Written by:
Courtney Battaglia BSN, RN
February 10, 2024
The Procedure Playbook: A New Educational Resource from VLN
VLN is excited to bring you The Procedure Playbook, our latest resource for people who take medicines to prevent blood clots and need a procedure or operation.
We worked with leading experts to break down complex clinical information into an easy-to-use handbook. You can access the Playbook here.
Why is it important for me learn about clinical guidelines?
The American College of Chest Physicians published updated recommendations on how to make medicine adjustments before, during, and after surgery. These guidelines can help your doctor learn more about the best way to manage your treatment—but it’s also important for you to stay up to date with this information to better understand why and how your treatment might change.
When you are taking medicines to prevent blood clots, even a small procedure requires careful planning. Learning more about clinical guidelines can help you feel better prepared and ready to go.
How will I understand this information? I’m not a doctor!
Since the clinical guidelines are written for doctors, they contain lots of medical jargon and can be difficult to understand. We created this comprehensive, simple guide to help you better understand their recommendations.
Who is this guide for?
This guide is an educational resource for people…
Who take medicine to prevent blood clots (and have been on the medicine for at least 3 months)
Who need a planned surgery while on this medicine
This information is not for people who need an emergency operation or a high-risk surgery that could cause a lot of bleeding.
This information is for general educational purposes only—it is not meant to be personalized medical advice. Everyone is different, so it’s important to work with your healthcare team to understand what’s best for you.
“The guidebook includes comprehensive information to help patients better understand relevant terminology and their risks of clotting and bleeding around the time of a procedure. It also provides general recommendations about if and when to stop and restart blood thinners or antiplatelet medicines and if and how to use bridging* therapy. It is important for patients to have this information so they can work with their doctor to follow a specific medication plan around the time of their procedure,”
Dr. Spyropoulos
What’s in the guide?
The Playbook includes information from clinical guidelines on how blood clot medicines should be adjusted before, during, and after surgery. These adjustments are different depending on the type(s) of medicine you take and the type of procedure you need.
*Bridging is a medical strategy used when patients need to temporarily stop taking warfarin before a medical procedure or surgery.
Perioperative antithrombic management (PAM) planning
Your doctor and healthcare team will create a plan for perioperative antithrombotic management, or PAM. Perioperative means “around the time” of surgery; this can be 1 week before surgery, the day of surgery, or 4 weeks after surgery. This period of time is when the risk of clots or bleeds is highest. The goal of this plan is to make sure that you have a safe surgery by balancing the risk of blood clotting and risk of bleeding.
Each person’s risk of blood clots or bleeding is affected by the type of condition they have, including whether they have a mechanical heart valve. This risk is also affected by the type of procedure. For example, a colonoscopy has a low-to-medium bleeding risk and a bowel surgery has a high bleeding risk. Your healthcare team will take these factors into consideration when creating your PAM plan.
Stopping and restarting your medicines
We know that remembering when to stop and restart your medicines can feel overwhelming, especially with the stress of preparing for a procedure. We’ve included recommendations on how to adjust your specific medicine(s) while considering your risks and the risks of the procedure.
The guide includes personalized medicine management worksheets to help you keep on top of medicine adjustments. You can print these sheets and fill them out with your doctor. These are great resources you can use to discuss when to stop and restart medicines with your healthcare team.
There are also calendars to help you visualize exactly when to make medicine adjustments based on the date of your surgery.
Never stop taking your medications without talking to your doctor first.
American Heart Month: How to Keep Active During the Colder Months
For those living in the Northern latitudes, the winter months can bring freezing temperatures, snow, and shorter days. Even if you live in warmer climates you may still experience rain, unpredictable weather, and cooler days. After the excitement of the holidays, cozying up in blankets all winter feels really inviting. But it’s important to stay physically active even during the slowest, quietest months of the year.
Always talk to your doctor before starting any new form of exercise.
February is American Heart Month—and getting enough exercise is an important part of heart health.
According to the American Heart Association, most adults should aim to get…
150 minutes/week of moderate-intensity aerobic activity OR
75 minutes/week of vigorous aerobic activity OR
a combination of both throughout the week
They also recommend adding in moderate- to high-intensity muscle-strengthening activity at least 2 days per week.
Moderate-intensity exercise can include things like brisk walking (at least 2.5 miles/hour), water aerobics, and gardening, and vigorous-intensity exercise can include running, tennis, and jumping rope.
These recommendations can seem like a lot if you haven’t been exercising routinely. Luckily there are lots of ways to get in those minutes here and there during the week—and the best part is that you don’t even need to leave the house.
Here are a few tips about how you can reach those exercise goals from home this winter:
Clear a space in your home for exercise
It may be hard to get started with an exercise routine if it’s been a while since you engaged in regular weekly activity. The first step can be as easy as finding a quiet space in your home. This may be a room or even a small corner where you exercise.
People taking medicines to prevent blood clots are at higher risk of bleeds, which can be caused by injury. Keeping your exercise space clear from clutter can help you keep safe.
Choose exercise activities that seem enjoyable
There are so many different types of activities that you can do from home. You can choose the type of activity you think would be most fun to do and adjust that activity to your ability level.
Just dance
Dance can be a really fun way to get moving and get your heartbeat up.
There are many different types of exercise classes available online that you can do from home. These can include Zumba, salsa, or step aerobics.
Equipment needed: none; all you need is your feet
Activity level: moderate (ballroom or social); vigorous (aerobic dancing)
Adjustments: start slow when trying out dance for the first time. Look for beginner activities and take a break if you become out of breath.
Say Namaste
Yoga is a very popular form of exercise that can also easily be done from home. There are many different types you can try. Hatha focuses on your breathing, Vinyasa is faster moving, Bikram follows a set form of poses—and there are many more. Yoga classes are also available online.
Equipment: yoga mat; support block and straps (optional)
Activity level: light-to-moderate (depending on type of yoga and poses performed)
Adjustments: Yoga may look soothing but it can be very challenging if your muscles are tight.
Hop on a bike
Cycling on a stationary bike is a very popular form of exercise. It may seem intimidating at first but bikes and programs are adjustable.
Jump on your bike and put on a TV show or podcast in the background—the time will fly by.
If you need something more space saving, try a desk cycle that you can use while sitting.
Equipment: full stationary bike or desk cycle
Activity level: moderate-to-vigorous (depending on cycling intensity and type of cycle)
Adjustments: Start with a low speed with low elevation and stop if you’re feeling very tired. You can also increase the intensity as you go.
Try to get in some exercise every day
Some days it’s hard to even think about getting off the couch. Every day is different, and sometimes our energy levels are low—that’s OK. You should rest when you need to. But even on these days, it’s important to try to get in a little bit of activity, even if it’s only for 5 or 10 minutes.
Exercise “snacks”
For people who sit for long periods of time during the day for work, it may seem impossible to step away from your desk to get in a full exercise program. But you can actually spread a workout across the day with exercise “snacks.”
Every time you get up to get a snack, have a coffee, or go to the bathroom, extend your break to include a little bit of exercise. You can run in place, do jumping jacks, or jump rope. All of these snacks add up over the day.
We hope these tips make winter exercise at home more accessible and enjoyable. Your heart health is important all year round—and eating right and getting enough activity is something we all should strive for every day.
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