Why don't long haul pilots die from DVT?
Thread Starter
Why don't long haul pilots die from DVT?
I wonder if any experts out there can tell me why it is that young and fit women and men can and do die from Deep Vein Thrombosis due to sitting inactive in cramped conditions, yet there appears to be no recorded instance of an airline pilot suffering the same fate, despite many sitting relatively inactive for quite long time intervals for perhaps 20,000 hours all told in a typical working career. Why is this? Anyone?
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Next time spend a little more time on your homework Gidday before posting such an absurd assertion.
Of *course* there have been cases of pilots collapsing and dieing at the end of long flights - why would they not? - apart from having more generous legroom than the poor sods back in steerage.
Many in the past, but most recently reported in the case of an American at Narita - just one of the 25 people Dr Toshiro Makino reports have died at Tokyo airport over the
past eight years due to blood clots
caused by cramped airline seating.
Dr Makino said all the victims, including
the American pilot, had collapsed after
disembarking from long flights and
had died in the airport hospital.
As you're no doubt aware all the major airlines are most keen to keep a lid on this sort of thing for obvious reasons - not the least of which is desire to keep their most experienced crew well in the dark on both DVT and radiation hazards.
Seems they've succeeded with you Gidday.
Of *course* there have been cases of pilots collapsing and dieing at the end of long flights - why would they not? - apart from having more generous legroom than the poor sods back in steerage.
Many in the past, but most recently reported in the case of an American at Narita - just one of the 25 people Dr Toshiro Makino reports have died at Tokyo airport over the
past eight years due to blood clots
caused by cramped airline seating.
Dr Makino said all the victims, including
the American pilot, had collapsed after
disembarking from long flights and
had died in the airport hospital.
As you're no doubt aware all the major airlines are most keen to keep a lid on this sort of thing for obvious reasons - not the least of which is desire to keep their most experienced crew well in the dark on both DVT and radiation hazards.
Seems they've succeeded with you Gidday.
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Aye Dr. Mac, I did indeed follow that thread closely, flawed as it was, by vested interests and closed minds.
And duly filed it with the rest of the huge folder full of the travel related DVT, thrombosis, PE, tobacco, asbestos, harmless British Beef and cosmic radiation rubbish perpetrated by members of the medical profession who are in the pockets of large corporations - and especially airlines.
Flatly denying any, or all of these issues is like peeing into the breeze as public awareness and the evidence continues to accumulate.
http://www.thetimes.co.uk/article/0,,2-63436,00.html
And duly filed it with the rest of the huge folder full of the travel related DVT, thrombosis, PE, tobacco, asbestos, harmless British Beef and cosmic radiation rubbish perpetrated by members of the medical profession who are in the pockets of large corporations - and especially airlines.
Flatly denying any, or all of these issues is like peeing into the breeze as public awareness and the evidence continues to accumulate.
http://www.thetimes.co.uk/article/0,,2-63436,00.html
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Skip Undo – I don’t normally frequent this forum however, w.r.t. your reply above to Capt Gidday, I have to say that I don't much care for your tone.
Imho Gidday asked a reasonable question (i.e. question which I too am interested in – but on which neither of us might have done our ‘homework’ ) but which you then seemed to think as being beyond the pale; Worse still than that was that you then seem to think it ok to make rude / insulting suggestions w.r.t whether he has been hoodwinked by some huge conspiracy by (the) airlines.
Now, for many a moon, I have known pilots from both long and short haul and I have not been aware (until recently) about the subject of DVT and of how it might affect them. So, rather than try and rubbish peoples questions why not try and answer them with facts and figures as to the scale of the problem, and why is it that pilots are not reported as dropping dead from DVT on a regular basis, especially so when given their massive exposure to the problem ?!
Note: Below is copy/paste of a posting, made in Rumours and News, by a colleague on this subject:
So, as a MD (observed from your profile. Nb. does this stand for Doctor of Medicine, or Managing Director ?), could you please answer it for him / them, and hopefully in a civil manner.
[This message has been edited by CrashDive (edited 06 January 2001).]
