Deep vein thrombosis is formation of blood clot in a deep vein the cause is prolonged inactivity such as sitting during long travel in a plane or automobile or lengthy bed rest.
A study on the global burden of venous thromboembolism - when a dangerous clot forms in a blood vessel - found that annual incidences range from 0.75 to 2.69 per 1,000 individuals in the population. The incidence increased to between 2 and 7 per 1,000 among those 70 years of age or more.
"Venous thromboembolism in hospitalized patients was responsible for more years lost due to ill-health than hospital-acquired pneumonia, catheter-related blood stream infections, and side effects from drugs," said Dr. Gary Raskob, co-author of the Journal of Thrombosis & Haemostasis study.
What is DVT
Thrombo means "clot." Phlebitis is inflammation of a vein. Thrombophlebitis (throm-bo-fluh-BI-tis) occurs when a blood clot and inflammation develop in one or more of your veins such as the femoral vein or the popliteal vein or the deep veins of the pelvis. On rare occasions, thrombophlebitis (often shortened to phlebitis) can affect veins in your arms.
The affected vein may be near the surface of your skin (superficial thrombophlebitis) or deep within a muscle (deep vein thrombosis).
The cause often is prolonged inactivity, such as sitting during a long period of travel in an airplane or automobile or lengthy bed rest after surgery. The inactivity decreases blood flow through your veins and may cause a clot to form.
Paralysis, certain types of cancer and use of the hormone estrogen also may lead to thrombophlebitis. An inherited tendency for blood clots places you at higher risk of thrombophlebitis.
There is a risk that part of the blood clot may become dislodged and travel through the bloodstream to the lungs, where it can get stuck and block the flow of blood. This is called pulmonary embolism, and it is a life-threatening condition.
The symptoms of DVT include pain, swelling and redness of the leg and dilation of the surface veins.
For this reason, if you think you may have DVT, it is important to see your doctor urgently. If you experience pain in your lungs or chest or difficulty breathing, contact your doctor immediately, or go straight to a hospital emergency department.
There is clinical evidence to suggest that wearing compression socks while traveling also reduces the incidence of thrombosis in people on long haul flights.
Travel Tips to Help Prevent Deep Vein Thrombosis
Lately air travel has become more and more unreliable and annoying due to multiple flight cancellations and travel interruptions. Any card carrying road warrior frequent flier can relate multiple stories of being stuck almost anywhere due to weather, mechanical issues, personnel problems and lately...the abrupt FAA grounding of all MD-80 aircraft.
Frank's story went a little differently, though. Frank is a road warrior in every sense of the word: he flies often and at least monthly finds himself in another country. When he's not flying, he's driving to another sales call. Frank is the Vice President of a manufacturing firm and is responsible for making all his customers happy...something that still requires face time! Frank was having a typical week, three cities in 5 days, when he woke up with a red, hot swollen left leg and shortness of breath. Frank's travels had been interrupted by the dreaded traveler's blood clot, a Deep Vein Thrombosis, or DVT. Now he wasn't fighting for the sales contracts, he was fighting for his very life! This may have been avoided if Frank had learned his risk factors and followed some simple travel tips.
A DVT (Deep Venous Thrombosis) is a condition in which a blood clot or blockage forms in the deep veins in the leg. These can develop in other places in your body, but are much more common in the lower legs. If the clot breaks free and travels through the bloodstream, it can actually lodge in the lung. This clot in the lung is called a PE (pulmonary embolism), and can cause shortness of breath, difficulty breathing and even death!
How common is DVT
Each year, 600,000 patients will experience some kind of venous thromboembolism or DVT.
Each year, at least 50,000 and perhaps as many as 200,000 patients will die from blood clots that obstruct blood flow to their lungs (pulmonary embolism).
DVT complications have been linked to over 200,000 deaths each year, more than AIDS and breast cancer combined, but it's amazing that no one seems to care much about preventing this public health concern. The airline and travel industry has given it lip service after a few well-publicized deaths; but the general traveling public awareness of this potentially fatal public health concern from travel is relatively low.
Who is at risk for DVT
There are certain groups of people who are more at risk of developing these life-threatening clots.
Risk factors include varicose veins, blood clotting disorders, recent childbirth or pregnancy, use of birth control pills or hormone replacement therapy, obesity, and heart disease.
The risk is even higher in patients over 40, those with casts immobilizing their foot and ankle, a sedentary lifestyle, smoking history, certain types of cancer, chronic illnesses like lung disease or inflammatory bowel disease (Crohn's disease or ulcerative colitis) and recent major surgery. This is further compounded by sitting for long periods of time in a car, airplane or train, especially with your legs crossed. It seems like almost everyone traveling this summer has one or more of these risk factors!
What are the symptoms of DVT
Many people have either no warning signs or very vague symptoms prior to forming a significant clot. The symptoms are usually: swelling in the leg and calf, redness and increased warmth in your leg, and pain in the inner thigh and calf. If you experience any warning signs, immediately contact your doctor for an evaluation. Do not mess with this potentially deadly condition!
How is a DVT diagnosed
A simple ultrasound of the veins of your leg can determine if you are suffering from a DVT. Often, superficial thrombophlebitis can have the same symptoms and is much less serious; so a timely ultrasound evaluation is critical. Patients who receive early treatment may reduce their incidence of pulmonary embolism to less than 1%.
If you have risk factors for DVT and plan on taking a long trip this season, follow these tips to reduce the likelihood of developing a blood clot:
Remember, a DVT can put a real cramp in your vacation or travel plans, and even potentially kill you! If you are at risk, take precautions before you suffer from this possible "killer legs".
Dr. Marybeth Crane is a podiatric foot and ankle surgeon and managing partner of Foot and Ankle Associates of North Texas, LLP, in Grapevine, Texas. She is also a veteran road warrior and always wears compression stocking while traveling!