How to Go Back to the Office After a Blood Clot

Go Back to the Office Cover

For nearly my entire adult life, I have worked at a desk job in an office setting, where it can be next to impossible to get regular movement in, let alone walking in during the day. Even before my blood clot, I noticed sitting all day was negatively impacting my health. My back, shoulders and neck hurt from sitting with poor posture and little movement, I had regular eye infections from staring at a computer screen all day, I wasn’t getting up to drink enough water, and I was steadily gaining more and more weight. When I stopped to look at my own life, I realized I was hardly moving in a day. While working from nine to five (or six or seven), I went from my bed to my car to my desk to my car to my couch to my bed. And then I did it all over again – for five days a week. Yes, I tried to get out on the weekends or when the weather was nice to walk my dogs, but day-to-day my movement was severely restricted. I became anxious about the time I was sitting and how my health was being affected, and even more so after my DVT and PE.

After a blood clot, it can be scary to go back to work – particularly if you are going back to a job where you are required to sit or stand for long periods of time, maybe even all day long. Sitting for long periods of time can not only be detrimental to your overhaul health, but can place you at risk for blood clots – just like sitting in a car or on a plane.

The good news is, there are some things you can do to help reduce your risk and prevent blood clots, especially if you are going back to work in an office. Here’s a simple plan for how to go back to the office after a blood clot and reduce your risk if you have to remain seated all day.

Before you go back to work  
Talk to your doctor

It can be really simple to have a discussion with your doctor prior to returning to work or before accepting a new position, especially if you are changing your lifestyle. Be sure to add it to the list of things you talk about when discussing your treatment and recovery. It can be as easy as, “I work in an office all day and I can’t really leave my desk, what can I do to help protect myself now that I have had a DVT?” Or you could say, “I’m worried about sitting at a desk all day at work. What specifically can I do to take care of myself?” Or, “Is it harmful for me to sit all day and if so, what can I do given that I currently work at a desk job?” Ask your doctor to write his or her recommendations down on letterhead so that you can share them with your employer.

In addition, be sure to discuss additional risk factors with your doctor and familiarize yourself with the signs and symptoms of blood clots.

Talk to your employer

Once you have had a discussion with your doctor about returning to work, talk to your employer. And, this can be the more difficult part, but you can do it. Request a meeting with your supervisor, department head or HR representative, even before you return to your job, if possible. Take your letter from your physician’s office about the things you will need – especially if it involves more frequent breaks, longer breaks or a modified work station – and share it with your employer.

Talking to your employer can be difficult because it is often hard to share personal medical information and you are not necessarily obligated to do so in a work setting; however, it is important that you work together with your employer to make modifications to keep you safe. You can say, “I am looking forward to coming back to work next week and since my leg is still healing, I may need to make some modifications to my work environment to ensure I am doing all I can to take care of myself. Can we meet to talk about what we can do together?” From there, take your doctor’s note and some ideas to reduce your risk to the meeting. If your employer only has time to talk on the phone, that is okay too, do that.

Talking to my employer was one of the greatest challenges for me when I accepted a new job after my DVT and PE. It was important for me to take control of the situation as I was able to. For example, I shared with my employer that I would be getting up to stand during meetings so I needed to sit near the rear of the room, instead of with my team. It is hard to be assertive in a work setting, especially if you are not in charge, but once I made it known what my needs were, people in my office were more wiling to hear them if something came up.

Ways to reduce your risk at work
Move around

It is vital to take regular breaks every hour or so: get up, walk about, rotate your ankles and stretch out your calf muscles. Ideally, you want to get up and walk around every 90 minutes or so, just like you would on a long car drive or plane flight. Hopefully, you work in a place where you can get up at your discretion, but unfortunately that is not always possible. If you can’t move about freely, it is imperative that you do what you can to get movement into your day. Take the long way to the bathroom, hand deliver materials to your co-workers instead of waiting until they pass by your office, take the stairs instead of the elevator or offer to distribute the office mail. If your colleague calls you on the phone with a question, you could say, “I would be glad to help you out with this, is it okay if I come down to your desk to do so?” If you have a question, seek out the person to ask them instead of emailing. Chances are, he or she won’t say no to a face-to-face conversation, and you can help improve your working relationships too.

