Blood Clots From Prolonged Flying or Sitting? DVT - Deep Vein Thrombosis

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Blood Clots From Prolonged Flying or Sitting?

DVT - Deep Vein Thrombosis

_http://www.karinya.com/dvt.htm_ (http://www.karinya.com/dvt.htm)

 

Talk about a brutal coincidence. Dr. John Royle will never forget that

grey August morning in 1993 when the Melbourne vascular surgeon was climbing

the hill between his consulting rooms and operating theatre at Austin

Hospital. It was a routine walk for the then fit 59-year old who had only the

day

before flown back home from a conference in Hawaii, where he had presented

a paper suggesting Australians could be at greater risk of flight-related

deep vein thrombosis (DVT) then previously believed.

 

GRAPH

 

 

 

 

The phenomenon had already touched Royle personally; one of his colleagues

had recently died after a long-haul flight and the father of one of his

daughter's schoolmates had been struck down by a fatal DVT soon after

returning home on a flight from Europe. But Royle's customary stride was

interrupted by a sharp, cramping pain in his left calf. Ten seconds. Maybe 20.

That's all it took for him to recognize the telltale signs of a thrombus (blood

clot) in a deep vein of his leg which he knew had a risk of breaking free

from the vein wall and traveling to his heart or lungs, where it could block

the flow of blood and cause a fatal pulmonary embolism.

 

Royle took a detour to the hospital's lab for an ultrasound, where it was

found he had a six-to-seven centimetre long clot in his leg which, although

not life-threatening, had a risk of lengthening.

 

Royle was immediately hooked up to a drip of an anti-coagulant drug and

confined to the hospital for five days.

 

DVT only turned into a front-page issue last October 2000 when a fit and

active 28 year-old Englishwoman died shortly after stepping off a flight

from Sydney to London. That seemingly isolated case swiftly topped a short

casualty list. A British businesswoman collapsed and died at San Francisco

within weeks of the earlier death mentioned above, a 68-year-old British

tourist slipped into a coma and died after a 20 hour flight from London to

Melbourne plus two others who suffered fatal DVT's while enroute to London in

1999 and 1998 respectively. And Greggs article mentions many more. There are

some 20 million airbourne journeys to and from Australia each year, and how

many others are taking long-haul flights to other countries in which

similar conditions are evident? Although Australian hospitals do not record

whether blood clot patients had been recently on an aircraft, Dr. Reginald

Lord,

a vascular surgeon at St. Vincent*s Hospital in Sydney and possibly

Australia*s foremost expert on DVT, estimates that up to 400 people a year

could

be arriving in Sydney with flight-related DVT. St. Vincent*s treats about

40 per DVT cases per year, **almost one a week** . How many other cases do

you suppose go unreported and untreated in other countries?

 

Deep vein thrombosis (DVT) is a common but elusive illness that can result

in suffering and death if not recognized and treated effectively. DVT

occurs in ~2 million Americans each year. Death can occur when the venous

thrombi break off and form pulmonary emboli, which pass to and obstruct the

arteries of the lungs. DVT and pulmonary embolism (PE) most often complicate

the course of sick, hospitalized patients but may also affect ambulatory and

otherwise healthy persons.1-4 It is estimated that each year 600,000

patients develop PE and that 60 000 die of this complication.5-7 This number

exceeds the number of American women who die each year from breast cancer. PE

is now the most frequent cause of death associated with childbirth. Women

are a prime target for PE, being affected more often than men.

 

Deep vein thrombosis is a major complication in orthopedic surgical

patients and patients with cancer and other chronic illnesses. DVT can be a

chronic disease. Patients who survive the initial episode of DVT are prone to

chronic swelling of the leg and pain because the valves in the veins can be

damaged by the thrombotic process, leading to venous hypertension. In some

instances skin ulceration and impaired mobility prevent patients from

leading normal, active lives. In addition, patients with DVT are prone to

recurrent episodes. In those instances in which DVT and PE develop as

complications of a surgical or medical illness, in addition to the mortality

risk,

hospitalization is prolonged and healthcare costs are increased.

 

There is no doubt about it that DVT is real. Yes, in Australia there are

an estimated 2,500 that are claiming they suffered blood clots after flying,

and there probably could be many thousands more throughout the world.

However, our concern here, in this brief article, is not how to enrich the

lawyers but to bring this to the attention of those who do a lot of traveling

enabling them to take precautions for their own health. What about you? If

you fly long-haul you may be at risk, and perhaps you should take

precautions or at least get yourself checked?

