Why are we advised not to sit for prolonged periods of time, especially on long flights? To prevent blood clots !
Being immobilized for long periods of time slows down the blood flow. This may cause accumulation of blood cells in a certain part of a vein. In addition, we avoid drinking on the plane because that would mean getting up, squeezing by the other passenger and having everyone look at us before we dash to the bathroom. Less water means possible dehydration causing the blood to become thick. And suddenly, ouch! We experience a leg cramp. Is it just a muscle spasm due to sitting in the tight sardine-like seat or could we have formed a blood clot in our vein?
Normally, blood clots in response to injury preventing us from bleeding to death. However, sometimes blood clots will form without injury ( watch here ). They may either dissolve or cause a medical problem/emergency. If they get lodged in a vein or artery, they block the flow of blood to different organs like heart, brain or lungs resulting in a heart attack , stroke , or pulmonary embolism .
Thrombosis means the formation or presence of a blood clot within a blood vessel during life. This can occur either in a vein or artery (arterial-).
Causes of blood clots:
1. After surgery
2. Response to traumatic injury, auto accidents
3. Gradual buildup of plaque within an artery
4. Cancer
5. Autoimmune disorder
6. Infection
7. Bleeding disorders
8. History of varicose veins
9. Atrial fibrillation
10. Inflammatory bowel disease
Risk Factors:
1. Smoking
2. Elevated levels of homocysteine
3. Obesity
4. Prolonged lack of exercise
5. Use of contraceptive pill/patch
6. Advanced age
7. Mechanical heart valve
8. Sitting or laying in one position for prolonged period of time
9. Genetic factors
Signs and symptoms:
1. Sharp chest pain
2. Fast heart rate
3. Shortness of breath
4. Blood-tinged coughing
5. Swelling and tenderness in arm or leg
6. Vision disturbances
7. Weakness
8. Seizure
9. Severe abdominal pain
These signs and or symptoms should prompt you to seek medical help. A medical history and a physical exam will be performed by the doctor. If a clot is suspected, a Doppler ultrasound , CAT scan , or MRI can be done. Venograms / angiograms are rarely needed.
Treatment may depend on the location of the blood clot: artery or vein. Both require medications such as enoxaparin (Lovenox) , warfarin (Coumadin) , alteplase (Activase, TPA) , tenecteplase (TNKase) or others. Arterial blood clots are treated more aggressively and may also require cardiac catheterization .
Prevention consists of reducing the risk factors above. Taking these steps may minimize the plaque buildup and “hardening” of the arteries over time. Managing diabetes, cholesterol and blood pressure should be an understood fact. Don’t be immobile. Get out of the car or stand up and stretch in a plane or train routinely. Drink plenty of water. Know what medications you are taking. Find out if you can benefit from better nutrition. Consider medications and/or herbs. All these concerns should be taken up with your doctor.
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