgery on the vessels of the neck to prevent stroke (carotid arteries) is usually more effective than stenting. There stenting is offered only to those patients who cannot undergo surgery. And if we talk about surgical treatment of the iliac artery, stenting usually gives the best results in this localization.

Can leeches cleanse blood vessels?

– Is it possible to do without a stent, to clean the vessel by other means? Z .Abdulkhakova, Nizhnekamsk

– Preparations that would completely remove atherosclerotic plaques from blood vessels do not exist today. There are only rules of life and behavior that prevent further narrowing or slightly level it.

– Will the stents come off if you put leeches?

– There will be no migration of stents when using leeches. They are firmly fixed. But there is no evidence base for effective results from taking leeches, so I do not approve of this method of treatment.

– A year ago they put a stent in my carotid artery. Can I have a neck and collar massage? Is it possible to do neck gymnastics with turns forward and to the sides? Will the stent move? K. Kayumova, Kazan

– You can do both massage and gymnastics. This will not move the stent. But the stent needs to be monitored: every year an ultrasound of this vessel should be done. After all, it so happens that the stent is placed, but the disease does not go away. Again, a narrowing may form – either in this vessel, where the stent is located, or in another.

For almost two hours Roman Bredikhin answered questions from readers. Photo: AiF

– 10 years ago I underwent bypass surgery. Three years ago I did coronary angiography: one shunt clogged and the same process began in the second. Can a stent be inserted if I have angina pectoris? A. Aksilov, Kazan

– From my point of view, you need to go to a cardiologist with a complaint that conservative therapy is not helping you. Re-conduct coronary angiography and, on its basis, evaluate the indications for coronary stenting.A stent can give you a few more years of normalcy.

– Did a bypass of a vessel on the heart 3.5 years ago. Now coronary angiography has shown that the narrowing is progressing in another vessel – one of the vessels is clogged by 60%. What can be done? Albert, Kazan

– Without studying your specific case, you can only give general advice: according to Russian and international recommendations, you need to take antiplatelet agents (which thin the blood). These are acetylsalicylic acid preparations: the doctor selects them individually, based on risk factors.You also need to take statins, which can stop vasoconstriction and, in some cases, even reduce it. More detailed, individual recommendations can be given only after studying the examination results: cardiogram, ultrasound of the heart. One of the main tips is not to smoke, otherwise medications work very poorly and blood vessels continue to narrow. And not only in the heart, but also in the brain, in the legs.

The disease is inherited?

– My father had obliterating endarteritis, his leg was taken away.The sensitivity of my foot has been disturbed lately. Am I getting this disease? V. Nerobov, Kazan.

– Obliterating endarteritis occurs before the age of 40. Considering that you are about 80 years old, it is unlikely that you have the same diagnosis. However, you may have atherosclerosis, which is most common in older people. In case of leg pain, the first step is to do an ultrasound of the arteries of this leg to check if blood is entering it. If abnormalities are found, consult a vascular surgeon.

– My husband was diagnosed with “generalized atherosclerosis with damage to the arteries of the lower extremities.” Narrowing of the common femoral artery – 50%, on the right – 51%, on the left – 39%. The husband can walk only 50 meters without stopping. Valentina Nikolaevna

– Narrowing of the common femoral artery by 50% cannot cause restrictions in walking. Maybe during this time the disease has progressed, maybe some vessel has closed. You need to look again at the ultrasound of the vessels, maybe the narrowing is stronger than you say.Or look for another reason. It often happens that the restriction in walking occurs not due to damage to the vascular bed, but due to diseases of the joints, spine.

– I had an operation for lymphostasis. But erysipelas recurs – three times a year. What to do? Alevtina Antonova

– You are confusing two different diseases: lymphostasis and erysipelas. Yes, they are interconnected: due to the fact that erysipelas occurs, lymphostasis increases.And in the presence of lymphostasis, erysipelas progresses. Unfortunately, there are no radical cases of lymphostasis treatment in the world today, only palliative ones. But in Kazan, a center for the treatment of lymphostasis has been created, where this disease is fought with methods of conservative therapy.

The main symptom of lymphostasis is severe edema of the extremities. No wonder this disease is called elephantiasis. There is a complex therapy for lymphatic edema. It includes, first of all, a special type of manual massage with bandaging.The massage allows you to reduce the edema by a few centimeters, and then the leg is bandaged, that is, the edema is not allowed to develop. After that, a special, non-stretchable knitted fabric of the so-called flat knit is selected. Patients wear it with pleasure, because it gives a good effect, the leg takes on a normal shape.

With regard to recurrent erysipelas, you need to take antibiotics for two to three years, which will prevent the erysipelas from progressing. If there are relapses, then there is a flaw in your treatment regimen.To correct it, contact an infectious disease specialist.

What is the bruise talking about?

– Bruises appear on the arms and legs from the slightest pressure, what should I do? Who should I contact? E. Pavlova, Kazan

– A bruise is a hemorrhage. Its appearance suggests that either the blood coagulation system is disturbed, or that the vessel wall has become unnecessarily fragile. If this is a one-time, isolated phenomenon, then it is enough to pass a general blood test, so that the functions of platelets, the cells responsible for blood coagulation, are necessarily studied in it.And second, you need to take a coagulogram. If these two indicators are normal, but the condition continues to progress, then you need to go to a rheumatologist – a specialist who will check if you have autoimmune diseases.

