Pilot Dies of DVT

[Stumpie]

Hey guys, I do not think some of you are thinking straight. Most of your suggestions are common sense, which one hopefully accepts pilots have! Sure an Aspirin will help. Drinking copius amounts of water helps, as well as a balanced lifestyle. But, what I would really like to put across, is the ignorance many of us, (myself included until it hit me right between the eyes!) have regarding DVT's.

There seems to be too many people that still consider the main danger to be a long flight. If you take precautions and are NOT predisposed, ie do not have Factor V Leiden or one of the other similar conditions, then you like the majority will probably be ok. However, should you know of anyone in your immediate family that has had either a DVT or venous problems eg during pregnancy, then I would suggest you get a blood check and determine whether you are predisposed to clotting. If you are, then you are pre-warned and can take the appropriate measures such as injecting Heparin before a long range flight.

Some of you have asked what the symptoms are. Initially nothing or perhaps a twitchy feeling in your leg or foot. I felt that a vein in my foot was perhaps enlarged and was being irritated by my sock or shoe. The second time I knew exactly what was happening as I had, had prior experience. Next comes excrutiating pain once the vein blocks and will not allow the blood to flow. This pain by the way will continue, even during blood thinning treatment until the clot has been cleared. The danger of course is a small portion or the whole clot breaking loose and travelling to your lung,heart or brain, making you either very sick, killing you or perhaps worst of all turning you into a vegetable! Believe me, getting breathless when the clots go through ones lungs is not a pleasant feeling and shutting ones eyes at night hoping to wake in the morning is not to be recommended.

I am not trying to scaremonger here but, I am sure there are people out there that perhaps should take notice.

[Fountain Pen]

Guys, please don't treat this lightly....when my Vascular Surgeon said I was clear and can go back to flying....it was me that wanted to know if I was predisposed to clotting...so he said ok we will do a Thrombphilia test...6 files of blood is taken and it takes a few days for the result to come in...its obviously a complex test...the result was ok and I was not predisposed...

So why did I get DVT... another factor of DVT is if you had a major operation within the last 6 months....I did...I had a Kidney Stone removed in my left kidney...which I think was the contributing factor of me getting DVT as I had quite a bit of discomfort in my left kidney area that day as we set of from London to the Caribbean, when we landed was when I could hardly breathe...

I see a link here, for years I have been a big tea and coffee drinker when flying...hardly any water, so my urolgist said the reason I had a kidney stone was that am dehydrated all the time and I should drink 3 liters of water a day...I find that hard to do....but here again dehydration is 1 cause factor of DVT...of course anothe reason I got a kidney stone was that I tend to consume to many purine food...

So yes now, when I fly I will wear compression socks, I will get and move as muct as possible and streach my leg muscules as much as possible, I will drink a lot more water and keep away from tea and coffee, I take a low dose asprin now every day to dilute my blood a little....

Legally...you cannot fly while you are warfarin medication, in the USA the FAA will let you fly as I uderstand it but its on a dispensation....at the moment the CAA or CASA in Australia will not, I don't know about the others...so if my Throbphilia test would have shown that I was a natural clotter...I would have to be on Warfarin for the rest of my life...which means I can't fly period at the moment under the CAA rules...

My Vascular Surgeon said that Warfarin is a dangerous drug and should be used very carefully...I didn't like taking it as it made me feel sleepy at times a weak and a need for lots of blood tests to keep modifying the dose as it affects the INR depending what foods you eat...so all a nasty business this....but we all need some knowledge on this subject so as to prevent it occuring where we can......

[acbus1]

Interesting thread.

Can anyone explain how these socks work, please ("compression socks" someone called them).

I believe they are tight around the leg.......doesn't that slow the blood flow (by restricting it)? Wouldn't slow bloodflow encourage clotting?

Whatever theory someone (hopefully) comes back with, does it apply in everyday life? i.e. Would wearing these socks be beneficially in general, not just for flying?

[gregm]

Can anyone explain how these socks work, please ("compression socks" someone called them).

I believe they are tight around the leg.......doesn't that slow the blood flow (by restricting it)? Wouldn't slow bloodflow encourage clotting?

Stops legs swelling up because of poor circulation.

My dad had a heart attack in 1991, rather serious event with muscle damge, he took 12 months to recover and to get back to work. Now he is still working part time at the age of 75.

He flies 3 or 4 times a year Sydney to Perth etc has been to Singapore & Hong Kong from Sydney in recent years.

My father would not fly without compression stockings.

Blood clotting occurs when the blood stops moving, or moves slowly.

Anyway my understanding is that the main role of compression stockings is to stop the blood just sitting in lower limbs because of poor circulation
If you have ever taken your shoes off on a long flight and find them a tight fit when you put them back on, this is an example of blood sitting in your feet resulting in your feet swelling up. Happens to me and I suggest to most people.

