Compression stockings And DVT
 

My doctor has just advised me to wear support stockings on long flights, and to also take an aspirin before the flight.
Are support stockings the same as compression socks? Or are they firmer and are they bought at a specialty travel shop?
And has anyone worn them? and do they help?
Also, someone mentioned not to take a sleeping pill incase you fall asleep and don't get up and walk around. Is the risk of DVT higher at a higher altitude? I sleep for hours every night without getting up, and wonder what the difference is. I'm hoping to sleep to make the time go faster, but not if I'm putting my health at risk.
Thanks for any advice.

Kodi

I've had a DVT, and it was at my desk at sea level, not in a plane. I've since flown with no problems.

Some of your questions really can be properly answered only by someone who knows your medical history.

Travel shops won't likely sell fitted compression stockings, these usually come from medical supply stores (which are sometimes sidelines of major pharmacies.) Ask your doctor's receptionist for help on finding them in your area.

I don't wear these stockings on flights, and my haemotologist says I needn't, but see paragraph 2 of my post.

Catnapping for a bit in a seated position is one thing, but I don't think long sleeps are considered to be a good idea when you can't easily turn and shift position as easily as you do when sleeping in a bed.

kodi, Here's an article you might want to look at :
http://www.traveldoctor.co.uk/flights.htm

Hi Kodi.
Sue has given you excellent advice, and the link that Marci provided is brilliant.
I am a haematologist and, as Sue says, it is difficult to advise without knowing your medical history. Did you ask your doctor for advice or was this given due to any previous history or risk factor?
The main risk factor is previous DVT. There are a number of haemostatic (i.e. relating to the ability of your blood to form a clot) abnormalities that can cause you to be more susceptical to spontaneous clot formation - the most common is a genetic mutation of your clotting factor V (five) called Factor V Leiden.
Anyway, if you have a haemostatic risk factor then you are 8 times more likely to form a DVT. Add to this another risk factor such as contraceptive pill and you are 30 times more likely to thrombose. Then throw in a third risk factor such as flying and.....you get the picture.
The problem for us in our laboratory is that we are able to test for a number of these likely genetic risk factors (e.g. lupus anticoagulant, activated protein C resistance) but if we find one if there were a routine screening programme what would we do about it? Do we really want to tell an 18 year old that at some point in their life they may get a DVT when the only realistic prevention is life time course of warfarin (with all the dangers and restrictions it involves)? Add to that the likelyhood that airlines would refuse to fly anyone without indemnity that has been shown to have a major risk factor.
Take the aspirin as directed, wear the stockings available, drink plenty of fluids and try not to be immobile for too long. There are simple excercises that can be made on board. Lastly, don't worry about it because you are minimising the risk factors of flying with the above.

Thank you all very much for the information. No, I don't have any existing or past history regarding anything to do with DVT. I was just at my doctor's for a totally unrelated matter and happened to start talking about travel, and she mentioned the stockings and aspirin. I'd rather be safe than sorry, but don't want to be paraniod either.
I have flown to Europe many times with no problem, but now I'll be taking a trip to NZ....much longer!!

If you have no past history and drink plenty of water then you'll no doubt be fine.
Enjoy the trip.

well I am not a doctor but have worn the stockings on long flights (just got them at the chemist) and they were great no more sore legs .
I hope you like NZ I love it but I am a little bias its home

My doctor also advised wearing compression stockings, and she has a supply in her office. She said she always wears them when she flies. So I bought a pair there and wore them when I flew to Europe last month, and they felt fine. I also got up and stretched my calves several times during the flight. I'm at risk because of taking evista (a kind of non-estrogen substitute for HRT). In any case, wearing them made me feel virtuous (in the sense of doing something preventive...).

You've now got me interested to know whether there is a qualitative difference in the "travel socks" as advertised in the catalogues and shops, and "support stockings." Does it matter which you wear? I did not kinow about these on my last trip and wish I had. Also, on the last overnight overseas flight I took, from east coast USA to London via an airbus (USAirways), I saw a fairly large group of people gather at an area of the plane with some floor space & no seats to do exercises. If I'd had the support or travel socks/stockings & joined them, I might not have had that miserable leg pain from lack of movement while ON the plane, and badly swollen ankles for the entire trip! (Yes, the swelling went down overnight each night, but by afternoon of days filled with summer heat & walking, they were right back up there) Or, the problems might have been at least diminished.

eliztrav: I don't think the ankle swelling would have been alleviated by support/compression hose and exercise on your flight. My feet and hands always swell in heat and particularly when we were on cruises.

We just returned from Hawaii and as always had the swelling, even though on our flight over we drank lots of water and did try to walk a bit. My husband and I routinely take aspirin daily under doctor's orders.

I have a couple of rings that are a little large for me because they were bought on these kinds of trips before I realized my hands were larger than usual.

Thanks, Giovanna. Guess I will need to look for other solutions. Air travel just seems to bring it on!

kodi-

I am someone who usually wear compression stockings during transatlantic flights. Not that I think they will prevent me from getting DVTs, but they definitely keep my swelling down. My feet still swell, but to a much lesser degree.