– Revealed occlusion of the left vertebral artery neck. Is it possible to restore blood flow to the left vertebral artery? Vladislav Mikhailovich, 71 years old

– Take a referral and go to the Vascular Surgery Department of the ICDC. We do such operations.But the method of the operation (and the indications for it) will become known only after specialized diagnostics (for this we will make you a multispiral computed tomoangiography of the neck vessels). Sometimes it is an operation, sometimes stenting.

But you’re safe – translate Russian | English-Russian

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197 parallel translation

You’re safe now. And then an icy wind touched me, but it wasn’t a wind because all the leaves were still.

And then I felt an icy wind, but it was not a wind, because the leaves did not move.

No, but you’re … You’re thinking of this place all wrong, as if I had the money back in a safe.

But you think too bad of us.

Through some miracle, we’re safe here, but in the city, how do you know what would happen to you and …

Thanks to some miracle, we’re safe here, but how do you know

You ‘ ve only got sons, so you’re safe, but we –

..

But when you think you’re safe is precisely when you’re most vulnerable.

The most vulnerable is the one who thinks he is safe.

But you’re all safe and sound

But you’re all safe and sound.

You see, if the reactor blows, the rift opens, phenomenal cosmic disaster but this thing shrouds you in a force field, you have this energy bubble, so you’re safe.

– This is transport. You see, the reactor explodes, a rift opens, a catastrophe of cosmic proportions, but this thing will protect you with a force field, as if you are in an energy bubble, in it you are safe.

But you’re safe now, Father.

But you’re safe now, father.

But you’re safe from him now.

But you can no longer be afraid.

But you’re safe, aren’t you?

But you’re safe, aren’t you?

But you’re not. You’re safe.

However, you are all right.

Adjinakou, things look very bad … but as long as Kankpe is king you’re fairly safe.

Ajinako, the situation is not good. But as long as Kankpi is king, you are safe.

But I can’t until you’re safe.

But I can’t until you’re safe.

I can’t explain it but you’re safe with me.

I can’t explain it, but you’re safe with me.

But you’re safe!

You are lucky, you survived.

But you’re safe now.

But now you’re safe.

You think you’re safe here in this “paradise” of yours but you’re not.

You think that here in your “paradise” you are safe, but you are wrong.

But you’re safe from it if it’s in the freezer?

And when she’s in the freezer, do you feel safe?

But you’re not safe here.

But you’re not safe here.

I know you think you’re safe in those shoes, but nothing could be further from the truth.

Hundreds of times. And approximately, what was the percentage of correct answers?

Be rude, but I’m not going anywhere until I know you’re safe.

– Miss Which _ now _ will be thrown out _ on _ the go! Be rude if you want.

It’s safe, but, uh … you’re not gonna like it.

It’s safe there, but you won’t like it.

But I’m so glad you’re safe.

How glad I am that you are safe.

But the gate is locked. So tonight you’re safe.

But the conductor closed the gate, so you’re safe today.

You’re always sitting safe behind some fucking desk reading your bullshit reports, and that is why I have nothing but contempt for you.

You always sit at your fucking table and read your stinking reports.Therefore, you only arouse contempt in me.

You’ve been gone for a while, but you’re safe now.

You’ve been away for a while, but now you’re safe ..

But how do we know you’re safe here?

Where does this confidence come from?

OK, OK You can leave but I’m telling you, you’re safe here

No, no, if you want, run, but believe me, we won’t offend you.

But you’re safe now.

Are you safe now …

I’m glad to see you’re safe, but where were you?

– You can go to sleep.What have you been doing all night?

The only way this isn’t totally screwed up is if you’re knocked up but don’t worry, your secret’s safe with me.

Unless you’ve managed to get pregnant by having sex, but don’t worry, your secret is safe.

But you’re safe.

But you’re safe.

So, you must remember this one As long as you’re in the villige, you are safe. But after you crossed the borderline of the villige

Therefore, remember, until the moment you are in the village, you are safe, but after you crossed the borderline of the village, the very owner who gave you tea five minutes ago, can shoot you in the back.

But you’re safe now.

But you’re safe here.

We think you had a clot, but it resolved on its own. So, we’re gonna keep you overnight to be safe, and you can go back home tomorrow … or back to work.

We believe you had a blood clot, but it resolved on its own, so we will leave you overnight to be sure, and tomorrow you can return home.

But as your friend, I’m asking you to think about that. You’re safe here.

But as a friend, I ask you to think carefully.

But what would you care, as long as you’re safe?

What do you care if you are free?

It is a lot easier to resent your parents when you know they’re safe in some retirement village, but to know that she’s out there, maybe lying facedown in an alley … This is exactly what she wants you to do.

It is much easier to be offended by your parents when you know that they are safe in some nursing home, but when you know that she is on the street, she may be lying prone in someone’s garden… she just expects you to think so.

But maybe a little later in the evening you’ve had a few drinks you’re kind of loosey-goosey you’re safe with your girls then some kind of cute kind of hot kind of sexy hysterically funny but not funny-looking guy comes up and says it

Perhaps, then you will relax, .. … you will get a little drunk, decide that life is good, the girls do not climb. And then a chic cupcake rolls over, wildly cool or funny – to write, and says a rhyme.

But you’re safe. You guys are safe.

But you guys are safe.

See, you’re smiling, so I think it’s all fun and safe, but it’s a slippery slope from “have you ever been?” to “how many?” and “how often?”

See, you are smiling, it seems funny and safe to me, but the phrase “have you ever been” can easily spill over into “how much?” and “how often?”

