DVT in flight deck crew????

[Itswindyout]

This question is specific to CORPORATE.

We have often very cramped cockpits, unable to stretch legs out, not able to get out of seat and take long walk.

For example in the G2/3/4 series there is almost no space to stretch legs, and the flight times can be in the order of 6 hours.

Are there any chaps out there who have suffered a DVT, or do you have a friend who has suffered.!!!!

Have you even known you have a small DVT, the symptoms are just like a small cramp attack.

Are you now wearing support tights, just like the girls have done for a long time.

All comments and views welcome. Thank you.

[QDMQDMQDM]

It's a good point. In that sort of situation, I would consider taking 75mg of aspirin daily to prevent DVT.

QDM

[Anti-ice]

mmmmm, and with the locked flight deck door policy now, and flight crew not able to 'walk the aisles' for security reasons,its no surprise.

Also , until all carriers have phase 2 doors, F/C may feel they are a 'bind' by disrupting the cabin service for coverage.

[gingernut]

Its windyout--have you considered performing "calf pump" exercises to encourage movement of the blood in the deep veins. Pretend you have a pencil between 1st and 2nd toe, and draw circles. (Operational duties allowing!). Simillar effect gained by policemen in old films bending at the knees after standing on guard duty for several hours-"evening all !"

QDM-in the absence of other risk factors, do the benefits of administering low dose aspirin outweigh the risk ? (The guidelines I've seen all look a bit "wishy washy")

[QDMQDMQDM]

QDM-in the absence of other risk factors, do the benefits of administering low dose aspirin outweigh the risk ?

I don't think the evidence is there to come down one way or the other. I'd certainly consider it, though. The risk in a healthy young to middle aged person of low dose aspirin is very small.

QDM

[Flyin'Dutch']

What evidence is there to say that flightcrew are more at risk of developing a DVT?

FD

[Itswindyout]

FD: this is exactly the direction I was thinking of. In corporate we are usually in smaller cockpits, (sorry flight decks)!!!! and often the toes are the only areas that can be exercised.
I try to get out of the seat every hour, and consume water, (or coffee at TOD), long nights.....
I even do the "evening all" as my post sitting greating!!!!
Most of the longer haul corporate crews are old fa£ts, (present company included).
So is the 75mg aspirin a valid dose of non prescription medication. This would be a good precaution, remember the damage to to stomach warning.

Is there any any evidence?????????????

Most corporate flight crew probably think the leg pains are from squash, tennis or dirty dancing.......

[Flyin'Dutch']

IWO,

I was just in the process of emailing one of the PPRuNe moderators to ask if I could set up a small poll to find out what people's experiences are.

It will not be possible to make it scientifically watertight but is likely to give a reasonable indication of the incidence of this condition.

Hope to be able to post more in the near future.

Ciao,

FD

[QDMQDMQDM]

What evidence is there to say that flightcrew are more at risk of developing a DVT?

Prolonged immobility = increased risk. Good evidence for that.

QDM

[Itswindyout]

But why no reports, feedback or general info.

Nothing on CAA website, as far as I can see......

[Flyin'Dutch']

Q,

But is there evidence that this is a problem in flightcrew?

I attended a seminar last week where this was specifically brought up. The speaker there stated categorically that this was something they never saw in military aircrew. Even on the long patrol flights of 24hrs+

Hence my question/comment.

If you have access to material which indicates something different, I would be very interested in seeing it.

FD

[gingernut]

Flying dutch, it sounds like your asking the million dollar question.
(or even multi-million dollar)

QDM, take your point, but I'm not sure if there is enough evidence (yet) to support the use of low dose aspirin.

If we give aspirin to 10,000 otherwise healthy pilots, albeit working in cramped conditions, are we going to cause more problems than prevent ?

Didn't I read somewhere that NSAID's (yes I know its slightly different), silently kill about 2000 people a year in the uk.

I'm not sure of the evidence ? In this case do we rely on clinical consensus , and if so, is this any better than guesswork ?

The reason I'm interested, is because I'm faced with the question frequently by my travelling patients. I tend to consult my travel clinic colleagues, but I'm not sure on what evidence they base their opinions.

[QDMQDMQDM]

I suspect that on 24 hour patrol flights they are up and about, walking around reasonably often. I don't have any specific evidence, but it does seem reasonable that someone in a cramped corporate jet seat for 6 hours or more, without the opportunity to walk around because the small cabin is full of punters, might be at increased risk of DVT. Personally, I would consider taking aspirin, low dose, but it's a personal thing.

As you know, FD, if everything we did in general practice was evidence-based, we wouldn't be doing very much!

QDM

[Itswindyout]

The current information base is all second hand (at best) information.
Are there any AME's who have information however obtained, that might after suitable sanitisation become public knowledge.

QDM3: yes sitting for 6 hours on noes little butt, with no room to swing a cat, is slightly different from a long patrol, or even a G suited jet jock. ( I assume).

