Deep vein thrombosis (DVT) can be a worry for frequent travellers. It occurs when altered blood flow leads to the formation of a blood clot in a deep vein of the leg. Symptoms include a swollen or painful calf or thigh. In uncommon cases, part of the clot moves to the lungs, causing a pulmonary embolism (blocked blood vessel) that, if severe, may cause the affected lung to collapse. DVT isn’t caused only by travelling. Each year, it occurs in between one and three people per 1,000, according to the Department of Health, and, of those, only one in 100 cases is fatal. Nevertheless, frequent travellers may be more at risk than others. Professor Mark Whiteley, a consultant venous surgeon and phlebologist, explains why: “The things that cause clots are the Virchow’s Triad [named after German physician Rudolf Virchow]. These are changes in the blood, changes in the blood flow and changes in the vessel wall. Any one of those can cause a clot.
“When you fly, you have a change in the flow, since you’re just sitting there, so the blood isn’t flowing as it should. You’re up in the air, so you have decreased oxygen and have changed the consistency of the blood. Finally, if you have varicose veins, then the vein wall is stretched and bulbous, allowing blood to clot on this altered vein wall. So when you fly, you’ve got the perfect storm for DVT.”
Our 2019 article on this (see businesstraveller.com/ feature-category/smart-traveller) dealt with some of the practical ways to guard against DVT, such as staying hydrated, moving regularly on the plane and wearing compression socks. The publicity around these measures has probably saved many people who would have suffered from DVT from having serious problems. There’s no doubt, though, that some of us are more at risk than others, and so if you have varicose veins it would be a good idea to see a specialist.
Whiteley points out that a significant proportion of the population is unaware that they have varicose veins, as not all are visible on the surface. “Venous disease affects around 30-40 per cent of people, and of that 30-40 per cent, only 15-20 per cent of people know they have got problems with their veins, because they can see them. The others are hidden under the skin’s surface,” he says.
“Whether they are visible or not, most vein disease will cause aching and painful legs and can lead to swollen ankles and, ultimately, can go on to cause leg ulcers and clots. Yet even in those cases, if you go to the doctor you will often be given leg stockings or steroid treatments, neither of which really work because they don’t fix the underlying problem.”
For those people who do have veins that show, who have suffered from leg ulcers or superficial vein thrombosis (phlebitis), or who have a family history that might indicate problems are likely, Whiteley recommends having a pre-emptory scan.
Since my own varicose vein was visible, I thought it worth at least having a scan. My attitude towards undergoing surgery is that I have successfully avoided it all my life, and I intend to continue doing so. Nevertheless, a scan isn’t painful, and at least then I could make an informed decision. So it was that I found myself having an initial consultation with Whiteley at his clinic just off London’s Oxford Street (he also runs clinics in Guildford and Bristol).
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