Imho Gidday asked a reasonable question (i.e. question which I too am interested in – but on which neither of us might have done our ‘homework’ ) but which you then seemed to think as being beyond the pale; Worse still than that was that you then seem to think it ok to make rude / insulting suggestions w.r.t whether he has been hoodwinked by some huge conspiracy by (the) airlines.
Now, for many a moon, I have known pilots from both long and short haul and I have not been aware (until recently) about the subject of DVT and of how it might affect them. So, rather than try and rubbish peoples questions why not try and answer them with facts and figures as to the scale of the problem, and why is it that pilots are not reported as dropping dead from DVT on a regular basis, especially so when given their massive exposure to the problem ?!
Note: Below is copy/paste of a posting, made in Rumours and News, by a colleague on this subject:
<font face="Verdana, Arial, Helvetica" size="2"> This by ‘Old King Coal’: This whole DVT thing is quite worrying, particularly so as I often spend absolutely bloody hours sitting in my (not very comfy) flight deck seat.
By way of proof, if on a four sector day it transpires that I do the first and last sector (and the other chap does the middle two), then when I’ve completed the walk-around it’s quite likely that I won’t then have much of a chance to get out of my seat for what can be 7+ hours, i.e. until prior to the last sector and it’s associated walk-around check – end even then this walk only lasts for about 4 minutes. Nb. ( we do 25’ minute turn-arounds and if running behind schedule then we have to really go at it to be on our way asap – thus not much time for a constitutional )
Now I do this day in day out, week in week out, month in month out – perhaps I’d better book an advanced place in a cardiac unit.
Also, and as if the potential for the above wasn’t bad enough, I‘m also starting to suffer some very intense lower back and neck pains – where my seats lumbar support is totally crap.
To be honest, and imho, the pax have a lot more opportunity to move about than the flight deck crew ever do.
</font>
By way of proof, if on a four sector day it transpires that I do the first and last sector (and the other chap does the middle two), then when I’ve completed the walk-around it’s quite likely that I won’t then have much of a chance to get out of my seat for what can be 7+ hours, i.e. until prior to the last sector and it’s associated walk-around check – end even then this walk only lasts for about 4 minutes. Nb. ( we do 25’ minute turn-arounds and if running behind schedule then we have to really go at it to be on our way asap – thus not much time for a constitutional )
Now I do this day in day out, week in week out, month in month out – perhaps I’d better book an advanced place in a cardiac unit.
Also, and as if the potential for the above wasn’t bad enough, I‘m also starting to suffer some very intense lower back and neck pains – where my seats lumbar support is totally crap.
To be honest, and imho, the pax have a lot more opportunity to move about than the flight deck crew ever do.
</font>
<font face="Verdana, Arial, Helvetica" size="2"> This in reply by ‘Jurassic Jet Man’: I think you have to make yourself get up and stretch. I get out of my seat at least once an hour, depending on workload, and do some sretching exercises in the cockpit. I also take a quick walk through the cabin once during a long flight. My cousin has DVT from being couped up in a French hospital with a broken ankle. The British docs cannot shift it - she is seriously looking at total leg amputation - tough for a pretty 30 something with kids.
This condition is a total bugger, and is utterly avoidable.
</font>
This condition is a total bugger, and is utterly avoidable.
</font>
<font face="Verdana, Arial, Helvetica" size="2"> This in response by ‘Old King Coal’: JJM, good advice and point taken - however there's not too much room for 'streching' in a B737 flight deck.
Also, and to this day, I have only once ever seen a fellow colleague activily indulge in some stretching exercises (he placed his toes on the 'stirrups' and his backside on the top of the seat - resulting in loads which are a testiment to the strength of Boeing engineering, i.e. that the seat back didn't break - and 'pulled' out on his leg muscles.
Yep, outside of that single example, all I've ever known is us sitting there for hour after hour as if glued to the seats, i.e it just doesn't seem to be the done thing to leave the flight deck for something so 'unwaranted' as moving ones legs and / or retaining vascular circulation.
So, does anybody out there in PPRuNe land have any details on whether flight crew are prone to DVT etc ? ... because it seems to me like we ought to be !
