September 2nd, 2010

What are the real risks if any, of developing a deadly clot from flying?

Blood clots can form in the veins of people who are sitting or standing still for long periods of time, as in long car drives and long airplane flights. The medical name for these clots are “deep vein thrombosis or DVT’s. Because of the restriction to movement in economy class seats, it is also humorously referred to as “Economy Class Syndrome”.

In the U.S. alone, hundreds of thousands of new cases of DVT’s are reported every year and 1% of the cases can be fatal, because the clot can migrate to the lungs causing a pulmonary embolism which can block the lung, causing asphyxiation.

Causes and Symptoms of DVT’s

These clots happen to people when there is:

• A decreased rate of blood flow (as in sitting still for a long period of time without using calf or leg muscles)
• Damage to the wall of the blood vessel (from a trauma, surgery or implanted medical device)
• A medical or genetic condition in certain people that causes the blood to clot unnaturally

DVTs can be present with or without symptoms. Symptoms in the affected leg (rarely but sometimes in the arm) to watch out for are:

• Pain
• Swelling
• Redness
• Engorgement of the veins near the surface of the skin
• Warmth

Tests for determining if you have a DVT and why?

If your physician has reason to believe that a DVT may be present, we may order a D-Dimer test. This test shows the presence of elevated proteins that are trying to dissolve the clot.

Also if you or a family member has experienced more than one DVT, your physician may want to check for a genetic disorder called Factor V Leiden that causes blood to coagulate too aggressively.

To determine if a DVT is present, your physician may also use various imaging techniques like:

• Ultrasound
• CT

Medications for treating DVTs

Your physician may recommend that you take blood thinning medications like heparin and later on warfarin to prevent the clot from growing larger or to stop other clots from forming.

If the clot doesn’t seem to be dissolving on its’ own, he/she may recommend other kinds of medications (thrombolytics) that actually dissolve the clot, though these are normally reserved for more serious cases.

Preventing DVTs While Traveling

Restricted movement during travel can increase the chance of a DVT forming. Normally your calf muscles are flexed and cause the movement of the blood through the veins but this doesn’t happen when sitting still. While traveling we suggest:

• Move as much as possible. Get up and walk around.
• If walking around is not possible, rotate your ankles, point and flex your toes, lift your knees into the air. (Do all exercises for 2 minutes every 30 minutes)
• Firmly massage your legs starting at the ankle up toward the knee joint.
• Stay well hydrated.
• Avoid alcohol and caffeinated beverages which can cause dehydration.
• Do not fold or cross the legs for long periods of time while traveling.
• Speak with your physician about the use of compression stockings which have been shown to significantly reduce the risk of DVTs in susceptible individuals.

Supplements I suggest that are beneficial for overall health and can also help to prevent DVTs from occurring:

• Vitamin E (400 to 800IU) this helps to thin the blood.
• Niacin is fibrinolytic which means it helps to prevents clots from forming and may help to dissolve existing clots.
• Grape Seed Extract helps to maintain normal circulation and protects blood vessels.
• Vitamin C helps to protect blood vessels as well.
• Ginger extract helps to keep the blood from excessively coagulating to prevent clot formation.

If after any long flight or trip you notice that any of the symptoms described above occur and no not resolve after a day or two, I suggest you seek medical advice.

Wishing you the best of health,

Curt Hendrix, M.S. C.C.N. C.N.S.