Tips to prevent blood clots while traveling

No matter how you travel keep moving                                         Liz Macera

In 2003 David Bloom, a 40 year-old news reporter, died suddenly from a blood clot to his lungs. Bloom most likely developed the clot first in his leg during a flight from the US to Iraq. According to preventdvt.org 300,000 die annually in the US as the result of blood clots, including those that developed during prolonged travel as well as other causes. Those over the age of 60 are at increased risk.

A blood clot, or deep vein thrombosis (DVT), can develop in the legs any time one is immobile. Normally the strength of a heart contraction pumps blood to the lower extremities; however, this force is not strong enough to return the blood to the heart without assistance. The circulatory system depends upon assistance from the contraction of leg muscles to help the blood return to the heart.

When the leg muscles do not pump sufficiently or there is an obstruction in the vessels, blood will pool in the lower extremities. Anytime blood is stagnant, there is the possibility it will clot. Prolonged sitting in an airplane, car, or bus can increase the chance of clot formation.

A clot in the lower extremity might not cause difficulty other than swelling and pain. The real danger comes if and when that clot becomes dislodged and travels to the lungs. Termed pulmonary embolism, this can be life-threatening because it interferes with the movement of oxygen from the lungs to the blood.

Here is a video clip showing how a clot forms and then migrates to the lungs: http://www.youtube.com/watch?v=gGrDAGN5pC0&feature=PlayList&p=319B24E31CDEFCE1&index=1

Fortunately there are medications that can thin the blood and keep the clots from enlarging while the body works to dissolve it. These medications can reduce the chance of a clot going to the lungs.

There is no way to completely eliminate the risk of developing a blood clot, but the measures below are thought to reduce the risk.

1. Drink plenty of water As long as you have no medical reason to limit your water intake, drink water regularly. While 8 glasses of water is the usual recommendation, there is no research that supports the notion that this is the right amount for everyone. Drink enough water so that your urine is light yellow in color.
2. Avoid caffeine and alcohol. Both tend to worsen dehydration.
3. Stop every 1-2 hours while on the road. If you are traveling in a bus, airplane, or train, stand up. If you travel by train or ship, get up and walk frequently.
4. Walk as much as possible on the days that you travel. At the airport uses the stairs when possible rather than an elevator or escalator. Walk to your gate rather than using the moving sidewalk. When traveling by bus or car, walk for several minutes at each stop.
5. Exercise your legs. Exercises that contact the leg muscles help the blood return to the heart. Examples are leg lifts, flexing your feet. Stretching is also helpful. Here are some links to leg exercises for traveling:
   • leg extensions http://www.youtube.com/watch?v=BHH0Y5Eb8Xo
   • seated quadriceps http://www.youtube.com/watch?v=YsmfbXz7LVU&feature=channel
6. Graduated compression stockings. Purchase lightweight (8-15 mm Hg pressure) support hose for travel or get a prescription for medium weight (25-35 mm Hg pressure) knee-high support hose.  Smooth out all the wrinkles.
7. Don’t smoke. Smoking increases the tendency of your blood to clot.
8. Check with your health care provider about additional steps you can take. For example, if you are at risk for developing clots because of a medical condition, medications, or your genetics your doctor or health care provider may prescribe medication to help prevent DVT.

The most reliable sign of a DVT is the sudden onset of swelling in one leg. Pain may or may not be present. If you have any concern that you may have developed a DVT, call your health care provider right away.

For more information:

Medline Plus http://www.nlm.nih.gov/medlineplus/ency/article/000156.htm#visualContent

Mayo Clinic http://www.mayoclinic.com/health/deep-vein-thrombosis/DS01005

American Academy of Family Physicians http://www.aafp.org/afp/20011215/tips/4.html

Centers for Disease Control http://wwwn.cdc.gov/travel/yellowbook/ch6/embolism.aspx

This article is for education purposes only and does not constitute medical advice. Contract your health care professional for advice specific to you.