</font>
Also, and to this day, I have only once ever seen a fellow colleague activily indulge in some stretching exercises (he placed his toes on the 'stirrups' and his backside on the top of the seat - resulting in loads which are a testiment to the strength of Boeing engineering, i.e. that the seat back didn't break - and 'pulled' out on his leg muscles.
Yep, outside of that single example, all I've ever known is us sitting there for hour after hour as if glued to the seats, i.e it just doesn't seem to be the done thing to leave the flight deck for something so 'unwaranted' as moving ones legs and / or retaining vascular circulation.
So, does anybody out there in PPRuNe land have any details on whether flight crew are prone to DVT etc ? ... because it seems to me like we ought to be !
</font>
[This message has been edited by CrashDive (edited 06 January 2001).]
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OK Skip Undo, tell us about the "vested interests" and "closed minds" you found.
What (I hope) all all us would like to do is to sort out the truth from the scare. Pilots get very irritated when a shock-horror newspaper story comes out to the effect that all type X aircraft are deathtraps, that flying with airline operator Z is tantamount to suicide, that aircrew are all drunks and so on and so on.
Nobody denies that pax (and even aircrew) have died during or after flights, long or otherwise. Some of then even of DVTs. Whether there is a causal link with flying, cramped or not, still has to be established. It is entirely possible that there is a link, though available statistics would seem to suggest that it isn't likely to be a strong one.
What impresses me is proper statistics, not anecdotes about Dr Makino.
Consider if you will - Approximately 22.94 million people traveled to and from Narita Airport on international flights in 1997. If only 25 people have died of DVTs there in eight years then it must be one of the safest places on earth.
The question is quite simple. Is there a statistically significant excess of people suffering/dying from DVTs after long (or short) airline flights over that that you would expect in a comparable non-flying population?
The jury is still out on that one, but current evidence is not strong.
Nobody, as far as I am aware, is flatly denying anything - certainly not me.
And please tell me the large corporation whose pocket I am in - I'll must ask them for a raise
Actually I've just realised that I must be a member of the International Medical Conspiracy - we've got the pax, now for the crew!
I think I detect a Conspiracy Theory theoretician
What (I hope) all all us would like to do is to sort out the truth from the scare. Pilots get very irritated when a shock-horror newspaper story comes out to the effect that all type X aircraft are deathtraps, that flying with airline operator Z is tantamount to suicide, that aircrew are all drunks and so on and so on.
Nobody denies that pax (and even aircrew) have died during or after flights, long or otherwise. Some of then even of DVTs. Whether there is a causal link with flying, cramped or not, still has to be established. It is entirely possible that there is a link, though available statistics would seem to suggest that it isn't likely to be a strong one.
What impresses me is proper statistics, not anecdotes about Dr Makino.
Consider if you will - Approximately 22.94 million people traveled to and from Narita Airport on international flights in 1997. If only 25 people have died of DVTs there in eight years then it must be one of the safest places on earth.
The question is quite simple. Is there a statistically significant excess of people suffering/dying from DVTs after long (or short) airline flights over that that you would expect in a comparable non-flying population?
The jury is still out on that one, but current evidence is not strong.
Nobody, as far as I am aware, is flatly denying anything - certainly not me.
And please tell me the large corporation whose pocket I am in - I'll must ask them for a raise
Actually I've just realised that I must be a member of the International Medical Conspiracy - we've got the pax, now for the crew!
I think I detect a Conspiracy Theory theoretician
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>>The question is quite simple. Is there a statistically significant excess of people suffering/dying from DVTs after long (or short) airline flights over that that you would expect in a comparable non-flying population?<<
A well designed epidemiological study could answer this, but at some considerable financial cost.
The number of people who drop dead within minutes or even hours of developing a DVT seems to be a minute proportion of all those who develop DVTs. Perhaps only very active individuals can exert enough muscle pumping in their legs to dislodge the fatal clots early. The participants would need to be followed for probably 14 days after their flight to ensure an accurate estimation of death rate.
The prevalence of DVTs varies in the literature depending on the screening test used. The easier the test the fewer clots it finds - ultrasound vs isotope scans for example.