If you absolutely cannot leave your desk during the day, be sure to do what you can in your space to move. Do calf, ankle and leg exercises from your seat (you can see some examples here), jumping jacks, squats, stretches or simply get up and down out of your chair several times in a row each hour. Or, when you take a phone call, stand up to answer and carry on the call. Do something that keeps your blood flowing as often as you can.

Hydrate

Keep a water bottle or cup at your desk and drink from it – often. It is important to stay hydrated not only to prevent blood clots, but for overall health. If you have problems drinking water throughout the day, try drinking from a cup that has a straw, it helps. You could also set your alarm to drink every hour or take a long swallow after every phone call or email. Use the need to refill as an opportunity to get up and move. Also, avoid or limit caffeine because it contributes to dehydration.

If you work in a place where you are not allowed to have drinks at your desk, that is a concern and one that I suggest talking to your employer about. You may have to ask if you can walk away from your desk to drink regularly or keep your water in a spill-proof container. If this is your situation, drink water on your commute to work, at your breaks and again on your drive or ride home. Continue to hydrate once you are home from the office.

Modify your work station  

I also don’t like to ask for things, especially at work, so it was hard for me to ask my employer for assistance during my recovery. My employer noted that I was in pain during the day and asked if anything could be done to help. I said, “If I had a work station that allowed me to move more, it would really help with the pain and swelling I experience.” I could have also gone to my superiors and said, “I am experiencing regular pain sitting all day and that is not how I want to feel working here, can we talk about some things that might help my situation?”

My employer and I worked together to find a convertible standing desk to fit in my office. Even if you think your employer will never say yes (I did), it doesn’t hurt to ask because the worst thing they can say is no. If the answer is no, then you move on with your personal plan to take care of yourself. Asking for something that costs money can also be easier with the doctor’s note you requested.

You could also ask if you could make your own desk (think crates and shelves or boxes to elevate your monitor and keyboard) or ask if you could have a bigger space.

Wear compression stockings

Compression stockings are specially designed stockings or socks that apply pressure to your lower legs, helping to maintain blood flow and reduce discomfort and swelling. They may be prescribed by your doctor or you can get them at the drug store or even online. Read this complete guide for more information about how compression stockings can help you.

What to do when work is not working for you
Consider your options beyond your present situation

If your work is not working for you and is affecting your health, you may need to consider what alternative employment options exist. And please understand, I know leaving your job or searching for a new one is not, for one moment, easy. I also know more people than not, cannot afford to leave a job without another one lined up. However, if your job is putting your health in further jeopardy, it may be a good time to step back, take a look at the bigger picture and take steps – even small ones – to see what other opportunities are available to you.

 

Reader Writes In: What are your tips for going back to the office after a blood clot? Were you able to develop a plan in your workplace?

There is hope for healing and you are not alone,

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How to Engrave Your Medical ID

How to Engrave your medical IDAfter spending a week in the hospital, whether or not I needed to wear a medical ID bracelet was the last thing on my mind when I was finally discharged. In a matter of days, my entire world was turned upside down when I was diagnosed with blood clots in my leg (DVT or deep vein thrombosis) and lung (PE or pulmonary embolism).

I was worried about the new job I was supposed to start, what an INR was, when I could run again. I also wondered why this happened when I was doing my best to take care of myself for first time in my entire adult life. I felt scared, alone, sad, overwhelmed and I decided it would just be better for me to stay indoors rather than worry about what would happen outside where I could fall and hit my head on concrete or – my worst fear – get in a car accident. It was then that I realized that without a medical ID, no one would be able to help me if one of these accidents occurred.

Why You Need a Medical ID if You are Taking Blood Thinners

Blood thinning medications or anticoagulants save lives because they treat or prevent potentially life-threatening blood clots. However, they also pose one possible and very serious side effect: Bleeding. Since blood thinners slow the clotting of blood, unwanted and sometimes dangerous bleeding can occur with the use of these medications – especially with a fall, a head injury or a traumatic accident.

