There are lots of things that can either be frustrating or scary about flying. There’s the lost/delayed luggage, delays, lines at security, turbulence, lack of space, and of course…snakes on planes (at least in Hollywood). I’m pretty familiar with all of these annoyances (except the last one!) because I spend a lot of time flying. Even though there’s nothing fun about these things, it’s still worth it to me in order to have the opportunity to move around this globe and explore. Vacations are important to your health and well-being – and for me they are important for my work and my happiness.
However, on my recent trip to India, I unfortunately added another flying annoyance to my list. Blood clots from flying. It is not just an annoyance, it’s a life threatening situation caused from flying. Deep Vein Thrombisis (DVT) and Pulmonary Embolisms (PE), can sadly be a byproduct of a long haul flight, and after 12 years of circling the globe as a travel blogger, I encountered it.
What is DVT and PE?
Deep Vein Thrombosis – the most serious health risk you’ve never heard of Deep vein thrombosis is a blood clot that forms in a deep vein, usually in a leg. The clots can break off and lodge in your lungs (called a Pulmonary embolism), and can be fatal. The clot that is trapped in the lung leads to blockage of blood flow and can be extremely dangerous if not treated appropriately.
How I ended up in Urgent Care and Diagnosed
“I think you should go to Urgent Care and have a CT Scan, “ the doctor on the phone urged me. I was taken aback as it seemed like an overreaction to what I believed to be a virus or cold that I caught while I was in India. I had called my doctor’s office to get an appointment before the weekend because I had this annoying cough that I couldn’t get rid of and my chest really hurt underneath my right breast when I took in big breathes or simply laid down. I thought I could get in to see a doctor and get some antibiotics for whatever infection I might have. Simple.
But now this ER doctor they had transferred me to was telling me to go to urgent care. “I have an event tonight I’m going to, can I just go tomorrow instead?” I asked annoyed by the fact that I was going to have to Uber to the suburbs to see a doctor.
“You could,” she said slowly, “but I think you should go tonight. It won’t take long – I just looked up the wait lines at the Urgent Care and you should be able to get in right away.”
“Okay, I guess I can quick go, “I responded reluctantly, still wondering if this was really necessary.
Because I’m cheap, and didn’t think this was any big deal beyond a nasty cold, I decided to take an Uber Express Pool. I don’t have a car in Denver, which is normally not an issue as I never go out to the suburbs and I bike or walk most of the time. This Uber was going to be expensive and I wanted to save some money. The express pool is the cheapest way to travel as they don’t even let you off at your destination, but near it and then you occasionally have to walk a few blocks yet. As the Uber driver dropped me off about 4 blocks from the Urgent Care in Aurora, my final words to him were, “If I die walking to Urgent Care it’s on your hands.” We all laughed and I started walking.
The pain in my chest and my cough seemed to be getting worse by the minute; I found it hard to breath without pain. Before I knew it I had an EKG, blood tests, an IV in my arm, and suddenly they were taking me in for my first ever CT scan. The doctor came back and told me they found 3 blood clots (pulmonary emboli) in my lungs and proceeded to tell me how lucky I was.
I was lucky because up to a third of pulmonary embolisms will ultimately be fatal; a sudden death situation.
Still in disbelief, I sat there letting this all sink in. I knew I was lucky, but I don’t think the severity of it had sunk in yet. My sister had a similar situation which nearly killed her a few years ago from a long haul flight, and I knew from her experience that this was going to mean a long time on blood thinners and careful monitoring. So of course my first question to the doctor was “Can I still travel?”
“Yes, you can still travel,” she replied. I felt relieved for a moment until she then launched into the prescriptions I would need to start, including one that required me to give myself a shot in the belly. My relief quickly vanished. But, at least I was still alive…and I could still travel.
My Signs of DVT and PE
Once I knew the diagnosis, I started to go back over the last 2 weeks in India and things that I thought were odd at the time, suddenly started to make sense. It was like connecting the dots in a murder mystery!
Signs of DVT and Pulmonary Embolism
Symptoms of DVT can include (usually the leg or arm):
• Swelling of your leg or arm
• Pain or tenderness that you can’t explain
• Skin that is warm to the touch
• Redness of the skin
Symptoms of a PE can include:
• Difficulty breathing
• Faster than normal or irregular heartbeat
• Chest pain or discomfort, which usually worsens with a deep breath or coughing
• Lightheadedness, or fainting
My flight to India was an overnight 14-hour flight from Newark to Delhi. On long flights I always get the aisle seat so I can easily get up and down and walk around without bothering the person next to me. However, since this was my niece’s first big trip out of the country, I decided to let her have the window seat which then put me in the middle seat. Feeling a bit trapped (and not wanting to be a bother to the person next to me), I didn’t get up and walk around as much as I normally do. Plus, since it was an overnight flight I did actually sleep for a good 5 solid hours where I didn’t move at all from my economy seat. This lack of movement for a prolonged time is likely what made the clots form. In addition, I take estrogen which also increased my susceptibility to clots.