As SLF I normally take an asprin prior to a long flight, due to its effect of thinning the blood and thus improving circulation. My theory is that this will reduce the possiblity of DVT and a cardiac incident whilst on a long flight.


http://hcd2.bupa.co.uk/fact_sheets/m...hrombosis.html

[Fountain Pen]

Well I think that's their official name I'm not sure...but readilly available at some chemist stores I guess....or at least at places that sell physio stuff etc...

Believe me they are very comfortable to wear...bit of a pain to get on the first time as its virtually made of elastic material, you put them on and they come up to the knee...then you can put on your normal socks and there you are no one will know or see your compression socks unless you lift the bottom of your uniform pants half way up your leg and you can see the sock....

I've got white ones, but they come in black as well and other colours, but they are nice to wear and at the end of a hard day when you get them off you can feel that they have been doing their job well....people who have bad cases of Varicose Veins they wear them all the time...but I think for pilots its just while flying, as on the ground you get exercise and good circulation with plenty of O2...

Another factor of DVT is lack of Oxygen....sitting at a cabin altitude of 6500 ft all day.... some good deep breaths out of the mask it seems will also prevent DVT.... compression socks prevent pooling in your legs below the knees...I have a tendency to sit for quite a long time without even moving a leg muscle, then have to make a consceous effort to move myself around, to get blood circulating...

I'll do some reaserch and find out the physics behind it and post it.....the NHS put out a flyer on DVT its excellent, the DVT department at a hospital should have one, "there must be a simpler way of Avoiding DVT" its called.....

[Old Smokey]

A sideline note to those using Aspirin is that it must be taken every day of your life, not just immediately before the flight.

Regards,

Old Smokey

[Red Mud]

When this topic was started it created an informative and possibly life-saving discussion. I spend two hours in the car to/from work only to sit at my desk and then fly for a few hours in aircraft that don't always allow a little saunter within the cabin. I also tend to ignore the nature calls until after landing which seems to set me up as an ideal candidate for DVT. I wouldn't have thought much of it but a few months ago I had what felt like a cramp in the lower portion of my right calf. Despite repeated stretching it still continues to tighten and ache and now a similar sensation is developing in my other calf. After having read this thread, I think a quick trip to my surgeon is in order. It may be nothing but ...
Thanks.

[LegsUpLucy]

CAA take note......

I think it would be really useful to lobby the CAA on this,perhaps via Balpa or similar organisations.
We are bombarded with leaflets on CRM etc. i think perhaps we should be getting facts and health advice on all aspects of flight deck concerns on this topic from the approriate authority!!

[Fountain Pen]

Yes I think its a good idea...DVT is a curse and not only that if all pilots are aware of the possible causes and recognizing the the symptoms, will go a long way if only of saving lives....

Its the dehydration from sitting at 40,000 ft and the lack of O2 and of course not moving enough...big culprits...may be some of us that are concerned, get this Thrombphilia test, found out if you are predisposed...

I think that being on Warfarin should not stop you from flying...after all you will be out for about 6 months, its not a pleasant medication and your potential for bleeding is high due to some little injury for instance...

Your right....CAA should put something out to allert pilots of this problem that seems to be appearing, aviation medicine section should formulate something to educate everyone for prevention of this problem.

Also kidney stones....if you look up the CAA website and get on to kidney stones...its up there with heart attacks, you are grounded until all stones have been removed and CAT scans show that you are clear...mine was discovered by just blood in the urine, but an attack will make you pass out I have been told by doctors...

Then the CAA will want x-rays every 2 years to see if the stone is re-occuring, as the probability is high, I'm due for my x-ray next year, BUT it to me its all interrelated...WATER is the key....

[Thomas coupling]

There's that advert on TV currently that shows a DVT moving along a vein towards the heart/brain in SMOKERS - creepy to watch.
About a year ago, I learned from my father in law that a colleague of his was sitting at home with some friends when he started to complain of a pain in his thigh which then moved to his abdomen, then his chest, his neck and minutes after he complained of this 'uncomfortable pain' he was dead from a stroke!!!!
All this was witnessed by about 6 people...... Creepy.

Aspirin has too many side effects.

Try lots and lots of H2O........and keep moving.

[scanscanscan]

British Heart foundation booklet advises you not to sit still for longer than 20 mins....so where does that put the long haul pilot?

[Whirlybird]

There's something here I don't understand. Why should DVT be any more likely in an aircraft than, for instance, sitting at a desk or PC for long hours, driving from one end of the country to the other (you don't change gear much on motorways), etc etc? Is it more likely? Or is it just that suddenly we hear about it a lot?

