After recent media stories of leg clots following air flight travel there has been alot also written in the medical press.

Leg clots can occur at any time , but especially when your legs are not active for prolonged periods of time. This may be on a plane flight , bus or train trip , or just a 2 hour car trip.

Anyone can get a leg clot, but some people are more prone than others. For example pregnant women or women taking the contraceptive pill. People on certain medication , or those with heart disease or that have recent surgery.

The problem with leg clots is two fold . Firstly they cause alot of pain and swelling in the affected leg, this can take many months to go away. Secondly (even more importantly) these clots can break away from the leg and travel to the lungs and heart. This can result in severe sudden shortness of breath , chest pains and even sudden death. Since I started at this surgery in 1994 we have seen at least 50 cases of leg clots (more than half having no risk factors), and unfortunately a few deaths.

Well , how do we stop leg clots? There is no "fool-proof" method of stopping leg clots. However a working committee in the UK has recently come up with some recommendations that should greatly reduce leg clots from air travel. They break down the risk groups into people with "No risk" , "Minor risk", "Moderate risk" , and "High risk".

No risk group

For people with no known predisposing factors for leg clots (DVT).

exercising in the seat and around the cabin; while sitting, exercising calf muscle every half hour by rotating ankles for a few minutes; avoiding excess alcohol and caffeine-containing drinks both before and during the flight; drinking only water or non-caffeinated soft drinks or juices when thirsty.

Minor risk

e.g. For those people over the age of 40, people with varicose veins, leg infections , pregnant.

Do what has been written above plus taking only short periods of sleep, unless sleeping position can be attained (laying flat); not taking sleeping pills; consider wearing support stockings.

Moderate risk

e.g For those people with heart disease , diabetes, contraceptive pill , HRT,

All the above plus taking preflight low dose aspirin under doctor supervision.

High risk

e.g. For those people with recent major surgery, stroke, previous or present leg clots,

Consider avoiding or postponing flight; if travelling then all the above but recommend heparin injections instead of aspirin.