But if you’re careful, you should be safe the rest of the way.

But if you drive carefully, then everything will be quiet.

You shouldn’t be here, but as soon as you’re safe out of the city, you try and get away.

Once you get out of town, try to escape, okay?

Property’s always a safe bet … but you gotta know what you’re doing, this ain’t soft money.

It is safe to bet on real estate, but you need to know what you are doing, and this money is not “soft”.

For some reason you want me, you know I don’t know why, but you always have, you’re always looking at me, watching me screw other women, your heart breaking and now it’s different, because I’m safe now, aren’t I?

I don’t know why, but you always wanted me, you always wanted me, you always watched my novels that broke your heart, and now everything has finally changed – I am free and no rivals.

But you’re gonna push it, so we need a safe word To signal your unconditional surrender.

But you will pull to the last, so we need a password word so that you can signal your unconditional surrender.

You’re probably upset that I’m even at a Laundromat right now, but don’t worry, I’m being safe, and I’m headed home.

But don’t worry, I’ll take care of myself. And I’m going home.

I don’t know who these people are, what they’re capable of but I will keep you guys safe, I promise that.

I do not know who these people are and what they are capable of but I will take care of you, I promise you will be safe!

But you have to promise us that you’re gonna keep it safe here.

But you must promise us that you will be very careful.

But just to be safe, you’re now 15.

But just in case, you’re already 15.

You’re perfectly safe but I think aliens are using you to speak.

You’re completely safe, but I think the aliens are using you to talk.

90,000 Medvedev beat Djokovic in the final of the US Open, as it was: online broadcast

TENNIS. US Open. The final. Men.

Novak DZHOKOVIC (Serbia) – Daniil MEDVEDEV (Russia) – 4: 6, 4: 6, 3: 6.

1:50 And now it’s Medvedev’s turn.

“First of all, I apologize to you fans and you have Novak – I know how important this match was to you. But you are still the greatest player in history for me!” – says Daniel.Then he lists his family, coaches and all the team members who helped him.

“To me you are the greatest tennis player in history.” pic.twitter.com/DZMH7MDr4N

– US Open Tennis (@usopen) September 12, 2021

And also thanks the fans. “I understand that today you were rooting for Novak, but you have supported me all week. Thank you!”

Well, a little about his wife, whom he promised a gift, because today is their wedding anniversary .. “I understood that if I lose, then I have no ready-made gift, so I had to play,” he shrugs.

Daniil Medvedev just won the #USOpen on his wedding anniversary.

Good thing, because he didn’t have a present ready? pic.twitter.com/eUXVYEyzup

– US Open Tennis (@usopen) September 12, 2021

“We have terrible news for you, Daniel – your wife is about to see us giving you a check for $ 2.5 million, so shopping is inevitable,” jokes the lady from the federation.

And then Daniel is also handed the cup.

And now he’s officially cool – he’s won one of the four major events in the world.

And even Novak cheered up and smiled.

And we end our broadcast on this wonderful note. We won’t see anything better anyway!

1:47 Congratulations to Daniel on his first Grand Slam victory. Novak is told that he is one of the greatest players of all time. The stands are buzzing like football,

The camera does not look up from Novak’s face. Djokovic is almost crying.

“Novak, you inspire all of us, your achievements are impressive,” they say to the Serb.He takes the microphone and congratulates Daniel. “If I chose whom to lose, I would choose you!” – says Novak. Medvedev is slightly discouraged.

Novak sniffs, but holds on.

“I love you guys.”

All the feels from @DjokerNole to the fans in New York. pic.twitter.com/PnEHevMVKk

– US Open Tennis (@usopen) September 12, 2021

“Although I didn’t win today, my heart is full of joy, thanks to you,” he says to the fans who drowned the whole match for him.

“Novak! NOVAK! NOVAK !!!!” – the stands are chanting.

1:45 The awards ceremony begins. Representatives of the tournament directorate, federation and sponsors came to the court.

And the kids who brought the cups.

And now – speeches.

1:40 This seems to be the most unemotional couple for such an ending. Daniil Medvedev does not particularly like to show positive emotions violently – we guess that they exist, but he certainly will not jump on the court.

And Novak, who said before the final that today he has a “match of a lifetime”, just lost this match with a crushing score of 3: 0. And now he sits with a stone face. Only a close-up shows that his eyes are wet.

Damn, and now they also participate in the ceremony …

1:35 AND THIS IS A VICTORY !!!!!!

DANIIL MEDVEDEV WINS !!!!

Danya finally filed normally, Novak hit the net with the ball, and Medvedev simply collapsed onto the court.

When it all sinks in. pic.twitter.com/3Jy5cQ8Vlx

– US Open Tennis (@usopen) September 12, 2021

That’s all – he is a champion, he wins a Grand Slam tournament for the first time in his life.

And he puts an end to Novak Djokovic’s dream of a calendar Grand Slam – in three games he defeats the Serb in the final.

1:33 Probably the most nervous game since the beginning of the game.

Daniel’s first serve does not go, Novak clings to the second.But Daniel does not let go either. Three long rallies in a row – two were taken by Medvedev, one by Djokovic.

On the fourth, Danya went on the attack – 40:15. And now he has two serves to win

1:27 Djokovic turned on at full power. He took his serve, closed the gap in the third set and generally looks exactly as we are used to seeing.

The stands are also for him – almost everything, except for Sharapova (probably) and a small group chanting “Rossi-si!”

