DVT/Deep Vein Thrombosis
Good friend and superb photographer Paul McKenzie recently had a stroke after traveling from his home in Hong Kong to Kansas City on business. He was very fortunate to receive excellent medical care after driving himself to the hospital and finding the ER empty. The clot busting drug did their job. My understanding is that the doctors there were noncommittal as to the cause of the stroke. After learning that Paul was relatively young and in great shape, my good friend in San Diego, the brilliant Dr. Cliff Oliver, was sure that Paul’s stroke was caused by DVT.
I asked Cliff to write something up for the blog. And he did.
DVT Prevention by Doctor Cliff Oliver
If you think that you might have a high risk of developing DVT, Deep Vein Thrombosis, be sure see your doctor before you travel. Two major categories of those at risk for suffering DVT are the elderly and, surprisingly, well conditioned athletes. I have had several clients in the past few years who have suffered DVT strokes over the past few years, several in the latter category.
Studies have concluded that airline passengers who wear compression stockings during flights of four hours or more can significantly reduce their risk of DVT as well as leg swelling (edema). The below-the-knee stockings apply gentle pressure to the ankle to help blood flow. They come in a variety of sizes and there are also different levels of compression. Class 1 stockings (exerting a pressure of 14-17 mmHg at the ankle) are generally sufficient. It’s vital that compression stockings are measured and worn correctly. Ill-fitting stockings could further increase the risk of DVT. Flight socks are available from pharmacies, airports and many retail outlets. Take advice on size and proper fitting from a pharmacist or other health professional.
While You Travel
If you are planning a long-distance plane, train or car journey, ensure that you:
- Wear loose, comfortable clothes.
- Wear a properly-fitted pair of flight socks (compression stockings).
- Store luggage overhead so you have room to stretch your legs.
- Do anti-DVT exercises. Raise your heels, keeping your toes on the floor, then bring them down. Do this 10 times. Raise and lower your toes 10 times. Do it at least every half an hour, more if you are awake.
- Get up and walk around whenever you can.
- Drink plenty of water.
- Don’t drink alcohol or take sleeping pills.
A scientific study split a group of more than 600 passengers classed as low-to-medium risk of having a DVT episode during or after flights from from London to Arizona and New York into two groups: Half took no preventative measures against DVT while the other half wore Dr. Scholl’s Flight Socks providing a compression level of 14-17mmHg at the ankle. The result? More than 4% of those not wearing Flight Socks suffered from some form of thrombosis during the flight to Phoenix and more than 3% flying to New York. The incidence of thrombosis among those wearing Dr. Scholl’s Flight Socks was zero.
For optimum efficiency, you should wear your compression socks throughout your journey, and not necessarily only during your flight; you may have long distances to travel on one or both sides of your flight and should ideally also wear them then too. Wear them in place of socks or hosiery and always ensure that they are pulled up to just below the knee. Make sure they are free of wrinkles and do not roll them down.
The obvious way to prevent DVT on long flights is to get up and move around frequently. Few people do; it seems they are reluctant to get up because they are embarrassed or afraid they will inconvenience the person in the next seat. They just sit there like bumps on a log for hours and hours and hours. Movement is the key to avoiding DVT.
A little sodium or potassium citrate in your drinking water before and during the flight will help prevent flocculation (thickening of the venous blood). Use “potassium citrate” if you have high blood pressure issues.
The following supplement, Nattokinase (1 three times daily before meals), and Diphasic PM (2 before and after traveling) help keep the blood flowing.
More
You can help support the BAA Blog by purchasing your compression flight socks here
You can order the two supplements above from Dr. Oliver via e-mail. Most of you know that it was Cliff who put me on the path to better health and longer living more than 20 years ago. If you would like to learn the whole story please shoot me an e-mail with the words “Health Basics File” cut and pasted into the Subject Line. Please remember that I will not be back on line until mid-November.
Learn more about Dr. Oliver at the Center for Balance website here or friend him on his Facebook page here.
Those who are 100% serious about improving their health should consider working with Dr. Oliver on Skype. Your first 30 minute consultation is free. Again, you can reach Cliff via e-mail.
A Similar Take on DVT
The information below is from the Dr. Scholl’s DVT Socks website page here.
|
|
|
The information above is from the Dr. Scholl’s DVT Socks website page here. |
Fly Safely!
