The deep veins that lie near the center of the leg are surrounded by powerful muscles that contract and force deoxygenated blood back to the lungs and heart. One— way valves prevent the back— flow of blood between the contractions. (Blood is squeezed up the leg against gravity and the valves prevent it from flowing back to our feet.) When the circulation of the blood slows down due to illness, injury or inactivity, blood can accumulate or "pool" which provides an ideal setting for clot formation.
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Cause The precise cause of Traveler's Thrombosis, while currently not clear, appears to be related, in part, to long periods of sitting and inactivity. The decrease in activity may lead to inadequate circulation of the blood in the legs. In addition, the veins may be slightly constricted, which could also impair circulation in the legs that alter blood flow or normal clotting mechanisms may make some people more likely to develop a DVT. Some of these risk factors include a prior DVT, certain heart diseases, cancer, pregnancy, smoking, older age, and some blood clotting disorders. Recent major surgery or trauma is also a risk factor. Certain medications may also contribute to formation of the thrombus. Birth control pills and related hormones have been found to make some people slightly more susceptible to forming DVTs.
Symptoms Not all DVTs cause noticeable symptoms, but the most common are:
- Swelling (edema) and redness in the affected leg, often associated with some pain in the same area.
- Increased warmth of the affected leg.
- Severe chest pain or problems breathing may indicate a pulmonary embolus and should be evaluated immediately.
Treatment If you suspect that you may have developed a DVT, you should immediately contact your physician or go to an emergency room. Be sure to mention that you have recently completed a long journey, as that information may aid in making the correct diagnosis. Different procedures will be used to check for the presence of a DVT and to evaluate a possible pulmonary embolus, if indicated. If a DVT or PE is found, then you will usually be started on a blood thinner to help prevent the clot from becoming larger while it slowly resolves.
Prevention Since it has not been scientifically established that there is a direct relationship between DVT and flying, there may be no need for specific preventive methods. However, some practices may be found to be beneficial:
- Wearing support socks and hosiery such as Jobst Travel Socks has been proven to help prevent DVT.
- Increasing leg muscle activity during long periods of sitting improves blood flow in the legs. This may include walking around the cabin or exercising your lower legs and ankles while seated.
- Drinking adequate fluids, and avoiding alcohol and caffeine, may also help by preventing dehydration.
- Loose— fitting clothing may be beneficial in avoiding constriction of veins.
- Some recommend taking short naps, instead of long ones, to avoid prolonged inactivity.
- If you have any of the risk factors for DVT, consult your physician before long trips. If indicated by a physician, special support socks or stockings can reduce blood pooling in the legs and blood thinning medications may be prescribed.