Prabhat Bakshi POPS (proactive care of older people undergoing surgery) senior house officer, Judith Partridge POPS clinical research fellow, Jugdeep Dhesi POPS consultant Department of Ageing and Health, Guys and St Thomas' NHS Foundation Trust, London SE1 7EH, UKA 66 year old man presented for preoperative assessment and optimisation before a left thoracoabdominal oesophagectomy for oesophageal adenocarcinoma (T3N2). He had undergone three cycles of chemotherapy and developed a deep vein thrombosis in the right popliteal vein. He was started on low molecular weight heparin. His medical history included deep vein thrombosis of the right leg and pulmonary embolism four years ago, myocardial infarction, hypertension, and hypercholesterolaemia.Correspondence to: P Bakshi pbakshi@doctors.org.uk For personal use only: See rights and reprints