How to Fly Safely After a Pulmonary Embolism or Blood Clot
Blood clots can be life-threatening when flying. When we fly, the blood that pools in our legs has a tendency to form clots, which can grow large enough to obstruct a vein and cause a painful and dangerous DVT (deep vein thrombosis). If the clots are able to move into the lungs, they can cause a life-threatening pulmonary embolism. Pulmonary embolisms block the flow of blood and oxygen throughout the lungs. People who have thrombophilia or another blood clotting condition, or who have a history of blood clots, are especially at risk of experiencing a dangerous blood clot while in the air.
Despite these risks, flying can be a safe experience. There are a number of steps that travellers can take to ensure health and safety. Before reading on, please note that I am not a doctor, but I was diagnosed with a pulmonary embolism and a condition called Factor V Leiden. I have participated in informational support groups for each condition. For your safety, please share this information with your doctor and discuss it.
Everyone is at risk of developing a clot while flying, though some people have a higher risk than others. The chart above can help you assess your risk. Note one thing that is not mentioned: Being an elite athlete raises your risk of a clot while flying. Studies show that around 85% of after flight blood clot victims are athletes.
Keep in mind, that everyone is at an increased risk for a blood clot while flying.
Blood Clot Symptoms
Even with precautionary measures, you can have a pulmonary embolism or a DVT (deep vein thrombosis) after airplane travel. If you have any symptoms of either of these conditions (listed below), go to the emergency room. Pulmonary embolisms often are fatal. Prompt administration of blood thinners and bed rest can prevent long term vein, heart, or lung damage as well as a fatal blood clot. The emergency room is the safest place for you if you notice any symptoms of a blood clot, DVT, or pulmonary embolism. You do not have to have all of the symptoms to have a clot.
Deep Vein Thrombosis (DVT)
A DVT is a blood clot that forms in a vein. The most common site for these clots is in the large veins of the legs, particularly behind the knee. Some of the symptoms of a DVT are:
- Swelling, usually in one leg.
- Leg pain or tenderness.
- Reddish or bluish skin discoloration.
- Leg warm to touch.
White these symptoms are typically in a leg, they can also occur in the arms or other body parts. A DVT can feel like a pulled muscle, muscle cramp, or "Charlie horse." The extremity often has a bruised or discolored appearance and swelling.
Pulmonary Embolism Symptoms:
- Sudden shortness of breath.
- Chest pain-sharp, stabbing that may get worse with deep breath.
- Rapid heart rate.
- Unexplained cough, sometimes with bloody mucus.
- Night sweats.
How Clots Form
Why Flying Increases the Risk of Clots
When we fly, we tend to sit in the same position, with knees bent, for hours on end. Muscle movement pushes our blood back to the heart, so when we sit, the blood may pool. The longer blood sits still, the greater the chance of a clot. Bent knees or crossed legs make it even more difficult for blood to circulate. When one is stationary for 1-2 hours, the risk of a DVT or pulmonary embolism increases. On airplanes, many passengers are seated in the same position for at least 2-8 hours. International travelers are seated for an even longer period of time.
Planes also carry other risks. The lower air pressure and lower humidity on planes appear to increase the coagulability of the blood and increase the risk of pulmonary embolism or DVT.
Tips to Prevent Blood Clots
The length of a flight directly effects the risk of developing a clot. When a flight time extends to four hours or more, the risk of developing a DVT or pulmonary embolism increases dramatically.
- Break your flights into shorter segments if possible. Look for flights with a layover or an airplane change, so that your flight is broken into shorter segments. To prepare for long international flights, speak with to your doctor about using Lovenox or another anticoagulant.
- While flying, keep your blood moving. Try to get up and walk the plane at least once every 1-2 hours. While you are seated, do not cross your legs. Keep your legs as straight as possible to make it easier for your blood to circulate. Do leg and foot exercises as these will help to move blood and prevent clots.
- You can wear graduated compression hose or "travel sox" for your flight. These special socks will help to prevent blood from pooling in your legs. Make sure that they do not bind. To be sure of the fit, have a professional help you to choose the correct size based on your measurements. Your other clothing should be loose-fitting clothing so as not to constrict while you are seated.
- Stay hydrated. Drink around 8 ounces of liquid every hour. Make sure that this liquid is a hydration beverage with electrolytes. Pedialyte, Gatorade, or Powerade are all good choices. If you have a history of clots you can make arrangements with the airline to take "medical" liquids through security. I find it much easier to buy powdered Gatorade, measure out enough for a 32-ounce drink, and put it in a sandwich bag. Once through security, I purchase 32 ounces of water and pour in my mix. This gives me enough liquid for four hours of flight time. I will still drink additional drinks at layovers and sometimes on the plane. I find that if I use Gatorade, I can drink 8 ounces an hour with little need to use the restroom. If I drink water, I will have increased urination. This shows that my body holds onto the liquid in Gatorade but not water. note that water actually seems to increase the risk of clots.
- Heal Raises: Sit with your feet flat on the floor in front of your. Lift up your heal and hold it for 5-10 seconds. Lower it to the floor. Repeat 10 times.
- Toe Raises: Sit with your feet flat on the floor in front of you. Lift up your toes and hold for 5-10 seconds. Lower to the floor. Repeat 10 times.
- Toe Circles: Straighten your legs as much as possible and lift them slightly off of the floor. Make small circles with your toes.
- The Alphabet: Straighten your legs as much as possible and lift your feet off of the floor. Trace the alphabet with your right toes and then repeat with your left.
- Slides: Slide your feet as far forward as possible and then bend your knees slide them back as far as possible. Repeat 10 times.
- Knee Lifts: Lift up your right knee towards your chest, about 3 inches off of your seat. Lower it. Lift up your left knee and do the same thing. Alternate legs until each leg has lifted 10 times.