activities may be printed in their in-flight magazines or shown through a video. Getting up to stretch your legs once per hour or performing simple moves in your seat to pro- mote circulation are both helpful at improving circulation in the legs.

What are DVTs and how do they occur Extended periods of immobility combined with cramped

conditions and the increased pressure of the cabin when flying may be a risk factor in blood clot formation in the legs or deep vein thrombosis. Combine these risks with the effects of gravity, and you can experience an increase in fluid in your legs and feet causing them to swell. A DVT will begin with a severe ache, usu- ally, in the calf, that worsens over time. Te leg may swell or turn red around the clot. If you experience any of these symptoms, see a doctor. Te danger with DVTs is that they can become enlarged and dislodge from the leg or other parts of the body and work their way into the blood- stream and lungs. Once these clots reach the lungs, they can cause a pulmonary embolism which is a life-threatening condition. Symptoms include rapid or painful breathing, shortness of breath, chest pain that travels up to the shoulder, feeling faint or dizzy. If you experience any of these conditions during or after a flight get the attention of a flight attendant or call a doctor. Unfortunately, these symptoms may not occur for sev-

eral days after travel, making it difficult to definitively link DVTs to flying.

What can you do

In addition to moving during long flights or doing some in-seat exercises there a few things you can do to reduce the pooling of blood in your legs that will also make your trip more comfortable. Start before your flight by doing some power walking to get the blood circulating through your legs. If you don’t have time to walk at home, do a lap or two at the airport.

Tis next point should be an obvious recommendation,

wear loose-fitting, comfortable and breathable clothing. Try not to rest the back of your knees on the seat inhibit- ing blood flow and try to sit with your feet raised on your luggage. Drink lots of water and avoid too much alcohol or caffeine which causes you to become dehydrated. If you have varicose veins, diabetes, are pregnant or going

on an extremely long flight you can invest in compression socks or stockings. Tese are specialized for various condi- tions and help to push blood up from the lower leg to the rest of the body. Tey are available in different strengths and sizes. A recent study went so far as to say that they may reduce the risk of blood clots in the legs by more than 12 times.

How to reduce your risk of DVTs:

• If you can tolerate aspirin, take a baby aspirin (81 milligrams) one-half hour before takeoff.

• Wear loose clothing and comfortable shoes. • Avoid crossing your legs while seated.

• Get up from your seat and walk up and down the aisle at least once an hour.

• Drink at least eight ounces of water every hour or two and avoid alcohol, caffeinated beverages, and salty foods.

• Exercise your feet and ankles occasionally.

Factors that can place you at increased risk of developing blood clots in the legs:

• Women taking birth control pills or hormone therapy • Obesity

• Height — tall and short people over 6'3" or under 5'3.” • Travellers who have just had surgery or injury to abdo- men or legs

Deep vein thrombosis of the right leg – notice the swelling and redness.

• Frequent flyers, flying five or more times in a three month period

• Flights over four hours • Personal or family history of DVT

• Poor circulation or blood disorders leading to increased clotting tendency

• Those over the age of 40 • Pregnant women • Smokers • Dehydration • Diseases such as heart failure or diabetes • Varicose veins • Sleeping Onboard • Drinking alcohol or taking sleeping pills

Exercises to do during your flight

Ankle circles: Lift foot and circle ankles clockwise and counterclockwise. Complete 15 seconds of rotations in each direction for both feet every hour.

Rocking feet: Place your heels side by side and lift toes up while keeping toes on the ground then rock the foot forward lifting your heels and resting on the balls of your feet. Repeat for 30 seconds to one minute.

Leg lifts: Lift your leg with a bent knee using your thigh muscles. 20 repetitions per leg.

Shoulder roll: Roll your shoulders in forward circles and then reverse circles for five to 10 rotations in each direc- tion.

Neck roll: Release tension in your neck and shoulders by doing stretching rolls from shoulder to shoulder in both forward and back rotations.

Spring 2017 • 65

Photo by James Heilman, MD.

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