Medicine is full of contradictions. What your doctor is scratching his bald shiny head about against what's worrying the weight challenged fat lobule lying on the couch is usually miles apart. I am not talking KFC lane here.
DVT to a doctor is pulmonary embolus in waiting. An acute cardio respiratory compromise as primary presentation with bleeding from thrombolytic treatment needed as complications. Very high mortality exercise.
Most patients though are worried about their leg girth and cosmetic appearance while quieing at KFC.
The longer it stays in the leg, the longer the body can lyse the clot, provided the patient does his or her part, taking treatment to stop propagation.
Meantime patient wants it gone yesterday, unaware the only place that such could happen is release into a cul-de-sac.
Once DVT is formed, pretty little can be done but allow the body thrombolytic system take over while we support with warfarin outpatient or heparin if can be admitted or pregnant. Cléxane helps but even that does very little to the clot in situ.
Prevention is therefore critical.
Virchows triad has been the cornerstone pathophysiology since Adam and Eve got snared.
Blood has to be kept flowing. It is pumped out to body by the heart. Nothing pumps it back though. The active calf muscle action is the only indirect saving grace. Without that activity leg elevation above heart level comes to rescue, that is if you don't have a wooden spoon wielding wife on watch.
The other two legs of this preventative triad is the consistency of the blood and quality of the endothelium, both of which you don't have that much active control over unless you have cult based principles edging you closer to your grave.
We are by nature not allowed to dictate against cults, so we will stay with the flow first leg.
Planes, economy class planes to be specific are bad for people with any risk of DVTs. Not only don't you have space to move, wooden spoons are everywhere.
Dehydration which under normal circumstances can be quenched with a drink gets a little more difficult within planes, more so if you have to buy the water at prices that should be criminal if jurisdiction could be found.
Not much chance of you seeing the DVT in time to blame the airline either. The perpetrator will claim ignorance in a week.
Your only solution would therefore be to wear your preventative elastic stockings every time inactivity of any sort is anticipated.
Oral contraception including estrogen supplements, weight challenge, dehydration, trauma, polycythemia, vasculitis, Chrons' disease... should probably be added to complete the list.
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