DVT's

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Millions of Australian’s and Kiwi’s take long-haul flights every year, whether to the northern hemisphere to escape the cold snap and bask somewhere on a beach or to escape the heat and head to cooler climates. Be it a bar in San Torino, a vineyard in France, a beach in Ibiza or a sojourn in a Phuket resort: it’s no fun if you’ve got a DVT.

What is a DVT?

DVT, or deep vein thrombosis, is the development of a small clot generally in a leg. More often than not, this is because the sufferer had been static (immobile) for some period of time before the onset of leg pain. For this reason, long haul flights are a perfect recipe for clot formation.

DVTs can be dangerous, even lethal, for a number of reasons. While the clot in your leg may lead to local injury to your blood vessels and tissue, cause swelling and significant pain, it is when this clot dislodges that it may do the most damage. Tracking up your venous system and into the heart, it may be pumped into the blood vessels of your lung. This can lead to poorer oxygenation of the blood pumping through your lung, vital for continuation of life. Large emboli (dislodged clots) can shut off blood supply to large sections of lung and cause significant breathlessness and deterioration. Such ‘pulmonary emboli’ can be deadly.

Am I at risk of a DVT?

There are a number of risk factors for DVTs, including:

• Immobility for long periods of time, such as long-haul flights, prolonged hospital stay or bed rest or after giving birth
• Pregnancy
• Use of the combined oral contraceptive pill
• Hormonal replacement therapy, for example in the treatment of menopause
• Diagnosis of cancer – some cancers are particularly prone to making the blood ‘procoagulant’, meaning more likely to form clots
• Trauma – local trauma to your leg may have damaged blood vessels
• Obesity
• Advancing age
• Past DVT

How to prevent DVTs

• Use of compression stockings will help increase circulation in your legs in times of immobility. The squeezing quality of these specialty socks mimics and assists in the natural muscle pump quality of your legs.
• Walking up and down the aisle of the plane. This will put your leg muscles into action and get some blood moving! It is recommended to do this every couple of hours on long haul flights.
• Avoiding crossing of your legs is contentious in clot formation. Many say it is a myth, but it may also prevent the onset of those nasty pins and needles, so it’s worth avoiding anyway.
• Weight loss – always an ideal measure for whole health.
• If you’ve previously had a DVT, it’s worth talking to your GP about revising some of your medications. Is it really necessary to still be on Hormone Replacement Therapy? Is there an alternative to the contraceptive Pill?

How do I recognise a DVT?

DVT’s can come on suddenly or gradually. A DVT may begin with a dull ache in the leg, much like a cramp, that grows more severe with time. Your leg will swell and potentially become red and oedematous (fluid-filled). It will be painful to touch, especially in your calves or thigh.

A PE (a clot that has shot up to your lung) will come on very suddenly, with acute shortness of breath, cough and chest pain. The chest pain is sharp in quality and worse on taking deep breaths. In some cases the cough produced some pink or red sputum (phlegm), on a tissue if held over the mouth while coughing.

Both of these are emergencies and you should attend your Emergency Department as quickly as possible.

Once identified a DVT is likely going to need dissolving using a series of medications commonly known as blood thinners. Warfarin is a well known example of this and requires close monitoring by your GP.

References

Ho, W. (2010). Deep Vein Thrombosis. Australian Family Physician, 39(7), pp.468-474.