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HindustanTimes Thu,24 Apr 2014

Long flights, veins: in deep discord

Jaya Shroff Bhalla, Hindustan Times  New Delhi, October 07, 2012
First Published: 22:57 IST(7/10/2012) | Last Updated: 01:05 IST(8/10/2012)

With more people taking long-haul flights, incidences of deep vein thrombosis (DVT) have increased manifold. Most outpatient departments in the Capital get at least 20-25 patients of DVT every month, of whom at least 25% have been on long-haul flights.

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"More people are undergoing major orthopaedic and cancer surgeries for travelling. The fear of developing thrombosis in the legs during long flights is not new for these patients but incidents have definitely increased because of air travel frequency," said Dr Kumud Rai, director, vascular surgery, Max Healthcare, Saket.

"There is more awareness about the disease also. Earlier, people weren't sure about the cause for swelling after journeys," he said.

Rashika Jain, 25, with no history of surgery developed a swelling in her calf muscles after a six-hour journey from Delhi to London last month. After consultation with her family physician in Delhi, she underwent a Doppler scan the day after and the diagnosis revealed that she had developed vein thrombosis in the flight. Doctors then analysed that she had developed the condition as there was family history of clotting problems.

"A six-hour journey was not a really long flight for anyone with a direct medical history to develop DVT. So this incident was a little shocking but there are freak cases once in a while, so one can imagine that the problem is a little severe for those with surgery histories," said Dr Rai, whose patient Anupam Verma, 47, who owns a perfume packaging plant in Bahdurgarh suffered a major DVT attack soon after he returned from a six-hour flight from Singapore last year.

"I fly frequently for work, so it was difficult to connect my swelling to a long flight. When the doctor correlated the two, I was initially shocked but then I accepted and then on, I take a lot of precautions when flying," he said. Verma was initially given injections to dissolve the swelling and later put on blood thinning medication for 18 months.

According to WHO, over 2.2 billion journeys are made by planes every year globally. On an average, one person is affected for every 20 long-haul flights carrying 300 passengers.

A multi-centric study (2007) published in PLoS Medicine, a medical journal, showed that chances of getting DVT are tripled from taking long haul flights. The research covering 8,755 people showed that the increase in risk was greater in younger people (less than 30 years old), women who used contraceptive pills, people who were overweight, and people who were shorter than 5ft 4in or taller than 6ft.

The signs of DVT are mild nausea, swelling of the leg or arm (sometimes it occurs suddenly), pain or tenderness in the leg that may only be present when standing or walking, redness or discolouration of the skin, feeling of increased warmth in the area of the leg or arm that is swollen or that hurts.

"It is always advisable to drink plenty of water when travelling to prevent the occurrence of DVT. It's best to completely avoid alcohol as it leads to dehydration," said Dr Biren Nadkarni, orthopedic and joint replacement surgeon at Sitaram Bhartia Institute of Science and Research.

"The risk of DVT increases if the travel time is longer than four hours or you have other DVT risk factors," he warns. Dr Nadkarni also advises frequent walks along the plane aisles.

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