Step 3 - Reducing your risks
Reducing your risks
Assessing your personal blood clots risk:
To help you assess your personal risk of suffering from VTE, your admitting surgeon or physician will provide you with a “Blood clots and YOU” brochure along with your patient admission pack. The brochure (see Additional Resources section on the following page - 'Signs to watch for') contains a self-assessment checklist and a post-operative recovery plan which you can use to self-assess your risk of VTE. You can then design a personal plan to follow after your surgery. This will help reduce your risk of suffering from post-operative VTE.
Reducing the risks:
Most patients remain at risk of VTE over a six to eight week period after surgery or a hospital procedure. During this time, there are a number of things you can do to reduce your risk of suffering from VTE:
Drink adequate amounts of water. The UK’s National Institute of Clinical Excellence (NICE) recommends proper hydration as a key recovery step for mitigating the VTE risk of patients who have undergone major or minor surgery  . Ensuring that your body is properly hydrated whilst recovering from a surgical procedure greatly reduces your chances of developing DVT  .
Note: As a general guide, if you drink less than 4 glasses of water a day, if you are going to the toilet less than four times a day or if the colour of your urine is dark yellow, you may be dehydrated.
It is recommended that you drink at least 4 glasses of water a day.
However, you should note that drinking too much water can flush essential electrolytes from your body. If you are unsure about how much water to drink, please consult your doctor.
 National Institute of Clinical Excellence. (2010). Reducing the risk of deep vein thrombosis (DVT) for patients in hospital. Venous thromboembolism - reducing the risk (CG92). London; United Kingdom
 Kelly, J., Hunt, B. J., Lewis, R. R., Swaminathan, R., Moody, A., Seed, P. T., & Rudd, A. (2004). Dehydration and venous thromboembolism after acute stroke. Q J Med, 293-296.
Barrett, K. E., & Ganong, W. F. (2012). Ganong's review of medical physiology. New York: McGraw-Hill Medical
Undertake reasonable amounts of activity as advised by your doctor or nurse. Although it is important to rest while recovering from surgery, mobility helps your blood to circulate, reducing its chances of pooling in your legs or lower body. Sluggish blood is more likely to be associated with a deep vein thrombus. Hence medical experts and the National Stroke Foundation of Australia recommend early post-operative mobilisation of surgical patients to reduce their risk of suffering from VTE [1,2] .
Note: Useful activities include leg exercises which you get taught in hospital and general walking. Your doctor and nurse will give you details of distances and frequency of exercise, as well as how to increase your exercise regime. This will be individualised according to your level of general fitness and health, the procedure you have had and your recovery response.
 Frantzides, T. C., Welle, N. S., Ruff, M. T., & Frantzides, T. A. (2012). Routine Anticoagulation for Venous Thromboembolism Prevention Following Laparoscopic Gastric Bypass. Journal of the Society of Laparoendoscopic Surgeons, 33-37.
 National Stroke Foundation - Australia. (2010). Clinical Guidelines for Stroke Management.
Walter, J. B., Talbot, I. C., & Gardner, H. A. (1996). Walter and Israel general pathology. New York: Churchill Livingstone.
Wear your graduated compression stockings; these will help improve blood circulation in your legs, ensuring that it doesn’t stagnate in your lower body. Immobile blood is much more likely to clot, and current medical research has directly linked the use of graduated compression stockings with a decrease in the risk of DVT among surgical patients  .
Note: Please consult your doctor or nurse for specific instructions regarding how to wear and look after your graduated compression stockings. It is important to note that graduated compression stockings:
- Need to be applied correctly in order to be effective. Otherwise, they can reduce blood flow to your legs and cause injury (You might locate a YouTube demonstration video to assist you).
- Need to be worn at all times, including while in bed. It is recommended that patients obtain two pairs of stockings so there is ample time for laundering and careful drying whilst continuing to wear a pair for VTE protection.
- Require specific laundering and drying. Please follow the supplier’s or manufacturer’s instructions for the care of your compression hosiery.
Please refer to the Additional Resources section or click here to access the T.E.D TM Anti-Embolism Stockings Patient Guide (2013) from Covidien. This resource (on the 'Blood Clot signs' page) provides detailed information regarding the proper use and care of your compression hosiery.
 Sachdeva, A., Dalton, M., Amaragiri, S., & Lees, T. (2010). Elastic compression stockings for prevention of deep vein thrombosis. Cochrane Database of Systematic Reviews.
Medications: Your doctor may have prescribed anti-clotting medicines for you. Please make sure that you understand your blood thinning medication plan before and after your hospital visit. (See also the Additional Resources section (on the ‘Signs to watch for’ page) or click here to access the ‘Blood Clots – reducing your risk’ leaflet.)