Safe Road Trips and Car Travel After Pulmonary Embolism or Blood Clot
It is well established that air travel raises the risk of potentially fatal blood clots. Did you know, however, that traveling by car, bus, boat, and train can also be risky? Anytime that you sit still for more than 1-2 hours, your blood begins to coagulate. Coagulation means clots. This risk is increased for anyone who has thrombophilia, clotting disorders, surgery, pregnancy, hormone use, and/or a history of blood clots. Once you have had a pulmonary embolism or deep vein thrombosis (DVT), you need to be extra cautious when traveling as you are at an increased risk of a second clot. As traveling is already a risk, if you have a history of clotting, you will need to be especially careful when you travel.
I am not a medical professional; I am a patient and advocate. Please bring your questions or ideas to your doctor.
How Unwanted Blood Clots Form
How to Prevent Clotting on Road Trips
Road trips and other extended car travel increase the risk of blood clots. Many people like to get in a car and drive straight through to their destination, only stopping when they need gas. It gets the trip over with more quickly, but puts the driver and occupants at a much larger risk. Blood clots can travel to the lungs, block the flow of oxygen, damage the lungs, possibly cause heart damage, and in a number of cases cause instant death. Luckily, they are easy to prevent.
The largest reason that the risk goes up on a road trip is that the car occupants are sitting still for hours on end. Blood that is pooled and sitting still has a tendency to form clots. People are at a greater risk for this happening when they are in one position for greater than 1-2 hours. The best rule of thumb is to take a break every hour or two. Get up, walk, and stretch and the risk of blood clots decreases.
The next thing that can increase risk on a road trip is dehydration. Many people worry about bathroom breaks while driving. They worry about restroom availability, cleanliness, and time used for the bathroom break. To decrease the need to urinate, people will often drink less while taking long car trips. This increases the risk of a potentially fatal blood clot. Make sure that you are drinking while you are driving. Avoid drinks that will irritate the bladder or are diuretics. Tea, coffee, and drinks with caffeine (soda) will all cause increased urination. This can contribute to dehydration and clots. It will also discourage you from drinking as you will get irritated about having to use the restroom frequently. Stick with water, Gatorade, Powerade, or Pedialyte.
- Stay hydrated.
- Take a break every 1-2 hours.
- Use a GPS device and have it recommend driving breaks.
Additional tips for high risk drivers and passengers:
- Don't cross your legs.
- Investigate the use of graduated compression stockings.
- If at very high risk, ask your doctor about low molecular weight heparin.
- Break your trip into small chunks and use hotels in between.
- Have your INR checked 3-4 days before your trip to make sure that you are therapeutic.
My Personal Experience
When driving or being a car passenger, for every 8 hours in the car, I spend an hour out of the car. My TomTom is always on when I take longer trips. (By longer, I mean any trip that takes an hour or more in the car.) It has a great feature called, "driving breaks." It will alert me every two hours that I need to take a break. It gives me a 15 minute warning when I am getting close to my time. I can mark the time when I take my break and get back on the road again.
Throughout the trip I need to make sure that I am hydrated. I carry water and Gatorade with me. When it is hot or when I visit a dry climate, I must be very conscious of how much I am drinking and when my last drink was.
I had a pulmonary embolism July 18, 2008, and am at increased risk for a future clot due to that history and heterozygous Factor V Leiden. I have had no problems with car travel so far.
If you need information about air travel after a blood clot, please read my article on this topic:
How to Fly Safely After a Pulmonary Embolism or Blood Clot.