1:26 Damn, Novak still made the first break of the match! The score now stands at 3: 5.And now serve the Serbs.

1:25 Danya is wrong again – and now Novak has a break point

1:24 Medvedev made a double mistake – the score was 40:40.

1:23 Clean feed! 40:30! One ball to the title!

1:22 Novak takes one ball, Dania takes the second. 30.30

1:21 Second serve – ace! 15:15

1:20 First serve – Novak accepted and won. 0:15

1:19 Novak does not go – he changed the racket, but still put the ball into the net.However, he still took his serve. The score is 2: 5, and now Daniel will have a chance to win a set, match and tournament on his serve!

1:16 And here it was a little scary – at some point it seemed that Daniel suddenly realized that he was only a few draws away from the title. And that he flinched. But no, he pulled himself together and took his serve. The score is 5: 1.

1:11 Djokovic takes his serve quickly. 1: 4 becomes the score.

1:10 Miracles Continue – Daniel took his serve and brought the score to a menacing 0-4 in the third set.

From the outside it seems that Daniel is tired – he began to use his strength more carefully and rush around the court less. And Novak, on the contrary, is energetic and cheerful. But when it comes to strikes, Medvedev’s ball flies where necessary, and Djokovic’s – into the net.

Magic, not otherwise.

1:05 AND THE BEARS MAKE A BREAK AGAIN !!

Something happened to Novak – he began to make mistakes in simple situations. I hit the net twice when I did not the most difficult shots. And Daniel took advantage of this state of the Serb – he took his second serve in this set and made the score comfortable for himself – 0: 3.Now he also has to serve.

1:00 Wow, what a difficult game it was: Novak rushed to recoup, clung to every ball, walked to the net – but Daniel is just incredible today. Pulled out. 0: 2 score in the third set already.

0:54 This does not happen at all! Daniil Medvedev again makes a break on Novak Djokovic’s serve! And now in the third set he immediately leads the score! The score is 0: 1, Danya, let’s go!

0:50 So we have the third set.

The situation is unusual and very dangerous for Novak Djokovchiv – he wins 2-0 in sets.The Serb urgently needs to include all reserves in order to save the situation.

And Daniil Medvedev is still beautiful – cold-blooded, accurate, fast. And as usual, he is charged with energy from the stands, which almost without exception cheer for his opponent.

0:49 THERE IS A SECOND SET !!

Daniil Medvedev takes his serve and wins this game, and with it the second set – 6: 4 !!!

Medvedev leads in 2: 0 games. This has never happened before in the history of Daniel’s meetings with Novak.

0:48 Djokovic played another ball, 30:40

0:47 One ball is backed by Novak. 15:40

0:46 The third was played, Novak tried to shorten it, but Daniel ran and dodged the Serb! 40: 0!

0:45 Second ball – won with second serve, 30: 0.

0:44 Daniel’s first serve – ace .

0:42 This time Daniel failed to start a fight on Novak’s serve – although there were chances.But Djokovic is so great – the worse he is, the more stubbornly he clings to each ball. The score is 4: 5, and Dana has to take the game in the next game.

0:40 Danya takes his game to zero and does it so beautifully that you are amazed – he twice forced Novak to chase the ball all over the court, like a cat chasing a red dot from a laser pointer. The score is 3: 5, and the fun begins in this game.

0:35 Still, Novak was able to take his serve, albeit with great difficulty.Then he collapsed on a chair and began to change the polo. The score is 3: 4, the ball goes to Daniel.

0:33 What’s going on! Now Dani succeeds in everything – he even threw the ball over Novak with a candle so that the Serb only got into the net. Wonders!

0:30 Daniil sold out Submitted an ace (already 11th in the match, Novak has only 5). Then, in an excellent drawing, he drove Novak into one corner, and he hammered into another. Game taken – 2: 4.

New balls are brought in.

0:25 THERE IS A BREAK !!!!

The Serb’s serve went wrong again – and for the first time in the second set Medvedev got three break points at once. The first Novak won back, but on the second Danya didn’t let him breathe and took someone else’s serve!

The score becomes 3: 2, and now Medvedev himself will serve.

0:21 What a game!

Daniel did not immediately serve, but Novak was great at the reception. Several long rallies, three break-points – but Daniil still hit the Serb and took his game.2: 2 and Novak is freaking out (and is cautioned by the referee).

0:20 Here comes the first broken racket! Novak is furious

0:10 And another super joke! 14 punches and Novak takes the lead again. “More” on his pitch. Then he quickly grabs another one.

Account in the second set – 2: 1 in favor of Djokovic. Now the Russian will serve.

0:09 If anyone wanted to understand why Novak is the greatest – that’s why. At the most important moment, he took and dropped two aces.And he has “more”.

But Medvedev is also not weak – he did not allow the third ace, accepted, drove the Serb into the rally and won the ball. Smooth.

0:07 Great prank! Daniil accepted, Novak attacked, Dania counterattacked – 12 hits and Medvedev had a break point.

0:05 “Come on, come on!” Rushes from the stands. And something clearly Serbian is also rushing.

0:02 Daniel did not hesitate and just as quickly took the game on his serve 1: 1 – both tennis players continue to confidently take their games.

0:00 This time the Serb did not allow Medvedev to start the set with a break – he calmly took his serve to zero. 1: 0, led by Djokovic. Now it’s the Russian’s turn to serve.

23:57 BEGIN THE SECOND SET.

