The first inkling that drummer Zak Starkey had that something might be amiss, was a feeling of ‘muscle tightness’ in his right leg during a band rehearsal.
‘I’m always running around like Tigger and I didn’t feel any real pain, just some tightness in my leg – so I thought I’d just pulled a muscle,’ says Zak, 59, who played with The Who at their two sell-out shows in aid of the Teenage Cancer Trust at the Royal Albert Hall last month. (He was reinstated to the band last week after briefly being dropped just days earlier over what the band later described as ‘communication issues’.)
‘When you’re a drummer you often get a bit of pain here and there, especially when you’ve been drumming for as long as me,’ says Zak, who has also played with Oasis during his 40-year career and is tipped to join them on stage at their eagerly-awaited sell-out stadium concerts this summer.
‘But I’ve usually found that after a good night’s sleep I’m as right as rain.’
Zak is the son of Beatles legend Ringo Starr (born Richard Starkey) and his first wife Maureen. He had been looking forward to playing a couple of gigs in January of this year with rock group Mantra of the Cosmos (his main musical project outside his work with The Who), at the Cavern Club, the Liverpool venue made famous by the Fab Four in the Sixties – so ‘shrugged off’ the feeling in his leg.
Yet he was in for a shock – the ‘tightness’ in his leg was a warning sign of a potentially life-threatening blood clot.
‘After the second gig, I got back to my dressing room and took off my sweatpants and saw that my right calf was double the size of the left one,’ he recalls.
‘It looked like something out of Popeye and was throbbing – I was absolutely sh*****g it, because I’d never seen it so swollen. There was clearly something wrong,’ recalls the twice-married father of two, who divides his time between homes in Henley-On-Thames and Jamaica.
Zak Starkey suffered from a DVT, a blood clot in one of the deep veins in the leg
Zak, pictured with his father and Beatles drummer Ringo Starr (born Richard Starkey)
Zak was so concerned that he took a cab from Liverpool to London the next morning, where he saw a specialist privately.
‘The doctor examined my leg and gave me a blood test and ultrasound which confirmed that I had a DVT [deep vein thrombosis, a blood clot in one of the deep veins in the leg],’ says Zak.
DVTs usually form in the calf, causing pain, swelling and redness – they require emergency treatment as if the clot dislodges, it can travel to the lung. This can cause a pulmonary embolism – a potentially fatal condition as it reduces oxygen supply to other organs in the body, causing heart attacks, a stroke and even death.
Around 60,000 people a year in the UK develop a DVT and an estimated 25,000 a year die from a preventable blood clot in the vein, according to a 2015 NHS Health Research Authority report.
But that figure refers to people who have been hospitalised, so it could be an under-estimate because many cases are ‘silent’ or asymptomatic, leading to misdiagnoses or delayed recognition.
‘DVT is an underrated risk and one of the leading causes of cardiovascular death in the UK,’ says Alun Davies, a professor of vascular surgery at Imperial College London.
‘A feeling of tightness in the legs, along with leg pain, swelling and redness are classic symptoms of deep vein thrombosis.
‘If someone develops such symptoms they should seek urgent medical care at A&E or from their GP.’
Risk factors include having recently had surgery or taking a flight, particularly long haul. Any period of inactivity can contribute to the blood thickening and a clot forming, says Professor Davies.
Being a smoker may also raise the risk of a DVT as it makes blood sticky and more likely to clot, but he adds: ‘The evidence is not clear cut’.
The risk also increases with age, ‘though again we don’t fully understand why,’ says Professor Davies. ‘It could be related to lots of things’.
Zak thought that his DVT might have been caused by ‘sitting cross-legged too much’ and not ‘limbering up sufficiently’ before the Cavern Club gigs. (Although Professor Davies suggests there must have been a longer period of immobility prior to this.)
The test for a DVT, a D-dimer blood test, measures levels of a protein produced by blood clots. This is followed by an ultrasound to check the blood flow in the deep vein.
Treatment usually involves regular walking and exercise and taking anticoagulants – blood thinners such as warfarin or new medications such as apixaban and edoxaban – which patients need to take for ‘a minimum of three months’ to prevent a further DVT, says Professor Davies.
People who have suffered recurrent blood clots or have a heart valve problem may be prescribed an anticoagulant indefinitely.
These drugs don’t treat the clot itself – if it’s very large and there’s a risk of it developing into a pulmonary embolism, a type of medication called a tPA (tissue plasminogen activator) may be prescribed to break down the clot, although this is rarely given, says Professor Davies.
Zak Starkey performs with The Who during The Who Hits Back! tour in 2022
He estimates that those who’ve suffered a DVT run a 5 to 10 per cent chance of the condition recurring over their lifetime – some research suggests about three in ten people may experience a second DVT within a decade of their first.
Professor Davies adds: ‘There is some evidence that the longer you remain on such medication [a blood thinner] the less likely you are to have recurrent DVT.’
However, long-term use of blood thinners raises the risk of excessive bleeding and gastrointestinal problems such as stomach ulcers. Warfarin use can also contribute to reduced bone density.
Whether the patient should wear compression stockings after a DVT is a matter of debate.
The argument for them is that they improve blood circulation in the legs, helping prevent blood pooling. Yet while European, Australian and New Zealand guidelines advise wearing them for up to two years after a DVT, the NHS places more emphasis on taking blood thinners, staying active, maintaining a healthy weight and drinking plenty of fluid (DVT is more likely if you’re dehydrated).
‘However, most clinicians think that patients would benefit from wearing compression stockings,’ says Professor Davies, who co-authored a recent paper in the British Journal of Surgery, which concluded in their favour.
‘If you don’t treat DVT seriously the patient can end up with a permanently swollen leg which can lead to leg ulcers, among other things,’ says Professor Davies. ‘The most recent evidence suggests you need to wear a stocking for around a year to reduce the chances of getting post-thrombotic syndrome [symptoms include pain, swelling, itching, discoloured skin and varicose veins] and I would personally recommend doing so.’
Professor Davies also suggests anyone at high risk who’s about to take a flight but not regularly taking a blood thinner, should ask their GP about being prescribed one to take one or two hours before their flight.
Zak says that learning he had a DVT was ‘a shock’, but he’s relieved that it was diagnosed so quickly, that he’s been deemed ‘not high risk’ (he’s not been advised to wear compression stockings) and that he ‘isn’t dead’.
And if he follows the medical advice, there is no reason why he shouldn’t follow in Ringo’s footsteps and still be drumming away in his 80s after starting as an eight-year-old when his ‘Uncle Keith’ – the late WHO drummer, Keith Moon, one of his father’s closest friends – gave him a kit.
Unlike some rock stars of his vintage, Zak says that he has ‘never really had any other health issues’, considers himself ‘in pretty good shape’ and has made a good recovery from his DVT.
‘I often go walking with Paul Cook [from the Sex Pistols] in the countryside around London,’ he says. ‘And my four-year-old daughter, Luna Lee Lightnin [from his second marriage to Australian born artist and singer Sharna Liguz], likes being thrown up into the air and that keeps me fit.’
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