The risk of DVT is real. Be sure to fly safely.
later and love, artie
Following Up on DVT:
Nov. 26, 2007 — Having a DVT (deep vein thrombosis) or a pulmonary embolism may make a heart attack or stroke more likely, especially in the first year after having a DVT.
Danish researchers report that news in The Lancet.
A DVT is a blood clot that forms in a vein deep in the body. A pulmonary embolism is a sudden blockage in a lung artery, usually due to a blood clot that travels from a deep leg vein to the lungs.
Click here to see all the active links: http://www.webmd.com/dvt/news/20071126/dvt-tied-to-heart-attack-stroke-risk
Thanks Artie. Very nice of you to post this kind of information. I once had an incident where it felt like my skin on my thigh was caught in a zipper. I suspected DVT and immediately began to pace the aisles. Fortunately no after effects and no further occurrences. Based on the advice you posted I just ordered a pair of socks for my next long flight. Much appreciated.
YAW. That sounds exactly like a DVT episode so you were lucky. artie
Art,
My first clot may have been a superficial clot because it was not diagnosed when it happened. I had just gotten back to McKinley Nat Park (now Denali) in August 1967 after 10 days in hospital thanks to a bear which objected strenuously to my presence – on earth! At the time I was climbing every weekend throughout the year, usually with 60 to 80 pounds in my pack. I was in good shape.
That clot was, in my opinion due to a bite in my left calf that left a scar about 4″ long and an inch or inch and a half wide interfering with circulation.
In 1987 after a marathon drive to NYC from Anchorage (six days if I remember correctly) I had a DVT that was not diagnosed until it hit my lung in Saskatoon on the way back to Anchorage. I was on Coumadin for about 6 months. In 1997 I had a couple of superficial VT’s and went on Coumadin permanently (I was on coumadin at the American Bald Eagle Festival when you were there).
Ironically, in ’87 Ii suggested to my doctor in Anchorage that we collaborate on an article about bloot clots on long flights. He would not do it because ‘it had not been shown that clots were associated with long flights.’ I just recently read that Wall Street Journal published an article on research showing the link in 1987.
I used the compression stockings when I got out of the hospital in Saskatoon for the drive back to Anchorage. The problem with the stockings is that in my case they do not stay up resulting in them acting like a rubber band around my calf restricting blood flow. Not good.
When I fly now or drive long distances I wear cycling tights (I am a cyclist). They seem to help keep leg swelling down and they do not fall down the way stockings do. I also try to increase my PT/INR (clotting time)by increasing my Coumadin dose. So far this strategy seems to work – I am still alive.
The mauling was probably more a trigger than a cause of my clots. My mother had clotting problems (after an injury), my youngest brother is on Coumadin after a DVT, my first brother died from a pulmonary clot after a hit and run accident (and possible beating by drug dealers in Queens) on his bike while riding home from work – so clots seem to run in the family.
For people with no clotting history I think it is a good idea to take precautions against what has been dubbed tourist class syndrome on long flight. Bike tights seem to be a good idea and unless the doc advises otherwise a couple of aspirin can help (check with an MD before taking meds, even aspirin).
I owe thousands of images to Coumadin without which my wife would undoubtedly have collected my life insurance long ago.
When hiking and photographing in bear country (anywhere in Alaska) I recommend carrying a can of bear spray and a .357 or .45 handgun. If a bear attacks spray it. If that doesn’t work the handgun is for backup. Put the muzzle in your mouth and pull trigger.
Hi Jim, All that sounds exciting. I have a ton to say so I will be as brief as possible.
#1: Coumadin is a poison. All aspirin causes internal bleeding, even children’s aspirin. There are several completely safe natural alternatives. How do I know? I take them as I formerly experiences lots of A-Fib episodes. I would suggest that you get in touch with Dr. Oliver. Your life, your call.
#2: As I believe that I stated above, it is important to get socks that are correctly fitted.
#3: good luck with our next bear encounter…
a
to all: Just saw a patient today with DVT/PE after a 16 hour flight from South Africa to Boston. She is on treatment and should do well but will need support hose and instruction for future trips. She is only 24.
