Blood Clots and Travel

Thanksgiving marked the unofficial start to the big end-of-year travel season, which means for many people December will be filled with long flights (four hours or more) and sitting in airports, waiting out delays or connections between two long flights. For others, end-of-year travel means long car or bus rides, and even train rides. Each of these modes of travel increases the risk of deep vein thrombosis (DVT), more commonly known as blood clots.

We’re used to hearing information on the risks of DVT in long air travel, but sitting in a tight space for long periods of time in the air or on the ground puts travelers at elevated risk.

DVT forms in the deep veins of the legs, the ones not visible directly under the skin, when travelers are confined in a small space, remaining relatively still. Often, these clots dissolve on their own—the problem arises if a part of the clot separates and travels to the lungs, causing a pulmonary embolism (a blockage), which can be fatal.

Therefore, prevention and risk reduction are crucial.

In previous columns, I have discussed the general risk factors for developing DVT (as well as spider and varicose veins), but briefly, they are obesity, pregnancy, age, recent surgery, personal or family history of blood clots, active cancer or recent treatment for cancer, estrogen treatment (in contraceptives and hormone replacement therapy), additional mobility limits (a leg cast, for example), and even varicose veins themselves.

Combine any of these risk factors with travel, and a person has additional increase in risk for DVT.

So how can travelers protect themselves?

Talk to your doctor if you think you may have a risk for blood clots. Be sure if you’re already on an anticoagulant (blood thinner) that you always follow your doctor’s recommendations for use.

Wear compression stockings.

Move your legs as much as possible during long trips. If you are traveling by car, those frequent stops for gas, snacks, or to use the restroom do more than help solve boredom; getting up and moving around is very important to your leg health. If you’re on an airplane, use that long line for the restroom to stretch out your legs and also do squats. If you can’t make frequent stops, or if you are stuck in the middle seat on an airplane, stow all your bags in the overhead compartment and stretch out your legs, flex your ankles, and exercise your calf muscles to improve the flow of blood.

Know the signs of blood clots in advance.

The symptoms of DVT include swelling of the leg or arm, unexplainable pain or tenderness, skin that is red and warm to the touch. But note that many people do not have symptoms at all.

Like DVT, pulmonary embolism doesn’t always show symptoms. But you may experience difficulty breathing, faster or irregular heartbeat, anxiety, lightheadedness. The more telling and immediate symptoms include fainting, chest pain or discomfort, worsened with a deep breath or coughing, and coughing up blood. For any of these symptoms, either of PE or DVT, seek help immediately.

For PE and DVT, prevention is so important. Stretching and exercising are always good practice, but if you do have varicose veins and know you do a lot of traveling or sitting in confined spaces, it may be time for you to get them treated.

To get more information on leg and vein health, or if you are ready to seek treatment for varicose or spider veins, contact us at 760-944-9263 or visit our website at