Before any surgery, talk to your doctor about this important new study

What’s the last thing you want to deal with after surgery?

The details.

Even after simple out-patient surgery, you may feel overwhelmed by instructions about bandage care, antibiotic and painkiller use, follow up doctor visits, insurance paperwork–and this barrage of details comes while you’re still under the influence of a post-anesthesia fog.

One of those details–often included in post-surgical paperwork–includes a warning about pain or burning in the legs. These are symptoms of venous thromboembolism.

But instead of scrutinizing paperwork, let’s face it, you’re more likely to ease yourself into bed and sleep as soundly as your incisions will allow.

Meanwhile, you may be in serious danger.

Lingering risk

In the hours and days following surgery, risk of developing venous thromboembolism (VTE) is fairly high, even for healthy patients.

Venous thromboembolism is an umbrella term for deep vein thrombosis (strands of protein that prompt blood clotting in the legs) and pulmonary embolism (blockage of a lung artery from a clot broken away from the legs).

This chain of events is often fatal, but it’s not just related to surgery. Certain diseases raise risk (diabetes, heart disease, some cancers), advanced age can be a factor, and many travelers who fly long distances confined to
cramped seats develop deep vein thrombosis.

But after you’re wheeled out of surgery, do your doctors actually know how high your VTE risk really is?

Probably not, says a new study.

Researchers at the University of Oxford followed medical records of nearly one million surgery patients for more than six years. Study leader Dr. Jane Green told HealthDay News, “What is most striking is that not only is the risk higher, but that it lasts much longer than people have thought.”

RESULTS:

• One of every 140 patients who had surgery with a hospital stay was re-admitted with VTE within three months of their surgery
• At greatest risk: hip or knee replacement patients (one of every 45 was re-admitted)
• One of every 85 cancer patients was re-admitted
• In minor outpatient surgeries, one of every 815 patients was re-admitted

To get a true comparison of risk levels, researchers also followed medical records for a control group of subjects who had no surgery. Among these, only one in 6,200 was admitted to the hospital with VTE.

Block that clot!

In response to the Oxford study, one doctor told Health Day that surgery patients should have “prophylaxis extended for weeks.”

“Prophylaxis,” of course, is doctor-speak for “drugs.”

In this case, the blood thinner Coumadin (warfarin) is the drug of choice. But as Health Day notes, Coumadin is “not an easy drug to manage.” Frequent blood tests are required to prevent internal bleeding, which can be fatal.

Dr. Allan Spreen recommends using “a little heparin, very short term, in-hospital.” Heparin is an anticoagulant that prevents new clots from forming.

And then there are supplements with a lot of success in this area:

• Nattokinase–an enzyme that’s been shown to prevent and dissolve blood clots (highly recommended by Dr. Spreen, along with generous doses of vitamins C and E.)
• Pycnogenol–a natural anti-inflammatory that supports cardiovascular health
• Horse chestnut–helps with circulatory problems associated with varicose veins
• Butcher’s broom–another herb that supports vein health
• Ginkgo biloba–shown to promote good circulation and may help prevent peripheral artery disease

Other non-drug treatments include compression stockings to help with blood circulation, and bed rest with legs elevated above the heart to reduce swelling.

Sources:

“Duration and Magnitude of the Postoperative Risk of Venous Thromboembolism in Middle Aged Women: Prospective Cohort Study” British Medical Journal, Published online ahead of print, 12/3/09, bmj.com
“Blood Clot Threat After Surgery Worse Than Thought” Ed Edelson, HealthDay News, 12/3/09, healthday.com