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Blood thinners after surgery

pulmonary embolism



My wife broke her hip and her doctor prescribed a blood thinner. Can you explain why? 




Your wife’s doctor is playing it safe and for good reason. On average, people who have had knee or hip surgery are given a 50/50 chance of developing a blood clot in the veins deep in their bodies.


You’ve probably heard warnings about developing DVT (deep vein thrombosis) when you are on a plane or taking a long drive. That’s because blood needs to be on the move. All of your organs rely on blood cells to deliver oxygen, fight infections and cleanse waste products. Muscle contractions make it possible for blood to travel throughout your body. Your heart contracts to send blood on its merry way but, if you aren’t walking, standing, flexing your ankle, or moving your hands and feet, blood has no way of returning back to the heart and ends up standing still. Blood that stagnates will thicken and eventually form a clot.


Now here’s the thing: if that clot breaks off (known as an embolism) and starts making its way to your lung or heart, it can block blood to these vital organs, resulting in death. A blood clot in the lungs – called a pulmonary embolism – kills more Americans than breast cancer and AIDS combined, ending life for 300,000 people every year. Yet, with timely intervention and prevention, death can be averted following an acute episode with excellent survival rates. Your wife’s doctor is preventing your wife from getting a blood clot in the first place.


Any older person who has recently had surgery (especially hip surgery), has suffered a stroke, or is extremely overweight and isn’t able to move around very well is at risk for DVT (deep vein thrombosis). Symptoms of a blood clot are any new swelling, soreness, pain or warm spot on your arm or leg. If your wife shows any of these signs, call her doctor immediately. To determine if there is a blood clot, her doctor may order tests that use ultrasound, x-ray or an oversized blood pressure cuff placed around the thigh. Not all DVT blood clots break off and travel towards the heart or lung and some never exhibit any symptoms.


Symptoms of a pulmonary embolism (PE) are much more severe and demand immediate medical attention. A blood clot may have gone to your wife’s lungs if she suddenly has difficulty breathing, chest pain, a fast heartbeat, fainting spells, a mild fever or a cough with or without blood. Anyone who experiences these symptoms – especially after surgery, stroke or being sedentary – should call 911.


Blood-thinning drugs (anticoagulants) are the most common way to both prevent and treat blood clots, as they lower the body’s normal blood-clotting capacity. Heparin is frequently prescribed and given intravenously when the condition is urgent. Once patients are stabilized, they are often prescribed blood-thinning pills in the form of Coumadin or under the generic name of Warfarin. When taking these drugs, bleeding can become a troublesome side effect, upon which your doctor will need to monitor and adjust the dosage. Besides pills, your wife may be prescribed compression stockings to wear.


Preventing DVT is really everyone’s business – especially since 600,000 people a year develop a deep vein blood clot. Change your position often during long trips, get out and walk every hour or so during car rides and walk up and down the aisles when you’re on a plane. Don’t cross your legs for any length of time, eat less salt, exercise, and if you are overweight or smoke – get it under control. If you’d like a free copy of “Your Guide to Preventing and Treating Blood Clots”, call the Agency for Healthcare Research and Quality clearinghouse at 1.800.358.9295 or download it here. You may also be interested in their “Guide to Coumadin/Warfarin Therapy” by calling the same number or download it here




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