Again Novak serves first;

23:55 But, of course, it’s too early to rejoice. If anyone has forgotten, then in his last four matches at this US Open, Novak Djokovic gave the first set, and then turned on and won.

We are not hinting at anything, and we are sure that Medvedev himself noticed this.

23:54 THERE IS THE FIRST SET!

Daniel served with confidence. If Novak had any illusions about intercepting the serve and trying to save the party, Medvedev quickly dispelled them.

6: 4 – with this score Daniel wins the first set. Now you can catch your breath a little.

23:50 A couple of times Daniel managed to start a shootout on Novak’s serve, but so far without much success – this game was taken by a Serb. 4: 5 and now Daniel will serve for the set.

23:47 Medvedev gives a great presentation! He takes his serve under zero – two aces and two goals are won by the second hits. And then it is true – what is the time to drag out? You need to win quickly, in Moscow, you know: not morning!

Score 5: 3 in favor of Daniel.

23:45 It was interesting again in the seventh game. No, Novak did not forget how to serve – but this time Dana began to manage beautiful shots at the reception. Especially good was the attempt to dodge when the score was 30:15 – but Novak guessed it and shortened the ball no less beautifully.4: 3, we are approaching the most interesting stage of the first set.

23:40 Daniil hammered the ball into the center of the court with a beautiful shot, when Novak had already been won back. So another quick game ended – 4: 2.

They are going fast, I must admit – three quick games in a row.

23:37 Djokovic responds with the same courtesy – 3: 2, serving again with Medvedev.

23:35 Danya coped with it in two minutes – he bombed with his serve without any options at all.3: 1.

23:32 Daniel had two break-pons, but at that very moment the Serb remembered how to serve – and issued a super series of four aces in a row! The score is 2: 1, now Daniel will serve.

23:30 Novak seems to be waking up. In the third game, he first screwed up two serves in a row, but then he pulled himself together. And he began to serve in such a way that it immediately became difficult for Medvedev.

23:26 And Daniel takes the second game – 2: 0! Great start.

23:23 AND MEDVEDEV MAKES A BREAK!

In the very first game, Danya takes Novak’s serve. 0: 1, and now the Russian will serve.

23:18 Novak feeds first

23:10 And on the podium – as the operators show – Rod Laver himself is sitting . The one who was the last tennis player in history to win all four Grand Slam tournaments in one year. It is his record that Djokovic wants to repeat today.

23:00 So, Novak and Daniel are on the court, warming up and throwing balls.As usual, nothing can be read on Djokovic’s face – when he is not fooling around, he is always about the same. But Medvedev has such a concentrated look, as if this is the match of his whole life. Wouldn’t burn out.

Daniil Medvedev’s mission today: prevent history and win his first Grand Slam title. pic.twitter.com/wBHJlwC9cy

– US Open Tennis (@usopen) September 12, 2021

22:50 At Eurosport, meanwhile, Mats Wilander discusses with the hosts the chances of the finalists.The Swede, of course, drowns for Novak (a historical event, a chance for a calendar helmet, and so on). But he shows that Daniil is better now with his feet – he moves better on the court and can attack from comfortable positions.

Your words, Mats, and tennis god in the ears.

22:30 So, only half an hour is left before the main match of this month. Everyone is in anticipation – and the US Open website posts a comparison of the two heroes of the evening. And along the way, he also conducts a vote – who will win today.So far Novak is in the lead.

Novak. Daniil.

Who leaves New York victorious?

Watch the men’s singles final on ESPN? https://t.co/RXX9HMIcAN

– US Open Tennis (@usopen) September 12, 2021

Good afternoon,

today a rare event for our site – an online broadcast of a tennis match. But this is the match that cannot be missed: the first and second rackets of the world ranking meet in the US Open final – Novak Djokovic and Daniil Medvedev – and one of the participants in this match represents Russia! In fact, in Grand Slam tournaments, the first two seeding numbers do not reach the finals every time (and in the women’s tournament this year the most unexpected final of all possible happened).But this time, both finalists did not allow for a second to doubt their right to fight for the trophy.

Novak Djokovic on the way to the final beat Holger Rune from Denmark (6: 1, 6: 7, 6: 2, 6: 1), Tallon Grikspor from the Netherlands (6: 2, 6: 3.6: 2 ), Japanese Keito Nishikori (6: 7, 6: 3, 6: 3, 6: 2), American Jenson Brooksby (1: 6, 6: 2, 6: 2, 6: 2), Italian Matteo Berrettini (5: 7, 6: 2.6: 2.6: 3) and Alexander Zverev from Germany (4: 6, 6: 2, 6: 4, 4: 6, 6: 2).

Medvedev has victories behind his back in New York over Richard Gasquet from France (6: 4, 6: 3, 6: 1), by Dominik Kepfer from Germany (6: 4.6: 1.6: 1) , Spaniard Pablo Andujar (6: 0, 6: 4, 6: 3), Briton Daniel Evans (6: 3, 6: 4, 6: 3), Botich van de Sandshulp from the Netherlands (6: 3, 6: 0, 4: 6, 7: 5) and Canadian Felix Auger-Alyassim (6: 4, 7: 5, 6: 2).

The statistics of the Russian at this tournament looks impressive – just one lost set in six matches! But in the final it is unlikely to make any difference: Novak Djokovic is already stronger than any of the opponents Medvedev has ever played with, and he also has a completely phenomenal season.The Serb won all three Grand Slam tournaments, and now only one victory separates him from a unique achievement – the calendar Slam, that is, victories at all four major world tournaments in one year. Neither Federer nor Nadal succeeded in this. Moreover, none of the tennis players have been able to do this since 1969, when Rod Laver assembled such a Helmet. If Djokovic repeats this achievement, he will finally become the greatest tennis player of all time.

