Health and Wellbeing

Safe Travel – Travel Thrombosis / Am I fit to fly ?Travel has become extremely common with many of us travelling long distances for both pleasure and work. Before travelling one should ask the question Am I fit to Fly?

Travelling in itself is now very safe and very few people will ever encounter problems.

Some people however, will embark on long distance travel without any thought for their underlying medical problems.

If you do have medical problems then you should clearly consult your GP who is in a position to advise you, or at the very least to recommend somebody who can advise you.

I became interested in Travel Thrombosis almost twenty years ago when by chance three people came to see me in a week, who had suffered from serious blood clots entering their lungs.

At that stage although people did develop blood clots when travelling very little was known about it. Today we know that the most important factor associated with developing blood clots is immobility. People will get on an aeroplane and sit doing absolutely nothing for 8-10 hours and surprise surprise when they get off the aeroplane at the other end will complain of pain in the calf, a swollen leg or in some instances shortness of breath and have pulmonary embolisms.

The purpose of this article is to give you some insight in to the problem and what you can do to avoid it. Deep Vein Thrombosis occurs in the deep veins of the leg, it starts usually in the calf veins and progressively grows over a period of hours or sometimes days until it becomes quite a substantial clot, a piece of which can break off and travel to the lung, it is the clot travelling to the lung which gives rise to shortness of breath and can in some instances prove fatal.

Clearly the best thing to do is to avoid getting the clot in the calf in the first place.

There are three things which cause clots in the calf :

  1. Sitting still so the blood becomes relatively immobile
  2. Damage to the veins which can often be relatively trivial simply resting the leg across an iron bar
  3. A previous position for the blood to clot where the blood becomes more clottable.

Some people will know because they have had previous problems that they have a tendency to form blood clots and these travellers can take sensible precautions, all passengers should consider whether they are at risk of developing a clot, clots usually occur in flights lasting more than five hours and often occur in people who have been making multiple flights, often several flights in the preceding month.

If you think you are at risk you should ask for advice. For normal passengers who are fit with no underlying medical problems simply taking exercise before you get on the flight, wearing some sort of compression stocking, which can be bought in a chemist or in aircraft shops and taking exercise when you get off the plane is probably all that is needed.

If you are elderly, if you have got co-existing medical conditions then it would be sensible to take additional precautions and again your own doctor can advise. Those precautions may involve taking an anti-platelet agent and Zinopin is a neutral pharmaceutical which fulfils this requirement, alternatively you can have injections of low molecular weight Heparin which you take before and during travel or more recently an anti-thinner inhibitor which inhibits blood clotting, a tablet again can be taken before travel.

The message is that with a little thought and sensible precautions everybody can travel safely without the risk of developing either a clot in the calf or blood clot in the lungs.

If you are unlucky enough not to have considered the risks and end up landing in an airport with pain in the calf or developed swelling in the calf within a day or two of landing  then you should seek immediate medical advice.

The diagnosis of a Deep Vein Thrombosis is used using a non-invasive duplex ultrasound imaging. If the diagnosis is made, a simple course of anticoagulation will prevent it extending and giving rise to a Pulmonary Embolism. Early treatment often results in a very good outcome and no residual symptoms.

It really is a question of being aware that these problems can exist even though they are relatively infrequent and taking sensible precautions either to avoid them or recognising the problem early on and getting definitive treatment.

More advice on travel can be obtained from The Vein Clinic in Sandyford.