Despite efforts to avoid a DVT, if your leg (especially your calf) becomes swollen, red and tender to touch and it doesn't resolve itself within a few days, then make an appointment with your doctor. Your doctor will examine your leg and foot and ask questions about your family history, diet and recent travel routine. If female, your doctor might also ask if you're pregnant, recently gave birth, taking birth control pills or undergoing hormone replacement therapy because higher levels of estrogen can easily precipitate blood clotting.  The birth control pill is riskiest during the first year of use, although modern formulas tend to be much safer than their predecessors several decades ago. Your doctor may prescribe a blood thinner (anticoagulant) such as heparin if he/she suspects a DVT. Blood thinners decrease your blood's ability to clot, although they don't break up existing blood clots  Your family doctor is not a circulatory specialist, so you may need a referral to another doctor with more specialized training. A circulatory specialist or vascular surgeon is trained to distinguish between all the potential vascular issues that can occur in the leg and elsewhere. There are a number of serious conditions that cause leg swelling and pain including diabetic neuropathy, venous insufficiency (leaky vein valves of the lower leg), chronic compartment syndrome (swelling of the lower leg muscles), popliteal artery entrapment, bacterial infections and cellulitis.  Your specialist may use a diagnostic ultrasound to try to see clots in the upper leg, or a venography (x-ray with injected dye) to test for clots in the lower leg. Ultrasounds are compared over time to see if a clot has grown or reduced. The specialist may also conduct a D-dimer blood test to detect if a clot exists. D-dimer is a chemical that is produced when a clot gradually dissolves. If a DVT is detected, then your doctor may decide to give you stronger, more powerful drugs to stop the clot's progression and then to ultimately dissolve it. After starting heparin injections, you might be given other injectable blood thinners (such as enoxaparin) or pills such as warfarin (Coumadin). If you have a serious, high-risk DVT, your doctor may give you a thrombolytic-type drug via an intravenous line, which can quickly dissolve a clot.  You may be prescribed a new oral medication that has been recently approved by the FDA that does not require blood monitoring, such as dabigatran, rivaroxaban, or apixaban.   Commonly used thrombolytic agents for DVT include streptokinase, urokinase and recombinant tissue-type plasminogen activator (r-tPA).  Thrombolytics can trigger serious internal bleeding and are traditionally used on DVT that are considered life-threatening, although these drugs have evolved considerably in recent years, prompting discussion as to whether they should be used on all types of DVT.  If you cannot take blood thinners, your doctor may have a small filter surgically placed in a vein in your abdomen, preventing clots from moving to areas where they could cause harm.  If you're in the hospital, a mechanical device for compressing your feet or legs may be used for a few days. These are especially useful in conjunction with blood thinners.
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