Patient education: Deep vein thrombosis – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

What is deep vein thrombosis? — Deep vein thrombosis ("DVT") is the medical term for a blood clot in the deep veins. Most DVTs happen in the legs (figure 1), but a DVT can also happen in the arms. When a DVT happens, blood can back up and cause swelling and pain.

Why are blood clots dangerous? — If a blood clot forms or gets stuck inside a blood vessel, it can clog the vessel and keep blood from getting where it needs to go.

Blood clots can also travel to other parts of the body and clog blood vessels there. For example, a clot that forms in the leg could end up blocking a blood vessel in the lung. This can make it hard to breathe. Sometimes, if the clot is large, it can even lead to death.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

To help with pain and swelling:

●If the blood clot is in your leg, prop your legs on a pillow when in bed and on a chair or footstool when you sit. Do not put the pillow under your knee sideways so that your knee is bent. Instead, put it the long way to support your knee and lower leg (figure 2).

●If the blood clot is in your arm, prop your arm on a pillow when in bed or sitting. Try to keep your arm above the level of your heart.

You should also:

●Take all of your medicines exactly as your doctor tells you to. Blood clots are treated with medicines called "anticoagulants." These are sometimes called "blood thinners."

•Follow your doctor's instructions about diet and your medicines. Depending on which medicines you take, you might need to pay special attention to what you eat.

•Make sure that you know what other medicines are safe to take. Certain other medicines can affect the way that anticoagulants work.

•Make sure that you take your medicine exactly as instructed. It's very important to take the right dose. Too much can cause bleeding, and too little can allow your blood to clot.

•Try to take your medicine at the same time each day (or at the same times, if you take it twice a day). If you forget or miss a dose, call your doctor or pharmacist to find out what to do.

•When you start taking the medicine, you might need to have your blood tested.

•If you take warfarin (brand name: Jantoven), you will need regular blood tests to check how your blood is clotting. This is important to make sure that you get the correct dose of warfarin for you.

•Get your medicines refilled before you run out.

•Avoid things that could increase your risk of injury or bleeding. For example, avoid sports where you could get hurt, and be very careful if you need to use sharp tools.

●Lower your risk of getting another blood clot. Your risk is higher if you miss a dose of medicine or stop taking your medicine. Other ways to lower your risk include:

•Try to be active – Walk, garden, or do something active for 30 minutes or more on most days of the week.

•If you spend a lot of time sitting, try to stand up and walk around at least every 1 to 2 hours. Avoid sitting with your legs crossed. If you can't get up, bend and straighten your knees and ankles and wiggle your toes. Also move your hands, wrists, and arms.

•When driving or traveling in a car, try to stop every 1 to 2 hours to get out and stretch your legs.

•If you travel by plane, move your arms and legs regularly. Walk around and stretch your legs at least once every hour.

•Wear elastic or compression stockings. This can improve blood flow in your legs.

•If you smoke, it's very important to try to quit. Your doctor or nurse can help you if you are having trouble quitting.

In some cases, people get something called an "inferior vena cava filter" ("IVC filter") or "superior vena cava filter" ("SVC filter"). If you had surgery to get an IVC or SVC filter, your doctor or nurse will tell you how to take care of your incision. The filter might need to be removed in the future.

What follow-up care do I need? — Your doctor or nurse will tell you if you need to make a follow-up appointment. If so, make sure that you know when and where to go. Have your blood tested when your doctor tells you to.

When should I call the doctor? — Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You feel short of breath or have trouble breathing.

●You have sharp or severe chest pain when you breathe.

●You are coughing up blood.

●You have signs of stroke, like sudden:

•Numbness or weakness of the face, arm, or leg, especially on 1 side of the body

•Confusion, or trouble speaking or understanding

•Trouble seeing in 1 or both eyes

•Trouble walking, dizziness, or loss of balance or coordination

•Severe headache with no known cause

Call the doctor or nurse for advice if:

●You notice new or worsened swelling in your arm or leg.

●Your arm or leg becomes numb or very painful to touch.

●Your leg hurts when you walk, or your arm hurts when you move it.

●Your arm or leg turns blue or gray.

●You have discomfort when you take a deep breath.

●You have any of these signs of abnormal bleeding:

•Nausea

•Blood in your bowel movements or dark-colored bowel movements

•Headaches or dizziness

•Nosebleeds or any other bleeding that does not stop

•Dark red or brown urine

You should also tell your doctor if you:

●Have an injury such as a fall where you hit your head

●Bleed from your gums after brushing your teeth

●Have heavy menstrual periods or bleeding between periods

●Have more bruising than usual after a minor injury

●Have diarrhea, vomit, or are unable to eat for more than 24 hours

●Have a fever (temperature higher than 100.4°F or 38°C)

●Cannot take your medicine for any reason

More on this topic

Patient education: Deep vein thrombosis (blood clot in the leg) (The Basics)
Patient education: Pulmonary embolism (blood clot in the lung) (The Basics)
Patient education: Choosing an oral medicine for blood clots (The Basics)
Patient education: Taking oral medicines for blood clots (The Basics)
Patient education: Staying healthy when you travel (The Basics)
Patient education: What can go wrong after a heart attack? (The Basics)
Patient education: Factor V Leiden (The Basics)

Patient education: Deep vein thrombosis (DVT) (Beyond the Basics)
Patient education: Lower extremity chronic venous disease (Beyond the Basics)
Patient education: Pulmonary embolism (Beyond the Basics)
Patient education: Warfarin (Beyond the Basics)