Tuesday, April 08, 2008

Air Travel Advisory

The patients I see each day at the hospital are generally elderly and are suffering illnesses we associate with the aging process. Every so often someone is admitted who is much younger than average, perhaps middle-aged or less. I always take second notice when someone is exactly my age.

The most recent patient my age travelled across two continents in a long flight. When she returned home she noticed she had aching legs and afterwards some shortness of breath. But she never sought medical attention until she had a massive stroke that caused a large amount of damage to her brain. She has a huge deficit and is completely dependent. Investigations showed she had numerous blood clots in her legs, lungs and of course the one that moved to her brain.

I am well aware of the risks of developing blood clots in airplanes and always wear support hose during a flight. But many people are not and I was surprised that some of our staff members did not appreciate the connection. Blood clots can quickly develop with immobility. Most of our patients remain on low-molecular heparin after hip and knee surgery until they are up and about regularly on their own. One of our good friends was hospitalized with pneumonia this year. He was discharged home, developed swelling in one leg, but didn't know the symptoms of deep vein thrombosis. He was rushed to hospital and ended up in ICU with a pulmonary embolism a couple of days later.

Our medical director, Dr. Anne Crowe, published this case study about another patient in our facility who had a stroke after a relatively short plane journey. Plane travel is common and seating in the economy sections is tighter than ever. This information could save your life or the life of others. The following information is from mdtravelhealth.com.

Risk factors for deep vein thrombosis include

  • previous history of deep vein thrombosis
  • chronic swelling of the legs or feet
  • varicose veins
  • pregnancy
  • use of estrogen or raloxifene (Evista)
  • advanced age
  • cancer
  • obesity
  • stroke
  • recent hospitalization or surgery

To prevent the development of blood clots on long plane flights, the following measures are recommended:

  • Wear comfortable, loose-fitting clothing.
  • Do not place hand luggage where it may limit leg movement.
  • Walk about the cabin at regular intervals.
  • Perform isometric compressions of the leg muscles (i.e. contract the leg muscles periodically while sitting).
  • Avoid crosssing your legs.
  • Drink plenty of fluids.
  • Avoid alcohol and tobacco.
  • For those with any of the above risk factors, wear compression stockings, which can be purchased in most drug stores.

8 comments:

  1. Very good advice. My husband always takes aspirin. I know that aspirin is contraindicated in some people, but he's a believer.

    Stories like that are so sad. And doubly so because people suffer silently and try to be stoic when prompt medical attention could have prevented the loss of life and function.

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  2. Thank you for the advice, I never knew you could get blood clots traveling on a plane.

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  3. Going through Heathrow airport on my way to Ghana, I spotted some airline stockings & bought them. Love them--I wear them most of the time. And when I fly. I even asked for more as a Christmas present.

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  4. I've heard about this before.I never really travel on planes except float planes. If I do ever go on a jet flight, I will remember these tips-thanks.

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  5. I take an aisle seat and move around as much as possible during a flight. Most of my flights are many hours.
    Separate question, why the picture of The Palm?

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  6. So scary, isn't it? I remember when the NBC reporter David Bloom died after being in a tank in Iraq for days (in a squatting position) that DVT was more in the news then, but people don't think about the risk until something like that happens. Good post Ruth.

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  7. Cathy- Aspirin could be helpful for sure. There is no benefit in being stoic with certain symptoms. This lady had a window of more than a week where she had symptoms before her stroke.

    Birdman- You are young and active. Make sure you remind your parents and grandparents to move often in a plane.

    KGMom- Unless it is very hot, support hose is very comfortable. I like them for work.

    Larry- I went on a float plane for my honeymoon (!) to a fishing camp. I felt like I was in a flying volkswagon.

    SLD- I usually like window seats, but an aisle seat would be healthier for your legs. The picture was for you ;-)

    Jayne- I don't recall the story about David Bloom even though I am sure it was on our news. We need reminders now and then.

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  8. thank you for passing on this important information. My husband had a pulmonary embolism a year ago, and it almost went undiagnosed. He continued on for a week with symptoms that the emergency room doctor diagnosed as pleurisy at first. He is on coumadin for the rest of his life now, testing positive for Factor V Leiden (a genetic marker for the tendency to develop blood clots)

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