Rudolf Carl Virchow, the German physician described the causes of Deep Vein Thrombosis (DVT) as Virchow’s Triad in 1856, which consists of:
- Changes in the character of blood (Hypercoagulable) – increased tendency to clot formations.
- Changes in the character of ow in the veins (stasis, slow flow).
- Changes in the character of the wall of vessels (endothelial, injury, or dysfunction due to pressure).
Since then, technology has changed the mode of travel as more people travel by car, trains or planes today than ever before.
Modern transportation restricts our mobility and walking. This is particularly more pronounced in air travel. DVT has been dubbed as “Economy class syndrome,” reflecting the cramped legroom in economy class air line seating, but it can happen to passengers in all air seating classes. It can also happen on long rides in cars, trains and buses.
A two hour flight would not be a problem, however a 12 hour flight would be a big problem as well as “Hub – and – spoke flying” i.e. connecting flights interspersed with long hours of waiting.
Other risks factors for DVT in travel are:
- Previous history of DVT and pulmonary embolus
- Inherited conditions that cause increased risk for clotting (Thrombophilia)
- Patients with cancer
- Pregnancy and after the first 6 weeks of giving birth
- Overweight travelers older than age 60
- Taking birth control pills or hormone therapy
- Recent leg and pelvic surgery
- Heart disease
- People with severe varicose veins
DVT generally lacks any immediate marking and it is difficult to spot symptoms. However typical signs include, a swollen or painful calf or thigh, paleness and increased heat around the affected area.
If left untreated, there is an increased risk of pulmonary embolus – when a part of the blood clot breaks away and travels to the lung, which can be fatal.
How to prevent DVT during travel:
1. Below the knee compression stockings/hose with a 15- 20mmg pressure. It is vital that these stockings are measured and worn correctly as ill fitting stockings could further increase the risk of DVT.
2. Contact your doctor before travel if you are one of the people with a high risk.
3. Ensure that while traveling:
- I. Wear loose, comfortable clothes.
- II. Store luggage overhead to give you more room to stretch your legs.
- III. Do anti – DVT exercises, by raising your heels whilst keeping your toes on the floor, then bring your heels down.
- IV. Do this 10 times, then raise and lower your toes 10 times, whilst keeping your heels on the floor. Do this at least once every half an hour (but you may do it more often).
- V. Walk around whenever you can.
- VI. Drink plenty of water.
- VII. Do not drink alcohol which is a diuretic and will make you dehydrated and sleepy.
- VIII. Do not take sleeping pills as these reduce your mobility.