DVT and flying.
Discussion
When was the DVT, what are their other risk factors and was a specific cause/precipitating factor identified? The risks are very different if it was last week, last month or last year, and the risk factors of the specific individual. If the DVT was very recent, it would be extremely unwise to get on a flight. It's not just the confinement of the seat, being at altitude and low pressure envirinment causes significant changes in blood viscosity leading to formation of DVTs, which is why we don't see a similar level of DVTs after long bus, coach or rail travel.
The big risk isn't the DVT itself though, it's the risk of a pulmonary embolus, i.e., a piece of the blood clot in the leg breaking off and blocking the big artery from the right side of the heart to the lungs, which has 2 consequences:
1) It severely restricts blood flow and, if the clot is large enough, it can block the entire/almost all of circulation. That's pretty much instant "he/she just dropped dead!" time. No chance of recovery unless you happen to be outside a large hospital, ideally with a resident cardiothoracic surgery team (most don't have one), and you have a huge amount of luck on top of that.
2) The lungs can't oxygenate blood adequately so your body is starved of oxygen. Also not very good for staying alive.
These scenarios may sound unlikely, but, unfortunately, they happen quite frequently. Most PEs are not fatal but that's because they don't happen at 36,000 ft and 4 hours away from the nearest airport, and we can treat them. Not just that, but you're not out of the woods just because you're off the flight; you can develop a flight related DVT for several days afterwards, and developing a DVT means that until the clot has totally gone, you still have a risk of embolisation which can take weeks. Furthemore, the drugs you have to take to "dissolve" the clots prevent your blood from clotting. Sounds great. Except that they have risks of their own such as having a stroke as a result of an uncontrollable bleed in the brain. In fact, I had that exact patient; recent DVT, advised not to fly, ignored medical advice and went to Disneyland, had another DVT, anticoagulated, tripped on a paving stone, minor bump to the head, went home, husband couldn't wake her up the next morning, massive cerebral haemorrhage, died a few days later.
Only you and your partner can decide what level of risk you wish to expose yourself to but I'd suggest asking your doctor and following their advice. Also, you really, really should have a very good travel insurance policy, you must inform them of your partner's DVT, and double check specifically that they will cover for complications related to thromboembolic disorders especially pulmonary embolus including repatriation. A lot of travel health policies exclude pre-existing conditions and their complications and even a short intensive care unit stay is enough to bankrupt most mortals.
I am a doctor but not your/your partner's doctor etc. etc. Happy to answer more questions if you want to pm me.
The big risk isn't the DVT itself though, it's the risk of a pulmonary embolus, i.e., a piece of the blood clot in the leg breaking off and blocking the big artery from the right side of the heart to the lungs, which has 2 consequences:
1) It severely restricts blood flow and, if the clot is large enough, it can block the entire/almost all of circulation. That's pretty much instant "he/she just dropped dead!" time. No chance of recovery unless you happen to be outside a large hospital, ideally with a resident cardiothoracic surgery team (most don't have one), and you have a huge amount of luck on top of that.
2) The lungs can't oxygenate blood adequately so your body is starved of oxygen. Also not very good for staying alive.
These scenarios may sound unlikely, but, unfortunately, they happen quite frequently. Most PEs are not fatal but that's because they don't happen at 36,000 ft and 4 hours away from the nearest airport, and we can treat them. Not just that, but you're not out of the woods just because you're off the flight; you can develop a flight related DVT for several days afterwards, and developing a DVT means that until the clot has totally gone, you still have a risk of embolisation which can take weeks. Furthemore, the drugs you have to take to "dissolve" the clots prevent your blood from clotting. Sounds great. Except that they have risks of their own such as having a stroke as a result of an uncontrollable bleed in the brain. In fact, I had that exact patient; recent DVT, advised not to fly, ignored medical advice and went to Disneyland, had another DVT, anticoagulated, tripped on a paving stone, minor bump to the head, went home, husband couldn't wake her up the next morning, massive cerebral haemorrhage, died a few days later.
Only you and your partner can decide what level of risk you wish to expose yourself to but I'd suggest asking your doctor and following their advice. Also, you really, really should have a very good travel insurance policy, you must inform them of your partner's DVT, and double check specifically that they will cover for complications related to thromboembolic disorders especially pulmonary embolus including repatriation. A lot of travel health policies exclude pre-existing conditions and their complications and even a short intensive care unit stay is enough to bankrupt most mortals.
I am a doctor but not your/your partner's doctor etc. etc. Happy to answer more questions if you want to pm me.
