Mahjong, Deep-Vein Thrombosis and Jewish Women

Aunt Minnie, my mother, and many of their friends played Mahjong every Sunday afternoon for hours upon hours, peppered with sips of coffee, bites of strudel, and soft whispers about Uncle Irving’s ulcer.  The game of Mahjong was a favorite amongst Jewish Women, but is also played by millions of people in Asia as well as Asian-Americans.  Ruth Unger, president of the New York-based Mahjong League for twenty-six years, states that “you are mixing the tiles and you talk and you talk and these people become your network, your support group – everything you need.”

Mahjong first came to the United States in the 1920s by a man named Joseph Babcock who brought it from Shanghai.  The game became very popular and Eddie Cantor, the well-known Broadway star, sang the popular hit:  “Since Ma is playing Mahjong”.  Mahjong lacked standardized rules, but one Jewish woman changed this by founding the National Mahjong League in 1937 which became the ruling authority, issuing official American rules colloquially known as “Jewish Rules”.  It also pledged to devote all of its profits to charity, something that this league continues to do.  For example, they supported a pediatric wing at a hospital in Florida and another pediatric wing in the Nassau University Medical Center.

In 2007, The Hong Kong Medical Journal claimed that the game can cause “Mahjong Epilepsy”.  Allegedly, twenty-three people in Hong Kong and Taiwan suffered seizures only when playing the tile-clicking game.  It is not clear what caused the seizures – perhaps a new competitive spirit or larger bets could have precipitated these events.  It is also not clear, since no details are available, that they in fact had authentic seizures.  Recently, doctors in the Hunan province of China diagnosed a forty year old woman with a Mahjong- related deep vein thrombosis, which is a dangerous blood clot.  These doctors posted a letter in The Lancet Medical Journal which stated that the woman had been sitting for eight hours at a Mahjong game.  She had sudden pain in her legs and was brought to the emergency room.  Allegedly, she had sat perfectly still while playing the game and had only one soft drink during that entire time.  The letter stated that the Mahjong – related deep vein thrombosis initiated by minimal physical movements and dehydration could be complicated by stress and sleep deprivation.  The woman spent two weeks in the hospital for this condition receiving intravenous blood thinners while she wore compression stockings.  Currently, she has improved significantly and is under- going continuous therapy.  It is not clear whether she will ever play Mahjong again.

WHAT IS DEEP VEIN THROMBOSIS (DVT)?
Deep Vein Thrombosis occurs when a blood clot forms in one of the body’s deep veins, usually in the legs.  Although serious complications are rare, if left untreated there is a potential that the clot could travel to the lungs, causing a life-threatening condition known as Pulmonary Embolism.  Because only 30% of these patients experience symptoms, it can be difficult to recognize. 

DEEP VEIN THROMBOSIS RISK FACTORS
There are many reasons why people might develop DVT which include:

1. A history of DVT
2. Certain inherited disorders such as Factor V Leiden
3. Birth Control Pills
4. Injury to a deep vein during surgery
5. Injury to a deep vein secondary to trauma
6. Slow blood flow from lack of movement (after surgery, being bedridden, or sitting for long hours in an airplane or automobile or playing Mahjong)
7. Pregnancy
8. Certain treatments for cancer
9. Central Venous Catheter ( a tube placed in the vein to allow access to the blood stream for medication.).
10. Elderly
11. Overweight/obesity

COULD YOU HAVE DEEP VEIN THROMBOSIS?
1. Have you noticed any swelling in either of your legs, your ankles and feet or  
along any vein?
2. Do you experience pain, tenderness or other discomfort in your legs?
3. If you do experience pain in your legs, does it feel like a cramp in your calf and does it become more pronounced when standing or walking?
4. Have you noticed any pain or swelling in your arms or neck? 
5. Does there appear to be any unusual redness or warmth in your legs, arms or neck?
If you think you have DVT, call your doctor or go to the emergency room immediately.

In spite of the internet, iPhones, iPads, 3D movies, wonderful restaurants and hundreds of other social activities, the game of Mahjong continues exuberantly amongst the Jewish woman in New York, Miami, Chicago, and Los Angeles.  So ladies:  don’t get dehydrated, move around frequently and for goodness sakes, place smaller bets.