Sans a personal history of DVT or recent surgery, the stockings may be overkill.
Agree with the advise for hydration (lots of water), exercise, limit alcohol and caffeine, and take an aspirin if you have no contraindications.
Your internist can best advise you.
A recent Brit article suggested DVT is as common in First and Business class X'ing the Pond, so an upgrade may not help (I'm sceptical of their conclusion).
M (MD, ABIM,ABNM,ABR)

I was a little surprised to learn one of the top risk factors is being an athlete, particularly an endurance athlete such as a marathon runner.

A good site:
http://www.airhealth.org/

What exact part of their findings are you sceptical about Mikemo? Unfortuantely, it is very very true that DVT is not confined to economy. That's basic blood coagulation I'm afraid. There are many risk factors and if you have a combination of these and then add the fact that you are in a confined environment (first, business or cattle) then the chances of a clot are increased - regardless of how much you paid for your tickets.
The current trend in finding blame with the airlines will end in tears - mark my words. Look closer to home. Your biggest risk is genetic, so if you want to blame someone, blame your parents and not the airline. This litigeousness will end up with the airlines demanding negative Thrombophilia screens (the medical tests to indicate genetic problems) from passangers before they will allow them to be carried.

Kodi
My 74 year old wife died from DVT 5 years ago.
I always wear compression stockings on flights.
I have found that there are many different degrees of compression.
I purchase mine at a drug/chemist store for about $15 a pair and I buy those those with the highest compression rating.
The stockings are opaque and look like the support stockings that they are are so a woman would probably want to wear slacks.
My travel mate recently bought several pair of inexpensive sheer stockings advertised as support stockings but they are worthless.
Mine are so tight that it is very difficult to pull them on over my scrawny calves. You can purchase them in a variety of colors.
Better to be safe than sorry
Don

AR
No argument on all points, but the article's data need additional confirmation.
M

Don76, I'm so sorry to hear about your wife. thanks you so much for your reply and to all the others who replied. Don thanks the added information that support stocking don't do the trick. I'll be sure to get the compression stockings.
I am not a hypocondriac or a worrier, but from what I'm hearing and reading, for the sake of a pair of compression stockings, I think I'll get a pair. I don't have a swelling problem, but I agree with RebeccaM, I'll feel that I'm taking positive steps to take care of myself. Better to be safe than sorry.
Kiwicher, I'm really looking forewward to NZ....my first visit and a dream come true!

OMG, I'm not hypochondriac but now even I'm worried a bit about this. I've flown 4 times across the pond, am only 34, and as far as I know (from some fertility testing I had) I don't have a factor V leiden/clotting issue. But I can't help but wonder a bit now if I should wear the compression hose? And my DH, who is training for a marathon.. also 34, should he wear a pair?

Is this something new? I had never heard of it till today. Is this something that more and more they're seeing in long flights, or just something for the news to report since they've run out of things to say about Iraq?

~kat

kodi-
The stockings you want are NOT regular support stockings; they are called antiembolism stockings. They are constructed in such a way that they exert more pressure at the far end and progressively less as you go up the leg. The idea is to promote the return of blood through the veins to the heart. If you do wear them it is essential that you put them on properly. If not, and they "bunch up" in one section they can actually exacerbate the DVT risk by impeding rather than promoting venous return - rather like putting a rubber band around your leg. You can buy them at many drugstores or medical supply stores under different brand names.
The good doctor has given you sage advice about risk. There is increased attention paid to this these days mostly (IMHO) because airlines are attempting to shield themselves from potential liability lawsuits.

Thank you Seamus. I'm just heading out for a day of shopping , so I'll let everyone know how I make out.

One additional suggestion: you can get a two-chambered inflatable pillow-thingie that lets you "walk" while sitting down--air is forced from one side into the other, helping you increase circulation in your legs. I've used this on several trips, and it helps when it's difficult to get up and move about in the aisles. You can find them in the Magellan catalogue.

Ok, folks, I bought my "stockings". I bought them at the HOme Health Care store affiliated with my local drug Store ( Shopper's Drug Mart, Canada) and the girl there was very helpful.
I bought knee highs , which come in diffent colours and sizes. The brand name is Sigvaris Graduated Support Stockings. The package says, "15-20 mmHg is applied to an average ankle circumference". They are made in the USA and the box says "sigvaris is a registered trademark of a Swiss company.
ANyway, I'm all set, and hope the information is helpfull to others.

Hi again Kodi.
Let us know how you get on with the stockings on the flight. This information is always useful. You only need to take a bag of something like Doritos on board a plane and then watch them expand when in the air to see the pressure drop in the cabin during a flight. Anything that prevents your feet doing something similar has to be an advantage to maintaining the blood circulation flowing as freely as possible.
Have a great trip.

ok AR, I'll let you know. Nest week I'm taking a 4 hour flight to Calgary, so it will be a good practice run for NZ. I'm anxious to see how they feel. I don't usually have a problem but know my feet swell a bit. I always have to really push my shoes back on at the end of a flight!