For patients with a history of blood clots (also known as venous thromboembolism or VTE), flying can increase the risk of further clot formation due to long periods of immobility, changes in cabin pressure, and reduced oxygen levels.
Below is advice based on medical literature and guidelines to help reduce the risk of blood clots during air travel.
1. Consult with Your Doctor Before Flying
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Pre-flight assessment: It's crucial to consult with your GP or healthcare provider before flying, especially if you have a history of blood clots. They can assess your risk, review your medical history, and advise on any necessary preventive measures.
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Medication adjustment: If you are taking blood-thinning medication (anticoagulants) like warfarin, apixaban, or rivaroxaban, your doctor may adjust your medication or recommend temporary adjustments before or during the flight.
2. Compression Stockings
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Graduated compression stockings: Wearing medical-grade compression stockings can significantly reduce the risk of developing deep vein thrombosis (DVT) while flying. These stockings help to improve blood flow in the legs and reduce swelling. They should be worn from the time you board the flight until you are mobile again upon arrival.
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Proper fit: It is essential that the stockings are properly fitted. Ask your healthcare provider for guidance on the correct size and compression level.
3. Move Around Frequently
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Leg exercises: Sitting still for long periods can increase the risk of clot formation. Perform simple leg exercises, such as ankle circles and foot pumps, every 1-2 hours. These exercises help to improve circulation in your legs.
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Walk around: If possible, take short walks down the aisle every 1-2 hours to keep the blood flowing. Avoid staying seated for prolonged periods.
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Stretching: Stretch your legs and arms regularly to help maintain circulation.
4. Hydration
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Stay hydrated: Dehydration can increase the risk of blood clots, so drink plenty of water before and during the flight. Avoid excessive alcohol and caffeinated beverages, as they can dehydrate you.
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Avoid salty foods: Salty snacks and meals can lead to dehydration, so try to limit intake during the flight.
5. Medication for Prevention
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Blood thinners (anticoagulants): If recommended by your doctor, continue taking your blood-thinning medication as prescribed. For patients at particularly high risk, your doctor may prescribe short-term prophylactic anticoagulation before the flight.
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Aspirin: In some cases, your doctor may recommend a low-dose aspirin regimen as an additional precaution. However, this depends on individual risk factors and should only be done under medical guidance.
6. Use of In-flight Seats and Movement
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Choose an aisle seat: This allows you to get up more easily and walk around during the flight.
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Footrest: If possible, use a footrest to slightly elevate your legs to improve blood circulation.
7. Monitor Symptoms
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Watch for symptoms of DVT: Symptoms such as swelling, redness, warmth, or pain in one leg can be a sign of a blood clot. If you notice any of these symptoms during or after the flight, seek immediate medical attention.
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Pulmonary embolism warning: A pulmonary embolism (PE) can occur if a clot breaks off and travels to the lungs, causing symptoms like sudden chest pain, shortness of breath, dizziness, or fainting. If you experience these symptoms, seek emergency medical care.
8. Longer Flights & Transatlantic Travel
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Extended travel: For flights longer than 4 hours, the risk of clot formation increases. Take extra precautions as mentioned above, and consider speaking with your healthcare provider about additional preventive measures such as a low-dose blood thinner or other recommendations.
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Flight-related medical aids: Some long-haul flights offer in-flight medical equipment like pneumatic calf compression devices, which may help in reducing the risk of clot formation, but always check with your healthcare provider first before relying on these options.
9. After Arrival
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Avoid immobility: Once you arrive at your destination, avoid staying seated or standing still for long periods. Walk around as much as possible to encourage healthy circulation.
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Rest if necessary: If you feel fatigued or swollen after a long flight, elevate your legs, rest, and hydrate as needed.
Key Points from Medical Literature:
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Cochrane Review (2017): Evidence supports the use of graduated compression stockings for reducing the risk of DVT during long flights (greater than 4 hours), particularly for individuals with a history of VTE.
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NICE Guidelines (2018): The National Institute for Health and Care Excellence (NICE) advises that patients who are at high risk of VTE should be considered for prophylactic anticoagulation during long-haul flights, particularly if they have other risk factors (e.g., obesity, immobility).
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British Thoracic Society (2021): Recommendations for air travel with a history of VTE highlight the importance of early medical consultation, use of compression stockings, and hydration during long flights.
Final Considerations:
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Always follow the advice of your healthcare provider when it comes to medication and other preventive measures.
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Take note of any changes in your health before, during, and after the flight.
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For patients at particularly high risk of blood clots (e.g., recent surgery, active cancer, or pregnancy), flying may be contraindicated, and alternative travel arrangements may be necessary.
By following these recommendations and collaborating with your healthcare team, you can reduce the risks associated with flying and help ensure a safer journey.