90,000 Read God Caliber 58 online (completely and free)

Max Ostrogin God caliber 58

Chapter 1 Reaper

I saw a backpack.On the road. I was lying lonely.

– Maybe he ran away after all? Noah asked. – He threw off the load, came off. Happened after all …

– On the asphalt?

– I dropped my backpack, folded it again …

I shook my head.

– No, he’s dead. Did you count?

Noah nodded.

– How much?

– Three fifty.

“I have three two hundred,” I said. – Homer shot somewhere in the fifty-first minute. That is, in the fifty-first minute, they caught up with him. If the reaper hadn’t come close, Homer wouldn’t have fired.So?

– So, – agreed Noah.

– After the shot, of course, he dropped the choke, it took four kilograms. Perhaps he ran another two or three hundred meters. And that’s all. Homer is dead.

Noah squelched, wiped the snot with his sleeve.

– Maybe we thought wrong?

Noah tried to look into my eyes, I hate this habit.

– I get confused sometimes. – Noah continued to wipe himself off. – I count a second not in two steps, but in three. Five minutes, after all, only … Could have miscalculated.

I’m never wrong. That is, I don’t count a second in three steps, always in two. Homer himself taught me this – this is vitally important, he miscalculated a little – and that’s it, takeaway. And Noah really wanted Homer to stay alive. Because he is to blame, Noah. Hands itched to tell him about it. And around the neck. Although I myself wanted to believe, to be honest.

– Maybe they miscalculated. Let’s see. We need to deal with the bag. Give me a tarp.

Noah spread the tarp and I emptied the contents of my backpack onto it.

Three plastic bottles of gunpowder are the most valuable thing. Each has five hundred charges. One thousand five hundred shots. A real treasure. One bottle for Noah, two for me. Because I am stronger. Although no, he cannot be trusted with gunpowder, everything is me.

Bullet. We don’t need a bullet at all. Homer used an old screw fitting, we used smoothbore carbines. The union is four kilograms, the carbine is two. Difference. Plus Homer was very lucky – I mean growth and strength. Still old genetics. And we are new.Scrawny. Can not. Especially Noah. And we will not grow any more. So we can’t take the choke off.

– Maybe we will sell? – asked the greedy Noah.

– Who needs it? Everyone has their own calibers … and heavy yet.

I pushed the bullet off the tarp onto the asphalt.

Spare knife In scabbard. The handle is beautiful, type-setting, made of wood and copper, some kind of beast carved. Horse with a horn. He pulled it out of its scabbard. The knife was covered in yellowish grease, and I wiped the blade on my backpack. The name is engraved on the brass ring.

Cyrus.

I didn’t know any Cyrus, swung it, cut the bullet into two shiny parts.

– Wow! – admired Noah. – Blimey! Bulat?

I looked at the blade, admired the pattern, estimated the centering on my finger, threw it into the roadside ditch.

– Bulat.

– What are you! – Noah was indignant. – They can cut nails!

– Have you ever chopped nails? I asked.

Noah said nothing.

– So I didn’t cut it. It will dull instantly.And you can’t just sharpen it, you need a special sharpener. Will you carry a winepress with you? And sharpen for two days? And cook grease?

– Why then did Homer hold him?

– How do I know? Maybe some kind of memory. Only it weighs almost a pound, why do we need such a knife?

– I don’t know. Sharp …

Sharp. So sharp that you won’t notice how you cut off your fingers. And rusts. An absolutely unnecessary thing. Lubricate it, sharpen it, lubricate it again, and beware yourself. And that’s enough for three hits. And to hit who?

Bullets.Almost a hundred. Regular, lead. Also useless. We have a good supply, and bullets, and shot, and buckshot, and bullets are just in case, the weight is off. I collected the bullets into a handful and threw them into the bushes.

– Why are you throwing everything away? – Noah asked with displeasure. – Anything can come in handy …

– Shut up better, – I advised. – The less weight – the faster the speed, you should know that.

First aid kit. Here, of course, I did not throw anything away. He took the syringe for himself, the bandages, batteries and alcohol were honestly divided in half.

Cartridges. Two packs. Five forty five. In a green oily box.

– Oh! Noah groaned. – Cartridges! Throw them out too ?!

I thought. Cartridges are, of course, not entirely useless. Yes, there is no particular use from them in the hike. Because they are heavy. Each gram of weight means extra seconds of endurance, extra hundred meters of running. And this is everything. On the other hand, cartridges can be exchanged, Homer said that they are valued by the Ring. There people sit in the dungeons, they do not go on long hikes, there are cartridges in the price.If, of course, the weapon remains intact. Five forty-five, frequent caliber.

– Let me carry it, – Noah volunteered. – Cartridges. And what, I am easy …

Greed is a sin. Homer said so.

I removed the fold from my belt, pulled out the pliers.

– No … – Noah whimpered. – Do not.

I turned the bullets off the cartridges, poured the gunpowder into the horn. I wanted to pick off the primers, but I was afraid.

– I can’t, – Noah scratched his head. “You’re not doing it that way, you…

“ Shut up, ”I advised again.- Now I am the elder, now you obey me.

Noah muttered something displeased.

Blokholovka. Almost new. Noah immediately began to look at her predatory.