Also, is there any evidence that the socks work? I bought some, found them constricting and uncomfortable, and gave up wearing them. I prefer loose clothing on flights, not nasty tight socks that some expert thinks will work.

I now do on long flights as a passenger what I've always done - sleep. Lots! Being only 5ft 2ins, I can manage that quite comfortably in any seat, and I do. I change position as often as I do in bed at home, and being someone who wrestles with the bedclothes in their sleep, that's quite a lot. I don't worry about DVT at home, and I don't worry about it on flights either.

OK, let the flaming start.

[Fountain Pen]

Its more likely in an aircraft because of dehumidified air that comes into the cabin at high altitude and of course reduced amount of oxygen...thus the blood becomes thicker because of it....then if you don't move for quite some time, then there is a high probability a clot will form....

Even at the blood bank, they keep the blood slowly moving so as to prevent clotting, as the doctor told me if blood is stationary it will clot, then if you are predisposed to clotting, then you could be in serious trouble....so the compression socks will help blood from pooling in your legs and thus maybe prevent at DVT forming.

[Bob Viking]

DVT

So what do you advise that I do, after several hours sitting behind a tanker strapped to my exploding armchair?! So far I've stuck to a careful regimen of motoring the seat up and down every so often and turning upside down when I'm far enough from the tanker to not scare the cr@p out of them!
BV

[Fountain Pen]

Bobless!!!...what can I say...you have read the thread...figure it out for your self...there are so many factors....you will god willing live to be a hundred...so why worry....unless your exploding armchair gets you first....

[Carrier]

The owner of the operator I fly for has used Warfarin for many years. He has a licence and flies regularly. Perhaps standards are different in the African country we live in. In September he had a heavy nosebleed. This has happened before. At dinner that night quite by chance I happened to meet someone from Los Angeles who specialises in the human blood system and writes university papers on the topic. I mentioned my boss’s problem. The expert confirmed that Warfarin has a very thin tolerance between an inadequate dose and too much. He also has the same problem as my boss. He advised that there is a much better product available that he uses. This is called Plavix. He suggested that my boss should ask his GP to look into Plavix to see if it will be suitable for him. Anyone using Warfarin might want to do the same. I mentioned it to my boss upon returning to base. I am not sure if he has taken this up as I have since seen him with a similar nosebleed. Perhaps Plavix is not obtainable here or is too expensive.

More than two decades ago in Canada before I had any thought of flying, let alone flying for a career, I came across an interesting fitness book written specifically for pilots. I bought a copy on the basis that if it works for pilots it should be more than adequate for the general population. I have had no reason to regret this purchase. Indeed, I consider that this book, or an equivalent, is an essential part of any professional pilot’s kit.
Title: Canadian Pilot’s Fitness Manual
Author: David Steen
Publisher: Delacorte Press/Eleanor Friede, One Dag Hammarskjold Plaza. New York, NY 10017
ISBN 0-440-03670-4
Published 1979
This was written in co-operation with the Canadian Airline Pilots Association and the Fitness Institute of Toronto. My version dates from before DVT became well known. I suspect that a current edition would include reference to DVT. Even without reference to DVT I consider this book to be well worth having for any professional pilot. The DVT issue can be added by using the handouts from airlines.
I suggest any pilot who is remotely concerned with personal fitness and retaining a medical validation should have a copy.

[Fountain Pen]

Yes Carrier....what your expert says is correct...my INR reading was just so unstable...it was difficult to maintain @ 2.5...

reason is my diet....I like a drink and my choice is red wine....the foods I eat is another factor...especailly foods that contain vitamin K....throws everything out of balance while on warfarin....

The FAA in the States will allow you to fly while on Warfarin...but that is on an application and an approval...

CAA is considering its stance, and maybe will go the FAA way....at the moment CASA in Australia will not alow you to fly as the CAA in the U.K.....

Its all to do with the lack of O2 and dehydration....and as Long Haul is becoming more frequent with the A-380 etc....this will become even more prevalent...

As I said before...WATER is the key....

[wdh]

Carrier:

...has used Warfarin for many years. ... {The expert} advised that there is a much better product available that he uses. This is called Plavix. He suggested that my boss should ask his GP to look into Plavix to see if it will be suitable for him. Anyone using Warfarin might want to do the same

Errr..?
I believe Plavix is an alternative to Asprin, acting similarly against platelet clump formation, and therefore not really an alternative to Warfarin, which acts rather differently.

Anyone on Warfarin that suffers a severe nosebleed really should get their INR (clotting/bleeding propensity) checked fairly urgently... (there are more serious potential sites of bleeding...) And I would have expected anyone that had been on Warfarin for "several years" to be well aware of that.