A medical ID or medical alert bracelet or necklace is a very important tool that could save your life in an emergency situation. If you are ever hurt or injured – and not able to speak for yourself – a medial ID may be the only way first responders or doctors know how to begin treating you. If you are taking blood thinners – especially warfarin for which vitamin K exists to slow or reverse bleeding – medical professionals need to know immediately. If you are taking a new oral anticoagulant  for which there are no reversal agents,  doctors still need to know so they can care for you to the best of their abilities.

How to Engrave Your Medical ID

Medical IDs do not need to be elaborate and must be able to convey life-saving information as quickly and clearly as possible. A medical ID must be immediately recognizable as a medical ID – if it’s too pretty or cute, it might not get notice in an emergency.

Information that should be included on your medical ID (in order of importance or room you have to engrave):
  • Specific name of the medication(s) you are taking that affect life-saving treatments (i.e. anticoagulants, heart medications, aspirin, insulin, etc.)
  • Allergies (especially to medications like penicillin)
  • Whether or not you are diabetic
  • Name
Information that can also be included on a medical ID:
  • History of medical conditions (i.e. DVT, PE, heart attack, stroke)
  • Date of birth
  • Doctor name and phone number
  • Emergency contact name and phone number
  • Your address
  • Your phone number
  • Your blood type
Where to Get Your Medical ID

There are countless places to order a medical ID. They range in price from free (a wallet card or mobile app) to a few dollars (i.e. silicone bands) to hundreds of dollars (i.e. gold charms and bracelets). Here are a few of my favorites:

  • BCRN’s Shop on Amazon – My shop has some of my personal recommendations for a variety of styles (not personalized), for almost any budget, including silicone IDs that are great for quick ID and outdoor activities.
  • American Medical ID – A variety of styles, which you can personalize with your information, and prices. I wear an American Medical ID daily. Read my complete review of my American Medical ID here.
  • Road ID – Perfect for sports and outdoor activities, and displays a lot of information.
  • My MedicAlert Foundation – A classically designed medical ID that comes with a virtual subscription to a 24/7 Live Emergency Response Team for delivering accurate and clear health information securely to first responders and healthcare professionals during an emergency. This is where I ordered the medical ID that I wear when a lot when traveling.
  • Stay safe on the go with the Road ID mobile medical ID
  • You can also carry important medical information on a written or typed card in your wallet
  • You can order medical IDs from pharmacies
Medical ID Quick Tips
  • Be specific in what you engrave on your medical ID. An ID that says “blood thinner,” “anticoagulant,” “medical condition” or just displays a medical or red cross symbols is not specific enough.
  • Your ID, at a minimum, must say what anticoagulant you are on.
  • Make sure your medical ID looks like a medical ID. The purpose is functionality, not fashion.
  • You can carry multiple ID’s. I have one that I wear (bracelet or necklace), one on my keychain and the mobile app on my phone.
  • More reasons why you should wear a medical ID.

Share your story. Do you wear a medical ID? Are you planning on ordering one? Where is your medical ID from? Has it saved your life in an emergency? Do you think you need one? Why or why not?

There is hope for healing and you are not alone,

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How To Talk to Your Doctor about a Possible Blood Clot

Talk to Your Doctor about a Possible Blood Clot

Once in a while I get an email from acquaintances – or even strangers– describing what they fear is a symptom(s) of a blood clot in their legs. More often than not, the individual tells me they have already scheduled an appointment with their Primary Care Physician (PCP) and are waiting – and worrying – to find out what might be wrong. For many of these individuals, they have never had a blood clot before, and they want to approach their doctors with specific questions pertaining to testing and determining if in fact they do have a blood clot. And, many of these emails have concluded with, “What did you tell your doctor because I am worried he/she might not think to look for a blood clot?” I have found it is often difficult to decide how to talk to your doctor about a possible blood clot either because we don’t know what to say or are embarrassed to do so.