My blood clots likely formed in my legs from my initial long haul flight to India.
DVT normally starts with pain in your legs, that’s the sign of clots deep in your veins. I had a strange ache in my left calf while in India. However I rationalized it because it was so incredibly hot and humid in India I just thought any weird body reaction had to do with the intense heat. I tried to massage my calves but in general it was just a nagging ache that I lived with and didn’t really think too much about.
After a week in India with more long bus rides and train rides where I didn’t think too much about mobility and getting up frequently, I noticed a weird pain in the right part of my chest underneath my breast. I was laughing about something that had happened and when I took in a deep breath I had a pain in my chest. Once again, this was a nagging pain that would come and go (mainly when laughing and breathing deeply), but I just thought that it had to do with jetlag, the heat, or India’s pollution. At one point I did wonder if I had bruised a rib, but figured that if I did there was really nothing I could do. At the end of the trip I started to develop a cough that I thought was a cold.
The blood clots moved into my lungs while I was in India
After the long flight home to Denver, the cough became more frequent, I was feeling lightheaded, and the pain in my chest was becoming worse. However, I still thought it was just a cold or maybe irritation from the pollution in India that maybe turned into bronchitis. Little did I know that all of these symptoms that I had be disregarding were actually really serious.
Treatment for Pulmonary Embolism and Blood Clots from Flying
Since my pulmonary emboli are believed to be provoked by a long distance flight, my treatment is pretty simple – blood thinners. First they started me off with a drug called Lovenox; I had to give myself shots in the belly for 5 days. Now, they’ve switched me over to Pradaxin, a new blood thinner medication that I take twice a day. There are no extensive drug tests necessary like the older drugs, and it appears I’ll have to be on Pradaxin for about 3 to 6 months. Once diagnosed, the treatments are actually pretty simple.
What You Can Do to Prevent DVT on Long Flights
Before you panic and think that you’ll never fly internationally again, know that DVT is actually pretty easy to prevent. If I hadn’t been so lax about getting up and moving on that initial flight, this never would have happened. Yes, I was at an increased risk due to the estrogen I was taking, however I’ve been on a ton of long flights while on estrogen medication and had never had an issue before. This could have been prevented if I had just gotten up and walked every 2 hours! Here’s all you have to do to prevent this from happening on your next long haul flight or train ride:
• Take low dose aspirin starting 2 days before your flight and throughout your vacation until you are home. Aspirin thins the blood which prevents clots.
• Get up and move or do foot exercises every 2 hours. Set an alarm if you have to! Move your legs frequently when on long trips and exercise your calf muscles to improve the flow of blood. Extend your legs straight out and flex your ankles (pulling your toes toward you). Some airlines suggest pulling each knee up toward the chest and holding it there with your hands on your lower leg for 15 seconds, and repeat up to 10 times. These types of activities help to improve the flow of blood in your legs.
• Stay well hydrated, but with water. Dehydration causes blood vessels to narrow and blood to thicken, raising the risk for blood clots. Staying well hydrated improves circulation. Avoid alcohol and caffeinated tea, coffee, and soda, which all act like mild diuretics. These types of drinks would add to your risk for dehydration.
• Wear compression socks. Most doctors will recommend them for long flights. The pressure these stockings put on your legs helps your blood vessels work better and help prevent DVT. Before you go ‘Ewwww’, compression socks are not simply for old ladies, most of the major sock vendors make a compression sock now and they have really cool designs! Stockings with higher numbers have a higher level of compression. The recommended tightness for DVT is between 30 and 40 mmHg.
Compression Socks I Recommend
I have a few gear brands I love for travel and luckily they also make compression socks.
Ironically – World Thrombosis Day is October 13th – the exact date of my next long haul flight I take.
I think my biggest surprise about this whole thing is that after I told people about what happened to me, I learned of so many other friends and followers who have had similar diagnosis. And I even learned of a few friends who had stories of fatal results. This is more common than I ever knew. Everyone always thinks, “It won’t happen to me” – but it can.
I will still always love travel, and I will get on many more long haul flights because it is so important to me to see and experience the world. However, I will be much more mindful about how I handle long flights and will be much quicker to act on the signs. I hope now you will too.
Another good reason to have Travel Insurance
Since my clots formed on my flight to India, there was a good chance that I could have been fatally ill while in India. I think that I’m pretty lucky that I somehow avoided that scenario. However, if I had, at least I had travel insurance from Allianz that would have taken care of me while in India.
Don’t forget your Travel Insurance on your next trip! Get a quote now!
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