I‘ve been on airplanes a lot lately. I remember how excited I used to get about flying when I was a kid. I no longer look forward to getting squished into a can with 150 other sardines. Sitting there for hours on end with my arms pinned to my sides and nowhere to put my feet is not my idea of bliss.
Were I going on a really long flight, like to Africa (I wish), I’d need to start worrying about ‘Economy Class Syndrome.’
No, this is not a new fare class. Long airline flights put the traveler at risk to develop deep venous thrombosis (DVT), a blood clot in one of the deep veins in the leg or deep in the pelvis. If the clot stays local, it can cause swelling and sometimes pain, although these clots often don’t cause any symptoms at all.
But if the clot grows and part of it breaks off, it can be disastrous. Those deep veins carry blood up to the lungs, where it gets recharged with oxygen. A wandering clot from the legs can block the circulation to the lungs, keep oxygen from the blood, and lead to sudden death. This is a pulmonary embolus (PE). All because you were immobilized in a sardine can.
Flying on airplanes isn’t the only risk factor for DVT. We doctors know that PE is a risk for our hospitalized patients, particularly those who are elderly, who don’t move around much, who have cancer, and who have undergone major surgery. We try to prevent serious blood clots by giving low doses of blood thinner, by putting compression stockings or mechanical air-filled ‘boots’ on our patients, and by getting them out of bed and moving.
Pregnant women get DVTs just because they’re pregnant and the blood clots easier when you’re pregnant. This is a good thing, considering how much blood can be lost at the time of delivery, but it also increases the risk for DVT, particularly if bed rest is required before or after delivery.
Taking birth control pills can increase the risk of DVT a tiny bit, but the risk is nowhere near as high as it is with pregnancy, the state you’re taking the pills to avoid. Women on postmenopausal estrogen therapy also have a slightly higher risk of DVT. Obesity, cigarette smoking (I keep telling you, those things are bad for you) and a past history of DVT are all risk factors.
Immobility adds to the picture. So if you are an obese, cigarette-smoking couch potato, it’s time to get moving! Sometimes the risk can come from having the wrong parents. There are several inherited disorders that can cause the blood to clot too easily. If there is a family tree with lots of serious blood clots (especially PEs), let your health care provider know. You can be tested. If you have one of these disorders, your doctor will probably advise you to avoid additional risky behaviors like smoking or even birth control pills. If there are members of your family who have had serious ‘blood clots,’ you should let your health care provider know.
While you can’t control your family of origin, there are things you can do to lower your risk of getting these dangerous blood clots. If you’re having major surgery, ask your doctor what measures he takes to prevent DVTs. Controlling your weight, stopping smoking and exercising have so many benefits, and preventing DVTs is one of them.
I’m getting ready to catch the red-eye sardine can to New York, so when I’m not sleeping, I plan to be taking a stroll to the bathroom every few hours. Drinking lots of water and avoiding alcohol will keep me well hydrated in the dry airplane air. ‘Cause my son’s coming back from two months overseas, and I want to be there to greet him.
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