Traveler's Thrombosis: When Sitting Still Can Be Deadly

Deep vein thrombosis (DVT) (also known as venous thromboembolism) occurs when a blood clot develops in the deep veins of the legs and groin (the lower-abdomen/upper thigh areas). These deep veins are not visible at the skin's surface, and are not related to varicose veins. A clot that breaks loose and travels through the deep veins to the heart and lungs can cause severe blockage of blood flow or death.

People who develop DVT don't always have symptoms. However, those who do usually experience the following symptoms in one leg or the other (rarely both):

Symptoms of DVT include:

• Pain
• Redness, paleness, or blueness of the skin of the affected limb
• Swelling of a limb
• Tenderness along the vein
• Warmth

Sudden, severe shortness of breath, with or without chest pain, may signal that a clot has traveled to the lungs.

DVT can be diagnosed by ultrasound imaging tests, which highlight blood flow in the veins and show clot formation. If a clot is found, blood-thinning medication to stabilize the clot and allow it to dissolve will be prescribed immediately. Hospitalization may be required for several days for treatment and observation, and patients often take oral medication for several months afterwards, to ensure restoration of normal blood flow through the vein.

Risk factors for DVT include:

• Medical conditions, such as:
  • Blood disorders
  • Blood poisoning (sepsis)
  • Cancer
  • Heart attack
  • Heart failure
  • Inflammatory bowel disease
  • Varicose veins
• Taking birth control pills or estrogen therapy
• Genetic factors whether inherited or by natural changes in life can change your body protein levels
• Hospitalization
• Not moving your body for long periods of time
• Obesity
• Personal or family history of deep vein thrombosis
• Pregnancy
• Surgery, especially involving bones or joints

If you are planning any kind of travel that requires sitting for long stretches of time, be sure to do the following:

• If you are at high risk for developing DVT, your doctor may prescribe low molecular weight heparin, a medication that prevents clotting. Check with your own physician regarding your current health and medication use. You may also need to wear below the knee compression stockings.
• Arrange optimal seating: try to sit in an area that affords you some space, such as an aisle, exit row, or bulkhead seat.
• Avoid smoking; this is especially important if you are taking oral contraceptives.
• Do in-seat calf exercises and heel/toe lifts frequently to keep the blood circulating.
• Get up and walk around as much as possible—at least once an hour, if possible. Stand up and stretch your arms and legs in your seat if there is no room to walk.
• Stay hydrated, drink plenty of fluids, but avoid drinks that contain alcohol.
• Wear loose clothing and avoid tight clothing that restricts blood flow (eg, tight waistbands).

One cautionary note: DVT may surface after travel has been completed. If you experience any of the symptoms listed above, contact your doctor immediately.