– I wonder why he didn’t wear it? Noah asked.

“He always had two,” I replied. – I wore one, the other rested. He didn’t like fleas very much, a cultured person …

– How will we share?

– In all fairness, how else …

I unbuttoned the collar, took out a chain with a flea trap.I have a bad one, not very effective, made of old greased footcloths. Fleas, of course, climb on it, but immediately jump off, you often have to get it out, shake it off. Homer’s flea catcher is another matter – a real work of art, a flight of reason, what to say.

Therefore, I immediately threw mine away, and put on this round and good one.

Noah pouted.

– What did you think? You, or what? You are not worthy. Rejoice that you are alive at all. Homer died because of you.

– Yes, I could not …

– I could not – now it is too late to guess, Homer cannot be returned.But something tells me that he would hardly have left it to you.

– How do you know?

But I had already zipped up my jacket at the collar and did not intend to enter into further disputes about the flea-catcher, I had already determined its fate.

We continued to disassemble the backpack.

Tubes. White. Multi-colored. Some were empty, I threw them away at once, my empty one and a half, in others there were small things. Needle threads – left, matches – down, white balls – some unknown medicine, tried a piece, primers – shared.

There is leech powder in a red tube, I immediately recognized it by its smell, a useful thing. If you suddenly catch a blood clot, this is the only thing that saves you, you need to swallow half a spoon at once. Divided.

Honey was found in the yellow tube. Bitter and sweet at the same time. We ate it, ate it without thinking, and I remembered. Gluttony. Also a sin. Fatal. That is, mortal. Through gluttony, the satiety of their flesh without restraint, many people, even among the great, said goodbye to life.

Here is our Homer too.

True, it was not he who was fed up, but Noah, but what’s the difference? For sin extends not only to the sinner, but also to all who are near, how to feed, like a rotten microbe that eats away the brain. That’s how it was.

On the eighth day we moved south. First, through the familiar forest, then the ruins began, Homer said so:

– Remember, these are ruins. The real ones.

The ruins looked like a dump. Well, just not quite, there was some order in these ruins. There is a lot of square. Homer said that there used to be cities here.Only cities, no forest, no water, all the water is underground, in pipes. And if necessary, you open the tap and it flows. Then the Darkness happened, and everything got mixed up. Into okroshka.

We, by the way, also have ruins, there is still a city near the village, albeit a small one. But our ruins cannot compete with these.

It was not easy to get through the ruins. In addition, Homer himself was in no hurry, he listened and smelled everything, did not take his eyes off the binoculars, sat a lot, thought. I looked at the Pope.

Daddy was lying in his cage discontentedly, muttering.

Noah teased him with a straw, poked him in the nose, Pope was furious, pushed his paw through the bars, hissed, tried to bite Noah. It was funny, but we didn’t laugh. The day before yesterday Ivan laughed, now he is gone.

In general, Noah could not go with us – he does not feel anything, a cripple, a waste, he knit rugs with women, rabbits collect grass … But it happened so. It is unlikely that Noah was pleased with our campaign. Especially on the third day. And on the fifth, in the late afternoon. And on the eighth day there were only three of us left: me, Homer and Noah.

Out of six.

In the morning we came across a hedgehog. We made our way through these very ruins, and then suddenly there was a forest, all the trees were burnt, but they still grow. Both small and large. They walked, as always, without haste, listening, and suddenly the Pope on Homer’s back began to stir. He stirred, stirred, gurgled his womb – a sure sign that there was some kind of food ahead, he was greedy for food.

90,000 Read Thrombus online (completely and free)

Nilin Pavel

Thrombus

Pavel Nilin

Thrombus

This unusually sad, albeit purely private, story below, with just as romantic as it is unusual for us scandalous shade, any true unbiased researcher who wished to approach , I think, I would certainly have started with the funeral of Professor Dux.

1

Professor Valentin Nikolaevich Dux was buried at the Vagankovskoye cemetery on a gloomy afternoon in late autumn. A light rain fell. And the orators from the ministry and the institute, which was headed by the professor, hastily, as if in a nervous chill, read their long speeches, shielding the typewritten text with their palms.

These speeches, as often happens, did not even have a remote relation to the personality of the deceased, to the essence of his life. And, having already heard the first phrases, engineer Meshcheryakov did not try to listen to them any more.He stood confused, as if stunned by misfortune.

Those few blocks that were lined at the grave were enough only for officials and close relatives.

Meshcheryakov, who came later, stood on the outskirts, clinging to a slimy elderberry bush hanging over someone’s granite tombstone.

However, he, tall, naturally towering above the crowd, could clearly see the still beautiful, strictly death-focused face of the deceased, pale hands with very long fingers, already worked out and folded on his chest forever, a dark brown suit in a large cage and blunt-nosed heads of Yugoslavian shoes.

Meshcheryakov’s feet, wearing exactly the same shoes, were stuck in the wet, freshly dug clay of the grave mound. And the chilly shiver that rose up my legs from the cold slippery clay reminded of something that did not immediately equalize into a clear memory.

And this seemingly insignificant recollection greatly agitated Meshcheryakov.

It was, he recalled, after the war, in one thousand nine hundred and forty-six, or maybe forty-seventh, on the same October day, at the end of October.It was going to rain, then it was dripping like now, then it was pouring with might and main. And they, Moscow students, were digging potatoes. Several institutes came to help the collective farmers.