Who would want to pay the costs of such a study? Especially if there exists a likelihood that the sponsor won't get the answer they wish. Back to the Conspiracy Theorists
My take on this is that the case is Not Proven, but there's enough smoke....
I'll carry on with my bottled water and aspirin and await the experts deliberations.
PS: The ER docs in S Manchester used to teach that long haul flight contributed to rupture of intracranial aneurysms and consequent sub arachnoid haemorrhage. Anyone want to comment on that can of worms?
edited for nocturnal dyslexia
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[This message has been edited by Code Blue (edited 06 January 2001).]
A well designed epidemiological study could answer this, but at some considerable financial cost.
The number of people who drop dead within minutes or even hours of developing a DVT seems to be a minute proportion of all those who develop DVTs. Perhaps only very active individuals can exert enough muscle pumping in their legs to dislodge the fatal clots early. The participants would need to be followed for probably 14 days after their flight to ensure an accurate estimation of death rate.
The prevalence of DVTs varies in the literature depending on the screening test used. The easier the test the fewer clots it finds - ultrasound vs isotope scans for example.
Who would want to pay the costs of such a study? Especially if there exists a likelihood that the sponsor won't get the answer they wish. Back to the Conspiracy Theorists
My take on this is that the case is Not Proven, but there's enough smoke....
I'll carry on with my bottled water and aspirin and await the experts deliberations.
PS: The ER docs in S Manchester used to teach that long haul flight contributed to rupture of intracranial aneurysms and consequent sub arachnoid haemorrhage. Anyone want to comment on that can of worms?
edited for nocturnal dyslexia
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[This message has been edited by Code Blue (edited 06 January 2001).]
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I can't answer the initial question, but I can confirm that Aircrew have in the past, and still do, suffer from DVT. I suffered a Pulmonary Embolism at the age of 37. At the time I was flying relatively short ad-hoc charters, (ten hours once, Belfast- Tel aviv but it was a DC6 ) Luckily after three months off work thee CAA re issued my class one.
No one, including the Specialists could Identify what the cause was, but suggested I packed the Cigarettes in and kept fit. Recently a Colleague of mine suffered the same fate and luckily he survived as I did.
I sincerely hope no one suffers the same fate but unfortunately is does happen, Aircrew or Pax.
Regards.
) Luckily after three months off work thee CAA re issued my class one.No one, including the Specialists could Identify what the cause was, but suggested I packed the Cigarettes in and kept fit. Recently a Colleague of mine suffered the same fate and luckily he survived as I did.
I sincerely hope no one suffers the same fate but unfortunately is does happen, Aircrew or Pax.
Regards.
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As Code Blue says: "A well designed epidemiological study could answer this, but at some considerable financial cost."
Not necessarily that expensive. Give out FreePost postcards with tickets or boarding passes. Offer a little incentive - airmiles would be easiest. Ask for flightnumber, date, seatnumber and when/where DVT diagnosed. Ask for return of card between within 2/52 and 1/12 of traveldate. Obviously the dead won't be able to answer, but we have good data on treated/untreated death rates so could reasonably extrapolate.
As Code Blue notes: "The number of people who drop dead within minutes or even hours of developing a DVT seems to be a minute proportion of all those who develop DVTs.. & ..participants would need to be followed for probably 14 days after their flight to ensure an accurate estimation of death rate."
Another simple matter would be to mail all registered doctors in the UK asking for anonymous patient data and including a very simple FreePost postcard with a few similar tick-the-box questions. Again offer a few airmiles as incentive.
The response rates from pax/doctors might not be all that good, but it would start to give us some idea of what is (or is not) going on. A lot better than blundering around in the current maze of speculation and anecdote.
I would venture that the cost to (say) BA would be relatively small (and tax-deductible).
As for the answer "they want" - what about the kudos of being the first carrier to "take it seriously" and do a proper study? And if the answer is not "what they want" then what? Will people suddenly stop flying in significant numbers? I doubt it. Even if you double the risks for a standard population a DVT death remains a relatively much smaller risk than driving. Incidentally, on my recent CPT/LHR/CPT flight (horribly cramped - thanks BA), there was a rather muted announcement about stretching your legs and drinking plenty of fluids.
