Advice for after you have had a Venous Thromboembolism (VTE)

What is this information about?

This information gives you advice about: 

• how to look after yourself if you have had a type of blood clot called a venous thromboembolism (VTE).
• how you can reduce the chances that you will have a VTE blood clot such as a deep vein thrombosis (DVT) or a pulmonary embolism (PE) in future.

Why have I been given this information?

You have been given this information because you have had a type of blood clot called a VTE. Having a VTE can be dangerous and in some cases can be life-threatening. Following the advice in this leaflet will help you to recover safely from your VTE and reduce the chance that you will get another VTE.

Will I be given anti-embolic (TEDS) stockings to wear if I have had a blood clot in my leg?

Not everyone is offered anti-embolic stockings after they have had a blood clot in their leg. If you find that anti-embolic stockings help to relieve your symptoms, please ask your GP if it would be right for you to keep wearing them after you go home. 

If you do continue to wear stockings, get new ones every few months. Older stockings do not work as well.

What can I do to reduce my chances of getting another blood clot? 

• Keep active. Be active and move around as much as you can. 
• Keep to a healthy weight. If you are overweight, it is important to try to reduce your weight. This is because being overweight (or obese) is one of the things which is most likely to mean you may get another blood clot. If you would like support and advice on how to lose weight, contact your GP Surgery. 
• Stop smoking and avoid drinking too much alcohol. Smoking and drinking too much alcohol both make it more likely that you will get another blood clot. Cutting down or giving up smoking and drinking alcohol means there is less chance of you getting another blood clot.

If you would like advice or support with making lifestyle changes that will help you to keep active, lose weight and cut down on smoking and drinking alcohol do contact your GP surgery. You can also find advice on the NHS ‘Live well’ web pages.

What should I do if I need to:

• have an operation? 

Do tell the surgical team planning your operation that you have had a blood clot in the past.  This is because having an operation increases your chances of having another blood clot.    

Operations on your abdomen (tummy), gynaecological operations (for example an operation on your womb or ovaries) and operations on your bones or joints in your legs  (orthopaedic operations) are the most likely to cause blood clots. 

If you have one of these types of operations, and for some other operations, you are likely to need to have heparin injections or blood thinning tablets (anticoagulant medicines) to help to prevent you from getting a blood clot.  

• stay in hospital (be admitted to hospital) or have treatment for cancer? 

Do tell the team looking after you that you have had a blood clot in the past. This is important as you may need blood thinning medicines.

What if I am not able to move around much for a long while (I have a period when I am immobile)?

You may need heparin injections for as long as you are not able to move around. Your Consultant will talk with you about how long is right for you.

You could be immobile if, for example,: 

• you have to stay in bed (have bed rest) because you are recovering from an illness or injury 
• you are wearing a plaster cast or ‘boot’ because you have injured your leg or foot.

What should I do if I am going on a long journey or flight?

Going on a long journey by car, train or plane can make it slightly more likely that you might get a blood clot in your legs. This is because you are not moving around so much and because of the position that you are in when you are sitting down.  

You can reduce your chances of getting a blood clot on a long journey by:

• booking an aisle seat or asking to be given an aisle seat on health grounds. Having an aisle seat makes it easier for you to get out of your seat and walk around and to move your legs while you are sitting down. 
• moving your calves (your lower legs) and ankles. Move them in circles and bend your ankles often. 
• drinking plenty of fluids such as water, tea, or squash  
• avoiding sleeping tablets and alcohol 
• getting up and walking around at least every 90 minutes (every hour and a half) 
• wearing anti-embolic stockings. You can get these from a pharmacy.

What should I do if I become pregnant, or I am having IVF?

 If you are pregnant or having IVF do:

• tell your GP straight away. They should prescribe heparin injections for you as there is a greater chance that you may get a blood clot when you are pregnant or having IVF. 
• ask your GP to arrange for you to see (refer you to) a haematologist (a specialist in blood conditions) or an obstetrician (a specialist in delivering babies and caring for people during pregnancy and after they give birth).

Your GP should arrange your appointment so that you see the haematologist or obstetrician when you have been pregnant for six weeks. This is before the time that you would usually go to the Antenatal Clinic.

Your GP will be able to talk with a haematologist to ask their advice about how to care for you in the best way to reduce the chances of you getting a blood clot. They can do this before you have your appointment with the haematologist or obstetrician.

What should I do if I am taking a contraceptive, hormone replacement therapy or (HRT) or hormone manipulation therapy that contains oestrogen?

• Avoid oral contraceptive pills (contraceptive pills that you take by swallowing them) that contain oestrogen. You can take: 
  • contraceptive pills that contain progesterone and not oestrogen (progesterone only pills) 
  • progesterone implants or injections. 

• Avoid HRT therapies that contain oestrogen which are taken orally. Be aware, this includes people who are undergoing gender re-assignment.

HRT therapies which are given as a skin patch (transdermal patch) or a spray or gel which goes onto your skin do not increase the chances of you getting a blood clot. These are the best ways to give HRT therapy for people who have had a blood clot.

Ask your GP for further advice about HRT. If they are unsure of what would be best for you, they will ask a specialist for advice.

What should I do if I have a first degree relative (parent, sibling, or child) who might be prescribed a medicine or therapy such as HRT that contains oestrogen?

Do let any of your first-degree relatives who might need a contraceptive or therapy containing oestrogen that they should tell their GP that you have had a blood clot.

I think I might have another blood clot. What must I do straightaway?

If you think you may have another blood clot do seek medical help straightaway. Contact your GP surgery or go to your nearest A&E (Emergency Department).

Be aware, the most usual signs that you may have a blood clot are:

• DVT: Your leg is painful, red (this may appear differently in black or brown skin) or swollen and these symptoms do not go away.  
• PE: You are finding it difficult to breathe, have chest pain or are coughing up blood.

Who can I contact if I need further information or support after I have read this information?

Anticoagulation Teams:

You can find further information sheets on the Thrombosis UK website