FD any joy with the pole !!!!, this would perhaps provide a CHIRP type service.

IWO

[Flyin'Dutch']

IWO,

The question you raise in the second line of the first paragraph is answered already. Just awaiting designation.

;)

However as I would like to find out more about this from here I asked if we could do a poll. If you knew me you would not want to get me to do anything with a pole! :D

FD

[Bad medicine]

I haven't seen any evidence that DVT is any more common in aircraft than in any other group of immobilised people. There doesn't seem to be anything special about the aviation environment as far as the formation of DVT is concerned.

Certainly a cramped cockpit does discourage movement, but one can still get up occasionally or have a move around in the seat.

Gingernut has a fair point on the use of aspirin (risk:benefit), but it might be reasonable in a fit person with no significant GIT history, and taken with food.

Long patrol flights in large aircraft shouldn't be a problem. As far as fast jets go, maybe the G suit offers a degree of protection, although it won't be inflated for the majority of the flight. Perhaps they should pull a bit every 30 min or so to avoid any pooling :D

[727 exec]

Whilst my normal workplace has a large enough galley area to allow for stretching exercises, I'll admit to wearing 'flight socks' now for all the long sectors (trans-atlantic)...they come in an anonymous black colour, and are not uncomfortable.

Asprin...I'm aware that it can and does cause problems with stomach linings. There is a 'smart' asprin called Clopidogrel that does the same job - only better. I think it's probably an AME issue drug?

[slim_slag]

Was chatting with a Lovenex (low molecular weight heparin) rep the other day Stateside and asked him about DVT prophylaxis. He said there was more evidence that compression stockings worked better than LMWH or aspirin long haul.

Apparently they keep in on air force one, and give dubya a shot of it when he goes flying.

[gingernut]

There's nothing more I like to do on a Friday night, than come home and rip off my wifes flight stockings...........they've been itching me all day !

[filejw]

I had a DVT 10 yrs ago and resumed flying after 6 mos.I wear the stockings take the asprin and exersise my legs a lot.Also carry a sports cord that I use on trips more than 3hrs. At the time I was flying short haul flts and had some other factor ie. knee injury so the Drs. never really figured out what the cause was.

[aviate1138]

"Are there any chaps out there who have suffered a DVT, or do you have a friend who has suffered.!!!!"

Try < www.airogym.com > they manufacture a neat DVD device the area of your feet that you pump up and down and excercise each leg in turn for as long as you want - the inventor,ex Capt. Paul Richards was a BA 747-400 driver - his daughter runs the tiny company. Folds up and goes in a pocket.

Aviate 1138

[QDMQDMQDM]

Apparently they keep in on air force one, and give dubya a shot of it when he goes flying.

Why? He must have enough room on that thing to go jogging if he wants to. I gather he has a double bed, a gym and a shower room.

QDM

[Steamhead]

I have had DVT in 1998.
When asked, My consultant was of the opinion that it was much more prevalent in aircraft for the following reasons.
1) low oxygen level (7000 ft cabin altitude)
2) low relative humidity (12% approx) causing de-hydration
3) cramped seating

regards

[aviate1138]

Steamhead said....

posted 8th October 2003 21:38 ___ _ _ __ _
I have had DVT in 1998.
When asked, My consultant was of the opinion that it was much more prevalent in aircraft for the following reasons.
1) low oxygen level (7000 ft cabin altitude)

Aviate says....
If you take an altimeter into the cabin and set it at sea level/0ft then it is not uncommon to see it reach towards 10,000 feet on some flights. Saves A/C fuel use and so helps costs.

Why can't we have airliners with reasonable humidity and higher cabin pressure? We would all feel a lot better - pilots included. [ + less dandruff!] And we would probably fly a lot more long sector journeys and so make airlines more money.

Aviate 1138

[paul simms]

I have just been diagnosed with a suspected DVT. I am waiting for a Doppler Scan to confirm the diagnosis.

Symptoms were sore ankle, like a mild sprain, on waking in the morning. During flight (6 hours) knee started to feel sore, again fairly mild but it meant that I walked with a limp. Previous to this sector I had had a 6 hour sector followed by a rest day.

I put these symptoms down to a possible sprain as I had been carrying an overnight bag along with my flight case.

Following day reported for work with the same ‘uncomfortable but bearable’ symptoms for a single sector (4 hours) back to base.

During this sector symptoms remained but my calf muscle felt as though it had been kicked and was slightly swollen.

Once at home I notice my calf had swollen to about twice its normal size so I went to A&E.

That’s it.

Scan on Tuesday.

Anyone else had these symptoms and ignored them?

My Mother has already bollocked me for ignoring the symptoms so I don't need any similar responses. Ta.

[OKOC]

25 mg is sufficient according to wifey (RGN); 75 mg too much.