How to Prevent Blood Clots After Surgery

Take any prescribed blood thinners as directed by your surgeon. Depending on the nature of your surgery and your risk factors for blood clots, you may be put on one or more preventative medications. Make sure you know exactly what you're taking and why, and that you take your meds exactly as prescribed. You may, for instance, be prescribed:^[7]

• Coumadin, which is typically taken by mouth once per day.
• Lovenox, which you’ll likely self-inject twice daily using pre-loaded syringes.
• Aspirin for blood thinning purposes. Take only the recommended daily dose.

Keep active according to your condition and your care team’s advice. It’s important to stay mobile in order to reduce your risk of blood clots, but your level of mobility will vary based on your situation. If you’re bed- or chair-bound, for instance, you might focus on doing frequent leg and arm movements. If you’re able to move around, you might be advised to go on frequent walks around the house.^[8]

• Follow your care team’s instructions on what types of movement to do and how often. Don’t, for instance, start biking or swimming before you’re cleared to do so.
• If you’re working with a home health care worker, visiting nurse, and/or physical therapist, they’ll help guide you through the movements you should be doing.

Drink water regularly so you stay properly hydrated. Dehydration thickens your blood and makes clots more likely, so it’s critical to drink lots of water. It’s very difficult to drink too much water, so take frequent sips throughout the day and drink full glasses of water with meals. However, make sure to check with your doctor before increasing your fluid intake if you’re taking diuretics or on a fluid restricted diet, which is common for heart patients.^[9]

• Other liquids and foods with high water content (like many fruits and vegetables) will also help you stay hydrated. Avoid drinking too many alcoholic or sugary beverages, though.
• Don’t wait until you’re thirsty to take a drink. Carry a reusable water bottle around with you.

Follow your doctor’s advice for vitamin K-rich foods if you’re taking a blood thinner. Anticoagulant medications—most notably Coumadin and Lovenox—are negatively impacted by elevated vitamin K levels in your body. If you’re taking a blood thinner, it’s important to keep your intake of vitamin K-rich foods consistent. Continue eating the amount that you currently eat and avoid increasing or decreasing your intake.^[10]

• Don’t cut out vitamin K-rich foods unless advised to do so by your doctor. Dark leafy greens and other vitamin K-rich foods are very good for your health if you’re not on blood thinners.
• If you’re only taking aspirin, don’t worry—vitamin K doesn’t affect it.

Try natural treatments, if desired, despite the lack of evidence. While many foods, spices, vitamins, and supplements are reputed to help reduce the risk of blood clots, there’s generally little or no medically-sound evidence to support such claims. That said, it’s typically harmless to try these treatments, although you should always clarify with your care team whether there are any items you should avoid. Also, make sure to check for any possible interactions between natural treatments and your prescribed medications. Some possible treatments to consider include:^[11]

• Fruits: apricots, oranges, blackberries, tomatoes, pineapples, plums, blueberries.
• Spices: curry, cayenne, paprika, thyme, turmeric, ginger, gingko, licorice.
• Vitamins: vitamin E (walnuts, almonds, lentils, oats, wheat, etc.) and omega 3 fatty acids (fatty fish such as salmon or trout).
• Plant Sources: sunflower seeds, canola oil, safflower oil.
• Supplements: garlic, ginkgo biloba, vitamin C, nattokinase supplements. Talk to your doctor before taking supplements.
• Wine and honey.

Get clearance and take precautions if you plan to travel. You may be advised to avoid all long distance travel (especially travel lasting 6 hours or more) for at least 90 days after your surgery. If you are cleared to travel, however, make sure you take adequate precautions to limit your risk of developing blood clots.^[12]

• Ask your care team to show you simple leg stretches and movements that you can do at least every 15 minutes while sitting in a plane, train, bus, or car seat.
• Whenever possible while traveling, get up and walk around for 5 minutes every hour. Walk up and back the aisle on your train or plane, or stop the car and take a little stroll around the highway rest stop.
• Make sure to stay well-hydrated and wear compression stockings while traveling as well.

Monitor yourself closely for clots for 90 days, then generally thereafter. The highest clot risk occurs 2-10 days after surgery, but the risk remains elevated for 90 days afterward. Now that you’ve learned how to recognize potential clots and reduce your chances of getting them, continue to remain active and vigilant beyond the 90-day period.^[13]

• Remember that common symptoms of deep vein thrombosis (DVT) include pain, swelling, and redness, most often in the thigh or calf.
• Additionally, signs of a pulmonary embolism (a clot that has migrated to one of your lungs) include breathing troubles, chest pains, coughing (including possibly coughing up blood), and an irregular heartbeat.

Aim to reach or maintain a healthy body weight. If your surgery is scheduled for several weeks or even several months in the future, take the opportunity to shed a few pounds if needed. Losing some excess weight in a healthy manner, or maintaining a healthy weight if you’re already there, will reduce your risk of blood clots after your surgery.^[14]

• Seek advice on your ideal pre-surgery weight goal and the best ways to get there from your primary care doctor and, if possible, the surgeon who will be performing the procedure.
• It’s important that you focus on healthy ways to lose weight in a slow, steady manner. Prioritize eating a healthy diet, reducing your calorie intake, and getting regular exercise.

Stop smoking if you’re a smoker. Smoking increases your risk of developing blood clots, in addition to its countless other negative health impacts. Work with your doctor to develop a smoking cessation plan that works for you.

• You may worry that you’ll gain weight if you quit smoking, but it’s possible to quit smoking without weight gain. And, even if you do gain a bit of weight, it’s still better for your health to quit smoking.
• If you’ll be in the hospital for a few days after your surgery, remember that you won’t be able to smoke anyway. Quitting beforehand will make this experience easier on you.