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Warning Story: Flying And Deep Vein Thrombosis  
User currently offlineAndaman From , joined Dec 1969, posts, RR:
Posted (4 years 7 months 3 weeks 6 days ago) and read 6399 times:

A little warning story for the long haul fliers:

After a month long trip in Asia, which included ten flied legs, I have spent a lot of time in the Haartman Hospital in Helsinki. I needed quick help for the deep vein thrombosis.

It's also known as Economy Class Syndrome. I was upgraded to the business class with angled lie-flat seats on my last and longest leg NRT-HEL but that didn't help this time... I didn't wear the flight socks, didn't take the aspirin I should have.

It started with a little pain in my calf in the mornings especially but I thought it was just a muscle cramp. But suddenly the pain grew really bad and I had to go the hospital where they found the thrombosis very quickly. It's in control now, the medication is on and the blood clot should disappear soon. The medication and the controls will take a long time though, luckily I can inject myself at home. And luckily I didn't stay home too long, the deep vein thrombosis can kill you.

So, my advice: use those flight socks, make exercises, take the aspirin (consult your doctor).

27 replies: All unread, showing first 25:
 
User currently offlineSWA TPA From United States of America, joined Aug 2001, 1559 posts, RR: 34
Reply 1, posted (4 years 7 months 3 weeks 5 days 21 hours ago) and read 6145 times:

Thanks for the warning! Hope you are better in no time and I am glad you caught the DVT in time before anything worse happened!


I believe I can fly.....
User currently offlineOA260 From Ireland, joined Nov 2006, 26795 posts, RR: 58
Reply 2, posted (4 years 7 months 3 weeks 5 days 21 hours ago) and read 6123 times:

Glad your ok now. I always take aspirin and walk around on longhaul even if in Business or Economy class. I dont wear flight socks though but I think I will invest in some. I have not done longhaul for a while , I dont like it to be honest and did hundreds of thousands of longhaul miles when I was younger.

Now I prefer short and mid haul flights under 8 hours.

Certainly a lesson to be learned from those that might also be prone to DVT.


User currently offlineSW733 From United States of America, joined Feb 2004, 6293 posts, RR: 9
Reply 3, posted (4 years 7 months 3 weeks 5 days 21 hours ago) and read 6113 times:

DVT scares the hell out of me on long haul flights. When I do my personal trips to Africa and back, it's economy class all the way and I am adamant about getting up and walking around every other hour or so. Even when I am asleep, if I wake up and notice I have been asleep for more than an hour or so, I'll do a quick lap, or at least some serious arm, leg and body stretches.

Thanks for the warning, it makes me remember to keep on doing it...even in business class!


User currently offlineIkramerica From United States of America, joined May 2005, 21456 posts, RR: 60
Reply 4, posted (4 years 7 months 3 weeks 5 days 20 hours ago) and read 6040 times:

Warning: sitting still for a while and deep vein thrombosis.

It's nothing to do with economy class, nor truly with flying.



Of all the things to worry about... the Wookie has no pants.
User currently offlineCharles79 From Puerto Rico, joined Mar 2007, 1329 posts, RR: 6
Reply 5, posted (4 years 7 months 3 weeks 5 days 20 hours ago) and read 6010 times:

First of all I wish you a speedy recovery!

I must admit that I don't know much about DVT nor have I been affected by it but as I grow older (not sure wiser though!) I try to take good advise whenever I come across it. DVT wouldn't keep me away from long flights but I sure will prepare for it.

Quoting OA260 (Reply 2):
Now I prefer short and mid haul flights under 8 hours.

Now that I'm back in the US east coast I can appreciate the short (6-7 hr) flight time across the Pond. Flying to the UK or Germany from LAX was a real pain and I did consider 1-stop flights as an alternative...


User currently offlineCuriousflyer From United States of America, joined Oct 2006, 678 posts, RR: 0
Reply 6, posted (4 years 7 months 3 weeks 5 days 20 hours ago) and read 5995 times:

Scary, in your profile it says you are quite young too!

It happened also to a friend of mine, in the same age range, 36-45.

I looked it up on www.airsafe.com and Google, you can have it even after a 5 hours flight. You are at higher risk if you are over 60, or went through a trauma recently (eg accident or surgery), have coronary artery disease, are smoking, pregnant, obese, use oral contraceptives or have a family history of clotting problems.


User currently offlineAndaman From , joined Dec 1969, posts, RR:
Reply 7, posted (4 years 7 months 3 weeks 5 days 19 hours ago) and read 5871 times:

Thanks for the supporting comments!

Quoting Charles79 (Reply 5):
I must admit that I don't know much about DVT

Same here, not before this... Hard to say if the flight socks and aspirin would had prevented this, but I'll sure remember those when ever flying next time.