I Kid - glad you and your mate made it, but we KNOW that pax/crew get DVTs/PEs. What we need to know is whether a statistically significant excess of people are suffering DVTs after long (or short) airline flights over that that you would expect in a comparable non-flying population.
Until one of the major carriers gets off it's @rse and gets a proper study off the ground we will never find out. A little bit of gumption is all that is needed.
Not necessarily that expensive. Give out FreePost postcards with tickets or boarding passes. Offer a little incentive - airmiles would be easiest. Ask for flightnumber, date, seatnumber and when/where DVT diagnosed. Ask for return of card between within 2/52 and 1/12 of traveldate. Obviously the dead won't be able to answer, but we have good data on treated/untreated death rates so could reasonably extrapolate.
As Code Blue notes: "The number of people who drop dead within minutes or even hours of developing a DVT seems to be a minute proportion of all those who develop DVTs.. & ..participants would need to be followed for probably 14 days after their flight to ensure an accurate estimation of death rate."
Another simple matter would be to mail all registered doctors in the UK asking for anonymous patient data and including a very simple FreePost postcard with a few similar tick-the-box questions. Again offer a few airmiles as incentive.
The response rates from pax/doctors might not be all that good, but it would start to give us some idea of what is (or is not) going on. A lot better than blundering around in the current maze of speculation and anecdote.
I would venture that the cost to (say) BA would be relatively small (and tax-deductible).
As for the answer "they want" - what about the kudos of being the first carrier to "take it seriously" and do a proper study? And if the answer is not "what they want" then what? Will people suddenly stop flying in significant numbers? I doubt it. Even if you double the risks for a standard population a DVT death remains a relatively much smaller risk than driving. Incidentally, on my recent CPT/LHR/CPT flight (horribly cramped - thanks BA), there was a rather muted announcement about stretching your legs and drinking plenty of fluids.
I Kid - glad you and your mate made it, but we KNOW that pax/crew get DVTs/PEs. What we need to know is whether a statistically significant excess of people are suffering DVTs after long (or short) airline flights over that that you would expect in a comparable non-flying population.
Until one of the major carriers gets off it's @rse and gets a proper study off the ground we will never find out. A little bit of gumption is all that is needed.
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Mac the Knife, "but we KNOW pax/crew get DVT/PA's",
Well sorry, but the initial post " Why don't long haul pilots die from DVT ?" which also included " yet there appears to be no recorded instance of an airline pilot suffering the same fate ", and previous posts on this subject would indicate to me that a fair percentage of my colleagues are unaware that this problem is quite common amongst aircrew worldwide.
My post was not only to signify this, but also to reassure my fellow Aviators that, in the UK at least, if you are unlucky enough to suffer a DVT/PE that the Civil Aviation Authority do not adopt a draconian attitude towards the problem ie: withdraw your medical for life, on the contrary they are very helpfull and understanding and that within a period of time you could be flying commercially again. This is of course that when you did suffer the DVT/PE you did'nt end up Brown Bread.
May I say I'm glad that your glad that " me & my mate survived ".
Regards.
Well sorry, but the initial post " Why don't long haul pilots die from DVT ?" which also included " yet there appears to be no recorded instance of an airline pilot suffering the same fate ", and previous posts on this subject would indicate to me that a fair percentage of my colleagues are unaware that this problem is quite common amongst aircrew worldwide.
My post was not only to signify this, but also to reassure my fellow Aviators that, in the UK at least, if you are unlucky enough to suffer a DVT/PE that the Civil Aviation Authority do not adopt a draconian attitude towards the problem ie: withdraw your medical for life, on the contrary they are very helpfull and understanding and that within a period of time you could be flying commercially again. This is of course that when you did suffer the DVT/PE you did'nt end up Brown Bread.
May I say I'm glad that your glad that " me & my mate survived ".
Regards.
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The problem here is a lack of credible data surrounded by a distinct feeling that all may not be as the current scanty data suggest.
