Health Tip: Preventing Deep Vein Thrombosis

Deep vein thrombosis, or deep venous thrombosis, (DVT) is the formation of a blood clot (thrombus) within a deep vein, predominantly in the legs. Non-specific signs may include pain, swelling, redness, warmness, and engorged superficial veins. Pulmonary embolism, a potentially life-threatening complication, is caused by the detachment (embolization) of a clot that travels to the lungs. Together, DVT and pulmonary embolism constitute a single disease process known as venous thromboembolism. Post-thrombotic syndrome, another complication, significantly contributes to the health-care cost of DVT. Prevention options for at-risk individuals include early and frequent walking, calf exercises, anticoagulants, aspirin, graduated compression stockings, and intermittent pneumatic compression. Source: Wikipedia

The risk is greater for flights over six hours in length, the risk of DVT is also increased for those with underlying risk factors such as a history of DVT, pregnancy, taking birth control pills, cancer (current or treated), a personal or family history of blood clotting abnormalities, recent major surgery, smoking, and obesity. The risk of DVT is very real and happens to many people:

• Get comfortable in your seat and recline as much as possible
• Do not wear tight clothing. Wear loose fitting clothing
• Store your hand luggage in the overhead lockers to keep the room under the seat in front of you free
• Bend and straighten your legs, feet and toes while seated every half-hour or so during the flight
• Press the balls of your feet down hard against the floor or foot-rest to increase the blood flow in your legs and reduce clotting
• Do upper body and breathing exercises to further improve circulation
• Take occasional short walks around the cabin, while the aircraft is at cruising altitude
• Take advantage of stopovers where it may be possible to get off the plane and walk about
• Drink a reasonable amount of water
• Avoid alcohol and caffeine, which in excess leads to dehydration and immobility
• Avoid taking sleeping pills, which also cause inertia

The risk can be further decreased by wearing graduated compression stockings. You can usually find them for around $20 to $25. Do you have any of the following underlying risk factors for developing DVT?

• History or symptoms of venous insufficiency
• A family history of clotting conditions
• An inherited tendency to clot (thrombophilia)
• Cancer or had treatment for cancer in the past
• Pregnant or taking birth control pills
• Undergone major surgery in the last three months
• Had hip or knee replacement within the last three months or
• Ever suffered from a stroke

If you have any of these risks already, you should check with your doctor before ordering compression stockings. The doctor may suggest you wear stockings with a higher compression gradient. These stockings may require a prescription and custom fitting. If so, you can purchase these online and have your health insurance cover the cost if it is a covered benefit.

If you have no history of venous disease, you should consider wearing knee-high graduated compression stockings with 15 to 20 mm Hg compression gradient while on long airplane flights. These do not require a prescription, and can typically be purchased through local pharmacies or via the internet (but be sure you are purchasing graduated compression stockings and not simply support stockings or support hose).