Well, I'm happy this happened at home, not during the trip. And luckily there was enough pain I just had to go to hospital, sometimes you don't get the warning soon enough, I learnt.

Quoting OA260 (Reply 2):
Now I prefer short and mid haul flights under 8 hours.

Yeah me to, I started my journey flying HEL-BRU-AUH-BKK which of course took a lot more time than flying non stop but felt less exhausting.


User currently offlineBAViscount From United Kingdom, joined Mar 2004, 2338 posts, RR: 4
Reply 8, posted (4 years 7 months 3 weeks 5 days 19 hours ago) and read 5848 times:

One of my uncles developed DVT on a flight from London to Perth, WA in the early part of this year. He was going to attend his son's wedding, but ended up spending most of his time there either in a Perth hospital or housebound. He had worn flight socks all the way, but did hardly any exercise apart from the occasional walk around the cabin.

The DVT was apparently also the direct cause of very nasty ulceration of his leg, which caused him a great deal of additional pain, to the extent that he had to take morphine as a painkiller. Whilst the ulcers have now healed, the clot is still apparently present in his leg some eight or nine months later. Granted he is in his mid 70s, has previously suffered from angina and has had a triple heart bypass, but it just goes to show you how serious things can get even if you do take precautions. Personally I will be doing whatever it takes to prevent DVT in future, there's no way I would want to go through what my uncle went through!



Ladies & gentlemen this is Captain Tobias Wilcock welcoming you aboard Coconut Airways flight 372 to Bridgetown Barb
User currently offlineTvnwz From United States of America, joined Feb 2006, 2348 posts, RR: 2
Reply 9, posted (4 years 7 months 3 weeks 5 days 19 hours ago) and read 5835 times:

It just happened to me. Thought I tweeked my leg flying into PHX. DVT instead. I have spent the last month injecting myself in the stomach with Lovenox. Then 10 mg daily of Warfarin--a blood thinner and a form of rat poision, believe it or not. I fly exclusively First Class so the economy thing is a canard.

I can not fly again until mid December or the first of the year.

These do not appear overnight, but gradually develop, I am told. The pain comes when the vein gets about 90% blocked. Mine is in the upper Popetiel just behind the knee.

This is something every frequent flyer should be cautious about. If you get off the plane with a stiff leg and it continues for awhile--better see the doc. Or die. Your choice.

[Edited 2009-11-18 14:20:39 by TVNWZ]

User currently offlineOA260 From Ireland, joined Nov 2006, 26795 posts, RR: 58
Reply 10, posted (4 years 7 months 3 weeks 5 days 18 hours ago) and read 5746 times:

Qantas have a good video

http://www.qantas.com.au/mpg/dvt.mpg


User currently offlineSpacepope From Vatican City, joined Dec 1999, 2895 posts, RR: 1
Reply 11, posted (4 years 7 months 3 weeks 5 days 18 hours ago) and read 5715 times:

I had a friend die of it this fall in MUC, she was 29. She was doing a lot of long distance flying at the time. She threw the clot, and it got lodged near her lungs, causing a pulmonary embolism, then heart attack. After she was declared braindead her folks had to fly out from Minnesota to take her off life support. Can happen to anyone.


The last of the famous international playboys
User currently offlineTVNWZ From United States of America, joined Feb 2006, 2348 posts, RR: 2
Reply 12, posted (4 years 7 months 3 weeks 5 days 18 hours ago) and read 5697 times:



Quoting Spacepope (Reply 11):
She threw the clot, and it got lodged near her lungs,

My doc says you have four to six minutes and you will know the clot moved. And after four, he says, don't even try. You do not want to be saved between minutes 4 and 6.


User currently offlineTommy767 From United States of America, joined Aug 2003, 6584 posts, RR: 11
Reply 13, posted (4 years 7 months 3 weeks 5 days 17 hours ago) and read 5630 times:

This thing most certainly scares me. My ex-girlfriend had it an had to do the stomach injections. I'm pretty keen on connecting as opposed to non-stop on the cross country flights i take in order to get off the plane, walk around, stretch my legs etc. I'm usually booked in exit row anyway which certainly helps as well....


"Folks that's the news and I'm outta here!" -- Dennis Miller
User currently offlineGrimey From Ireland, joined Jun 2005, 449 posts, RR: 5
Reply 14, posted (4 years 7 months 3 weeks 5 days 17 hours ago) and read 5604 times:

What do pilots do? and what happens if they get it? can their class 1 medical be taken off them?

Grimey


User currently offlineJER757 From United Kingdom, joined Jun 2006, 350 posts, RR: 0
Reply 15, posted (4 years 7 months 3 weeks 5 days 17 hours ago) and read 5558 times:



Quoting TVNWZ (Reply 12):
My doc says you have four to six minutes and you will know the clot moved. And after four, he says, don't even try. You do not want to be saved between minutes 4 and 6.

