Summer is the time that many people choose to travel and with travel can come long periods of sitting in cars, planes, or other vehicles.
Long periods of immobility can cause deep vein thrombosis (DVT). A condition where blood clots form in the large veins in the legs, DVT can be extremely serious because the clots in the legs can break free and lodge in the lungs blocking blood flow into the lungs and then oxygen into the rest of the body — which can be fatal. This is called a pulmonary embolism.
Symptoms of DVT include swelling in one leg, pain in that leg that often starts in the calf and is frequently described as cramping, soreness, or tenderness, redness and warmth in the affected leg.
If you see symptoms of DVT, particularly if you haven’t been moving around as much as normal, you need to visit a doctor as soon as possible. Symptoms of pulmonary embolism include sudden shortness of breath, chest pain that worsens when you take a deep breath or cough, feeling lightheaded, dizzy, or fainting, rapid pulse and coughing up blood. If you see those symptoms, seek emergency care immediately or call 911.
The reason sitting for long periods of time can lead to DVT is because moving the muscles in the legs helps push blood back to the heart, and when people sit, they don’t move their legs as much.
Blood that collects in the legs can then clot because it’s not moving — just like that drop of blood on your finger clots and forms a scab when you get a cut — it clots when you make the blood stop moving with pressure to the area, a bandage or something similar.
According to the Centers for Disease Control and Prevention, the best way to avoid travel-related DVT is to walk around every two to three hours and to move your legs frequently between walking periods when you have to sit for long periods of time.
Their recommendation is straightening legs and flexing ankles (pulling toes toward your head) 10 times every hour, or pulling each knee toward your chest and holding with your hands on your calf for 15 seconds 10 times every hour.
If you think you have a clotting disorder, a condition where your blood clots differently (either more quickly or less quickly), visit with your doctor before you travel, or if you are on medications that can change how your blood clots, also speak with your doctor before you travel.
Again, if you see symptoms of DVT or pulmonary embolus, seek medical attention quickly. DVT and even pulmonary embolus have become much more treatable in the last several years. When I was a young nurse, DVT, pulmonary embolus or other clotting issues in arteries and veins usually meant intravenous heparin infusions over several days — usually more than a week, prolonged bed rest so any clots didn’t break loose and become pulmonary embolus, massive surgeries to extract clots, or in some cases amputation.
Now the most common treatments are interventional radiology procedures and/or oral blood thinning medications.
Interventional radiology is a field of medicine that has really changed during my career as a nurse. I am constantly amazed at the strides this field has made in improving the lives of people, particularly when it comes to vascular issues like DVT.
The interventional radiologist now can put a small tube, known as a catheter, into the large veins of the arm or leg. Those catheters are generally smaller than the diameter of a pencil — which is much less invasive than the surgeries used in the past and using a type of radiology called fluoroscopy (which is to a normal x-ray like a movie is to a photograph), they can then put other smaller catheters through the first catheter and remove the clot or infuse potent clot-busting medications directly into the clot, dissolving it over a few minutes to a few hours.
Most people can go home within a day or two, sometimes even the same day, and resume their normal activities within a few weeks, rather than the months of recovery that these issues needed in the past.
As with most things, the best thing to do with DVT is prevent the problem — move your legs frequently when you are sitting, and walk every two to three hours as you travel. I hope you never need to use your knowledge about DVT or pulmonary embolus symptoms, but if you do see symptoms of DVT of pulmonary embolus seek medical attention immediately.
