Road trips and long flights are common forms of travel for most Americans, but they can also pose health problems for people at risk of developing deep vein thrombosis (DVT).
DVT occurs when a blood clot forms in one of the larger or “deep veins” in the body, most often in the thigh or lower leg.
Blood clots can form during long-distance travel because of the long period of time sitting still in a confined space. Long periods of immobility can cause blood to pool in the legs, disrupting its normal flow through the veins.
According to the Centers for Disease Control and Prevention (CDC), anyone traveling more than four hours whether by air, car, bus or train can be at risk for blood clots.
“The good news is there are things you can do to protect your health and reduce your risk of blood clots during long trips, such as moving your legs frequently or taking a break to stretch your legs,” says Ankur Chandra, MD, a vascular surgeon at Scripps Clinic Torrey Pines. “These types of activities help to improve the return of blood from your legs.”
Many times the blood clot will dissolve on its own. However, problems can occur when a part of the blood clot breaks off and travels to the lungs causing a blockage. This is known as a pulmonary embolism (PE) and it could be life-threatening.
Symptoms of PE include shortness of breath, chest pain, coughing up blood, faster than normal or irregular heartbeat and very low blood pressure, lightheadedness or fainting.
“If you have any of these symptoms, seek medical help immediately," Dr. Chandra says.
Estimates suggest that 60,000-100,000 Americans die of DVT/PE (also called venous thromboembolism), according to the CDC.
The combination of long-distance travel with one of these risks may increase the likelihood of developing a blood clot, according to the CDC:
- Older age; risk increases after age 40
- Recent surgery or injury
- Use of estrogen -containing contraceptives, such as birth control pills
- Hormone replacement therapy
- Pregnancy and the postpartum period
- Previous blood clot or a family history of blood clots
- Active cancer or recent cancer treatment
- Limited mobility
- Varicose veins
- Catheter placed in a large vein
Because the symptoms can be very mild, DVT often goes unnoticed. Blood clots typically occur only in one leg and can cause pain, tenderness, swelling, unusual warmth, redness or changes in skin color.
“If you notice any of these symptoms, call your doctor. He or she will examine your legs and may order an ultrasound test, which uses sound waves to evaluate blood flow through the veins and indicates whether there is a blockage or obstruction,” Dr. Chandra says.
Because veins normally do not show up in an X-ray, occasionally a contrast material is injected into the vein to make it visible, and the images are taken as the material flows through the vein.
Given the serious complications of DVT, it’s important to get treatment promptly to help prevent pulmonary embolism and other problems.
Your doctor may treat you with an intravenous anticoagulant, such as heparin, to clear the blood clot. In addition, your doctor may prescribe warfarin, an oral medication that increases the time it takes for blood to clot and helps ward off DVT.
Most patients take warfarin for several months or more following treatment with heparin. In some cases, surgery may be recommended to remove the clot.
“Early treatment for DVT is usually very effective,” Dr. Chandra says. ”However, people who have one episode of DVT have a higher risk of recurrence. Some may have chronic pain and swelling in their leg as well, and may need to take special precautions to minimize the risk of complications,” he says.
Because the risk of DVT is highest among people who are immobile for long periods, it’s a good idea to avoid sitting or standing still for hours at a time. Wearing loose-fitting clothes is also recommended.
If you work at a desk, take frequent breaks to get up, walk around and get your circulation going.
On long trips, move your legs frequently and exercise your calf muscles to improve the flow of blood.
“Your doctor may also recommend that you wear compression stockings to help minimize the risk of developing DVT,” Dr. Chandra says. These special stockings put pressure on leg muscles and help blood flow from the legs back to the heart.
Talk with your doctor if you think you may be at risk for blood clots. If you have had a previous blood clot, or if a family member has a history of blood clots or an inherited clotting disorder, talk with your doctor to learn more about your individual risks.