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 workstation – 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 willing 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 around, 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 workstation
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 workstation 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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Such an important article, Sara. Most of us need to work! And our current modern work world generally involves a lot of sitting (or standing for hours and hours).
I am super fortunate that I work for myself and can create my own systems. But even then, I have to be a fantastic boss to myself and not allow myself to stay sitting for long stretches. In addition so some of the things you mention here, I set a timer on my phone to go off every 60 minutes. No matter what I’m doing, I stand up. At a minimum, I just stand and shake it out, move, stretch in place. Next best is just walking around my office — sometimes I water my plants or dust a bookshelf. Something to be productive while standing. Sometimes I stop and do some body weight exercises — crunches, pushups, squats… nothing super hard, but just moving my body. Ideally, I actually go out and walk around the building. And try to take one longer walk at lunch. If I’m on a tight deadline, it’s harder to do the longer break, but even if I just pop up like a jack-in-the-box when my alarm goes off, it’s something!
(And actually, I’ve done this now for a year and a half and I have to say that, like Pavlov’s dogs, the second I hear the alarm, my body just responds with standing… my cells know the drill, LOL)
Hi Martha. These are fantastic suggestions! Thank you so much for sharing. As you mention, it was very important to me to do something productive during a “break.” I am also fortunate enough to work from home now, but even so, when I take a creak, I will go walk down to the basement to fill the dog’s bowl or carry something upstairs that needs to be put away. I love the idea of setting a timer. I really need to do that because I get so involved in my work sometimes that half a day can go by and I might not even realize it. Thanks for sharing your thoughts. Take care.
After my calf DVT last summer, I invested in an Apple Watch – specifically to give me notifications of when I’ve been sitting idle too long and to get up and take a walk. Easy to use and works great! It also does much more – including tracking other health and fitness measurements. For people that sit a lot at their job like I do, it’s a life saver – quite literally!
Thanks for sharing about the Apple Watch, Jack. I do not know anything about it, but have wondered if it is helpful. I appreciate you taking the time to share your thoughts and how you use it – this is great info. Take care.
Changing one’s diet is most important. Reduce processed food, visit web sites listing food that improve blood, thins blood and desolve clots, eat some of daily. After a massive PE, I have been clot free and drug free for 7 years 4 months, do to changing my diet.
That’s what I intend on doing..the saddle PE and dvt have scared the tar out of me. What foods help you the best?
In your recovery article, you mentioned that you had concentration/mental acuity difficulties that hindered your return to work. I would like to hear more about how long it took before you were mentally (and physically, but the physical part is easier measure) able to return and what that part of your recovery looked like.
My husband had his first pulmonary embolism 3 years ago. It took him a little more than two years to physically recover. Six months ago, he had his second. The second was not as severe – we caught it early and we’re able to get it, essentially, treated outpatient. He is once again in the physical recovery state, but does not have quite so far to come back. Perhaps because of that, we are seeing that he has cognitive difficulty this time – he cannot focus, his ability to concentrate is limited to about an hour a day, and so he is unable to write or study. The physical recovery we know and understand, but we’re both a little scared by the mental challenges he’s facing right now. The brain is so vitally important to what makes us who we are.
I wish I had found your site the first time through – it is so nice to know that we are not alone in going through this. The doctors just tell us we will have to be patient but have not indicated if cognitive difficulties are normal or how long they take to heal. I was relieved to see you mention them and would take great comfort in any personal experience you care to share around that point.
Thank you for sharing this article. I am new to this and want to purchase a new recliner and wish to factor in the best sitting position when sitting. Is it a supline position keeping my nose and knees above my heart?