Do you know about DVT

If you or your loved ones may need to travel for long hours, and if you don’t know about DVT, please read the following.

On 29^th may, I lost my mother. She and my father had left for San Francisco to spend time with my elder brother’s family and to meet their 5 months old grand daughter for the first time. They were preparing for the trip for almost a month as it was going to be a long stay. They had done all the basic medical checkups including sugar, ECG, blood pressure and all the reports had turned out to be OK. I had gone to airport to see them off on 28^th night, ‘Take care you both’ is what she had said as I had waved to her hurrying back to the taxi. This was their third trip to USA and they both looked quite self assured knowing well what to expect for the next 24 hours. On 30^th morning, we were woken up by the telephone ring, ‘oh, so they reached home’, I said to myself as I picked up the phone. It was my brother on the other end and he gave the news in a controlled voice. The entire family was shaken up, what hurt more was the way it had happened.

From Mumbai, their first flight was up to Seoul, where they had a lay over of 2 hours. She was very normal till then, they both had taken a walk at the airport to loosen up a bit and to get ready for the next 10 hour leg to San Francisco. During flight, she had slept for the most of the time, had eaten her meals and had made no mention of any abnormal feelings. The plane landed at SFO by half past noon and they got out of the plane and started walking towards the immigration desk. They had walked for barely few minutes and all of a sudden, she started feeling uneasy and wanted to sit down. My father helped her walk few steps, holding her hands but she could do it no more and collapsed on her feet. She had become breathless and had stopped responding to my father. That is when he realized that this was serious and he called for help. One of the co passengers informed the airline staff, 10-12 minutes might have passed till the medical staff arrived with their emergency kit. They put her on oxygen, gave her a shot of blood thinner and tried CPR to revive her. She passed away soon, my brother could only see her lifeless. She was very normal till the plane had landed, she did not have any major illness before, had no history of heart trouble, all the recent medical reports were quite normal, then why did it happen, it made no sense.

We were told the autopsy reports could take few weeks, meanwhile, someone mentioned about the possibility of this being a case of an ‘economy class syndrome’, something I had heard about for the first time, so we all started looking for information on web and found that its description fitted well with what had happened to mother. The medical term for this syndrome is ‘Deep Vein Thrombosis’ (DVT), I am not a medical expert so the information that I am presenting here is taken from various web sites dedicated to DVT, please refer the sources for more complete information.

Deep vein thrombosis (DVT) refers to the formation of a thrombus (blood clot) within a deep vein, commonly in the thigh or calf. This condition is serious and potentially fatal if the clot gets detached from the walls of the veins and becomes part of the blood circulation system. The clot can get lodged in the lungs, condition known as Pulmonary Embolism (PE), which can cause sudden death. Apparently, DVT is difficult to diagnose by external examination but there are some known risk factors. Out of them, following factors applied to my mother,

1. Inactive state in a leg-cramped position for several hours, she had slept for most of the 10 hour flight from Seoul to San Francisco.
2. Elderly age, she was 56.
3. She had ‘Varicose Veins’ (enlarged veins) in her legs, a very common condition among men and women.
4. Swelling on the legs, her legs used to get swollen a bit after prolonged sitting/standing.

As per DVT Risk Assessment Tool, person with these conditions has high risk of DVT. Later, the death certificate confirmed that mother had died due to PE resulting from DVT in her left leg. Upon searching further we learned that DVT can be prevented with few basic measures while on a long flight,

1. Try to stand/walk for 5 minutes every hour, or do the basic in flight leg exercise regularly.
2. Drink lots of water.
3. High risk people may take some blood thinners (like aspirin) with doctor’s consultation before and on flight at regular intervals.
4. Graduated compression stockings or socks may be worn to improve blood circulation.

As we came to know more about it we realized that if only we knew about it or if we were warned about it, it could have possibly been avoided. There is plenty of information on the net about this, even the statistics of deaths caused due to DVT (PE) are quite alarming but we just did not know much about it,

1. The airlines do recommend doing in-flight exercises, but do they ever tell you about the possible worst case scenario if you don’t do it?
2. Are the medical practitioners in India well aware of this condition?, in our case, the answer was NO, mother had taken advice for the regular swelling on her legs from our family physician as well as from an Orthopedic Surgeon, and both had assured her it was not serious, even after knowing that she was supposed to fly to USA soon.

People tell me that things do happen when they have to happen; however, it’s hard not to get this troubling thought that, if only she had moved her legs more and drunk more water during the flight, she would have still been with us.

The purpose of sharing this is to make you aware of this condition and possibly avoid such losses in the future. May her soul rest in peace and may she forgive us.

Reference:

http://www.examiner.com/a-756119~Courthouse_Square_hosts_first_live_concert.html

http://news.bbc.co.uk/2/hi/health/6248586.stm

http://www.dh.gov.uk/en/Policyandguidance/Healthandsocialcaretopics/Bloodsafety/VenousThromboembolismVTE/DVT/DH_4123480

https://www.preventdvt.org/docs/pdf/DVTRiskAssessmentTool.pdf

http://familydoctor.org/online/famdocen/home/seniors/common-older/800.html

http://www.economyclasssyndrome.net/

http://www.dvt.net/

http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=264

http://en.wikipedia.org/wiki/Deep_vein_thrombosis