Dubbed the ‘economy-class syndrome,’ staying motionless on long-haul flights or roadtrips is a key factor in the occurrence of deep vein thrombosis (DVT).
However, leading Australian phlebologist (vein doctor) Dr Peter Paraskevas from Paras Clinic – Vein Health Medical, says travellers can take preventative action against DVT with a series of simple steps, so their legs are travel-ready.
Says, Phlebologist (Vein Doctor), Dr Peter Paraskevas “Having varicose veins increases the risk of developing clots in leg veins. However the widely discussed Vaccine Thrombosis with Thrombocytopenia syndrome (TTS) is different to the blood clotting condition DVT because it is triggered by the immune system’s response to COVID-19 AstraZeneca vaccine. The vaccine TTS results in both thrombosis and low platelet levels.”
Dr Paraskevas, pictured, shares his seven tips to avoid DVT on long-distance plane, train or car journeys:
Wear loose-fitting clothes that aren’t tight around your waist or legs.
Wear flight socks (compression stockings).
Store your luggage overhead so you can stretch your legs out.
Walk around and stretch whenever you can.
Drink plenty of water.
Do anti-DVT exercises: an easy exercise one is to keep your toes on the floor while raising and lowering your heels. Do this a few times every 2-3 hours.
Avoid alcohol or sleeping pills.
Flight socks are recommended for people at high or moderate risk of DVT. They should be worn throughout the flight. Use below-knee graduated stockings with an appropriate compression. Get advice from a health professional on correct size and fitting.
Visit your GP
If you think you have a high risk of developing DVT, see your GP before you travel. You may be prescribed blood-thinning drugs to lessen the risk of your blood clotting, or compression stockings (also called flight socks).
Studies show 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 (oedema). They come in a variety of sizes and there are also different levels of compression. It’s vital that compression stockings are measured and worn correctly. Ill-fitting stockings could further increase the risk of DVT.
Seek treatment for varicose veins prior to long-haul air travel
People with varicose veins are at a moderately increased risk of DVT on long-haul flights. Have them assessed by a phlebologist before you travel to determine if you need treatment. Generally, treatment is avoided within four weeks of travel. In that case, follow the standard DVT prevention protocol which includes compression stockings, regular hydration and walking on the plane. A protective blood thinner may be advised but only after careful assessment by the specialist.
“New non-surgical technologies have revolutionised the treatment of varicose veins, so there’s no reason why people need to travel with heavy, tired and uncomfortable legs, or with the threat of potentially developing blood clots,” says Dr Paraskevas.
Modern non-surgical treatments can take as little as 30 minutes; most patients can walk in and out and return to their normal lives immediately. These treatments are generally considered safe and effective and have up to 98% success rates, without scarring, hospital admission or general anaesthetic.
Call your doctor immediately if you have:
Swelling, warmth, or tenderness in the soft tissues of your leg.
Pain in your leg that gets worse when you stand or walk. This is especially important if there is also swelling or redness in your leg.
Travel-related deep vein thrombosis was first reported in 1954. Initially dubbed “economy class syndrome” researchers believed that there was a link between DVT and long-haul air travel in cramped conditions. The actual number of people who get DVT from travelling on long-haul flights is unknown and is difficult to determine, as the condition can be symptomless and may not occur until some time after travel.
How does it occur? DVT occurs when blood flows too slowly through the veins. The blood forms a clot that blocks up deep veins, usually in the legs. DVT doesn’t generally have any immediate symptoms, making it difficult to spot. However, typical signs include a swollen or painful calf or thigh, paleness and increased heat around the affected area. If left untreated, people with DVT are at risk of developing a pulmonary embolism, when part of the blood clot breaks away and travels to the lung, which can be fatal.
Dr Paraskevas says, “Evidence suggests that certain groups of people are at increased risk of developing DVT on flights of eight hours or more.”
Those at high risk include people with a history of DVT or pulmonary embolism, cancer, stroke, heart disease, recent surgery (pelvic region or legs), obesity, pregnancy, hormone replacement therapy and inherited tendency to clot (thrombophilia).