The Plane Truth About Your
What You Should Know About Travel & Deep
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
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
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
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 foot—particularly
if it effects only one leg—redness,
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.
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
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!
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 Cue—who
was on staff at the Medical College of Georgia—recognized
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.
Experts in medical compression stockings for treatment of venous and
Cleveland Clinic — Detailed
information about DVT and related conditions