Unless a well designed survey is implemented that situation will continue.
Postal surveys have response rates of 20% under IDEAL circumstances - it's usually around 10-12%. Death rates for untreated vs treated DVTs relate to in hospital or condition specific DVTs and cannot be extrapolated to the population under discussion here.
The choice of diagnostic test for DVT is paramount: a postal survey of Family Docs, with all due respect to you and them, simply is a non-starter. What types of DVT do you want to hunt for? Iodinated fibrinogen scans cost - even a Doppler U/s is expensive and are thought to be less sensitive for popliteal or distal DVTs - they are best suited for the potentially lethal proximal clots. Are you interested in all DVTS or just the potentially lethal? Some would argue that ascending venography is the gold standard assessment for DVT - who would finance that?
What is the role, if any, of a sudden return to activity -eg. the Baggage wrestle - in the presence of DVT, particularly in the young and more active population?
What other coexistent risk factors might confound the issue - the Pill, smoking, dehydration &c? These could each be addressed if only the design of the study is well thought out.
Whichever perspective you come from, a bullet-proof study is needed. The money is as always the key - you get what you pay for. Over the years I have also realised that the piper calls the tune and I have grave reservations that a major carrier would design deliberately, a study which would have even a slight chance of showing it's service needs a health warning.
It is going to cost and I cannot see anyone who both can and wants to afford it.
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[This message has been edited by Code Blue (edited 07 January 2001).]
edited for Sunday Morning dyslexia
[This message has been edited by Code Blue (edited 07 January 2001).]
Unless a well designed survey is implemented that situation will continue.
Postal surveys have response rates of 20% under IDEAL circumstances - it's usually around 10-12%. Death rates for untreated vs treated DVTs relate to in hospital or condition specific DVTs and cannot be extrapolated to the population under discussion here.
The choice of diagnostic test for DVT is paramount: a postal survey of Family Docs, with all due respect to you and them, simply is a non-starter. What types of DVT do you want to hunt for? Iodinated fibrinogen scans cost - even a Doppler U/s is expensive and are thought to be less sensitive for popliteal or distal DVTs - they are best suited for the potentially lethal proximal clots. Are you interested in all DVTS or just the potentially lethal? Some would argue that ascending venography is the gold standard assessment for DVT - who would finance that?
What is the role, if any, of a sudden return to activity -eg. the Baggage wrestle - in the presence of DVT, particularly in the young and more active population?
What other coexistent risk factors might confound the issue - the Pill, smoking, dehydration &c? These could each be addressed if only the design of the study is well thought out.
Whichever perspective you come from, a bullet-proof study is needed. The money is as always the key - you get what you pay for. Over the years I have also realised that the piper calls the tune and I have grave reservations that a major carrier would design deliberately, a study which would have even a slight chance of showing it's service needs a health warning.
It is going to cost and I cannot see anyone who both can and wants to afford it.
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[This message has been edited by Code Blue (edited 07 January 2001).]
edited for Sunday Morning dyslexia
[This message has been edited by Code Blue (edited 07 January 2001).]
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A start would perhaps be to do an aircrew survey, to find out how many pilots and cabin crew had had DVT.
From this it would surely be possible to gauge the numbers we are talking about?
Also, the CAA I guess would have info on the number of pilots who had suffered as their medicals would have been suspended.
This would be relatively straightforward, I am sure most airlines would (certainly should) be willing to participate.
From this it would surely be possible to gauge the numbers we are talking about?
Also, the CAA I guess would have info on the number of pilots who had suffered as their medicals would have been suspended.
This would be relatively straightforward, I am sure most airlines would (certainly should) be willing to participate.
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I Kid - your point is well taken. As I read it your post implies a question - if DVT/PE is such a dreadful danger how come I(you) have not noticed my mates dropping dead like flies after long trips?
Crashdive has "known pilots from both long and short haul for many a moon" and not noticed anything alarming.
If the syndrome IS real, then either you and Crashdive are remarkably unobservant or there is something different about pilots (yes I know there is but we won't go into that here).
