Lately air travel has become more and more unreliable and annoying due to multiple flight cancellations and travel interruptions. Any card carrying road warrior frequent flier can relate multiple stories of being stuck almost anywhere due to weather, mechanical issues, personnel problems and lately...the abrupt FAA grounding of all MD-80 aircraft. Frank's story went a little differently, though. Frank is a road warrior in every sense of the word: he flies often and at least monthly finds himself in another country. When he's not flying, he's driving to another sales call. Frank is the Vice President of a manufacturing firm and is responsible for making all his customers happy...something that still requires face time! Frank was having a typical week, three cities in 5 days, when he woke up with a red, hot swollen left leg and shortness of breath. Frank's travels had been interrupted by the dreaded traveler's blood clot, a Deep Vein Thrombosis, or DVT. Now he wasn't fighting for the sales contracts, he was fighting for his very life! This may have been avoided if Frank had learned his risk factors and followed some simple travel tips.

A DVT (Deep Venous Thrombosis) is a condition in which a blood clot or blockage forms in the deep veins in the leg. These can develop in other places in your body, but are much more common in the lower legs. If the clot breaks free and travels through the bloodstream, it can actually lodge in the lung. This clot in the lung is called a PE (pulmonary embolism), and can cause shortness of breath, difficulty breathing and even death!

How common is DVT? Each year, 600,000 patients will experience some kind of venous thromboembolism or DVT. Each year, at least 50,000 and perhaps as many as 200,000 patients will die from blood clots that obstruct blood flow to their lungs (pulmonary embolism). It is amazing that the complications from DVT have been reported to kill up to 200,000 people a year, more than AIDS and breast cancer combined, but no one seems to care much about it. The airline and travel industry has given it lip service after a few well-publicized deaths; but the general traveling public awareness of this potentially fatal public health concern from travel is relatively low. Who is at risk for DVT? There are certain groups of people who are more at risk of developing these life-threatening clots. Risk factors include varicose veins, blood clotting disorders, recent childbirth or pregnancy, use of birth control pills or hormone replacement therapy, obesity, and heart disease. The risk is even higher in patients over 40, those with casts immobilizing their foot and ankle, a sedentary lifestyle, smoking history, certain types of cancer, chronic illnesses like lung disease or inflammatory bowel disease (Crohn's or ulcerative colitis) and recent major surgery. This is further compounded by sitting for long periods of time in a car, airplane or train, especially with your legs crossed. It seems like almost everyone traveling this summer has one or more of these risk factors!

What are the symptoms of DVT? Many people have either no warning signs or very vague symptoms prior to forming a significant clot. The symptoms are usually: swelling in the leg and calf, redness and increased warmth in your leg, and pain in the inner thigh and calf. If you experience any warning signs, immediately contact your doctor for an evaluation. Do not mess with this potentially deadly condition!

How is a DVT diagnosed? A simple ultrasound of the veins of your leg can determine if you are suffering from a DVT. Often, superficial thrombophlebitis can have the same symptoms and is much less serious; so a timely ultrasound evaluation is critical. Patients who receive early treatment may reduce their incidence of pulmonary embolism to less than 1%.

If you have risk factors for DVT and plan on taking a long trip this season, follow these tips to reduce the likelihood of developing a blood clot:

1. Do not travel for 4 to 6 weeks after major surgery unless your life depends on it.
2. Exercise legs every 2 to 3 hours to get the blood flowing back to the heart. Walk up and down the aisle of a plane or train, raise and lower your heels while keeping your toes on the floor, rotate ankles while sitting, and take regular breaks on road trips.
3. Stay hydrated by drinking plenty of fluids; avoid caffeine and alcohol.
4. Consider wearing compression stockings. These are helpful in compressing the veins and decreasing swelling in the legs and calf.
5. Talk to your doctor about whether aspirin or another blood thinner is indicated due to your risk factors.
6. Exercise regularly, maintain a healthy weight and stop smoking!

Remember, a DVT can put a real cramp in your vacation or travel plans, and even potentially kill you! If you are at risk, take precautions before you suffer from this possible "killer legs".