As summer approaches, and we take our flights home to visit family, or fly abroad to explore new places with family or friends, it is critical that we are aware of this condition. Even if you perceive that you are fair physically, you never know, and limited movement on long flights can affect you.          

What is Deep Vein Thrombosis?

The blood supply of the leg is transported by arteries and veins. The arteries carry blood from the heart to the limbs; veins carry blood back to the heart. The leg contains superficial veins, which are close to the surface, and deep veins, which lie much deeper in the leg. Deep vein thrombosis (DVT) is a condition in which a blood clot (blockage) forms in a deep vein. While these clots most commonly occur in the veins of the leg (the calf or thigh), they can also develop in other parts of the body.

DVT can be very dangerous and is considered a medical emergency. If the clot (also known as a thrombus) breaks loose and travels through the bloodstream, it can lodge in the lung. This blockage in the lung, called a pulmonary embolism, can make it difficult to breathe and may even cause death. Blood clots in the thigh are more likely to cause a pulmonary embolism than those in the calf.

Long flights can be quite uncomfortable, limited leg room and it is worse if you are tall like myself. With lengthy flights and cramped conditions, leg cramps are a common occurrence. Travel-related deep vein thrombosis can be symptomless, and may not occur for some time after travel. However, there is some evidence to suggest that certain groups of people, such as pregnant women, or anyone who has had a stroke, are at increased risk of developing DVT on flights of eight hours or more.

Causes

Many factors can contribute to the formation of a DVT. The more risk factors a person has, the greater their risk of having one. However, even people without these risk factors can form a DVT.

 

Risk Factors

Blood or vein conditions:

-Previous DVT
-Varicose veins
-Blood clotting disorders
-Inherited tendency to clot (thrombophilia)

Other medical conditions:

-Heart disease
-Chronic swelling of the legs
-Obesity
-Inflammatory bowel disease
-Stroke
-Cancer
-Dehydration
-Sepsis

Women’s Health issues:

-Hormone replacement therapy
-Birth control pills containing estrogen
-Pregnancy or recent childbirth

Other:

-Age over 40 years old
-Immobility (through inactivity or from wearing a cast)
-Recent surgery (pelvic region or legs)
-Trauma (an injury)
-Smoking

DVT occurs when blood flows too slowly through the veins. The blood forms a clot that blocks up deep veins, usually in the legs. DVT doesn’t generally have any immediate symptoms, making it difficult to spot. However, typical signs include a swollen or painful calf or thigh, and increased heat around the affected area.

Before you Travel

If you think you have a high risk of developing DVT, see your GP before you travel. You may be prescribed blood-thinning drugs to lessen the risk of your blood clotting, or compression stockings (also called flight socks).

Studies have concluded that airline passengers who wear compression stockings during flights of four hours or more can significantly reduce their risk of DVT as well as leg swelling. The below-knee stockings apply gentle pressure to the ankle to help blood flow. They come in a variety of sizes and there are also different levels of compression. It’s vital that compression stockings are measured and worn correctly. Ill-fitting stockings could further increase the risk of DVT. Flight socks are available from pharmacies, airports and many retail outlets. Take advice on size and proper fitting from a pharmacist or other health professional.

 Recovering from DVT

If you have recently had DVT, you’re probably taking medication, such as warfarin, to prevent the formation of blood clots. If that’s the case, then your risk of developing DVT is low and there is no reason why you can’t travel, including long-haul. However, if you’re still in the recovery phase, you should get the all-clear from your consultant before travelling. You should also follow the general DVT prevention advice for high-risk travellers listed below.

While you’re travelling

If you are planning a long-distance plane, train or car journey, ensure that you:

-Wear loose, comfortable clothes.
-Consider buying flight socks (compression stockings).
-Store luggage overhead so you have room to stretch out your legs.
-Do anti-DVT exercises. Raise your heels, keeping your toes on the floor, then bring them down. Do this 10 times. Now raise and lower your toes 10 times. -Do it at least every half an hour (you can do it more often if you like).
-Walk around whenever you can.
-Drink plenty of water.
-Don’t drink alcohol or take sleeping pills.

Diagnosis

DVT can be difficult to diagnose, especially if the patient has no symptoms. Diagnosis is also challenging because of the similarities between DVT symptoms and those of other conditions such as a pulled muscle, an infection, a clot in a superficial vein (thrombophlebitis), a fracture, and arthritis.

If DVT is suspected, the doctor will immediately send the patient to a laboratory or a hospital for testing, which may include a blood test, Doppler ultrasound, MRI, or angiogram.

Treatment

If tests indicate a clot is present, the doctor will make a recommendation regarding treatment. Depending on the location of the clot, the patient may need hospitalisation. Medical or surgical care will be managed by a team of physicians which may include a physician, vascular surgeon, internist, hematologist (blood disease specialist). Often the condition is spotted by a Podiatrist.

Treatment may include:

-Medication – A blood-thinning medication is usually prescribed to help prevent additional clots from forming.
-Compression stockings – Wearing fitted hosiery decreases pain and swelling.
-Surgery – A surgical procedure performed by a vascular specialist may be required.

Your feet mirror your general health . . . cherish them!