Code Blue - through much of these DVT threads runs a suspicion that DVT/PE is a megamega problem the extent of which is being wilfully withheld from the public by Skip Undo's "..members of the medical profession who are in the pockets of large corporations - and especially airlines".
All that I can say is that long-haul flights have been going on for many many years and while you can conceal an elephant for a while it tends to make it's presence felt fairly soon, whether you like it or not. A mouse, on the other hand, may go un-noticed for years.
Postal surveys do indeed have a low response rate - that is why I suggested the airmiles bribe - but even 12% of 100 million pax/year would be a sizeable sample.
We don't have to be perfect methodologically first time round. Just get the big picture - 10,0000 pax and 10,0000 nonpax - any excess events. If none, then forget it. If yes then by all means start looking more closely at smokers/pill/etc.
As for the DVTs, we are not talking about picking up silent events - just the clinically obvious to start with. You were not suggesting subjecting all disembarking pax/crew to ascending venography were you? No, most people with symptomatic DVTs will end up (in the first world) in hospital, on heparin and probably have some kind of confirmatory investigation. The investigations will have already been done and the data is there.
Grandad Flyer's suggestion is excellent and 20,000 PPRuNers would be an immediate though imperfect sample to checkout (have mercy on us cry Danny's servers....) At least we could get some idea what size animal is in the room with us!
Crashdive has "known pilots from both long and short haul for many a moon" and not noticed anything alarming.
If the syndrome IS real, then either you and Crashdive are remarkably unobservant or there is something different about pilots (yes
I know there is but we won't go into that here).Code Blue - through much of these DVT threads runs a suspicion that DVT/PE is a megamega problem the extent of which is being wilfully withheld from the public by Skip Undo's "..members of the medical profession who are in the pockets of large corporations - and especially airlines".
All that I can say is that long-haul flights have been going on for many many years and while you can conceal an elephant for a while it tends to make it's presence felt fairly soon, whether you like it or not. A mouse, on the other hand, may go un-noticed for years.
Postal surveys do indeed have a low response rate - that is why I suggested the airmiles bribe - but even 12% of 100 million pax/year would be a sizeable sample.
We don't have to be perfect methodologically first time round. Just get the big picture - 10,0000 pax and 10,0000 nonpax - any excess events. If none, then forget it. If yes then by all means start looking more closely at smokers/pill/etc.
As for the DVTs, we are not talking about picking up silent events - just the clinically obvious to start with. You were not suggesting subjecting all disembarking pax/crew to ascending venography were you? No, most people with symptomatic DVTs will end up (in the first world) in hospital, on heparin and probably have some kind of confirmatory investigation. The investigations will have already been done and the data is there.
Grandad Flyer's suggestion is excellent and 20,000 PPRuNers would be an immediate though imperfect sample to checkout (have mercy on us cry Danny's servers....) At least we could get some idea what size animal is in the room with us!
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MTK:
If some form of ballpark screening exercise is what you want then any of the suggestions made here would provide some data. How you interpret those data would depend on perspective and to perhaps a lesser extent on the results themselves.
There seem to be 2 groups here: those who think there is a problem and those who don't. Everyone has agreed
that the info just isn't there. A screening survey might not clarify matters - it might just provoke a whole series of methodological arguments.
Try it by all means .."a journey of a thousand miles begins &c...." but don't be surprised if the results start an identical version of this thread, with identical comments at some time in the future.
I don't see the 'definitive' study ever getting off the ground (groan) because I do believe there are groups who would be happy to perpetuate the current state of ignorance on this.
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[This message has been edited by Code Blue (edited 07 January 2001).]
[This message has been edited by Code Blue (edited 07 January 2001).]
[This message has been edited by Code Blue (edited 07 January 2001).]
still can't type 
[This message has been edited by Code Blue (edited 07 January 2001).]
If some form of ballpark screening exercise is what you want then any of the suggestions made here would provide some data. How you interpret those data would depend on perspective and to perhaps a lesser extent on the results themselves.
There seem to be 2 groups here: those who think there is a problem and those who don't. Everyone has agreed
that the info just isn't there. A screening survey might not clarify matters - it might just provoke a whole series of methodological arguments. Try it by all means .."a journey of a thousand miles begins &c...." but don't be surprised if the results start an identical version of this thread, with identical comments at some time in the future.
