The Threat of Deep Vein Thrombosis

Jul 20th, 2001, 07:54 AM
Bob Brown
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The Threat of Deep Vein Thrombosis

Not that some of the concern over BSE and hoof and mouth disease seems to be abating, I think it is time we focused on a potentially dangerous situation that can arise on long airflights: Deep Vein Thrombosis.
In volume 357 of The Lancet, pages 1485 - 1489, there is a research article that reports the results of a study that investigated the threat of deep vein thrombosis in airline passengers. The passengers were all over 50 and involved 231 subjects. The passenges took round trip flights of 8 hours each way.
Part of the study group flew with support type stockings. The other part did not.
Of the unprotected group, 10% developed deep vein thrombosis as detected by ultrasound examination.
The cause is possibly attributable to the rigid positions that tourist class passengers must assume for long periods of time.

Not enough is yet known to begin talking about legislation to force the airlines to change seating configurations. And some researchers feel that this particular study was inconclusive and the results must be read with caution.

My own view is that this is an idea whose time has come. Circulatory ailments are more of a threat to us, the flying public, than has previously been discussed. It is more likely to affect many of us than any of the diseases like BSE or hoof and mouth disease.
I am among those who feel that cattle class seating is intolerable. Hopefully this study is the beginning of an effort to demonstrate scientifically that there is a definite health risk involved because of the seating conditions.

Although I have seen no studies reporting any link between air rage and cattle car type of seating on the airlines, I wonder how many passengers in first class and business class seating areas have fits of violence while flying.
Anybody seen a scientific study of air rage?
If so, please let me know. I would like to read it.
Jul 20th, 2001, 08:15 AM
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I don't know about "fits of violence" in 1st and Business Class but I have seen "fits of drunkeness" which lead to disgusting behavior.
Jul 20th, 2001, 08:58 AM
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I only have anecdotal evidence. A friend took a sleeping pill on a flight from Hong Kong to LA, thus not leaving his seat for most of the flight. A day later he ended up in the hospital with a life-threatening blood clot in his leg.

I always have been a "walker" -- but since then man.. I get more exercise IN the plane than I do at home.
Jul 20th, 2001, 04:23 PM
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I heard a doctor on T.V. say that its advisable to take an asperin before you fly, especially on long trips. Makes sense! Thins blood and prevents clots.
Jul 20th, 2001, 05:34 PM
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You don't have to be old or inactive to develop DVT, on the way to the Olympics in Austalia, 2 members of the British soccer team developed it. I'm like sally, an aspirin before flight time, then I'm out of my seat walking, I'd rather be tired on arrival then hospitalized, especially if you don't have great circulation to start with. wear loose clothing too, and support hose won't hurt either!
Jul 20th, 2001, 05:46 PM
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Great advice! So if you're on a flight to Paris at the end of August and you see me zipping up and down the aisle...
Jul 20th, 2001, 06:00 PM
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Sorry but I have to share this, wearing hose is discouraged on a plane due to the fact that in a fire they will melt to your legs. I drink lots of water on the plane and therefore, have to get up to walk to the restroom. No problems yet.
Jul 20th, 2001, 06:20 PM
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sorry sally I won't be on a plane to Paris tillOctober, but I'll follow the path youwore into the carpet..

And I'll wear the hose , more chance of DVT than fire, especially at my age, maybe a few scars would eliminate some of the varicose veins!!
Jul 20th, 2001, 07:52 PM
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A friend of ours had a mild hert attack due to this before it had the fancy name. In June we were in Australia and Qantas runs a video in 8 different languages explaining it and suggesting little foot exercises (same video, run 8 times with different language each time..They REALLY want you to be aware fo this. The excercises are very easy and seemed to reduce the swelling I usually get in my feet.
Jul 20th, 2001, 09:08 PM
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Two years ago I developed a blood clot in my leg which progressed to a pulmonary embolism prior to being discovered. The first question I was asked was...have you been on any long flights recently. I had just returned from Europe. I was 50 at the time and healthy. I am 6' 4" and was told because of my height I was more susceptible. Needless to say since this incident I do not stay in my seat on flights, long or short.
Jul 21st, 2001, 02:03 AM
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The threat of deep vein thrombosis (DVT) and pulmonary embolism (PE) as complications of long flights is very real, andnot only to the elderly: the youngest patient with PE after a flight from Bangkok to europe I have seen was just 23 years of age.

Risk factors for DVT/PE include:
long immobility
previous DVT or PE
nicotine use
estrogen supplements (birth control or menopausal treatment)
dehydration (also provoked by alcohol or caffeine).

Preventive measures may include:
wearing compression stockings AND exercising your legs regularly,
drinking lots of fluids: bring along your own bottle of water; avoid caffeine and alcohol,
wearing loose clothes
standing up and walking around for 5 minutes every hour
Having an subcutaneous injection of low molecular weight heparin (LMWH) before long flights (more effective than aspirin),

Last time I have seen a patient with PE after a long flight: 2 Monaths ago (BKK-ZRH).

enjoy your trips and stay healthy.

