Question:
Why do blood clots sometimes occur after surgery?

What causes life-threatening blood clots? What does the surgery do to us to make us susceptible to clots? Or are we always at risk for them, even without surgery? I have read of 3 or 4 deaths lately from blood clots 2 or 3 days after surgery where the person just died in his/her sleep. Why? I know exercise is supposed to help you not get them, and I know a clot is simply blood that's pooled long enough to stick together... but why is there 'pooling' at all? Any nurses or doctors out there with some answers?    — Veronica D. (posted on December 18, 2000)

December 18, 2000
I'm not a Doctor or a Nurse, however six days after surgery I was hospitalized with multiple blood clots in my lungs. My body warned me there was something terribly wrong, so I went to emergency and after spending 8 hours there, I was admitted and immediately put on heprin, I've been home since Oct. 31, and now on blood thinners for awhile. Not only did I survive but, I am doing wonderfully! I am 9.5 weeks post op, and have lost 60 pounds. Life is wonderful! I believe every case is unique.. and blood clots are not that common I was told. Getting them was my worst fear.. but, I am still here!
   — Joy Z.

December 18, 2000
Hey Veronica~ I am a nursing student and hopefully can answer your question. The reason we as obese ppl are at a higher risk for blood clots is because we have poor circulation to begin with. Obesity is a high risk factor for venous stasis, pooling of venous blood in the legs. Meaning that your "old, unoxygenated" blood is pooling in your legs, usually. Therefore, causing it clot more easily. Not only that but lack of exercise and mobility can lead to blood clots as well. Muscle movement is the major factor in moving that venous blood back up to the heart and lungs. If there is little or no movement, as in a post op obese patient, you tend to have more stasis of blood in your legs. Also, if you have factors that contribute to causing your veins to lose their valve patency, you can have a back flow of venous blood too. In the veins that return blood to the heart, you have valves to keep blood from moving backwards, if these valves are faulty then blood will flow backwards or not at all. Making you more susceptible to blood pooling. Now in a clot causing death in someone, that happens b/c the clot breaks loose and travels up and to the lungs, where your venous blood goes to get "refreshed" if you will, with oxygen rich blood. Since it is a clot, it gets stuck and can cause respiratory problems in the patient. So, the doctors put us on blood thinners to try to alleviate the problem of clots. Now these blood thinners don't break the clot down if one is present, they just help to avoid making a new one. If caught early enough, the patient will be put on bed rest and a therapy of heparin thru IV. This is the blood thinner. The signs and symptoms of a blood clot in the leg include, pain in your calf when you move your foot toward your body. If you were sitting with your feet planted on the floor and you took your foot and raised up your foot so that your heel is still on the floor, you would feel pain in your calf. Also, there may be warmth and tenderness behind your knee in that area. I hope I have not overwhelmed you with this information. If you have any other questions, please feel free to email me off list. I will be more than happy to help you in anyway I can. Hugs~
   — Marni

December 19, 2000
Blood clots form because of pooling of the blood in the large veins in the legs. This occurs when patients move theoir legs less, such as either during surgery or when spending a time in bed recovering after surgery. Stress, such as from surgery or injury, causes the blood to clot in these pools to clot more easily. Combine these changes with thickening of the blood that can occur after surgery due to mild dehydration, and the result is an overall increased risk of blood clots forming in the legs. Your doctors will use early ambulation, automatic compression stockings, and blood thinners to prevent these clots from forming. Be sure to do what you can to help, by getting up as much as is practical, and by putting your compression stockings back on when you get back into your hospital bed, and your risk of forming blood clots will stay low, hopefully just a few percent or less.
   — Michael A. T.