2022 Western Medical Research Conference

3 Ways To Stop Yourself Developing Blood Clots On Flights

Deep vein thrombosis (or DVT) is a condition where an abnormal blood clot develops in a deep vein, usually in the leg or pelvis, and can be caused by sitting in cramped conditions on long flights.

It's said to affect 60,000 people in the UK and can be potentially deadly if the clot dislodges and travels to your lungs. 

Here, we speak to Professor Mark Whiteley, leading venous surgeon, and founder of The Whiteley Clinic, about how you can reduce your risk of developing DVT on long-haul flights this summer…

Keep as active as possible on the flight

"It's important to keep as active as possible during the flight, particularly if it is a long flight (over four hours)," shares Dr Whiteley to HuffPost UK. 

You don't need to be doing downward dog in the aisles. A walk to the loo and back and a quick stretch every half an hour to an hour can be great, he says. "A good way to do this is by doing some simple stretching exercises and going for a walk up and down the cabin aisle at least once per hour."

Wear compression socks

You know those ugly flight socks you see in the WH Smith in the airport terminal? Sadly, they're actually essential for health flying, especially if you're at a higher risk of DVT.

"Compression socks speed up the flow of blood in the veins reducing the risk of the blood clotting," explains Dr Whiteley. "Below-knee graduated pressure stockings can also make the legs feel much better – and can be worn instead of socks."

Research actually backs this up – one study showed that passengers wearing compression socks develop less DVT and show that leg swelling is also reduced compared to those who don't wear the socks.

Stay hydrated

Experts say that cabin air is almost completely devoid of any moisture, so as well as the benefits to our skin and bodies, staying hydrated can be incredibly important for making our blood 'thicker and sticky' says Dr Whiteley.

"Blood flows at a slower rate in veins than in arteries. Therefore, being dehydrated can increase the chances of developing a blood clot in the veins," he explains.

So, next time the drinks trolley comes along, grab yourself some juice and water to quench your thirst on the flight. And try to avoid coffee, alcohol and tea, which can dehydrate you further.

The Warning Signs That Your Cholesterol Could Be High—And How To Fix It

High Cholesterol Warning Signs And How You Could Fix It

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Modern life can be full of indulgences, and it's all too easy to fall into unhealthy habits. While many of these habits might cause overt symptoms that signal when something is wrong, some health concerns offer very few signs of their presence until it's too late.

One of those common health concerns is high cholesterol, which is thought to affect around 86 million U.S. Adults over the age of 20, according to the Centers for Disease Control and Prevention.

Despite this being so common among adults, Dr. Norman Lepor, a cardiologist, told Newsweek that many people "won't know if their cholesterol is bothering them until they have an event, in which case it's often too late."

Cholesterol is a natural component of the body that's produced by the liver and transported around the body. A cholesterol level is composed of two elements: high-density lipoproteins (HDLs) and low-density lipoproteins (LDLs). The ideal reading for both should be below 200 milligrams per deciliter, according to the Cleveland Clinic.

As HDL is considered the "good" cholesterol, that level should be above 60 milligrams per deciliter, whereas LDL is thought of as the "bad" cholesterol and should be kept below 100.

Cholesterol levels should be under 200 to be considered healthy, and a higher reading puts the individual at risk of a medical incident. However, anything over 240 is considered highly dangerous.

Lepor, who is with Westside Medical Associates in Los Angeles, encourages regular screening for cholesterol levels to ensure that it's monitored, as it's often "under-assessed and under-treated." However, in some instances there might be signs which reveal the extent of the high cholesterol, encouraging people to change their habits.

Sustained High Cholesterol Can Lead to Chest Pains

When cholesterol is too high for a long time, it can cause the build-up of plaque in the arteries which then leads to complications. One of those problems, significantly, is chest pain or shortness of breath as the plaque obstructs the oxygen flow around the body.

"You're not going to notice any issues with cholesterol until you have developed a significant buildup of plaque, which then causes the obstruction in the arteries," Lepor said.

"It's not until there's a blockage that there's problems, and if that occurs in the coronary artery then patients may get some chest discomfort or become short of breath when doing activities that they wouldn't normally have a problem doing. They might also notice that they can't quite keep up with friends."

Many people won't notice these changes until "very late" in the process, once the artery is "laden with cholesterol" already, he added.

© Dr Norman Lepor Dr Norman Lepor pictured. Dr Lepor discussed the effects of plaque buildup in the arteries, as a result of sustained high cholesterol. Dr Norman Lepor Restricted Blood Flow Can Lead to Calf Pains

In addition to getting out of breath quicker than usual and possible chest pain, high cholesterol over a long period of time can cause leg pain for some individuals.

"If you have plaque in the arteries to the legs, you may find that you're getting pain in your calves," Lepor said. "We would call it claudication when you're walking uphill or walking quickly and there's pain. Those are certainly important symptoms not to ignore."

Claudication is defined as a pain or cramp in the muscle which can occur as a result of sustained exercise, but as Lepor notes, it can also be a sign of something far more troubling. If there is a "vascular insufficiency" which is affecting blood flow to the legs, the pain can be the presenting symptom.

"As the cholesterol bathes the arteries, the bad cholesterol can actually seep into the wall of the vessel and it causes this process. I use the analogy of rusting—it causes a rusting of the arteries, or atherosclerosis. This rusting of the artery leaves it ill and predisposed to blood clots forming on it," he said.