And although Meshcheryakov more than once during his student years, like his colleagues, traveled to collective and state farms on such “help”, he recalled at the grave of Dux only one gloomy day towards evening, in the rain and cold in an open field framed on three sides there is a forest and a narrow shallow rivulet with an unpretentious name Rogozhki.

Near this river after work, students and students washed their own, as they joked, waterproof shoes-all-terrain vehicles, for many the only ones then for all occasions.

And the kolkhoz girls, looking at the students in the distance, shouted something mocking at them, like what you will now know, city gentlemen, sissies, how much is kolkhoz potatoes.

It would be possible for tired, cold students to get angry with these girls. And Dux, this very Dux that lies in the coffin. Valka Dux called them over and said seriously:

– Well, wait a minute, girls. In the spring, in Moscow, at the institute, we will have exams on strength of materials. By the resistance of materials.It’s no easier than digging potatoes. There is a big request to you girls, be sure to come and help. Do you promise? Otherwise, we will not dig any more …

And the girls immediately calmed down in bewilderment. After all, who knows what this thing is – resistance material?

It was thirty years ago. Dux was then twenty-one or twenty-two. Not so much. And during this time, Valka Dux, Valentin Nikolaevich Dux, passed, without the help of the collective farm girls, not only exams on strength of materials, but all other exams, became a major engineer, professor.And now it has completely rounded out. And I?

Meshcheryakov saw many deaths during his youth, during the years of the war, which he happened to attend, as he liked to say jokingly. And death, it would seem, should not have burned his heart in such an unbearably agonizing anguish. But Dux, Valka Dux, almost the only friend, leaves. Already gone forever …

Either the grave clay suddenly warmed up. Either a sudden warmth came from somewhere. But Meshcheryakov became hot and stuffy. He unbuttoned his coat, unwound his shaggy scarf and heard the clumps of clay clattering on the thin, as if pitifully quivering, lid of the coffin, which had already been lowered by ropes into the grave.

“And I will never see him again,” Meshcheryakov said aloud. And he walked alone along a narrow, winding path among the wet gleaming iron crosses and the cold dimming marble obelisks of this ancient Vagankovsky cemetery.

– Dux did not reach Novodevichy …

– There was not enough gunpowder.

– He did not come out in rank, – some people, from those who dispersed after the funeral, were gloating and quite loudly talking in the bushes.

“I wish you could reach Dux,” Meshcheryakov wanted to shout to them.But he didn’t shout. And why do you need to get involved with nonentities, even in the cemetery who continue to gloat.

I didn’t want to shout or speak. I wanted to be silent. And sort through in memory, like multi-colored pebbles, in essence, insignificant memories.

Just give your memories a push. They easily cling to episode after episode.

Meshcheryakov remembered how they baked in ash then, about thirty years ago, this potato dug out of the cold earth with his own hands, how Dux took out a bottle of extremely disgusting moonshine somewhere, how carefully, literally, drop by drop, he poured it out so that, do not let God, do not offend any of the thirsty, as after supper, in spite of fatigue, they jumped over the fires and sang around the fires.And then everyone lay down in the calf shed, or something, on their own clothes, since there was neither hay nor straw on the collective farm. It was the poorest collective farm, where there was nothing to feed the cattle.

In the morning it turned out that one of the girls either broke or dislocated her leg. Can’t walk. And a collective farm truck will not fit here to deliver her to the nearest first-aid post, because a permanent bridge has collapsed and a wobbly passage of tied poles has been thrown across the Rogozhka River so far, along which one can only move on foot.And then one by one.

Along this shaky transition from the poles, Meshcheryakov had to carry a pretty girl with a dislocated leg in his arms.

He still, oddly enough, has retained the sweet memory of how tremblingly she breathed in his ear, gently tickling his neck with flaxen hair, which made him intolerably want to laugh. And, laughing, he was afraid to drop her into the river seething in cold foam.

Just think how long ago it was – more than thirty years ago.And how recently, if he still hears the warmth and tickling of her breath behind his ear.

And now he will see her.

2

At the gates of the cemetery stood an official from the institute “rafik”, where, talking noisily, the friends and acquaintances of the deceased were already climbing in, going to the widow’s memorial service. And right there at the little runabout stood a widow with a fair-haired slender daughter, equally similar to both the young Dux and the girl that Meshcheryakov once carried across the river.

– We are waiting for you, Dima, – the widow saw Meshcheryakova.- Sit down. And your Inga will do this very minute …

– No, Vera, I won’t go. I can not. I can’t today, ”Meshcheryakov said. – Let my Inga go both for herself and for me. I can not. Don’t be angry, dear …

Inga, a large, middle-aged woman, of “ideal male beauty,” as the wits joked at the institute, came up.

“Dimka cannot today,” she said almost in an initial voice. – He can’t. Firstly, he is now about three hours later, ”she glanced at her wristwatch,“ has to fly to the Urals on a business trip.And secondly, if he comes to you, he will definitely drink. That’s for sure. And this is absolutely forbidden for him now. Dangerous. And I probably won’t go either. I can’t …

“Well, well, as you know,” the widow sighed and, snapping off the door of a tiny car, sat down at the steering wheel. The daughter sat down next to her.

“But you could have gone,” Meshcheryakov said to his wife. – After all, you wanted to. And you always say that Vera is your best friend …

– I called home. Igor was brought to us.He was seriously ill. And Natasha, you know, left. I have to deal with him. And Vera doesn’t need you or me now. You see how well she holds up. I never expected. And look, how many people there will be to her now, – the wife pointed to the “rafik” who had driven off.