Avoid Painful or Fatal DVT During This Air Travel Season

Getting a DVT can be life-threatening especially for elderly travelers. Please share this article with your friends and relatives and enjoy your holiday visits, not visiting a hospital.

It is that time of the year when a lot of us visit friends and families often with long inter-continental and overseas flights. The immobility associated with long flights/drives is associated with an increased risk for developing a deep vein thrombosis (DVT).

Part of our business involves photographing the calf swelling and discoloration often associated with DVTs for documentation and easier communication. We specialize in mobile medical photography integrated with the electronic health record (EHR) without risking patient health information leaks. So helping diagnose a DVT is right up our alley!

 A photo of a DVT patient with a swollen left calf (via Wikimedia).

A photo of a DVT patient with a swollen left calf (via Wikimedia).

Like you can see here, photos of DVT conditions are valuable because a DVT patients will show

  • Asymmetrical swelling of the calf/foot where one leg becomes larger than the other. Photos document the subtle changes in size and extent of edema and are valuable for tracking over time by other medical specialists.

  • Depending on the extent of the DVT the skin in the calf and/or foot may get a bluish discoloration or become red. Photos are useful to see the extent of color changes over time.

So I asked my co-founder and also our own vascular surgeon, Dr. Aalami to tell us about what is DVT and how we can avoid them.

So, what is DVT?

DVT stands for Deep Vein Thrombosis. This is when a blood clot forms in one of the deep veins. The most common site for DVTs to occur is in the calf and leg veins. They can start small but propagate (get longer/larger) over time. We are taught about Virchow’s Triad when thinking about what increases the risk for DVTs.

This is when you have,

 An ultrasound echo imaging will be used to show the location of the DVT located deep in your body.

An ultrasound echo imaging will be used to show the location of the DVT located deep in your body.

  1. Blood flow stasis (slow flow),

  2. A hypercoagulable condition (a reason for blood to be thicker), and

  3. Vein injury (often to the inner-most lining of the vein- the intima). One frequent cause of this is to sit on one position, notably in aircrafts or long drives. We care about DVTs because of the life-threatening pulmonary embolisms (PEs) they may cause. This is when a piece of the clot breaks off and goes to the heart and lungs and cuts of circulation. It is important to note that the signs and symptoms of this are chest pain and shortness of breath.

How Would I Know I Have a DVT?

• Swelling of leg (or other affected areas)

• Red or blue skins on the leg

• Pain in the leg or especially when you try to walk or dorsiflex your foot (point your toes towards your head)

• Chest pain and shortness of breath could be a sign of PE from a DVT

Simple Steps Can Prevent a DVT

There are simple steps one can take to help prevent a DVT, especially when you know you will be immobile for long periods of time on a flight or long drive.

 Check out this FINAVIA airline website for more information on in-seat exercises to avoid DVT. There are also many good flight tips.

Check out this FINAVIA airline website for more information on in-seat exercises to avoid DVT. There are also many good flight tips.

  1. Wear Compression Socks: The simplest approach is to wear compression socks that go up to the knee. For prevention the low-medium compression grade (~15 mmHg-20 mmHg range) will suffice. These now come in stylish contemporary colors or designs (like Sockwell or Comrad or Many Others), so you don’t have to be embarrassed about your style being crimped.

  2. Wigle and Move Around: Blood has to fight gravity to work its way back up to the heart. The normal pressure in veins is quite low, 0-5 mmHg. Our body uses the “Calf Pump” to pump the blood back to the heart. We also have valves in our veins to help keep the blood from working its way right back to our feet. Something easy to do when sitting on a flight or in a car is to simply activate this calf pump by pointing your toe to your head and back down 15 times every hour. This will keep the blood moving. I like FINAVIA airlines’ [1] web page describing simple exercise steps.

  3. Ask for and Drink Lots of Water: According to Vein Association of Texas [2], Dehydration is also the leading cause of DVT (thickening of blood in Virchow’s Triad).

    Also, according to the World Health Organization (WHO) [3] the humidity in passenger aircraft is significantly lower (20% or less) providing a much drier environment facilitating dehydration. And while many of do like alcohol services in the cabin, it is also the source of dehydration—just ask for water with your orders.

    So always drink sufficient water in flights and do your bathroom break more often too to get out of your seats and get your leg circulation going!

  4. Taking Anticoagulants: If you are on anticoagulant medication, take them as advised by your doctor. Some doctors recommend taking a baby aspirin (81mg) before your trip but there is no solid research evidence that it can prevent blood clots in veins. Many still take it because of how effective aspirin is at preventing clots in arteries.

Don’t let DVT ruin your holiday visits.

Please share this article.

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Reference:

  1. Easy in-flight exercises to prevent deep vein thrombosis https://www.finavia.fi/en/newsroom/2017/easy-flight-exercises-prevent-deep-vein-thrombosis

  2. Dehydration and Blood Clots https://texasveins.com/dehydration-blood-clots/

  3. Cabin humidity and dehydration, World Health Organization https://www.who.int/ith/mode_of_travel/chad/en/

Photo Attributions (in the order of appearance)

  1. Economy class interior of B-5972, N509FZ [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons

  2. Deep vein thrombosis of the right leg.jpg, James Heilman, MD [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], from Wikimedia Commons, https://commons.wikimedia.org/wiki/File:Deep_vein_thrombosis_of_the_right_leg.jpg

  3. Ultrasonography of deep vein thrombosis of the femoral vein -annotated.jpg: Mikael Häggström [CC0], from Wikimedia Commons, https://commons.wikimedia.org/wiki/File:Ultrasonography_of_deep_vein_thrombosis_of_the_femoral_vein_-annotated.jpg

  4. Easy in-flight exercises to prevent deep vein thrombosis, A company Blog of FINAVIA airlines. https://www.finavia.fi/en/newsroom/2017/easy-flight-exercises-prevent-deep-vein-thrombosis