Many things can increase your chances of a DVT, and among them is bed rest. Knowing about DVT can help you understand your risk and prevent clots when you have to be in bed for an extended period of time.
What Is a DVT?
A DVT forms in a deep vein. The most common spots are the lower leg, thigh, and pelvis. But clots can develop in your arm, too.
The most serious complication of a DVT happens when a piece of the clot breaks off and travels through your body to your lung. When the blood flow through your lungs is blocked, that’s called a pulmonary embolism, or PE. This can damage your lungs. If the clot is large enough, a PE can be fatal.
Even if you don’t develop a pulmonary embolism, a DVT can leave you with long-term problems. These can include:
- Skin discoloration
- Ulcers on the affected body part
If you’ve had one DVT, you’re at risk for having one again.
The Bed Rest Factor
You might need bed rest for any number of reasons.
Bed rest can be necessary to recover from surgery or an injury, especially if you have another illness. It’s required for certain radiation cancer treatments as well.
Bed rest is sometimes recommended as part of the treatment for an existing DVT, in an effort to prevent a pulmonary embolism.
Your chances of getting a DVT depend on many things, including how long you’re not able to get up. If you are older or a woman, your risk goes up. As many as 13% of people on bed rest may get a DVT.
Why Do Clots Form?
Scientists refer to three conditions that – when all are present – can set the stage for a DVT. It’s called “Virchow’s triad,” and bed rest brings all three into play.
The first factor is called venous stasis. The blood flow in your legs slows down, and blood may pool there.
The second factor is called hypercoagulability. As the blood flow in your limbs becomes sluggish, your body doesn’t do a good job clearing out the substances that cause your blood to clot. Your body also produces less blood plasma – the part of your blood that delivers nutrients around your body and also carries away waste from cells. Your blood becomes thicker and more likely to clot.
The third factor involves your blood vessels themselves. When you lie down for a long period of time, the weight of your body can damage vessels, making it harder for blood to circulate.
What Treatments Help?
Your doctor may want you to take an anticoagulant medicine to help your blood move more easily. These are commonly called blood thinners, though they do not really thin the blood. These drugs help keep existing clots from growing and new ones from forming.
Common blood thinners for DVT include:
- IV: Heparin
- Injectables: Enoxaparin (Lovenox) and fondaparinux (Arixtra)
- Pills: Warfarin (Jantoven), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), and edoxaban (Savaysa)
You may need to take blood thinners for 3 months or longer.
Another type of drug is called a clot buster, or thrombolytic. You receive these drugs by IV or through a tube placed directly into the clot. People who take these drugs run the risk of severe bleeding, so they aren’t the first choice unless your clot is especially dangerous and other drugs haven’t worked.
If you can’t take blood thinners because of other health issues, your doctor may insert a mesh filter into a large vein in your abdomen, the inferior vena cava. This is designed to catch any clots that break loose before they can get in your lungs. The filter goes in through a small cut in your groin or neck and is guided into place. It’s a short surgery.
What Else Can I Do?
Be aware of any risk factors you may have in addition to the condition that prompted the bed rest. These can include:
Your doctor might suggest you wear special socks. These are called medical compression stockings, and they work by gently squeezing your legs. This improves your blood flow and keeps blood from pooling in your legs.
If you’re in the hospital, you might wear inflatable devices that squeeze muscles to keep your blood flowing. You might also have the foot of your bed raised.
Make sure you drink plenty of fluids while you’re on bed rest. This will help prevent thickening of your blood.
Can I Skip Bed Rest?
Sometimes, there’s no option but to stay put. But the thinking on bed rest has started to change in some situations, and you should discuss the options with your doctor.
For years, if you had a DVT, your doctor would order bed rest. This was thought to lower the risk of a clot traveling through your bloodstream to your lungs. But recent research suggests that bed rest doesn’t help people with DVT and that it may be fine for you to get up and move around.
Some researchers now question whether health care providers have been too quick to order bed rest during pregnancy. There’s no evidence, for instance, that bed rest helps with early labor or prevents premature birth. If your health care provider recommends bed rest, make sure you understand the reasoning behind the recommendation and discuss your risk of DVT.
Even if bed rest is necessary, get moving as soon as your doctor allows it. Studies show that early movement doesn’t just help prevent DVTs, it can promote healing and reduce pain.