Are we missing the point where the OP says she’s on medication?
I was diagnosed with a DVT 6 years ago. I’m on a daily medication of thinners.
I’ve since flown all over the world. - I take sensible precautions. I wear compression socks on both legs and I’m not sat still for more than 30/45 mins on a flight and I don’t drink on the plane, I keep topped up with water. - also helps with reminding me to move cos I need a piss.
I was diagnosed with a DVT 6 years ago. I’m on a daily medication of thinners.
I’ve since flown all over the world. - I take sensible precautions. I wear compression socks on both legs and I’m not sat still for more than 30/45 mins on a flight and I don’t drink on the plane, I keep topped up with water. - also helps with reminding me to move cos I need a piss.
Nurburgsingh said:
Are we missing the point where the OP says she’s on medication?
It's literally in the first sentence of his post!KAgantua said:
My partner has DVT in one leg and is on medication. We are thinking of doing a medium haul flight (8 hours) any recommendations? We are thinking of springing for Business class or extra legroom.
If you have an active DVT, you can have pieces that break off, like small pieces breaking off from an iceberg. It's those pieces that break off that then float off and cause a blockage in the arteries to the lung from the right side of the heart, not new clots forming in the pulmonary arteries. Being on an anticoagulant speeds up the process of liquefaction of the clot and reduces the risk of PEs but doesn't eliminate it. Yes, you're less likely than someone who's not being treated, and if you do have a PE, it's less likely to be a fatal PE, but you're still a hell of a lot more likely than the general population to have a PE because you have a DVT already.
If that happens at high altitude, as well as distance from an airport and medical facilities to consider, you also need to take into account what happens if your lungs are struggling to get oxygen into your blood and then you take that person up to 36,000 ft in a plane. A commercial plane is pressurised to around 8,000 ft altitude, so equivalent to an oxygen partial pressure of 15%. That's less oxygen that you normally breathe out after your lungs have extracted the O2. Your lungs and your body will cope with that if everything is working fine, but not if a significant proportion of your lung capacity is being blocked by a clot. What may have been a surviveable PE at ground level has now become a life-threatening one because the body is experiencing a double whammy of oxygen reduction, PE and high altitude.
Most people who take the risk will actually be fine, but some won't, and a few will die, bit like a reverse lottery, and what you're gambling with isn't just a couple of quid but your life.
If that happens at high altitude, as well as distance from an airport and medical facilities to consider, you also need to take into account what happens if your lungs are struggling to get oxygen into your blood and then you take that person up to 36,000 ft in a plane. A commercial plane is pressurised to around 8,000 ft altitude, so equivalent to an oxygen partial pressure of 15%. That's less oxygen that you normally breathe out after your lungs have extracted the O2. Your lungs and your body will cope with that if everything is working fine, but not if a significant proportion of your lung capacity is being blocked by a clot. What may have been a surviveable PE at ground level has now become a life-threatening one because the body is experiencing a double whammy of oxygen reduction, PE and high altitude.
Most people who take the risk will actually be fine, but some won't, and a few will die, bit like a reverse lottery, and what you're gambling with isn't just a couple of quid but your life.
As has been said, pulmonary embolus is more than likely going to be fatal. In my experience the post mortem said there would have been no chance of surviving, unless it happened as the person was being opened up for open heart surgery at the time.
Yes, many people do fly long haul regularly, but is it worth the added risk, or wait until the doctors give the all clear from any clots.
Don't stop living your life, but please take care!
Yes, many people do fly long haul regularly, but is it worth the added risk, or wait until the doctors give the all clear from any clots.
Don't stop living your life, but please take care!
Speaking as someone who has had several DVT in various locations (both anatomically and geographically 
) and done many long haul flights back in the day, i'd also advocate speaking to your haematologist/healthcare pro!!
Back in the early 2000's i got given heparin shots to take on each of my round the world trip stages. If your partner is already on meds, you need to be very aware of what those are, and any bad reactions to those especially the overseas names of those meds (often called something else for marketing reasons etc). For example, on apixaban you cannot take anti-inflamatories such as ibuprofen due to bad reactions.
) and done many long haul flights back in the day, i'd also advocate speaking to your haematologist/healthcare pro!! Back in the early 2000's i got given heparin shots to take on each of my round the world trip stages. If your partner is already on meds, you need to be very aware of what those are, and any bad reactions to those especially the overseas names of those meds (often called something else for marketing reasons etc). For example, on apixaban you cannot take anti-inflamatories such as ibuprofen due to bad reactions.
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