Lena Welch was diagnosed with a pulmonary embolism and factor V Leiden in 2008. She has participated in support groups for each condition.
Blood Clots and Air Travel
Blood clots can be life-threatening when flying. When we fly, the blood that pools in our legs have a tendency to form clots, which can grow large enough to obstruct a vein and cause a painful and dangerous DVT (deep vein thrombosis). If the clots are able to move into the lungs, they can cause a life-threatening pulmonary embolism. Pulmonary embolisms block the flow of blood and oxygen throughout the lungs. People who have thrombophilia or another blood clotting condition or who have a history of blood clots are especially at risk of experiencing a dangerous blood clot while in the air.
Despite these risks, flying can be a safe experience. There are a number of steps that travellers can take to ensure health and safety. Before reading on, please note that I am not a doctor, but I was diagnosed with a pulmonary embolism and a condition called Factor V Leiden. I have participated in informational support groups for each condition. For your safety, please share this information with your doctor and discuss it.
Everyone is at risk of developing a clot while flying, though some people have a higher risk than others. The chart above can help you assess your risk. Note one thing that is not mentioned: Being an elite athlete raises your risk of a clot while flying. Studies show that around 85% of after-flight blood clot victims are athletes.
Keep in mind that everyone is at an increased risk for a blood clot while flying.
Blood Clot Symptoms
Even with precautionary measures, you can have a pulmonary embolism or a DVT (deep vein thrombosis) after airplane travel. If you have any symptoms of either of these conditions (listed below), go to the emergency room. Pulmonary embolisms often are fatal. Prompt administration of blood thinners and bed rest can prevent long-term vein, heart, or lung damage and a fatal blood clot. The emergency room is the safest place for you if you notice any symptoms of a blood clot, DVT, or pulmonary embolism. You do not have to have all of the symptoms to have a clot.
Deep Vein Thrombosis (DVT)
A DVT is a blood clot that forms in a vein. The most common site for these clots is in the large veins of the legs, particularly behind the knee. Some of the symptoms of a DVT are:
- Swelling, usually in one leg.
- Leg pain or tenderness.
- Reddish or bluish skin discoloration.
- Leg warm to touch.
While these symptoms are typically in a leg, they can also occur in the arms or other body parts. A DVT can feel like a pulled muscle, muscle cramp, or "Charlie horse." The extremity often has a bruised or discolored appearance and swelling.
Pulmonary Embolism Symptoms
- Sudden shortness of breath.
- Chest pain-sharp, stabbing that may get worse with a deep breath.
- Rapid heart rate.
- Unexplained cough, sometimes with bloody mucus.
- Night sweats.
Why Flying Increases the Risk of Clots
When we fly, we tend to sit in the same position, with knees bent, for hours on end. Muscle movement pushes our blood back to the heart, so when we sit, the blood may pool. The longer blood sits still, the greater the chance of a clot. Bent knees or crossed legs make it even more difficult for blood to circulate. When one is stationary for 1-2 hours, the risk of a DVT or pulmonary embolism increases. On airplanes, many passengers are seated in the same position for at least 2-8 hours. International travelers are seated for an even longer period of time.
Planes also carry other risks. The lower air pressure and lower humidity on planes appear to increase the coagulability of the blood and increase the risk of pulmonary embolism or DVT.
Tips to Prevent Blood Clots
The length of a flight directly affects the risk of developing a clot. When a flight time extends to four hours or more, the risk of developing a DVT or pulmonary embolism increases dramatically.
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- Break your flights into shorter segments if possible. Look for flights with a layover or an airplane change so that your flight is broken into shorter segments. To prepare for long international flights, speak with your doctor about using Lovenox or another anticoagulant.
- While flying, keep your blood moving. Try to get up and walk the plane at least once every 1-2 hours. While you are seated, do not cross your legs. Keep your legs as straight as possible to make it easier for your blood to circulate. Do leg and foot exercises as these will help to move blood and prevent clots.
- You can wear a graduated compression hose or "travel sox" for your flight. These special socks will help to prevent blood from pooling in your legs. Make sure that they do not bind. To be sure of the fit, have a professional help you to choose the correct size based on your measurements. Your other clothing should be loose-fitting clothing so as not to constrict while you are seated.
