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If you're travelling on a long-haul flight, there are several ways you can reduce your risk of getting deep vein thrombosis (DVT).


Travel-related DVT was first reported in 1954 in a 54-year-old doctor who developed a blood clot following a 14-hour flight. The condition was soon dubbed "economy class syndrome" by researchers, who believed there was a link between long-haul air travel in cramped conditions and DVT.

The actual number of people who get DVT on long-haul flights is unknown and is difficult to determine, as the condition can be symptomless and may not occur for some time after travel.

However, there is some evidence to suggest that certain people, such as pregnant women or people who have had a stroke, are at increased risk of developing DVT on flights of eight hours or more.

What is DVT ?

DVT is a medical condition which occurs when blood flows too slowly through the veins. The blood forms a clot that blocks up deep veins, usually in the legs, and may sometimes travel as far as to the heart.


Symptoms?

DVT doesn’t generally have any immediate symptoms, making it difficult to spot. However, typical signs include a swollen or painful calf or thigh, paleness and increased heat around the affected area.

If left untreated, people with DVT are at risk of developing a pulmonary embolism, when part of the blood clot breaks away and travels to the lung, which can be fatal.

Before you travel

If you think you have a high risk of developing DVT, see your doctor before you travel.

You may be prescribed blood-thinning drugs to lessen the risk of your blood clotting, or compression stockings (also called flight socks).

Studies have concluded that airline passengers who wear compression stockings during flights of four hours or more can significantly reduce their risk of DVT as well as leg swelling (oedema).

The below-knee stockings apply gentle pressure to the ankle to help blood flow. They come in a variety of sizes and there are also different levels of compression. Class 1 stockings (exerting a pressure of 14–17 mmHg at the ankle) are generally sufficient.

It’s vital that compression stockings are measured and worn correctly. Ill-fitting stockings could further increase the risk of DVT.

Flight socks are available from pharmacies, airports and many retail outlets. Take advice on size and proper fitting from a health professional or pharmacist.

DVT high-risk factors:
  • History of DVT or pulmonary embolism
  • Cancer
  • Stroke
  • Heart Disease
  • Inherited tendency to clot (thrombophilia)
  • Recent surgery (pelvic region or legs)
  • Obesity
  • Pregnancy
  • Hormone replacement therapy
Flight socks
  • Flight socks are recommended for people at high or moderate risk of DVT.
  • They should be worn throughout the flight.
  • Use below-knee graduated stockings with an appropriate compression.
  • Class 1 stockings (exerting a pressure of 14–17 mmHg at the ankle) are generally sufficient.
  • Get advice from a health professional (doctor, nurse or pharmacist) on correct size and fitting.
While you're travelling
  • Wear loose, comfortable clothes.
  • Consider buying flight socks (compression stockings).
  • Store luggage overhead so you have room to stretch out your legs.
  • Do anti-DVT exercises. Raise your heels, keeping your toes on the floor, then bring them down. Do this 10 times. Now raise and lower your toes 10 times. Do it at least every half an hour (you can do it more often if you like).
  • Walk around whenever you can.
  • Drink plenty of water.
  • Don’t drink alcohol or take sleeping pills.

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Seasickness is hardly fatal, but with symptoms such as nausea, stomach cramps and vomiting, it can certainly put a damper on your cruise fun. Motion sickness is thought to be caused by the visual disorientation resulting from being on an object in motion (ship) competing against our body's natural inclination for balance. Whatever the technical cause, the majority of cruisers are familiar with how rough, rocking seas can leave us feeling less than our best.

Mal de mer, however, is not caused by choppy waters alone. Scientific studies have shown that some folks become seasick by suggestion. They simply convince themselves that being on a ship will make them ill. On the other hand, for those who can forget about it, it's often smooth sailing.

Some people have a genuine proclivity for motion sickness and will undoubtedly suffer more during rough seas. According to medical professionals, seasickness is more prevalent in children and women. On the other hand, children under 2 seem to be immune from the ailment. Of equally interesting note, elderly people are less susceptible.

If you have a propensity to motion sickness or are concerned that you might develop symptoms, arm yourself with preventive measures beforehand.

Drug Remedies

One of the most widely recommended remedies is
Transderm Scop, a scopolamine patch applied behind the ear at least eight hours before exposure, with effectiveness for up to three days. Available only by prescription, the Scop is preventive, not a treatment, and can cause possible side effects such as dry mouth, blurry vision, drowsiness and dizziness.

Over-the-counter drugs used to deter and/or treat mal de mer include
Dramamine, Meclizine (common name Bonine) or diphenhydramine (commonly known as Benadryl). On some ships these are dispensed freely. They are also sold in the sundries shop. Remember that the most common side effect of taking Bonine and Benadryl is drowsiness, and alcohol will exacerbate this.

Editor's note: For kids, less potent versions of both Benadryl and Bonine are available as well. Of course, we recommend that you talk with your doctor before giving your children any new medications.

Stronger, more effective prescription drugs can only be obtained from a physician (the ship's doctor can fix you up, but it often costs you the price of an office visit plus the pills, so you're better off going through your personal physician). These include
Promethazine and ephedrine, which when taken together produce quick results as well as potential side effects such as sleepiness. Another option is suppositories, administered by the ship's physician, which work magic for some people.

Drug-Free Remedies

If you don't like to take drugs, there are plenty of other options, if the numerous Cruise Critic boards' threads on seasickness remedies are any indication. Some swear by applying a
Sea-Band wristband the minute you embark. The easy-to-wear, acupressure-inspired product has a plastic bead that presses against the Nei-Kuan pressure point located on the palm side of the wrist. Efficacious in curbing nausea and vomiting without any side effects, it comes in both adult and children's sizes and can even be used by pregnant women. Sea-Bands are available without a prescription at major drug stores.

Others faithfully promote the benefits of
ginger, which studies have found alleviates nausea associated with motion sickness. The root can be taken in various forms, including powder, tea, pill and candy. Some swear that eating green apples helps with nausea, and some ships offer plates of green apples and crackers on their room service menus.

A Few More Tips

  • To acclimate yourself to shipboard life, it's advisable to spend as much time as possible out on deck, using the horizon as a point to maintain your equilibrium.
  • Booking an outside cabin in the middle of the ship -- the natural balance point -- is another option. Having a window will also give you a consistent view of the horizon point (unless you find yourself in stormy waters, sea spume splashing against your window).
  • It's also not a bad idea to take only port intensive cruises with fewer days on the open seas and to avoid itineraries where the ocean is bound to be rough such as North Atlantic crossings or the Caribbean during hurricane season.
  • Another wise option is to pick large, modern ships -- not a difficult proposition with the industry trending toward larger ships. Anyone who's sailed on a relatively new mega-ship, perhaps of 100,000-tons or more, knows that stabilizers are used when needed to provide the smoothest ride possible.

Remember that everyone reacts differently to the various remedies out there. It's on the cruiser to take part in a little research and self-experimentation.

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