I always respond to these inquiries with the same information (starting with I am glad to hear you are listening to what your body is telling you) and explain that in my situation there was no time to contact a physician because by the time I realized something was wrong, I was struggling not only to walk, but breathe because the blood clot had traveled from my leg and lodged in my lung as a pulmonary embolism (PE) escalating from a manageable situation to a critical one. There was no time for preliminary discussions because I was admitted to the Intensive Care Unit (ICU) for immediate care and observation.

Still, I believe many blood clots – especially blood clots in the limbs (DVT) – are treatable before they dislodge and cause major problems to the heart, lungs or brain. If I had identified the pain in my calf as a serious and needing medical attention, I would have wondered what to ask my PCP when I was there. I would have gone in and said, “It hurts and I don’t know why,” and would still be hoping for the best possible outcome. Still, it is not always easy to say ‘It hurts’ because we often feel like we have to have something visibly or horribly wrong to see a doctor or fear being labeled a hypochondriac later – when something really might be wrong. Before my PE, I often felt like I had some sort of limit placed on the amount of times I could see a doctor with unfounded complaints before I would be hesitant to go back in.

I’ve thought a lot about what I would have said to a doctor before my situation evolved into an emergency and after doing some reading and discussing options with other survivors, I have come up with some guidelines for how to talk to your doctor about a possible blood clot. First and foremost, one should have an understanding of the symptoms of a DVT, which can be read here. It is important to note if you are experiencing symptoms of a PE, heart attack, stroke, having shortness of breath, chest pains or lost consciousness, please seek emergency medical help or call 9-1-1.

How to Talk to Your Doctor about a Possible Blood Clot
Before Your Appointment:
  • Call your PCP/Sports Physician/Specialist/etc. and request the next available appointment. It may be beneficial to say on the phone “I am concerned about symptoms A, B, C being a possible blood clot and would like the next available appointment.” If your doctor cannot work you in within the next couple of days and your symptoms do not subside or if they get worse, skip your physician’s office and head to an Urgent Care instead. You could also ask to be put on a cancellation list if you have to wait a couple of days.
  • If you have redness or swelling that is coming and going in, for example, your leg take a picture with your phone or camera to take with you in case your leg does not look the same the day of your appointment.
  • Write down symptoms you have that you are worried you may not remember on the day of your appointment.
During Your Appointment:
  • Explain your symptoms in as much detail as you can. This is where it would be helpful to pull out your picture or written note.
  • Explain why you think it may be a blood clot (especially if the doctor asks). For example, I recently had a friend say, “One of my friends had a blood clot in her lung that almost killed her and she didn’t know what it was ahead of time so I am here as a precaution.” Or you could say, “I have been reading about blood clots and a lot of my symptoms seem to fit, I would like to rule it out.” Or, “I have a history of blood clots in my family and am concerned.”
  • If you have a history of blood clots (yourself or family members), please inform your doctor. If you are taking medications that may increase your chance of blood clotting (i.e. oral contraceptives), please inform your doctor. Even if this information has previously been noted in your medical charts, be sure to remind your doctor during your exam.
If Your Doctor Does Not Agree:

I have learned that we must be an advocate for our own health and have read countless stories where someone approaches medical staff with a concern and it is dismissed as something not to worry about. If you believe you are suffering from a blood clot (DVT) and your doctor does not agree, be sure to find out why he or she does not agree. If you are uncomfortable with the explanation, you are entitled to ask for a second opinion! If you do not want to wait to seek an additional opinion, there are specific tests you can request to rule out the possibility of a blood clot. This information is also helpful to have so you can understand if your doctor is considering the possibility of a blood clot by ordering these tests.

  • Request a Doppler Ultrasound (Also called a Doppler, a scan, an ultrasound, an image). A Doppler ultrasound test uses reflected sound waves to see how blood flows through a blood vessel and is the most common method of diagnosing DVT. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced blood flow through narrowing in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins that could break loose and block blood flow to the lungs (Web MD). This test is simple and may be scheduled at your doctor’s office or walk-in hospital lab. It should only take a few minutes to complete a Doppler and the results are available immediately. It does not hurt (unless you have pain in your limb, because they will push firmly on it to get a clear image). Do not be alarmed if your doctor orders more than once Doppler a couple of weeks a part to monitor your situation.