"That's where you have events like heart attacks and strokes or a need for amputation. Cholesterol plays a very important role in the development of plaque and the complications."

Rare Skin Blemishes From a Buildup of Fat

While those two signs might relate to cholesterol restricting the oxygen flow around the body, there is one other sign that's associated with high cholesterol levels.

Dr. Bradley Serwer, an interventional cardiologist at CardioSolution, told Newsweek that someone with long-standing high cholesterol can experience xanthomas, a blemish caused by the buildup of fat beneath the skin.

© Dr Bradley Serwer Dr Bradley Serwer pictured. Dr Serwer commented on the rare phenomenon of xanthomas as a result of high cholesterol. Dr Bradley Serwer

"It's important to note that high cholesterol often doesn't cause noticeable symptoms on its own. In rare instances, people may develop xanthomas, which are fatty deposits that can develop under the skin," the former cardiologist for the House, Senate and Supreme Court said.

"They can occur particularly around the eyes, but they aren't very common. It's vitally important to get regular cholesterol screenings to help identify if levels of cholesterol place a person at increased risk."

Xanthomas typically look like small bumps on the skin which can appear individually or as a cluster, ranging from red to yellow in some instances.

How Can High Cholesterol Be Treated?

While these symptoms often occur once the damage is already done, there are ways of reducing cholesterol levels through lifestyle choices. Serwer explained that a diet that's heavy in saturated fats, excessive alcohol and smoking will increase cholesterol, so simple changes to remove these factors will reduce the risk.

"If your cholesterol levels are unfavorable, I first recommend assessing your diet and reducing red meat, fatty and fried foods, and considering a plant-based diet," he said. "Exercise can be beneficial in raising HDL levels which in turn will lower LDL and lower your risk. When diet and exercise have failed then medications may be necessary to lower your levels and risk.

"It is much better to avoid a problem than to treat it after heart attacks and strokes have occurred. Early intervention with diet and lifestyle modification is always recommended, but if these fail to provide adequate improvements, early and aggressive pharmacologic intervention may be necessary."

Update, 05/30/23, 10:56 a.M. ET: This story was updated with Dr. Bradley Serwer's amended job title.

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Flying Afflictions And How To Avoid Them, From Popping Ears To Deep-vein Thrombosis

Generally, a flight time of longer than six or seven hours is seen as long haul. Photograph: Michal Krakowiak

This summer parents are looking for tips, advice and information on how to help their children thrive during the holiday months. You can read all about it at irishtimes.Com/health/your-family

Holiday time is fast approaching. Whether, like me, you are about to take off on your travels or you are looking forward to a well-earned break later in the summer, I thought it would be an opportune time to look at the effects flying has on our bodies.

Pressure, temperature and oxygen levels in an aircraft cabin fluctuate, and the humidity level is lower than it is at sea level. All of those things can interfere with some of our body's normal functions.

The longer the flight, the greater the effects on our bodies. Generally, a flight time of longer than six or seven hours is seen as long haul, which brings in flights to the west coast of the US and Canada. And of course, flying to southeast Asia and beyond opens up the possibility of 12 hours inside the cigar tube of an aircraft.

So what symptoms might you notice when flying and what can you do to lessen the effects?

Dehydration

This is common on long-haul flights and explains why your throat, nose and skin can feel dry on an aeroplane. Aircraft cabins have very low humidity levels, because about 50 per cent of the air circulating in the cabin is pulled from the outside, and at high altitudes the air is almost completely devoid of moisture.

What you can do

To stay hydrated, pack an empty water bottle in your carry-on that you can refill after going through security and take with you on the plane. Wear glasses instead of contacts to help prevent discomfort to the eyes. Restrict your alcohol intake as it acts as a diuretic (increasing fluid loss).

Ear problems

As the pressure in the cabin changes, the air pressure inside your inner ear tries to adjust. When the outside pressure changes quickly during take-off and landing, this may cause earache. We often notice our ears "popping", which is a sign the pressure in the ears is equalising. And the same pressure changes can also make our bellies bloat.

What you can do

Swallow or yawn to open the Eustachian tubes, which control the pressure in the middle ear, during take-off and landing. And to minimise the risk of motion sickness, choose a seat over the wing, where the degree of motion is lowest.

Risk of infection

You might think that recirculating air in the cabin would make you prone to getting an infection, but modern aircraft have advanced filtering systems that remove most bacteria, fungi and viruses from the air. In fact it's proximity to fellow passengers that poses the greatest risk. We became all too aware of this when Covid-19 emerged and airlines introduced mandatory mask-wearing during flights.

What you can do

Make sure you are up to date with Covid vaccination. Wear a mask during the flight. And carry a small bottle of hand sanitiser with you, so that you can wash your hands thoroughly and wipe tabletops clean.

The risk of a blood clot

Blood clots are associated with being immobile for long periods. They usually start in the leg (deep-vein thrombosis) but can spread to the lungs as pulmonary emboli. According to recent research, combining data from 18 studies, the longer you travel, the greater the risk of blood clots. The authors calculated there was a 26 per cent higher risk for every two hours of air travel, with the increased risk starting after four hours. Separate research found the incidence of symptomatic DVT in the month after a flight lasting more than four hours is one in 4,600 flights.

What you can do

Move around the plane regularly. In between, carry out leg stretches and foot rotations to help keep blood flowing. Keep well hydrated. And consider wearing compression stockings during the flight. If your legs swell or you become short of breath in the days after a long-haul flight, seek medical attention.

mhouston@irishtimes.Com

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