I don't see the 'definitive' study ever getting off the ground (groan) because I do believe there are groups who would be happy to perpetuate the current state of ignorance on this.
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[This message has been edited by Code Blue (edited 07 January 2001).]
[This message has been edited by Code Blue (edited 07 January 2001).]
[This message has been edited by Code Blue (edited 07 January 2001).]
still can't type [This message has been edited by Code Blue (edited 07 January 2001).]
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I have read that DVT is caused by blood pooling in the lower legs during long periods of inactivity. The blood may have clotted. So when you get up and move around after the flight if a clot breaks off and travels to the brain you are pretty well done for.
Now for a few years now I have taken half an asprin a day to thin the blood (my hypochondria about heart attack being the reason) so I would assume that if your blood is thinned you would be less likely to have your blood "sludge" in your lower legs after sitting for hours and hours on your bum
Maybe those worried about DVT should see their doc and ask if an asprin is the answer, at least in the short term.
Now for a few years now I have taken half an asprin a day to thin the blood (my hypochondria about heart attack being the reason) so I would assume that if your blood is thinned you would be less likely to have your blood "sludge" in your lower legs after sitting for hours and hours on your bum
Maybe those worried about DVT should see their doc and ask if an asprin is the answer, at least in the short term.
Guest
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faheel:
In general DVTs are associated with blood pooling in the legs and usually this is from immobility. Clots which dislodge actually arrive in the lungs first because of the way the plumbing is arranged - it can be fatal when the clot is big enough to stop the circulation of blood there completely.
An aspirin will reduce the chances of blood clotting - indeed it works as well as the so-called clotbusters for heart attacks. Stomach problems sometimes limit its usefulness.
PS: It has only been shown convincingly to reduce the risk of Heart attack in patients over 40 who have already had one such attack.
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In general DVTs are associated with blood pooling in the legs and usually this is from immobility. Clots which dislodge actually arrive in the lungs first because of the way the plumbing is arranged - it can be fatal when the clot is big enough to stop the circulation of blood there completely.
An aspirin will reduce the chances of blood clotting - indeed it works as well as the so-called clotbusters for heart attacks. Stomach problems sometimes limit its usefulness.
PS: It has only been shown convincingly to reduce the risk of Heart attack in patients over 40 who have already had one such attack.
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Guest
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Faheel,
please don't take the aspirin daily. As Code Blue has already said, it has only been proven to work to prevent certain conditions in certain patient groups, and as one who has been involved in aspirin studies in UK hospitals in a previous career, I can tell you there is no evidence to suggest that aspirin will prevent a DVT or PE at all, let alone during flight.
There is, however, conclusive evidence that statistically significant numbers of regular aspirin takers will develope gastrointestinal problems including stomach bleeding, and therefore you should only take it daily under the supervision of a doctor (which I am not). I often used to be told that if aspirin was invented today, it would be considered not safe for use in any patients.
please don't take the aspirin daily. As Code Blue has already said, it has only been proven to work to prevent certain conditions in certain patient groups, and as one who has been involved in aspirin studies in UK hospitals in a previous career, I can tell you there is no evidence to suggest that aspirin will prevent a DVT or PE at all, let alone during flight.
There is, however, conclusive evidence that statistically significant numbers of regular aspirin takers will develope gastrointestinal problems including stomach bleeding, and therefore you should only take it daily under the supervision of a doctor (which I am not). I often used to be told that if aspirin was invented today, it would be considered not safe for use in any patients.
Guest
Posts: n/a
hmmm,
Just don't know what to believe these days.
Have not heard about those studies, will have to do some serious research now.
The asprin I now take is a 100mg coated pill which is surposed to be absorbed thru the gut instead of the stomach If I understand it correctly.
Just don't know what to believe these days.
Have not heard about those studies, will have to do some serious research now.
The asprin I now take is a 100mg coated pill which is surposed to be absorbed thru the gut instead of the stomach If I understand it correctly.