You may have heard that air travel increases the risk of developing a deep vein thrombosis (DVT). But did you know that those traveling long distances by train, bus, and car are also at an increased risk? You may wonder, what about travel causes DVTs to develop? What are the signs of DVT? And finally, how can you reduce your risk this busy holiday season?
DVTs are blood clots in a deep vein which develop after long periods of immobilization. This leads many to believe the cramped legroom found in transport seating is to blame for the increased risk associated with traveling. Of these clots, 90% can be found in the legs. Other common sites for DVTs may include veins in the arm or pelvis. Studies have found that DVTs in the distal lower extremity have near to a 25% risk of propagating to the upper leg. DVTs found in the proximal lower extremity have about a 50% chance of migrating to the lungs. If a thrombocyte from the legs does travel into the lungs, it may lead to an acute pulmonary embolism, a potentially fatal event. Just how much is your risk increased during travel? Epidemiologic evaluations have found that the risk of developing such clots as much as triples in those traveling long-distance.
Perhaps the most concerning factor surrounding DVTs is that you may not know you have one. Often blood clots may be asymptomatic leaving a person without any indication of their development. When a person does present to a clinician for evaluation, symptoms typically include edema, pain, warmth, and erythema of the affected limb. In severe cases, the limb may even be gangrenous or cyanotic. Because a clinical examination may not be enough to confirm a DVT diagnosis, many doctors rely on ultrasonography or other imaging for their patients. In cases where results from non-invasive tests remain in question a venography, once considered the gold standard, may be used.
It is important to note that the overall risk of DVT is statistically low but, as a potentially life-threatening condition, it is best to take preventative measures. There are some ways to reduce your risks. These measures include wearing loose-fitting clothing while traveling. Also, be sure to get up and move around or do stretching exercises once each hour to allow for unrestricted blood flow. Finally, doctors recommend that you make sure and stay hydrated by drinking lots of fluids while avoiding coffee and alcohol.
For those at elevated risk, for example, persons who have recently undergone surgery, it may be advantageous to consider asking a doctor to prescribe compression socks before travel. Those with recurrent DVTs due to an inherited or environmental factor may even be prescribed anticoagulant drugs for travel under otherwise normal conditions.
Treatment for DVTs includes the use of anticoagulant drugs, often as a daily prescription. Also, compression socks are considered basic for all DVT patients, and some studies have shown them to be as effective as drugs, without the increased risk of bleeding. Non-pharmacological treatment may include inferior vena cava filters which may be placed permanently or temporarily. In extreme situations, a thrombectomy or pulmonary embolectomy may be performed.
As with all medical concerns, prevention rather than treatment after the onset is the preferred approach. Keeping in mind the risks, symptoms, and tips for prevention can keep all of those flying for the holidays happy, healthy and heart safe.