Traveller's Thrombosis

It has been known for many years that immobilisation can lead to the development of deep vein thrombosis (DVT). However, until a number of recent highly publicised deaths, the public was largely unaware that air travel could increase the risk of developing DVT. Although research in the area has produced conflicting results, it is generally believed that air travel can increase the risk of developing DVT if only because it increases factors, such as immobilisation and dehydration, which can increase risk of developing DVT. Medical research indicates that factors which may give you an increased risk of blood clots in the legs include:

• increasing age above 40 years
• pregnancy
• former or current malignant disease
• blood disorders leading to increased clotting tendency
• personal or family history of DVT
• recent major surgery or injury, especially to lower limbs or abdomen
• oestrogen hormone therapy, including oral contraceptives
• immobilisation for a day or more
• dehydration
• heart failure
• trauma
• varicose veins
• obesity
• tobacco smoking

Personal and environmental factors can increase the risk of developing DVT. These factors are covered above. It is important to remember that even if people have no apparent risk factors they are not immune from the possibility of developing DVT. Therefore, all travellers should take some basic precautions against DVT and those with known risk factors should take additional ones.

Advice for Travellers

1. Drink plenty of water
2. Avoid alcohol and caffeinated drinks
3. Move around
4. Flex legs to encourage blood flow
5. Do not sit with legs or ankles crossed
6. Wear loose fitting clothes
7. Consider wearing support stockings (Class 1 compression)
8. Consider taking a pre-flight aspirin
9. People at very high risk of DVT should consider either postponing their flight or the use of anticoagulation therapy

Inflight Workout

These exercises are designed to encourage a safe way to enjoy movement and stretch certain muscle groups that can become stiff as a result of long periods of sitting. They may be effective at increasing the body's blood circulation and massaging the muscles.

It is recommended that you do these exercises for three or four minutes every hour and occasionally get out of your seat and walk down the aisles.

Each exercise should be done with minimal disturbance to other passengers. None of the following exercises should be performed if they cause pain or cannot be done with ease.

1. Ankle Circles
Lift feet off the floor. Draw a circle with the toes, simultaneously moving one foot clockwise and the other foot counterclockwise. Reverse circles. Do each direction for 15 seconds. Repeat if desired.

2. Foot Pumps
Foot motion is in three stages

• Start with both heels on the floor and point feet upward as high as you can
• Put both feet flat on the floor
• Lift heels high, keeping balls of feet on the floor.

Continue these three stages with continuous motion in 30-second intervals.

3. Knee Lifts
Lift leg with knee bent while contracting your thigh muscle. Alternate legs. Repeat 20-30 times for each leg

4. Neck Roll
With shoulders relaxed, drop ear to shoulder and gently roll neck forward and back, holding each position about five seconds. Repeat five times.

5. Knee To Chest
Bend forward slightly. Clasp hands around the left knee and hug it to your chest. Hold stretch for 15 seconds. Keeping hands around the knee, slowly let it down. Alternate legs. Repeat 10 times.

6. Forward Flex
With both feet on the floor and stomach held in, slowly bend forward and walk your hands down the front of your legs toward your ankles. Hold stretch for 15 seconds and slowly sit back.

7. Shoulder Roll
Hunch shoulders forward, then upward, then backward, then downward, using a gentle circular motion.

All Travellers should observe advice a to f above and those in the "at risk" categories should observe g to i as well.

The information in this leaflet was sourced from The Pharmaceutical Journal and Quantas airlines.