How to Go Back to the Office After a Blood Clot

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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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Your Guide to Compression Stockings

What are 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 for conditions that cause poor blood flow in your legs, such as varicose veins (swollen and enlarged veins), venous leg ulcers (a sore, damaged area of skin that takes weeks to heal) and lymphoedema (when your body’s tissues swell up painfully). They are often also prescribed as part of follow-up and ongoing care after diagnosis of DVT to help reduce swelling, increase blood flow and regulate pain.

Why Wear Compression?

Compression therapy is important to recovery from DVT because it helps to slow the progression of vein disease and promotes a stronger circulatory system by supporting weak or wavy (also known as incompetent) veins and valves and accelerating blood flow back to the heart. If you have a DVT, it is recommended that you wear compression stockings for up to two years after your DVT and in some cases, for the rest of your life to promote good circulation and help prevent Post Thrombotic Syndrome (PTS).

Recent studies have indicated that wearing compression may not be as beneficial as once thought in preventing long-term problems after DVT, although many medical professional have concluded that more research is needed.

What Kind of Compression to Get

Medical grade compression stockings come in a variety of compression strengths (known as mmHg), depending on what you need. Be sure to discuss your situation with your doctor to get the right compression for you. The grades include:

  • 15-20 mmHg (Mild) – Generally for mild spider veins, slight varicose veins, achy legs.
  • 20-30 mmHg (Moderate) – Generally for leg fatigue and heaviness, moderate spider veins, pronounced varicose veins.
  • 30-40 mmHG (Firm) – Generally for severe varicose veins, post sclerotherapy and prevention of post-thrombotic syndrome.

Get fitted! Compression stockings have graduated pressure, meaning the pressure is strongest and the ankle and decreases as it goes up the leg. It is really important to get fitted by a professional for the correct size of compression stockings. A Certified Fitter (found at medical supply stores and some pharmacies, call ahead to ask about specifics) measures your calf and ankle sizes and also the length of your leg to make sure you have the right size to maximize compression benefits. Try to get fitted as early in the day as possible before swelling increases.

Compression stockings come in a variety of basic colors including beige, black, navy, sheer and nude. They also come in thigh-high, knee-high, waist-high and open-toed (which I love to wear in the summer!).

Where to Buy Compression
  • Medical Supply Stores (i.e. places where prosthetics, orthotics, wheelchairs, etc. are sold) – Many insurance companies will cover or supplement the cost of compression stockings if they are ordered through a medical supply store so I recommend checking there first. Most, if not all, medical supply dealers require a prescription from your doctor so be sure to ask for one. Also, check with your insurance ahead of time for a list of pre-approved dealers in your area. If insurance does not supplement your stockings, you will most likely pay full price at a medical supply store.
  • Chain Drug Stores/Pharmacies (i.e. CVS, Walgreens, Discount Drug Mart, etc.) – Pharmacies and drug stores are a great option to look for compression stockings because they often offer a less expensive selection of compression stockings.
  • Hospital Pharmacies – Many physicians will prescribe you a pair of stockings before you are discharged. Ask if you can return to the pharmacy to get a new pair in the future.
  • Online – You may be able to purchase compression stockings online (especially novelty ones, like colors and patterns!). Just be sure if you are purchasing from an online retailer, you are still getting the right grade compression for your needs. A quick Google Search should turn up a variety of fashionable compression stockings.
The Cost of Compression

Compression stockings are not cheap. Generally, you can expect to spend anywhere from $29-$110 per pair. Many of the drug store stores offer an “economy brand” of stockings that are in the $29-$40 range. Stockings ordered from medical supply shops range from $60 to upwards of $110. The cost of compression stockings vary depending on the length (thigh-high, knee-high or waist-high); material; brand and whether or not your insurance offers any coverage for compression stockings.

Medical Compression vs. Sport Compression

It is important to note there is a difference between what are known as medical-grade compression stockings and sport or recovery compression stockings. Runners and other athletes sometimes use compression socks to increase blood flow during exercise, which some think may reduce soreness, increase endurance and performance, stabilize joints, activate blood flow and increase coordination, although the research is not conclusive on this stance. Examples of sport compression stockings can be found from CEP and Zensah and range from $40-$60. Athletic compression stockings are not as pressurized as medical grade stockings and may not be suitable for your recovery needs. 

What to Expect

Compression stockings take a little while to get used to and can seem painful or even cause a burning sensation when first wearing them. As with many things dealing with recovery from DVT and PE, give your body a chance to adapt and a chance for them to start working.

Compression stockings may be work on one or both legs. You should expect to replace them every 3-6 months depending on how often you wear each stocking or pair of stockings.

Helpful Hints
  • Wear your compression stockings when you are going to be sitting and/or standing for long periods of time (i.e. at work – sitting or standing).
  • Put your stockings on as soon as you can in the morning when swelling is minimal and they will be easier to put on then.
  • You do not need to wear your compression stockings when you go to bed or if you are going to be lying flat. Blood flow is optimized when you are lying down so they are not needed. Your body actually needs a break from compression at some point and nighttime is the perfect time to take one.
  • Rotate your stockings (if you have more than one pair) for maximum wearability.
  • Be sure to follow the packaging instructions for washing your stockings. Contrary to what you may think, many types actually suggest machine washing and drying to extend the life of the stocking.
  • Many medical supply stores offer additional products to assist you in getting compression stockings on, for example, if you are struggling or do not have a lot of strength to pull them up.
  • Wear compression stockings when you are travelling (a long flight or car ride) to increase blood flow and reduce the risk of DVT.
  • You don’t have to have a DVT to wear compression! People who primarily sit or stand during the day can wear compression as a preventative measure to decrease the risk of DVT.
  • Wearing compression stockings can be damaging to your self-esteem because unless you wear pants and closed-toe shoes, they are not easy to hide. I’ve been wearing them in spite of my self-esteem lately and decided I am proud to show I am a Survivor.

 

Reader Writes In. Do you wear compression stockings? Why or why not? What kind do you wear? Have you noticed that compression stockings help or hurt you?

There is hope for healing and you are not alone,

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