Deep Vein Thrombosis: A Cockpit Concern

It’s warming up out there and I bet you’re thinking about some cross-country flying! There’s nothing greater than watching the landscape change from checkerboard

farmland to rolling plains to majestic mountains as the hours roll by.

With that throttle leaned back, you can easily spend four or five hours in the cockpit, enjoying the ride. Problem is you can’t very well get up and walk around in most GA aircraft, and prolonged immobility can pose some serious health problems. The biggest worry is developing deep

vein thrombosis or DVT, which occurs when a blood clot or thrombus forms in a leg vein. Some folks experience pain and swelling in the leg although if the clot is small there may be no symptoms.

The big problem happens if part of the clot breaks off and travels up to the lungs, cutting off blood flow. That’s called a pulmonary embolus or PE. If enough lung circulation is interrupted, the body can no longer pick up enough oxygen from the air and carry it by the red blood cells to the rest

of the body.

Obviously, that’s a life-threatening problem. DVT is not uncommon. It is known to occur in 1 in 1,000 people in the general population.

Any type of prolonged immobility increases your chances

of getting DVT. Long airplane, car or train rides have all been implicated. It appears that prolonged sitting slows the circulation to the legs and perhaps constricts blood vessels.

This increases the tendency for clots to form in the leg veins. Other conditions which alter blood flow or normal clotting mechanisms may make some people more likely

to develop DVT. Folks who have had a prior DVT, certain heart diseases, cancer, pregnancy, smoking, older age, or some blood clotting disorders are at greater risk. The older, high estrogen birth control pills also appeared to increase DVT risk.

You should suspect a DVT if you develop pain and/or swelling in the lower leg during or at the end of a long flight. As I said, sometimes there are no symptoms in the lower leg. If, however you develop sudden chest pain with or without difficulty breathing, that could indicate a pulmonary embolus. It needs to be looked at immediately. There are a bunch of tests that can be done in hospital or ER to determine what’s going on. If you do have a DVT or PE you will be put on blood thinners to discourage further clotting while the existing clots resolve.

So how do you reduce the risk of bad stuff like DVT or PE from ruining your cross-country flying? Here are a few things that might help:

• Increase leg muscle activity during prolonged periods of sitting. If you’re lucky enough to be flying a biz jet, get up and walk around. If you’re like the rest of us and stuck in the cockpit, frequently stretch the legs by extending the feet at the ankles to stretch the calf muscles.

• Wear loose fitting clothing especially pants to avoid constricting blood vessels.

• Prevent dehydration by drinking fluids but avoiding caffeine which acts as a diuretic. This can be tricky on a long flight with no bathroom. Plastic milk jugs or absorbent relief bags which can be purchased in aviation supply stores may be welcome additions to the cockpit.

If you do have any issues that increase your risk of DVT you might want to visit with your doctor before filing for a five-hour flight. She or he might recommend special support stockings that reduce the tendency for blood to pool in the legs.If risk of DVT in flight is significant there are a number of quite effective blood thinners that can be prescribed. After all, there are enough things to look at in a good cross-country flight plan without medical worries. Fly wisely. See you next month.