Jul 23rd, 2001, 04:58 AM
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don't just get mad at coach seating, the problem is anytime you sit for long periods of time. You can have the same problem when ride in a car for long periods of time with out getting out and walking around. That's why we get up and do deep knee bends etc.. when we fly. My mother-in-law had major problems from this after a 16 hour drive back from Denver.
Jul 28th, 2001, 04:40 PM
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Saturday, July 28 9:07 PM SGT --- CAPE TOWN
Airlines knew about economy class syndrome 30 years ago: report
International airlines were warned about the dangers of "economy class syndrome" more than 30 years ago but failed to caution passengers, a report here said Saturday.
The Cape Town-based Saturday Argus quoted a retired South African medical professor as saying he co-authored a report in the British Heart Journal in the late 1960s that stated that long flights increased the risk of deep vein thrombosis.
Peter Beighton said he wrote the report after studying the symptoms of 25 passengers who were treated at Hillingdon Hospital near Heathrow Airport outside London between 1963 and 1965.
One of the patients died from a cerebral embolism, he told the newspaper.
Beighton said he and Peter Richards, a young British doctor, concluded that sitting still for long periods combined with the pressure of aircraft seats pressing against the backs of passengers' legs and a shortage of oxygen in cabins created "an ideal climate for deep vein thrombosis."
In their report they advised that airlines should encourage passengers "to take a stroll to the washroom along the aircraft gangway for the benefit of exercise from time to time during a long flight".
He said it was shown to British Airways before it was published.
Two Australians and a South African who claim they were the victims of "economy class syndrome," this month began a legal battle for compensation from airlines they accuse of ignoring a potentially fatal health threat. The landmark lawsuits accuse Dutch carrier KLM, British Airways and Australia's Qantas of failing to warn passengers about the dangers of deep vein thrombosis (DVT) during long-haul flights in cramped conditions.
One of the complainants suffered permanent brain damage after developing a blood clot on a flight between Cape Town and Sydney. The other two suffered blood clots in the lungs and legs after flying between Britian and Melbourne.
Beighton said airlines could not feign ingorance about the risk that passengers might develop deep vein thrombosis as he and Richards had warned about it.
"The issue is that the airlines said they did not know anything about it but the reality is otherwise."
Airlines have generally expressed scepticism about the existence of the syndrome, arguing that the clots could be the result of underlying symptoms and are not necessarily linked to air travel.
Jul 28th, 2001, 05:44 PM
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We're planning on flying Chicago to Melbourne next month. Although we're flying business class, DVT scares me. Are there any estimates of incidence? Is the risk high enough to scrap our plans?
Jul 28th, 2001, 06:31 PM
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Oh, please, no! The chances of having a car accident, or being hit by a stone or brick falling from a building are higher than your chances of having DVT.

Just make sure that you don't drink any alcohol during your flight, bring along a water bottle, or even better, stand up and walk to the stewards station and ask them for some. Walk up and down the aisle a few times before coming back to your seat, do some stretching before you seat and while seated. By following this procedure about five, six times during a 12/14 hours flight, you're probably not having any DVT. Unless you have already had thrombosis, or any circulatory problems.

Jul 28th, 2001, 08:12 PM
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I was a victim of DVT two years ago on a six hour flight to Singapore. Due to lack of publicity of this condition at the time, I ran around with a badly swollen leg for four days until persuaded to go to a doctor.

He put me straight into hospital, where I stayed ten days as an in- and out-patient. End of holiday.

Currently I am one of 1200 victims in a class action against the airlines.

Don't take a chance with this. Do like Phil says.

Jul 29th, 2001, 02:51 PM
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Yes DVT is a problem but as other posters have mentioned, it is not only associated with air travel. My father developed a blood clot after an 8 hour car journey.

I wondered, should fodors put up a warning on this site to tell us addicted europe forum readers to get up and walk around every hour or so?
Jul 29th, 2001, 03:14 PM
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We shouldn't forget that the the dryness and pressure, typical of the air on planes, causes dehydration, and consequently, the risks of DVT increase if compared to a car trip. Nevertheless, no one who is walking capable should stay immobile for too long, be it on a plane, car, train or bus. Some walking and stretching, bending over your knees, making circular ankles, wrists, legs movements, decrease the chances of a circulatory problem, as does drinking a lot of water.

Jul 29th, 2001, 06:47 PM
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I always prided myself in being a "no-complaints" traveller. I would hop on 5-13 hour flights, buckle in, and not get out of my seat until we got to the other end -- eat, read, and sleep in the same position.

Now I've got to rethink all of this. Yes, economy seating has gotten more uncomfortable. (No complaints here though. I think this is what is enabling the airlines to keep fares so affordable. It is cheaper for me to fly to Hong Kong today than it was 25 years ago!) Yes, age is creeping up. Maybe we'll all have to be more vigilant -- hydrate, get up and walk about, eliminate alcohol and caffeine on board, and wear nylons!
Jul 29th, 2001, 06:54 PM
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