Your doctor was most likely referring to a massive pulmonary embolism (PE). This is where a huge clot is thrown off the DVT completely restricting blood flow to the lungs. This results in a large drop in blood pressure, and potentially lethal cardiac arrythmias among other things. These are the ones that need immediate, rapid treatment. Luckily they are extremely rare without significant prior risk factors, and warning signs (swollen, painful calves).

Far more common is a less significant PE: A smaller clot is thrown off the DVT and makes its way to the lungs. Yes it causes problems, but treatment is nowhere near as rapid as for a larger one. Treatment is usually days on anticoagulants in hospital.

DVTs are extremely uncommon in those without any other prior risk factors; these include smoking, obesity, diabetes and existing peripherovascular disease. There are however, always exceptions to any rule, meaning that its something everybody traveling long haul in any class should think about and take adequate precautions against.

It goes back to the old statistics game: How many people fly long haul every day? And how many of those develop DVT/PE? Very very few.



Gale force fog... don't you love it?
User currently offlineAndaman From , joined Dec 1969, posts, RR:
Reply 16, posted (4 years 7 months 3 weeks 5 days 17 hours ago) and read 5496 times:



Quoting JER757 (Reply 15):
DVTs are extremely uncommon in those without any other prior risk factors; these include smoking, obesity, diabetes and existing peripherovascular disease.

I quess I am one of the rare cases then. I'm skinny, not smoking, no diabetes, no family history of clotting problems, no heart problems... I have medication for high blood pressure though, runs in the family.


User currently offlineDocLightning From United States of America, joined Nov 2005, 19278 posts, RR: 58
Reply 17, posted (4 years 7 months 3 weeks 5 days 16 hours ago) and read 5454 times:



Quoting Ikramerica (Reply 4):
Warning: sitting still for a while and deep vein thrombosis.

It's nothing to do with economy class, nor truly with flying.

Not per se, no. But economy class flights do a really good job of combining multiple risk factors.

1) prolonged immobility
2) upright
3) in an environment where you are likely to get dehydrated

At least in J class, it's easier to get out of your seat and easier to move your legs around.


User currently offlineGeorgiaAME From United States of America, joined Aug 2005, 942 posts, RR: 6
Reply 18, posted (4 years 7 months 3 weeks 5 days 3 hours ago) and read 4979 times:



Quoting Ikramerica (Reply 4):
Warning: sitting still for a while and deep vein thrombosis.

It's nothing to do with economy class, nor truly with flying.

As a physician with 20 years of cardiovascular training behind me, and as a guy who loves to travel long distances, I have to side with Ikra. If you probe deeply into the history, the overwhelming majority of people who present with DVTs following a prolonged flight had those clots before they even boarded, and invariably, there is an undiagnosed blood clotting disorder that is present and had never been recognized beforehand. No question in my mind that the flight didn't help the situation, but rarely causes them. As for aspirin, I really, really hate to rain on the parade, but there is no reproducible, scientific evidence to date that shows that aspirin works prophylactically to prevent clot formation inside of a vein. From a physiological standpoint, a vein is not an artery, the biology is very different between the two vessels. Aspirin does indeed reduce the incidence of second clots forming in arteries, ie the ones that cause a second, (and not the first) heart attacks and strokes, but alas, not veins. (For the record, I've never had a heart attack, but I still take my low dose aspirin every day, and I make sure I take it before flying. I know it won't protect me, but it does give me some peace of mind)

Moral: wiggle your toes and ankles every 30-60 minutes, DRINK, the dehydration is the major culprit, and wear support hose to compress your leg muscles. You will feel better after landing.



"Trust, but verify!" An old Russian proverb, quoted often by a modern American hero
User currently offlineFerroviarius From Norway, joined Mar 2007, 223 posts, RR: 0
Reply 19, posted (4 years 7 months 3 weeks 5 days 1 hour ago) and read 4263 times:

Good afternoon,

while I am not a physician - I am a physicist - I should like to mention that one possibly should be careful with Aspirin. If one never had used it any earlier one might be inclined to not try it for the first time before or during a long distance flight.

The first - and last - time I took an aspirin - this was many years ago because of a cold - I ran into severe problems with my stomach, which lasted for two days. The doctor later explained me that, though it probably cannot be said to be an allergy in the strict definition of the words , a not negligibly small group of persons cannot digest aspirin and will feel rather sick after they have taken aspirin.

Since you do not like to run into a bad stomach problem during a SIN-EWR flight, you might try Aspirin some days BEFORE you intend to travel unless you are sure that your body tolerates aspirin in normal doses.

Of course, this rule applies to any kind of medication and even food. New and exotic stuff might be fine and interesting but one might consider it to be the safest to not consume anything really new before travelling by plane.

