Living in Australia has many benefits. A temperate climate and great outdoor life. But being born "down under" automatically means you're thousands of miles from other countries. And long distance travel can be lethal. The culprit is the pulmonary embolism (blood clot). But North American who face long plane flights are not immune to it.
Dr. Gabrielle McMullin is a vascular surgeon at Sutherland Hospital, Sydney. She told the annual meeting of the Royal Australian College of Surgeons that Australians are amongst the highest users of long airplane flights in the world. And too many are dying from pulmonary embolism.
Blood clots form in the legs during long flights due to decreased movement of the legs, cramped seating, pressurized cabins, dehydration and alcohol consumption.
Dr. McMullin says, "As a surgeon I see at least one patient a month with venous thrombosis (blood clot) as a result of lengthy airplane travel."
McMullin says that a small number drop dead as they walk off the plane. It happens when the blood clot breaks away from the vein wall and travels to the lungs.
But more commonly the clots damage leg veins so badly that chronic ulcers are the result.
Sitting in a cramped plane for 20 hours nearly killed a colleague of mine. Blood pooled in his legs. Blood platelets then formed a clot, which broke away just after he landed in Sydney. Prompt treatment saved his life.
But pulmonary embolism is not a rare disease. Every year about 650,000 North Americans are admitted to hospital with this diagnosis. And 100,000 die.
Several years ago Dan Quayle, former Vice-President of the U.S. developed chest pain and shortness of breath. Doctors in emergency diagnosed pneumonia and sent him home on antibiotics. But the following morning the real diagnosis was made, "pulmonary embolism."
It's amazing that venous circulation in the legs doesn't cause trouble more often. Day after day the circulatory system fights Newton's pull of gravity. Fortunately, the movement of leg muscles pressing against veins keeps the blood moving.
Two types of blood clots occur in the legs. One is a superficial inflammation (phlebitis) localized just under the skin. It's normally the result of varicose veins.
Superficial phlebitis causes a reddened streak on the skin and the clot may feel like a tender red cord. These clots rarely travel to the lungs and clear up in a few days.
Deep blood clots, on the other hand, are another matter. 50 per cent of patients with deep thrombophlebitis have no warning leg symptoms until pulmonary embolism strikes. This is the type you never forget.
Many years ago, I performed a hysterectomy on a healthy woman who had a large fibroid uterus. She experienced an uneventful postoperative course.
Six days after the operation, I visited her in the hospital on a Sunday morning. She was recovered, had no complaints and had called her husband to take her home. Ten minutes later I was called and rushed back to her room. A massive pulmonary embolism had her within minutes.
My crystal ball predicts more cases of pulmonary embolism in the future, due to an aging population that requires more surgical procedures.
But I believe the great majority of cases will be self-inflicted. The national epidemic of obesity means more cases of diabetes, hypertension and varicose veins. Add inactivity to this mix and you have the perfect combination for pulmonary embolism.
So what do I do on long plane flights? The same as I do every day. I try to keep the blood well oiled in several ways. Having had a bypass operation I take an 81-milligram Aspirin tablet daily. This makes blood platelets more slippery and less likely to stick together to from a blood clot.
Knowing what I know now I'd follow this program starting at about 50 years of age. Studies show that his decreases the risk of cardiovascular disease. But before taking Aspirin, check with your own doctor.
To add more oil to the blood, I take 800 units of Webber's natural vitamin E. You know it's natural E when you see the letter "d" in front of alpha tocopherol. Synthetic E is labeled "dl".
I agree that excessive alcohol consumption is undesirable either on the ground or in the air. But an alcoholic drink also oils blood platelets. In addition it decreases the level of fibrinogen, a small particle in the blood that promotes clotting. And yes, I also fidget a lot (that comes naturally!) and walk as much as possible during long plane flights.
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