Approximately 600,000 Americans are affected by blood clots each year—and according to the National Blood Clot Alliance, over 15% will die due to a blood clot entering the lung. These blood clots, otherwise known as deep vein thrombosis (DVT, or blood clots in the leg or arm) and pulmonary embolism (PE, or blood clots in the lung) are the number one reason orthopedic surgery patients return to the emergency room following joint replacement surgeries.
While these are some frightening facts, there are preventative measures both patients and physicians can take to reduce the likelihood of developing DVT or PE. But before looking at prevention, let’s take a look at the most prominent causes of each.
Potential Causes for DVT or PE Blood Clots
Unfortunately, our bodies don’t usually work as well as we get older. With age, the body's natural ability to clot takes over even when it's not in its best interest. By choice or circumstance, many elderly individuals remain sedentary, which makes blood become sluggish, causing blood to slow and clot.
While no tests have been deemed conclusive, chemotherapy seems to be a factor in the development of DVT and PE. Researchers believe that, while fighting cancer, the chemo can damage blood vessels or reduce the production of proteins that protect from clots.
A lack of mobility slows blood flow, which makes blood clots more likely among obese men and women. Excess fat on the body also slows blood from moving easily through the deep veins—where it has more work to do. This slower movement can result in buildups that become clots. A BMI over 40 has been pinpointed as the tipping point. You can check out your approximate BMI with the National Heart, Lung, and Blood Institute’s online BMI calculator.
Being in a resting position for any length of time—whether temporary or permanent—opens the door for blood clots. This could be individuals who have had a stroke or are paralyzed, or disabled individuals confined to a chair for the majority of the time.
We’re not here to lecture you on smoking. But, it’s not good when it comes to blood clotting. The chemicals in cigarette smoke damage the lining of blood vessels, which can cause clots to form. In addition, nicotine is a stimulant, which speeds up the heart by about 20 beats per minute and causing arteries throughout the body to become smaller. This makes it harder for the heart to pump through the constricted arteries, causing blood clots.
Pregnancy and Birth Control
Estrogen does not cause blood clots, but it does increase the risks. Pregnant women and even those on birth control or postmenopausal hormone therapy have higher levels of estrogen, increasing the chance of developing a blood clot. There are a variety of ways to work around this, but as always, it's best to speak with your physician.
Blood Clot Symptoms
While not always easy to self-identify, there are a few warning signs to watch for post-surgery, or just in general. You may have a blood clot if you see or feel:
New unexplained swelling
Skin redness or streaks
Unusual soreness or pain
A warm spot
If the clot has moved to your lungs, common symptoms include:
Dizziness or fainting
A mild fever
A cough, with or without blood
Preventing Orthopedic Surgery Blood Clots
No one but Cher can turn back time to become younger, but looking at the list of blood clot causes, basic patient prevention becomes more clear: lose weight, keep active, and quit smoking. Some of this is easier said than done, so a physician will often prescribe a smoking cessation program prior to surgery, and recommend physical therapy even before surgery to get prepared. A few other suggestions:
Wear loose-fitting clothes, socks, or stockings. Not only does it feel good, but it’s also good for healing. You may also choose to wear compression stockings with physician approval. These tight-fitters are known to improve blood flow.
Elevate your legs six inches above your heart, i.e. watch TV in bed with a few pillows under your legs. It improves circulation and reduces swelling.
Avoid standing or sitting for more than 1 hour at a time. At work? Take a quick trip up and down the stairs to get the blood moving.
Eat less salt. Even if your excessive salting of everything hasn’t affected your blood pressure, high salt consumption damages the inner lining of blood vessels, increasing the likelihood of blood clotting.
Uncross your legs. Forget modesty, crossed legs can cut off circulation and lead to blood clots.
Physician Treatment for Blood Clots
If you’re prone to blood clots, have a family history of them, or simply fit the mold for a likelihood to develop one, your physician may prescribe a blood thinner prior to or after your orthopedic surgery. Be sure to ask your physician about this if they don’t bring it up; blood thinners have few side-effects, with easy bleeding being the most common.
If you or a loved one is about to undergo orthopedic surgery, it’s important to understand the threat of blood clots, review available resources, and most importantly, know what questions to ask your physician. You may also want to ask them about BandGrip, a quick and easy skin closure application that uses micro-anchors to hold the skin together following surgery. It allows the body to heal naturally, and significantly reduces the risk of wound dehiscence, as it doesn’t involve sewing or stapling. You can see how BandGrip works here!