What is Deep vein thrombosis?
Deep vein thrombosis is a thrombus (blood clot) within a deep vein, often in the region of the thigh or calf. The blood clot can either partially or completely block the flow of blood through the vein. It occurs when the flow of blood becomes restricted in a vein, forming a clot. Causes are poor circulation because of problems such as heart disease, a recent heart attack or stroke, varicose veins, or from inactivity or prolonged bed rest.

Deep vein thrombosis might develop during long-haul flights and is sometimes referred to as ‘economy class syndrome’ because cheaper seats often found in 'economy class' areas have less leg room. Nevertheless, it is not just confined to economy class seating or to the longer flights.

Deep vein thrombosis can be caused by a narrow or blocked vein in which blood gathers and clots. This might occur after such as a blow to a leg, following some surgery or radiation therapy. It can also occur during pregnancy as there is then an increased tendency for the blood to form clots to prevent excessive bleeding during childbirth.  Deep vein thrombosis can sometimes occur as the following a severe infection, liver disease and some cancers.

Deep vein thrombosis is more common in elderly folk or people with a weight problem, but healthy people of all ages are not immune. Some people do not have ‘blood thinning’ substances (from birth) and are more susceptible to blood clotting. Certain medicines, such as the contraceptive pill and HRT, could increase the risk of developing deep vein thrombosis.

So...  certain people are more vulnerable. These include pregnant women, the overweight, the elderly, smokers and people with coronary artery diseases and certain blood conditions.

How can I tell - what do I look for?
The symptoms of deep vein thrombosis include:

• tenderness and redness in the affected area
• pain and swelling in areas drained by the vein where the blood clot is located
• fever
• rapid heart beat
• sudden, unexplained cough
• joint pain and soreness

Serious!
The serious complication of deep vein thrombosis is a pulmonary embolism. This is when a blood clot breaks free from a vein wall and travels to the lung and blocks an artery. A pulmonary embolism can be life-threatening and needs immediate medical attention. Deep vein thrombosis can also cause  miscarriage or stillbirth if a blood clot breaks free and lodges in an artery in the placenta, thus reducing the oxygen supply to the foetus. If your doctor suspects a blood clot, they will perform a physical examination and look into your medical history. A sharp pain when your foot is flexed upwards may indicate a blood clot in the leg. Other tests may also be conducted, including an ultrasound scan, X-rays of  veins after dye is injected to check blood flow, or measurement of the body’s blood-clotting mechanism

Prevention - better than cure
To lessen the likelihood of deep vein thrombosis, try and avoid prolonged bed rest. If for any reason you are confined to bed, move lower limbs regularly. Smoking is strongly discouraged. Regular exercise is important too. The use  of support stockings is recommended if you have severe varicose veins.

Aspirin caution
The chances of developing deep vein thrombosis from a long flight are thought to be rare (one in around several million), but preventative measures can still be taken . A single low-dose aspirin just before boarding a flight helps to thin the blood. However, do not take aspirin if you have stomach ulcers or suffer badly from indigestion. This can cause bleeding in the stomach. Loose clothing is advised, as is staying mobile prior to boarding the aircraft, as well as during the flight period.

One easy method to keep circulation going is to wriggle your toes and flex your ankles, walking up and down the aisle when you can. Do not sit with crossed legs. Drink plenty of water during the flight, and avoid alcohol (alcohol can dehydrate the body). People at most risk of developing deep vein thrombosis should consult a doctor before flying. Obtain medical advice if you have symptoms suggesting deep vein thrombosis, even if they appear some time after you have flown, or after a short flight.

Deep vein thrombosis can be be successfully managed and resolved but only if treated early.

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