deep venous thrombosis

AKA Economy Class Syndrome. This is blood clots that form when a person is forced to sit immobile for a long period of time. Clots in the brain, heart, and/or lung are, of course, serious.

A study in Tokyo's Narita Airport has shown that 25 people have died from the problem in the airport clinic in the past 8 years. (Insert Airport Terminal joke here.) About 150 had serious, though not fatal, other problems.

Source: Reuters

Deep Venous Thrombosis (DVT) is essentially a clot (thrombosis) in a large vein in the body. Typically this occurs in the leg, but in rare cases it can occur in other parts of the body. The clot blocks the normal flow of blood through the vein and can cause a variety of symptoms including swelling, numbness, pain, warmness of surrounding tissue, and redness. Typically 50% of patients will have no symptoms at all.

In most cases, a DVT is not a life threatening condition. In cases where the clot is below the knee, the chances of embolism are rare. There is a risk that part of the clot could break free and become lodged in the lungs. This can lead to serious complications and death. Typically DVT is aggravated by smoking, trauma, pregnancy, the use of birth control pills, and prolonged lack of movement such as after surgery.

In most cases, DVT is diagnosed by the use or an MRI or venogram (a somewhat painful X-Ray used with dye injection). Treatment depends on the severity, but typically consists of a prescribed anticoagulate such as heparin.

Deep-vein thrombosis is the condition is which blood clots form in veins, usually in the legs. Risk factors include:

• Sitting still for a long time, such as on an aeroplane.
• Hight blood pressure.
• Varicose veins.
• Age.
• Obesity.
• Any condition that causes an increased clotting tendency, such as a recent injury, pregnancy, or several diseases.

In the case of a thrombus in the leg, symptoms and risks vary, depending on where the clot is. Clots in other areas are rare, and may cause no obvious symptoms.

In the case of a clot in the popliteal or tibial veins, there is usually some calf pain, although there will not be much swelling.

If the blockage occurs in the femoral vein, the condition is more serious, and there will be significant calf and thigh pain, accompanied with swelling below the knee.

A clot in the Iliac vein is most serious of all, as this will restrict blood flow from the whole leg, and there will be swelling and pain over the entire limb.

While there are risks from these problems, it is not these that lead to DVT being a condition about people worry. If the clot breaks free, and ends up in the heart, lungs or brain there may be very serious consequences, possibly including death.

When DVT is suspected is can be diagnosed with an ultrasound scan. In minor cases anticoagulant drugs are given, and the clot will be broken down by the body. In more serious cases, where there is risk of the clot breaking off an operation known as a thrombectomy will be necessary.

So, kids, here's what you do if you DON'T want your legs to fall off after a particularly long flight in an economy-class ANA seat that was designed for an anorexic midget:

1. Get up during the flight. They tell you to stay in your seat when the seat belt light is on. When they turn it off, they tell you that you can move around. Take their advice! Ideally, you shouldn't endure an eight to fifteen-hour flight without at least getting up to sprinkle frozen urine on the Marshall Islands. Even if you don't have to pee, take a stroll around the airplane after the flight attendants' carts are put away. Check out the creepy foreign people lit up by their little seatback televisions. See if you can get the Sexy Stews' phone numbers.
    
2. When you're seated, move your legs around from time to time. JAL has advised its passengers to rotate their feet in circles, stretching the calf muscles and the ligaments around the ankle. This is a really simple exercise, and it works to relieve the tension you get from a lack of legroom.
    
3. If you're too big for the seat, consider a larger seat. If you have frequent flyer miles or spare cash, get an upgrade. A big buttery leather business class seat will not screw over your circulatory system like a cramped hunk of carpet and aluminum will. Plus, you get caviar and booze with the deal.
    
4. If you're prone to blood clotting for whatever reason, take your damn anticoagulants. And if you don't have the common sense to do this, I wonder how you can afford a long-distance air ticket. (Then again, you might be a congressman.)

What this feels like when you get it

I have depression and am medicating for that. Side effects and symptoms are weight gain and odd sleep patterns. This set me up for the DVT. I had been awake over 24 hours and then slept 17 hours. When I woke up I was in serious pain.

The pain was in my left lower leg and foot, all the way up to my knee and a little line up the inside of my thigh. It was a throbbing burning sensation. My lower leg was also somewhat swollen, felt a little hard to the touch, didn’t relax at all. It wasn’t so big as to prevent me from dressing, just a little swollen and firmer to the touch than my other leg. I was able to walk to the car that took me to hospital, but it hurt a lot at each step.

I described the pain to the doctors as like having knife wounds all over my lower leg. After a wait I was put on a gurney but my leg wasn’t raised. In all the many hours I was at the hospital I wasn’t given any painkillers, but found out later that it would have been ok after the initial diagnosis to have used paracetamol or equivalent. I was in pain the whole time at the hospital and didn’t notice any lessening in pain level the next couple of days except with painkillers. They diagnosed the DVT using ultrasound scanning, which showed the thrombosis running the whole length of my inner thigh. I was given anticoagulant medicines and told I should be fully recovered after 6 months.

During the following two weeks the pain lessened slowly, and let me walk almost normally at least for shorter stretches. After that the pain has been gone except when I take a longish walk. I wear a constraining sock to help my circulation.

This is only meant as a description of how the thrombosis felt for me, symptoms vary.