Best wishes,

Ferroviarius


User currently offlineTango-Bravo From United States of America, joined Jun 2001, 3802 posts, RR: 29
Reply 20, posted (4 years 7 months 3 weeks 4 days 23 hours ago) and read 3842 times:

On the subject of DVT, from a layperson's perspective it was interesting (and sad) to learn that...

The main reason hospital staff now get patients up and walking as soon as possible, even surprisingly soon after major surgery, was the discovery that 70% of unexpected deaths in hospitals were/are caused by clots forming in the legs of patients due to inactivity.

During Operation Iraqi Freedom, an embedded reporter in excellent health died for unknown reasons until an autopsy revealed that the cause of death was clots that had formed in his legs due to extended periods spent riding in Humvees in cramped seating (same as soldiers with whom he was embedded).

When clots move from one's legs to their lungs (pulmonary embolism), the result is death in 80% of such cases.

Pulmonary embolisms are more likely to occur in the roughly 25% of persons whose PFO (Patent Foramen Ovale) valve located in the heart remains open. At birth the PFO is open, and then becomes closed on its own in about 75% of persons. Pulmonary embolisms can pass through an open PFO and lodge in the lungs, which as noted above is fatal in approximately 80% of such occurences (as it was for my younger brother exactly 2 years ago today, and nearly was some years earlier for niece in her 20s who was thankfully among the 20%)

All of which is to say that DVT and the potential thereof is an issue to be taken seriously...and that long flights are indeed among the "DVT waiting to happen" situations... and why, within the context of this topic, I make a point of doing in-seat leg excercises/stretches at least hourly when on a flight...even on the 1.5 hour connecting flight I often take. Lufthansa had/has an excellent video on their longhaul flights that provided valuable information to me along the line of practical in-seat leg and arm stretches that I still remember and practice some 7+ years later.


User currently offlineTVNWZ From United States of America, joined Feb 2006, 2348 posts, RR: 2
Reply 21, posted (4 years 7 months 3 weeks 4 days 23 hours ago) and read 3815 times:



Quoting Tango-Bravo (Reply 20):
and why, within the context of this topic, I make a point of doing in-seat leg excercises/stretches at least hourly when on a flight.

I am a big walkaround, exercise guy on planes. And this is always good advice. I think my DVT was caused by this:

Quoting GeorgiaAME (Reply 18):
DRINK, the dehydration is the major culprit, and wear support hose to compress your leg muscles. You will feel better after landing.

I was not drinking enough water. I am still getting used to the compression socks. Will start flying again the first week of December.


User currently offlineAndaman From , joined Dec 1969, posts, RR:
Reply 22, posted (4 years 7 months 3 weeks 4 days 20 hours ago) and read 3707 times:



Quoting Tvnwz (Reply 9):
It just happened to me. Thought I tweeked my leg flying into PHX. DVT instead. I have spent the last month injecting myself in the stomach with Lovenox

I inject myself with Klexane, probably same stuff. I really hope I don't have to that too long, though too the needle isn't that bad...
I was planning to escape the Christmas somewhere, but probably flying is out of question. Not planning to take a ferry to Sweden either, similar dark winter & christmas there..  Wink


User currently offlineTVNWZ From United States of America, joined Feb 2006, 2348 posts, RR: 2
Reply 23, posted (4 years 7 months 3 weeks 4 days 20 hours ago) and read 3692 times:



Quoting Andaman (Reply 22):
I really hope I don't have to that too long,

Had to do it for 2 weeks until my INR numbers were between 2.5 and 3. Depending on how bad and where, you might be able to go. I'm in MKE. Similar weather. Need some sun!


User currently offlineKL911 From Ireland, joined Jul 2003, 5114 posts, RR: 12
Reply 24, posted (4 years 7 months 3 weeks 4 days 19 hours ago) and read 3663 times:



Quoting Ikramerica (Reply 4):
Warning: sitting still for a while and deep vein thrombosis.

It's nothing to do with economy class, nor truly with flying.

10 hours in the office can do the same, nothing new here. Wish you are well soon though! Best thing is to drink wine or beer onboard, makes the blood thinner. And ofcourse water against dehydration.



Next trip : DUB-AUH-CGK-DPS-KUL-AUH-CDG-ORK :-)
25 Boeing757/767 : So glad you're OK! Another story -- my neighbor had just returned NRT-ORD-ROA and felt a pain in his chest. He didn't worry about it but his wife quic
26 Lightsaber : First, we all wish you a speedy recovery! My preference is to hydrate and move about. (I'm not allowed aspirin for my own personal medical reasons.) O
27 Post contains links JER757 : Of course, the latest evidence suggests that aspirin is useless in primary prevention of cardiovascular problems, and predisposes to other problems i
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