Heading off for vacation can be relaxing and rejuvenating, but extensive travel can increase the risk of some serious health problems that could put you in a hospital far from home. Understanding the stresses of travel and what can go wrong can help you minimize the risk.
Question: How can travel be risky?
Answer: It is not widely appreciated that long trips with many hours of sitting and little movement affect the body in ways that can cause life-threatening conditions. Under normal conditions, people move around enough for blood to flow efficiently from the feet and legs back to the heart and lungs. Muscle contractions in the legs play an important role in helping blood to move up against gravity. Without this muscle movement, blood can pool in the lower extremities and increase the risk of blood clots forming.
When a blood clot forms in a large vein in a leg, it can reduce or completely block circulation of blood through that vein. This is called deep vein thrombosis, or DVT. When it occurs in a leg, the typical symptoms are leg pain, swelling, tenderness and redness or discoloration of the skin. If identified in time, DVT is completely treatable.
About half of the time, DVT has no symptoms at all. However, the blood clot, or parts of it, can travel through the blood to the lungs where the clot can lodge in an artery and block blood flow to parts of the lung. This is a medical emergency known as a pulmonary embolism. As described by Dr. Joseph A. Caprini on his excellent Venous Resource Center website, the typical symptoms are “shortness of breath, rapid pulse, sweating, sharp chest pain that worsens with deep breathing, low blood pressure, unconsciousness and coughing up blood.”
Without prompt emergency care, this condition is potentially deadly.
Q: How can the risk of DVT be reduced during long trips?
A: There are things that all of us can do such as drinking plenty of fluids and avoiding excessive alcohol intake, both of which also reduce the risk of developing kidney stones that can send a traveler to the hospital. In addition, it helps to frequently breathe deeply and, most important, to move the legs, change position frequently and walk around when possible. Also, avoid seated positions that put pressure on the back of the legs and impair normal blood flow. This can be challenging for shorter people when their feet do not easily reach the floor. When this is the case, it can be helpful to put something on the floor that can support the feet and raise the knees.
Factors that increase the risk of DVT include older age, obesity, cardiovascular and lung diseases, recent surgery, swollen legs, use of birth control medication and current or recent pregnancy, among other things. For Caprini’s individual risk assessment tool, visit venousdisease.com.
Prior to a long flight, bus or train ride, there are a few nutritional considerations that might decrease DVT risk. Consider a meal of salmon before travel. The fish oil omega-3 fatty acids help to reduce the tendency of blood to clot too easily. Maybe make it “surf and turf” with some lean beef to also provide a good source of the amino acid arginine, which dilates blood vessels to facilitate blood flow. Consume adequate amounts of fluids and salt to help your body maintain normal blood volume.
Alan Titchenal, Ph.D., C.N.S., and Joannie Dobbs, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa. Dobbs also works with University Health Services.
