Blood Clots After WLS: Causes, Symptoms & Treatments
May 9, 2016Blood clots developing in the deep veins (Deep Venous Thrombosis, or DVT) of the legs and thighs of bariatric patients are a major cause of concern and morbidity. These clots are especially dangerous because they can break free and travel through the heart and lodge in the main arteries of the lung. When this process occurs, it causes a severe lack of oxygen and can potentially result in death.
The Connection Between Being Overweight and Blood Clots
Being overweight directly increases one’s risk for developing clots. The extra weight and pressure on the veins increases the resistance of the blood passing through and leads to stagnation of the blood in the veins and promoting clots.
Several conditions and situations increase one’s susceptibility to forming these clots. Obesity also leads to an increased inflammatory state in the body which may lead to increased clotting. In fact, the more one weighs the risk of clots increases proportionately.
Having surgery increases the risk also as one is immobile during the procedure with more ‘dead weight’ on the veins and increasing blood stagnation. In addition, patients are often less mobile after surgery which, again, increases the stagnation in the veins.
Certain other conditions increase the risk including Factor V Leiden, polycythemia (excessive red blood cells), use of oral contraceptives, protein c/s deficiency, having antiphospholipid antibodies, some auto-immune conditions, and most importantly, smoking. All of these make one more susceptible to forming clots, then in combination with having surgery and being obese, puts the bariatric surgery patient at particularly elevated risk.
Smoking is easily the main concern as it is entirely preventable. In fact, in my practice, I will not offer surgery to patients who are actively smoking as the risks of clots and other post-operative complications is increased so much that it defeats the health benefits of having bariatric surgery. The risks of smoking are far greater than remaining obese.
How to Diminish the Risk for Blood Clots
Firstly, smokers need to stop smoking and there are various means to assist in this. An honest discussion with your primary care provider will be helpful in finding the right way for you. In the end, however, it falls on you to want to quit.
Walking and early ambulation after bariatric and all surgeries in the obese population will diminish the risk considerably.
The motion of walking activates the “calf pump” which promotes healthy blood flow through the legs and prevents dangerous stagnation of blood. All of my patients are encouraged to walk within a few hours of coming out of anesthesia and once they are steady on their feet. Walking every few hours while awake will continue promoting healthy blood flow.
In a concentrated effort to further diminish the risk for blood clots, patients are provided with leg wraps and pneumatic compression devices. These wraps and devices will actively push blood through the veins when patients are unable to on their own, as in during their surgery.
In addition, blood thinners are routinely given around the time of surgery such as Heparin (and related products) injections under the skin. Patients who are at particularly high risk may be candidates for a filter placed in the vena cava (Greenfield filter, Vena Cava Filter) to break up any clots that try to get through to the heart. The risk for these blood clots may last for an additional 6 weeks after surgery so it’s important to continue walking even when patients get home.
Patients who are at particularly high risk may be candidates for a filter placed in the vena cava (Greenfield filter, Vena Cava Filter) to break up any clots that try to get through to the heart. The risk for these blood clots may last for an additional six weeks after surgery so it’s important to continue walking even when patients get home.
Of all these things, walking immediately after surgery is the one thing that can help the most. It improves post-operative pain, and more importantly having patients be an active part of their own recovery and well-being. Weight loss surgery is one component of extensive lifestyle change and getting healthy. With these changes, a longer healthier life awaits, so start walking now and continue after surgery to get to a healthier new you.
 | ABOUT THE AUTHOR Dr. Nirav Naik founded New Life Weight Loss Solutions in 2014 to raise the level of bariatric care in Kern County. Not only does Dr. Naik have 20 years of experience in weight loss surgery, providing safe and effective procedures, New Life Weight Loss Solutions also has nonsurgical options. Dr. Naik has a reputation for being innovative in his field, and is very passionate about bringing that innovation to Bakersfield while helping to create healthier, happier lives. |
