You may hear the term ‘deep vein thrombosis’ when flying and your airline may even recommend certain in-flight exercises to prevent it from happening to you on long plane journeys. But do you even know what deep vein thrombosis (DVT) is, and how it can affect you?
Most of us dismiss the risk of DVT, but around 1 in 6000 travelers will experience this potentially deadly condition after a long-haul flight. DVT can easily be prevented by taking a few simple precautions, so take your health into your own hands and educate yourself on the symptoms and treatments.
What is Deep Vein Thrombosis?
A deep vein thrombosis is essentially a blood clot (thrombus) which occurs in our deep veins. Legs are the most common place for a DVT to appear, but you can also get them in the arms and lower torso.
Clots block veins and affect blood circulation so that other parts of your body don’t get the oxygen and nutrients they need. The real danger of a clot however, is that small parts can break off and move to other areas of your body, blocking blood flow to essential organs. DVTs in particular can travel to the lungs and cause a pulmonary embolism, which may lead to sudden death.
What causes DVT?
Deep Vein Thrombosis is often caused by physical inactivity, which is why long haul flights pose a risk for the condition. Any flight longer than 4 hours can lead to a DVT, if you don’t make an effort to move around from time to time. Gravity causes blood to pool the legs; when you move, the muscles in your legs contract, pushing the blood upwards, but when sitting still for extended periods of time, your circulation slows down and blood can thicken, making it more likely for a clot to form.
While anybody can develop a DVT, certain people are more at risk than others. Males and older people are generally more prone to the condition, due to the natures of their blood composition. Pregnancy causes blood to clot more easily, so poses an increased risk of DVT, as do estrogen based hormone therapies, including contraceptives and menopause related medications.
Certain medical conditions can also increase the likelihood of blood clots, including cancer, HIV, varicose veins, heart disease and conditions related to blood clotting. Injuries or recent leg traumas such as surgery can also increase the risk developing a DVT.
Lifestyle choices including smoking and obesity are linked with increased DVT occurrence, and you should always be cautious if you have any family history of DVTs.
Major risk factors for DVTS are:
- Advanced Age
- Oral contraceptive medications
- Hormone replacement therapy
- Recent surgery or trauma, especially to the hips and legs
- Leg injuries
- Certain diseases and medical conditions
Signs and Symptoms of DVT
The signs for DVTs can be quite ambiguous, and upon examination often lead to a completely different diagnosis. After flying, however, you should take all of these symptoms as a sign of a potential DVT: swelling, pain or tenderness, skin redness or discoloration and warmth in the area. Unfortunately around 50 percent of DVT cases don’t exhibit any symptoms at all.
Pulmonary embolisms can occur hours or even several days after the clot first formed and can catch people completely by surprise. Pulmonary embolisms are often mistaken for heart attacks and may display symptoms including shortness of breath, chest pain, coughing up blood, a sensation of lightheadedness, fainting and rapid heart rate. However, again, in half of cases, the only symptom is sudden death.
If you have any risk factors, prevention is key as you may never even realize that you have developed a clot.
How is DVT treated?
If you show signs of having developed a DVT, there are a few tests your doctor can use to verify the presence of a blood clot. Imaging tests of the veins are commonly used, such as ultrasound of the area, MRI and CT scan. Venography is perhaps the best imaging method to detect DVTs, where a doctor injects a dye into your veins and then takes x-rays to see if there’s a blockage. a D-dimer blood test can be performed for low risk patients, although it may not completely rule out the existence of a DVT.
DVTs are one of the few medical conditions that won’t benefit from bed rest! Treatments can take several forms, but staying mobile with gentle walking exercise will aid recovery, if the patient isn’t in too much pain. You may need to wear compression stockings, which gently squeeze the ankle and leg to help more blood in an upwards direction. If your doctor judges that your clot is unlikely to break apart, he or she may recommend that you undergo these at-home treatments with follow up imaging tests to monitor your progress.
For riskier cases, the most frequent treatment is prescription of anti-coagulant medication, which thins the blood. Anti-coagulants are usually taken for around three months, and can be used in conjunction with compression stockings.
How to prevent DVT
When taking flights longer than 4 hours, it’s important to do some light exercise from time to time. While seated, occasionally stretch and bend your legs. Tense your calf muscles and flex your toes to stimulate blood circulation. There are also specific exercises you can do to prevent DVTs, which can easily be performed in the small space of your seat. Some airlines provide instructions on exercises you can do; otherwise look online for some before you fly.
Make sure that you have as much leg room as possible, without luggage taking up the space under the seat in front of you. Stand up and walk around once every couple of hours; even a quick trip to the bathroom should be sufficient. Rather than sitting down, try to walk around while waiting at the airport, especially if you have connecting flights.
Class 1 compression stockings worn during a flight can be helpful in addition exercises, and can be purchased easily at a pharmacy.
If you have any risk factors for developing a DVT, talk to your doctor before your flight for a full assessment.
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