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The Plane Truth About Your Veins
What You Should Know About Travel & Deep Vein Thrombosis

by Linda Coffman

November 2009: There's something I have to plan for every time I travel to embark on a cruise. It's not my wardrobe, although an essential clothing element plays a big part in it: it's my veins and keeping them healthy.

A First-Hand Look At Deep Vein Thrombosis
Pretty cast, right? Who knew the danger that lurked beneath its feminine pink surface? Certainly, not me. After breaking my leg and taking a flight home from Florida last year, I spent my days in a wheeled chair. Unknown and unnoticed until I experienced excruciating chest pains and could barely breathe, I had developed deep vein thrombosis (DVT).

DVT is an insidious condition that, in my case, was nearly fatal. The blood clot in my leg threw off smaller clots that lodged in my lungs, a condition called pulmonary embolism. After three days in Intensive Care and a series of painful heparin shots at home, I was on a regimen of anti-clotting medication (warfarin) for a year. For me, monthly trips to the clinic to monitor medication levels in my bloodstream finally ended, but I have a lifetime of concern ahead of me.

Why am I mentioning this now? To help spread the word. Nearly half of all DVT cases have no symptoms and nearly three-quarters of adults are unaware of DVT or its dangers. Last summer Reuters issued the warning that, "People who travel have nearly triple the normal risk of developing a dangerous blood clot, with a measurable increase for every two hours spent sitting in a car or wedged into an airline seat..." In a related report, which was published in the Annals of Internal Medicine, researchers at Harvard University in Boston combined the results of 14 studies involving 4,000 patients and concluded, "Our findings demonstrate for the first time a clear association between travel and VTE."

VTE is venous thromboembolism, the development of a blood clot in a vein, usually in the legs. The Cleveland Clinic defines it thus, "Deep venous thrombosis (DVT) and pulmonary embolism (PE) represent different manifestations of the same clinical entity referred to as a venous thromboembolism (VTE)." The Harvard study also found the risk of developing DVT is one case in every 4,600 airline trips. That doesn't sound very dire, unless you are, like me, that one case. With a history of DVT, I'm at an even higher risk of developing it again. Chance are 40% that I could experience more blood clots within one to two years.

Are You At Risk?
You don't have to be a frequent flyer, or break your leg, to have DVT risk factors. Unfortunately, most adults don't realize what DVT is, despite the fact that complications resulting from it kills more people annually than automobile accidents, AIDS, and breast cancer combined. My husband Mel, who is a frequent flyer with millions of air miles beneath his wings, was unaware of DVT.

A combination of two out of three underlying conditions are generally responsible: slow or sluggish blood flow through a major vein; a tendency for your blood to clot quickly (sometimes a hereditary condition); and irritation or inflammation of the lining of a vein.

You also may be at risk if you injure a vein, endure a lengthy surgical procedure, have a heart attack or stroke, or are inactive for prolonged periods such as when your mobility is restricted by extended bed rests, plaster casting, or during long-distance travel on airplanes or in cars. Other elements that play a key role in your risk are a history of smoking, age (over 40), high blood pressure, congestive heart failure, obesity, chronic respiratory failure, some cancers, varicose veins, pregnancy, a sedentary lifestyle, and estrogen hormone replacement therapy. I had several of those risk factors, yet I was unaware of them.

Diagnosis, Treatment, Prevention
A relatively simple and painless ultrasound scan can diagnose DVT. Some of the warning signs that you need to see your doctor immediately are leg pain, swelling in the thigh, calf muscle, ankle, or footparticularly if it effects only one legredness, and skin that feels warm to the touch. Once you've had a DVT, the odds of another clot forming are high.

Obviously the hospitalization and treatment I described above is painful, expensive, and can affect the quality of your life so your best bet is prevention. You can do that by exercising regularly, maintaining a good body weight, eating healthy foods, and quitting if you are a smoker.

Adding compression stockings to your travel attire can reduce the risk of developing DVT by 50% and that's really important for travelers whose mobility is restricted for long periods of time. Your heart pumps blood up through your leg veins against gravity and while you walk the contraction and relaxation of calf muscles aids in keeping blood flowing to the heart. Graduated compression stockings act as a layer of muscle by gently squeezing vein walls together and allowing the valves to close properly, which restores normal blood flow and aids in circulation when you can't get up to move around freely. 

Staying Healthy
Whether traveling by car or plane, my personal travel routine now includes drinking a lot of water and getting up to move around every hour. That adds a lot of time to road trips, but it's essential. While I'm seated, I flex my ankles frequently to keep the blood in my legs moving. I also wear SIGVARIS compression stockings (aside from my pretty-in-pink cast, there is a wardrobe component here). My stockings are dress black and, from just looking, you'd never suspect they are helping my veins to pump blood upward normally. As a bonus, my ankles no longer swell as they often did after a long flight.

The next time you're planning a cruise, take a few moments to think about that long plane flight or car ride to get to port. Keep in mind that when you remain seated without moving for over five hours, the risk of DVT could be four times higher!

Staying hydrated, moving around frequently, and slipping into compression stockings are small steps to staying healthy. You don't have to break your leg to develop DVT, or to take the steps necessary to prevent it.

I was fortunate that a family friend, the late Dr. George Cuewho was on staff at the Medical College of Georgiarecognized my symptoms and Mel got me to the Trauma Center there in time. I had twenty minutes to live when my treatment began and I will be forever grateful to Dr. Cue and the Medical College staff for the care I received. Sadly, most cases of pulmonary embolism as severe as mine are diagnosed in the morgue.

Related Sources:

SIGVARIS Experts in medical compression stockings for treatment of venous and lymphatic diseases

Cleveland Clinic — Detailed information about DVT and related conditions


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