Jun 21, 2015

The Relationship Between Surgical Procedures and Blood Clots

Wake-up time. If you're going to have surgery in the near or distant future, please read this post. As common, a little history first.  

Blood clot
Blood clots are a solemn reminder of just how fragile the human body is. Blood clots usually appear in your legs and are called deep vein thrombosis (DVT), the most common type of blood clot after surgery. They typically remain in the legs, but can break free and begin to move through the blood stream, like to the lungs or brain, known as an embolism. I had two blood clot experiences as a stroke survivor, and with both, the hospital kept me for a week each time. You might think that doctors and nurses are obsessed by blood clots, but this event is serious business. And the obsession is valid.

Blood clots can lead to a stroke, another name for an embolism that travels to the brain. Strokes can result in long-term disabilities including
slurred speech, an inability to speak, one-sided weakness, and facial drooping, for example. 

Pulmonary embolism
A pulmonary embolism means one clot landed up in your lungs, causing possible pain and severe shortness of breath, resulting in death for 30%.   

Clots are often associated with surgery. The reason is, the person is lying still during the procedure and potentially for many hours post-surgery. (Blood clots, as mentioned in my blog, can also form when an person is motionless for long periods of time, such as during airplane ride a long car trip. http://stroketales.blogspot.com/search?updated-min=2013-07-01T00:00:00-04:00&updated-max=2013-08-01T00:00:00-04:00&max-results=2)

The type of surgery you are having can also increase the risk of having blood clots after the procedure. If your surgery requires your arteries, veins, or tendons to be cut or repaired, the risk of a blood clot is higher because your body works to stop bleeding by forming clots. 

The risk factors for blood clots both during and after surgery may include:
  • History of Blood Clots: If you have had a blood clot in the past, your are more likely to have one in the future.  
  • Genetics: If your family is prone to clots, you may be, too. 
  • Atrial Fibrillation: Patients with an irregular heart beat have an increased risk of forming blood clots.
  • Pregnancy: The chance of blood clots increase as the body makes blood clot faster in preparation for child birth.
  • Cancer: Some types of cancer make blood clot more easily.
  • Hormone Replacement Therapy (HRT): One known side effect of HRT is the increased risk of forming blood clots.
  • Obesity
  • Smoking
  • Prolonged Immobility which include the time during anesthesia and recovering
  • Heart Valve Issues people with replacement heart valves or heart valve problems have a higher risk of forming clots that can then travel to the lungs or brain.

After surgery, if you are able, get up and move during your recovery, one of the ways to prevent blood clots. Staying well hydrated by drinking ample amounts of water can also reduce your risk of forming clots, too.  


One treatment for blood clots post surgery is heparin, a medication that is given by injection or by IV to prevent the formation of clots, to reduce the clots that already formed, or to keep the blood clots from getting larger. Another is Coumadin, or the generic Warfarin, given to help the body remove a clot from the bloodstream.

In cases where there is a high risk of the clot moving to the lungs or brain, especially after surgery, a device called an inferior vena cava filter (or Greenfield Filter) may be placed, which acts like a tiny porous vessel, catching clots before they can damage the lungs or brain. A small incision in the groin or neck is how the filter is put into place in the inferior vena cava. But the blood clots can break off and go to your lungs or brain anyway. That is how I had a pulmonary embolism. The filter can catch all, but sometimes not everything.

So you really have to hope for the best because the cold truth is, you never know what's gonna bite you in the ass next.

5 comments:

  1. Blood clots after knee replacement surgery terrify me. This fear keeps me using a cane when I walk in the community. I think two friends who hobble along when they walk because they do not want to use a cane are nuts. If they saw themselves walking they would know they are fooling anyone.

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  2. That's so true, Rebecca. Is knee surgery in your future? If so, my post spells out all the risks, but there are some things to help, too.

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  3. My husband broke his femur April 2014 and had an intramedullary rod and screws put in to repair it. Unfortunately the rod did not "fit" correctly, and the orthopedic surgeon had to remove all of the hardware. The 2nd surgery to do this was in January 2015. Six days after that surgery, my husband woke up at 5 a.m. with the classic "thunderclap" headache, and immediately started vomiting, moaning, and could not stand up. I immediately called 911, as I knew we were in trouble.
    The ER Dr diagnosed an atypical migraine. I knew better, and insisted on an MRI. Sure enough my hubby had suffered a cerebellar stroke.

    Looking back, after the 1st surgery, the Dr ordered blood thinner shots that I continued to inject in hubby's stomach for 3 weeks post surgery.
    After the 2nd surgery to remove the hardware, the Dr prescribed no blood thinners of any type.
    I can't tell you how often I've kicked myself in the rear over not thinking a thing of it. Why didn't I ask the surgeon about it?? Why??!!
    I know it doesn't do a darn bit of good to "What if?", yet I do it...

    I know from now on, I will make sure to ask, ask, ask! I just wish I had asked on January 23rd..

    Joyce,
    I bought your book, and I could hardly put it down. I've worked in several skilled nursing facilities (OT), and you "hit the nail on the head"! I laughed, I cried, I got mad..you definitely have a gift as a writer! I'm just sorry you had the stroke in the 1st place.
    I could actually picture a few of the places I've worked at as I read your story.
    I will say, I've worked in a couple that were great, and I've worked in some that weren't. My employment at the latter was short lived, as I refused to treat anyone in a way that I myself wouldn't want to be treated.
    Believe me, I've got no illusion in thinking I was indispensable, as obviously I was..
    But I also knew I had to be able to go home and like myself. No amount of money is worth not liking who you are. As my wise Grandma used to say, "Take a job just for the money, you'll EARN every penny.".
    Regards,
    Kan



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  4. You mention hydration. Most people do not know that water alone is a diuretic. We also need a pinch of salt, dissolved in the mouth to help the water get into our cells. Unprocessed sea salt is the best.

    One dear friend had chest pain and the second nitro did not help. We were 45 min from the hospital. I gave her a pinch of salt and then a bottle of water. In 45 seconds the chest pain was gone. In an emergency, we believe that the salt and water could do the same for blood clots anywhere in the body. It helps them to lyse (their dissolution) back into blood.

    This is nothing more than the oral version of a saline IV. It is called the Water Cures protocol.

    www.WaterCures.org A simple, easy and free solution for improving your health.

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  5. You're right on, Jon. Thanks for the comment.

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