Know the warning signs'Knowledge is power' and in the case of patients with myeloproliferative neoplasms (MPNs) a sensible step to take in order to maintain optimal health. We strongly advise you and anyone caring for you to play it safe by learning the signs of a deep vein thrombosis (DVT), stroke and heart attack. Deep vein thrombosis A deep vein thrombosis (DVT) is a blood clot that develops in a deep vein, usually in the lower leg. Signs include Calf swelling which is usually different from the mild ankle swelling that many people get during long haul flights. Calf pain that is noticeable, or worse when standing or walking. These are not always signs of a DVT, but if you experience these symptoms you should seek medical advice. Deep vein thrombosis can cause pain in the leg and can potentially lead to complications. A DVT usually develops in a deep vein in the leg but can occur elsewhere, for instance in the arm. Although air travel is widely thought to increase risk of DVT, the risk increases for long journeys regardless of mode of transport. In most cases of DVT the clots are small and do not cause any symptoms. The body is able to break down the clot and there are no long-term effects. Larger clots may partially or totally block the blood flow in the vein and cause symptoms such as: Heart attack If you believe you are having a heart attack, don’t waste time but get help immediately. Make a note of what times your symptoms began. Always tell the medical team who is treating you that you have an MPN because this may make a difference in the care you need. The signs of heart attack are different in men than in women, but include: Pain in the chest: Men and women many experience pain or discomfort in the centre of the chest Pain in other areas of the upper body: Some may feel pain or discomfort in the arms, back, neck, jaw, or stomach Women have a different experience: Women are somewhat more likely than men to experience shortness of breath, nausea and vomiting and back or jaw pain Stroke If you believe you have had a stroke, don’t waste time but get help immediately. The sooner you get medical help the more chance that damage can be prevented. Make a note of what time your symptoms began. Always tell the medical team who is treating you that you have an MPN, because this will make a difference in the care you need. Difficulty walking: You might feel dizziness, loss of balance or loss of coordination. Trouble with speaking and understanding: You may slur your words or be unable to find the right words. Paralysis or numbness on one side of your body or face: You may develop sudden numbness, weakness or paralysis on one side of your body, or one side of your face may droop. Trouble with vision: Blurred or partial vision Headache: You may experience a sudden or severe headache Every minute counts when someone is having a stroke, so be sure to get to the A&E department and get medical help immediately. Visit the Stroke Association website for more information about spotting the signs and dealing with a stroke.