- Stay hydrated. Drink around 8 ounces of liquid every hour. Make sure that this liquid is a hydration beverage with electrolytes. Pedialyte, Gatorade, or Powerade are all good choices. If you have a history of clots, you can make arrangements with the airline to take "medical" liquids through security. I find it much easier to buy powdered Gatorade, measure out enough for a 32-ounce drink, and put it in a sandwich bag. Once through security, I purchase 32 ounces of water and pour it into my mix. This gives me enough liquid for four hours of flight time. I will still drink additional drinks on layovers and sometimes on the plane. I find that if I use Gatorade, I can drink 8 ounces an hour with little need to use the restroom. If I drink water, I will have increased urination. This shows that my body holds onto the liquid in Gatorade but not water. Note that water actually seems to increase the risk of clots.
- Heel Raises: Sit with your feet flat on the floor in front of you. Lift up your heal and hold it for 5-10 seconds. Lower it to the floor. Repeat ten times.
- Toe Raises: Sit with your feet flat on the floor in front of you. Lift up your toes and hold for 5-10 seconds. Lower to the floor. Repeat ten times.
- Toe Circles: Straighten your legs as much as possible and lift them slightly off of the floor. Make small circles with your toes.
- The Alphabet: Straighten your legs as much as possible and lift your feet off of the floor. Trace the alphabet with your right toes and then repeat with your left.
- Slides: Slide your feet as far forward as possible and then bend your knees and slide them back as far as possible. Repeat ten times.
- Knee Lifts: Lift up your right knee towards your chest, about 3 inches off of your seat. Lower it. Lift up your left knee and do the same thing. Alternate legs until each leg has been lifted ten times.
More Information About Blood Clots
More Information About Pulmonary Embolisum
- Tips And Recommendations For Pulmonary Embolism Survivors: Information About PE Recovery
- Safe Road Trips And Car Travel After Pulmonary Embolism (PE), Deep Vein Thrombosis (DVT), Factor V L
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Kim Farmer on September 20, 2019:
I have ape and it is in my right lung. I’m on Eliquis. In hospital for four days. It has been six weeks. My lung was damaged. I cannot breath good. I’m 56 yrs old. Blood clots are coming up all over my left arm. Feel awful. Any help?
Mark on October 08, 2017:
Thank you for this information. Labor Day this year , 2017 I ended up in the er and was diagnosed with several blot clots in my lungs. I am 52 in pretty good health and was shocked to find out that I had this. I too am diagnosed with factor V Leiden. I am on elequis a new blood thinner. It seems to be working according to my Dr. I am very fatigued and feeling afraid this will happen again. My Dr. Told me to start walking a little each day but I can't seem to do too much without feeling like my legs are like lead. I am relieved to read about so many others experiences, it makes me feel better.
Barbara on September 04, 2017:
I took a 2.5 hour plane trip for a vacation. After I returned, I was having severe pain in the bottom of my foot for weeks. I saw my primary care doctor and a podiatrist. The podiatrist recommended a CT scan...there was a blood clot in my calf. I was 65 years old, heterozygous Factor V Leiden and never had a clot before. I was put on Xarelto for 4 months and the clot resolved without any residual effects.
Elizabeth on May 08, 2017:
Thank you for most useful info. Hard to get from doctors
Steve G on September 05, 2016:
I had a massive PE about 4 years ago following a hip replacement. A couple of tips for you when flying. Wear compression stockings...and never ever fly economy. It will cost you more to fly business class but if you are worried about clots its the only way to go. This way you can keep legs elevated...move around the cabin without inconveniencing other pax. Believe me it well worth the cost. If you happen to already had a PE...please discuss you travel with your treating MD. If you tell the airline about your circumstances, they may well ask you for flight clearance from your MD that you are OK to fly. Steve G ex Qantas staff
sharon on June 22, 2016:
just been diajosed with 3 clots on lung been put on warfarin injections am due to fly to morocco in sept will this be ok
sheliabcakes on September 11, 2014:
I have had two PE and I am 35yrs old. With on going exhaustion and shortness of breath for the last 3 1/2 years. I how can I find support?
Sara on September 08, 2014:
Well done! My mom suffered a PE over a year ago & we worried about her flying. You have answered all of our questions but will advise from dr. about travel for her.
Lena Welch (author) from USA on March 30, 2012:
Thank you for being my first comment!
RTalloni on March 30, 2012:
Thanks for an interesting read on an important topic, as well as for the information in preventing and recognizing clotting conditions like pulmonary embolism. Voted up.