Dear Artie,
This is just to inform you, and your readers on this blog, that DVT does NOT cause a stroke, unless there is a hole in the heart! DVT is a clot in the veins (usually of the leg), which can break off and travel to the lungs, via the heart, and block the pulmonary arteries. This can lead to pulmonary embolism and death. However, the clot from the leg veins cannot travel across to the left ventricle, which pumps blood to the brain, among other organs. If the rare event there is a hole in the heart septum that separates ‘impure’ blood in the ‘right heart’ from the ‘pure’ blood in the ‘left heart’, a clot dislodged from a leg vein can travel from the ‘right heart’ to the ‘left heart’, and can then be pumped into the cerebral arteries, thus causing a stroke.
I hope the above clarifies matters.
This is not to say that DVT is not dangerous. It is, and can be fatal, if the clot blocks the pulmonary arteries.
Hi Ajit, I am not sure if Dr. Oliver responded to your comment but when I asked him he told me that there are many new studies that show that DVT episodes can cause strokes even in folks without the hole in the heart…. Please do not take it personally but I have little faith in Western Medicine. If you would like to learn why, shoot me an e-mail and request my Health Basics File. Briefly I was told in the mid-1980s that I have “advanced coronary artery disease” and was put on all manner of (poisonous in the long run) heart meds. I have been working with Cliff for about 20 years. Via changes in diet, moderate exercise, and way too many supplements :), I have been weaned off all of my heart meds for well more than a decade. My BP in the doctor’s office is usually about 135/70. And I have had only one bout of a-fib in the last 7 years and that one was my fault–dark chocolate.
respectfully, artie
Thanks for sharing the great write up Artie.
DVT is a real threat and I experience it myself with swollen legs on longer flights. Wearing the compression socks is a valid solution and is part of my travel kit now. Sitting exercises, getting up, stretching, and walking although annoying to the flight staff are good preventative measures also.
YAW Roger and be sure to drink lots of water during the flights!
a
For sure, hydration is key. Another reason to get up and about during long flights is to grab a water and to use the facilities.
Thanks, Artie. I was looking for Compression Socks to order yesterday but didn’t know what kind I should get. I just ordered a pair of DVT Flight Socks. Definitely a great article and advice.
YAW Lana. And John and David below as well 🙂
a
Thanks for this info Artie. I am going on a long flight to Australia and I would have never thought about this.
Thank you, kind sir.
Thanks Art for doing the warning about DVT’s . It is a real threat at all ages and condition and especially with long air flights. The advice is good and especially the advice to MOVE on the flight-I am lucky at my age since I have to go to the bathroom a lot. The main complication besides local swelling and pain is Pulmonary Embolus(clots from the calf or pelvic area dislodge and float to the lung vascular system blocking vessels-the size of the clot and acuteness of the event helps determine the seriousness of the event ). This situation can cause sudden death ,breathing problems,etc and before CT diagnosis was the greatest missed diagnosis with sudden death . Post postpartum patients were susceptible along with post surgical and do not complain when your Surgeon and nurse make you walk just after your delivery and surgery because this is why they do it. I unfortunately break all the rules when I drink red wine but balance it with water(rationalization?). Stay healthy and alert to potential problems with long trips as you age and be active on long flights !!
Hey Chas, YAW. Thanks for sharing your thoughts on DVT. later and love, artie
Artie DVT/PE happens to be an area of my medical expertise. You did a good job in your write up. One thing to note is that the only way to get a clot to travel from the leg VEINS to the ARTERIAL circulation of the brain is to have a communication between the right and left atria in the heart — something called a patent foramen ovale. It is a very rare cause of arterial embolism and stroke in association with DVT. There are specific tests to determine if such a hole exists. It is a congenital condition. The hole is supposed to close shortly after birth. I think the advice about hydration, exercise, use of support hose is right on. I know much less about the supplements you recommend but who knows, they might work. 🙂 One other interesting tidbit Studies have shown that risk is directly related to length of flight the uptick occurs after about 6 hours of nonstop flying So you Mr World Traveler are likely to be more at risk than those of us who stay closer to home. 🙂 It would help a lot if airlines were a little more generous with space for passengers in coach. Don’t hold your breath for that to happen Best, hope all is well Loving my Induro tripod. Just finished a business and photo trip to the Four Corners area including long exposures in slot canyons. Tripod was great and pictures are razor sharp. Not like the bird pics I did with you this summer. Bob
Hi Bob,
I am not sure that you are 100% correct. See my comment to Ajit above.
later and love, artie
Thanks Artie!
I am wearing these socks on every flight, they prevent also the swelling of the legs the next day.
YAW Ruth. a