Although less common and sometimes unnecessary depending on your situation, you may also request or your physician may order if imaging results are unclear (test descriptions compiled from Web MD):

    • A D-Dimer Test is a blood test that measures a substance released as a blood clot breaks up. D-dimer levels are often higher than normal in people who have a blood clot. A low d-dimer test result may mean that a deep vein thrombosis or pulmonary embolism is less likely. A high d-dimer test result may not always be caused by a blood clot in the leg or lung. This is completed by a intravenous blood draw, so please note it you have a sensitivity to needles.
    • Magnetic resonance imaging (MRI) test uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. In many cases MRI gives different information about structures in the body than can be seen with an ultrasound. MRI also may show problems that cannot be seen with other imaging methods. Using MRI to look at blood vessels and the flow of blood through them is called magnetic resonance angiography (MRA). It can find problems of the arteries and veins, such as a blocked blood vessel. Sometimes contrast material is used to see the blood vessels more clearly. This test is non-invasive, but requires you to sit or lay still for a period of time as the images are taken. Some people find this test uncomfortable if you do not like small spaces
    • A computed tomography (CT) scan uses X-rays to make detailed pictures of structures inside of the body. During the test, you will lie on a table that is attached to the CT scanner, which is a large doughnut-shaped machine. The CT scanner sends X-rays through the body area being studied. In some cases, a dye called contrast material may be used. It may be put in a vein (IV) in your arm, or you may drink it in some cases.
    • A venogram is an X-ray test that takes pictures of blood flow through the veins in a certain area of the body. During a venogram, a special dye (contrast material) is put into your veins so they can be seen clearly on an X-ray picture. A venogram looks at the condition of your veins and the valves in your veins. It shows the veins in your body and whether or not they may be blocked. This test requires some preparation ahead of time and should be discussed in detail with your doctor.
After Your Appointment:
  • Follow up with any tests your doctor has ordered. If you have been instructed to seek further testing at a walk-in lab or hospital testing facility, call right away to get the hours of operation and do not delay further testing.
  • Follow up with your doctor regarding treatment if a blood clot is discovered.
  • If you are unhappy with your diagnosis, seek an additional opinion or if your condition worsens, seek urgent medical care.

Share your story. Did you request an additional test from your doctor and if so, what was it? How was your blood clot diagnosed initially? Did you visit your doctor with any concerns? What did you say to your doctor? Have you been an advocate for yourself in diagnosing a blood clot?

There is hope for healing and you are not alone,

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How To Share Your Story

 

Share Your Story

Storytelling is the essence of Blood Clot Recovery Network. After I survived a pulmonary embolism (PE or blood clot in my lung), I set out to tell others about my experience. My story was the first thing I wrote for this blog. While my story is ever-changing – and I bet yours is too – there is great value and release in sharing our experiences with others. As the author of this blog I have read hundreds, if not thousands, of stories and each of them has affected me in some way. Each one I remember, each one stands out. Each one reminds me that I am not, in fact, alone on this journey. I hope you find the same value in the Patient Stories here.

We all have a story to tell and every story is important. In fact, emerging research has shown the importance of and value in allowing patients to share their stories. It gives patients a voice – and I like to think a small purpose – after what they have gone through. If you would like to share your blood clot story with others, below are some simple guidelines to help you do so.

How to Share Your Story with the Blood Clot Recovery Network Blog:
  • Make it all about you (or your loved one) and make it original (please don’t submit the same story you have written for someone else).
  • As a general guideline, make it 500-800 words in length.
  • Give your story a title.
  • Include a picture, if you want to. It can be of yourself, your family, your pet, your hobby, your artwork or a place you love to go.
  • Submit your story and photo via email to sara@bloodclotrecovery.net and I’ll get back to you about publication details, including the best platform on which to share your story.

I can’t wait to hear from you. Please note, I receive a lot of patient stories, and it may take 4-6 months to publish your story on the blog. 

There is hope for healing and you are not alone,

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