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DVT — deep vein thrombosis — sometimes results from long flights; it can kill

When I travel abroad, which I do frequently for work, I try to run every day for an hour. It gives me energy and a great look at my new surroundings. After starting a run in Manila recently, I stopped three minutes into it. My breathing was shallow and labored. I also had nagging pain in my calves. The discomfort had been with me since I landed in the Philippines four days earlier.

Back in Washington a few days later, I again was out of breath. But this time, I had just walked up two flights of stairs. I Googled "shortness of breath + calf pain + long flight," and found a possible cause: deep vein thrombosis (DVT), or blood clotting, that could travel up to my lung and cause a pulmonary embolism, a sudden blockage in a lung artery that could kill me.

I drove to the hospital and told the admitting nurse why I believed I had DVT. Fifteen minutes later an ultrasound technician was looking at the veins inside my right calf.

"Oh, my god," she said in a whisper.

"You found a clot?" I asked.

"Don't move," she said.

She had found two, one a large clot just below my knee. She was worried that if I moved, the clot could travel up to my lungs. A nurse quickly gave me anticlotting medicines.

A doctor came a few minutes later and said that based on my story, I had almost surely had a pulmonary embolism in Manila and again in Washington. And at that moment, he said, I probably had several clots in my veins. He told me that the anticlotting drugs would not break apart the clots — medications to do that can cause serious bleeding and generally are used only in life-or-death moments in the emergency room. Instead, he said, I would start a regimen of two medicines— Coumadin orally and daily shots of heparin — to prevent my clots from getting bigger and further clots from developing. I was not yet out of danger, and so I would be kept in the hospital for a few days for observation.

So began my education on deep vein thrombosis. I returned to Google and learned that 350,000 to 600,0000 Americans get DVT every year, and up to 100,000 die from it.

I found that the biggest risk factors for DVT include surgery, immobilization, smoking, obesity, genetic tendencies to form clots (see related box) — and long-haul flights.

I reached a Web-based clearinghouse of information on DVT, ClotCare. The founder, Dr. Henry Bussey, said that the few studies on DVT showed that long-distance flying could be a "substantial risk." He also said those with a tendency toward clotting were older people with poor circulation, women who were on hormonal medicine and people with a genetic condition that allows clots to form more easily.

After I'm off my anticlotting medicine, my doctor will test my blood to see if I have a genetic disorder. And when I need to fly, I'll take precautions and be observant (see box).

John Donnelly is the author of "A Twist of Faith: An American Christian's Quest to Help Orphans in Africa.''

Avoiding DVT

• On flights of more than five hours, experts say, it's important to drink lots of water and avoid drinks that cause dehydration, such as coffee, tea and alcohol.

• Take frequent walks up and down the aisles. If you can't walk around, stand up at your seat and do toe lifts, heel lifts and ankle circles to keep the blood flowing.

Warning signs

• Swelling in the calf area.

• Pain in the calf, ankle or foot that is often worse when standing or walking. The pain often starts in the calf and can feel like cramping.

• In the affected area, the skin will feel warm and may turn pale, red or blue.

WHAT TO DO

• If you suspect you have DVT, contact your doctor immediately.

• If you also have shortness of breath, go to an emergency room. A pulmonary embolism can be life-threatening.

DVT — deep vein thrombosis — sometimes results from long flights; it can kill 03/23/12 [Last modified: Friday, March 23, 2012 4:30am]

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