HOW To avoid getting a VTE

By Dr. Dave Hepburn | May 19, 2010

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dr daveWhenever I have to take a flight, I, being a Scot, usually go coach ... on points ... preferably someone else’s points. But as I head back to the cattle car to huddle with the great unwashed (even though I personally shower every Wednesday, usually), I have to pass those in business class as they recline in peace, their feet soaking in a Grecian urn of rose water, having already feasted on pheasant femurs and unicorn nectar as wee Asian lasses knead their necks.

On rare occasion I have actually got to travel business class but recalling that I usually fly coach I, with reserved humility and sensitivity, PLAY IT TO THE HILT BABY!! I am first on the plane, plop in that big Lazy Boy like a wealthy CEO or plumber (though most have their own Lears) hide my Archie and Jughead and pick up a Fortune 500. I don’t read it, I just glance over the top of it trying to make accidentally deliberate eye contact with those heading to other side of the commoners curtain, those who trudge by glaring at me as though saying “You lucky slug. You feast with the gods as we will get nothing but a two ounce bag of pretzels mixed with some crunchy carb trans fat thing that has not yet hit the store shelves other than in Pets-R-Us.” Yup I am a slug. I jangle my non-plastic fork against my non-plastic knife as, of course, we get real silverware, there being no terrorists likely to sit in first class other than first class terrorists and as I know of no terrorists who like warm cookies with cold gelato ...we’re OK.

I am a Scot, broad shoulders, fish-belly white skin, short legs, sense of humor, large girth (it’s an ethnic thing, no sense fighting it) and a disdain for anyone whose mother happened to name them King Edward. But it is not good being a Scot on a flight in coach. Should I and my shoulders be seated in a middle seat, well just shoot me with a crossbow and be done with it. Of course, adding to the misery, no sooner will we have reached our cruising level when the guy in front pushes a button and his chair reclines with a snap, the snap being my kneecaps.

When the flight comes to an end one of three things always happens.

As if on cue everyone reaches for a cell phone as though four hours deprived of one has created withdrawal symptoms.

Others will turn to the person they have sat beside for the past half a country without saying boo and start to unveil their life’s story. “Well that was a heck of a flight; is this home for you?”

“It is. When I was a child I was born at a young age ….”

Or, you might get quite short of breath.

“Look mom, grandpa is so excited to see us he can hardly catch his breath.”

“That’s not excitement Billy. Grandpa is having a blood clot firing off into his lungs from his legs, also known as a venous thromboembolism. Now would you like an ice cream while I go and get Grandpa’s luggage and will?”

One in every 6000 grandpas who have taken a flight over four hours will get a blood clot. But blood clots can also form in shorter flights and indeed the risk increases the longer the flight and the more frequent the flights are. If grandpa is obese or on the birth control pill his risk goes up.

To avoid getting a VTE:
-Remain adequately hydrated remembering that excess alcohol will make you less hydrated

-Avoid tight fitting socks or stockings though sometimes you can use graduated compression stockings, making sure they don’t clash with your kilt.

-Spend periods out of your seat (that would be the airplane seat, not your pants).

-It is important to exercise the calves to prevent blood from pooling in the legs. It needs to be sent back upstream in our carcass to our head or love handles. I used to do this by doing handstands in the aisle, though due to letters of protests and no doubt jealousy ... I no longer wear my kilt.