 

 

With over 1 million passengers at any one time in the air and up to 10%

medically unfit to fly, according to one estimate, problems both minor and

serious are just as likely to happen at 7000 ft. as on the ground. Regardless

of whether you are sitting in an airplane high in the sky or on the ground

at the movies - one is suscptible to DVT, because the rate of blood flow

to your lower limbs is reduced by about two thirds. According to some

estimates, there are about 2,000 passengers that die from the condition every

year. **The airlines are not in the business of scaring people, ** says Andrew

Keller, Director of the Airport Medical Centre at Sydney*s Kingsford Smith

airport, who sees one person a day with leg swelling and perhaps one every

two months with actual DVT. **There*s always the risk of a terrorist

boarding an aircraft: do you warn passengers about that too?**

 

More leg room on long-distancce flights would NOT solve the problem of

DVT. At a recent summit attended by representatives from 16 major airlines,

concluded there was a **probable link** between passengers on long flights

who suffered potentially fatal blood clots. Australian researchers have noted

a **serious lack of definitive information** on the instances of DVT and

pulmonary embolism. Alex Gallus, a professor of Haematology and Director of

Pathology and Ross Baker, Director of thrombosis and Haemophilia Service at

Royal Perth Hospital, also have exploded the myth of *economy class

syndrome*. **Business and first-class passeengers are not immune (to DVT), so

more generous seating space is unlikely to be the answer and *economy class

syndrome* is likely to be a misnomer ** the professors wrote in the latest

Medical Journal of Australia. On long flights the professors recommend

regular foot exercises, generous fluid intake, loose fitting clothing, and

avoid drinking too much alcohol.

 

 

WHAT IS DVT?

Deep Vein Thrombosis or DTV happens when blood clots form in the calf or

thigh after prolonged sitting (especially on long-haul airline flights). The

leg swells and may become red and painful to the touch. The blood clot

breaks away from the wall of the vein when the sufferer starts moving around.

The clot is carried along with the blood and partly or completely blocks

the flow of blood in the vein. If the blockage travels to the lungs, it may

cause chest pain, breathing difficulties and possibly death!(Schematic

picture)

 

 

WHAT ARE THE SYMPTOMS?

Sharp pain when the foot is flexed upwards, tenderness and swelling in the

leg, fever, rapid heartbeat, sudden unexplained cough and joint pain. The

leg may become red and warm to the touch.

 

 

WHO IS MOST AT RISK?

Those aged over 40 years, the obese or overweight; those with blood

disorders leading to increased clotting; pregnant women; smokers, cancer and

heart disease sufferers, those with a family history of DVT, those who have had

recent surgery or injury to a lower limb, women on hormone replacement

therapy, those on the pill, people with varicose veins.

 

 

WHAT SHOULD I DO?

 

 

Wear loose, non-restrictive clothing, don't let luggage cramp your leg

room and avoid crossing your legs for prolonged periods. Move around in your

seat, flex your ankles up and down and massage your calves every hour or so.

Avoid sleeping for long stretches, drink plenty of water and don't

overindulge in alcohol or caffeine. If you are at risk of developing DVT, wear a

compression stocking and see your doctor about having an anti-coagulant

injection. (While the blood-thinning properties of aspirin play an impotant role

in the prevention of heart attack, there is still doubt about its

efficiency in preventing DVT).

 

In addition, there are supplements which can be taken to help in aiding

circulation of the blood. The herb ginko Biloba has been proven clinically to

aid peripheral circulation, i.e., to the hands, feet and head. Research

suggest that substances in fish called Omega-3 fatty acids may help lower the

risk of blood clots by reducing blood triglyceride (a blood fat) levels

and preventing blood platelets from clumping together to form clots. (New

England Journal of Medicine, April 1997). Dr. Robert Vogel, Cardiologist

University of Maryland, USA, reports **studies have found that fish oil

supplements may help the blood vessels dilate, thin the blood and correct

certain

heart rhythm disturbances** (Medical Tribune, June 4, 1999). A German team,

led by Dr. Clemens von Schacky found that after two years of fish oil

suplementation, the arteries of patients, on average, offered more room for

blood flow that those taking a placebo (Anals of Internal Medicine, 1999,

130.554-62).

 

Omega-3 is found in fish such as salmon, sardines, swordfish, mackeral,

halibut and also in the vegetarian source linseed oil. Other supplements that

may also be beneficial include Bioflavornoids, which help protect and

maintain capillary and connective tissue strength. these include rutin and

hesperdin, which occur naturally and vitamin C in fruits and some vegetables

and grains. Horsechestnut is a herb used to assist in treatment of varicous

veins and numerous clinical trials have found it to be a safe and effective

treatment for the relief of chronic venous insufficiency including

oederma, pain, tenseness, inching and leg fatigue. If you are taking medicines

to

treat circulatory disorders, always seek advice from a health

professional, as some drugs used to treat circulatory problems have been known

to

interact with certain herbs. In our opinion, a combination of natural herbs

could be an answer.

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