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Leg Flexing
Compression hose
Clot formation
Arterial clots
Postthrombotic Syndrome
Risk Factors
Common misconceptions
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Updated February 20, 2005

Messages 2001

12/28/01 Walter Van der Elst: After a KLM flight from Dubai to Amsterdam, my wife Astrid saw her doctor about pain and swelling in her upper legs, cramps, and dizziness. The doctor diagnosed after-effects of flu and gave her some muscle relaxants. A few days later she had cold sweat, lack of oxygen, and fainting, which was diagnosed as a heart attack. She was transported immediately to the first aid at the hospital. where they only got the correct diagnosis after her leg started swelling. Now, more than a year later, she still tires easily and has a swollen leg, not the good health that a 45 year old woman should be enjoying.

12/26 Tim Hentzel: I flew from Minneapolis to San Francisco (5 hours, Northwest Airlines, no mention of DVT risk) approximately one week before the pain started about 12/1. It felt like a strained muscle. When it continued for ten days I saw a doctor who diagnosed DVT by ultrasound and started blood-thinning drugs. After two weeks, the clot is not diminishing and the pain is unbelievable. I am a competitive triathlete, age 26. After recovery I plan to assist in spreading the word to help others avoid this.

12/26 James R Doty, MD. I am a neurosurgeon, 44 and healthy when this happened. Flying from Taipei to Los Angeles I fell asleep reclining in business class. Arriving in Los Angeles, I noted pain and a knot in my right calf that I assumed was a simple cramp. Exiting the aircraft, I suddenly became profoundly short of breath and walking a few steps was exhausting. I rested for a few minutes, analyzed the situation and concluded that I had suffered a pulmonary embolus. I called my partner and we went to the emergency department. My oxygen saturation was quite low. I was given oxygen and a CT scan of the lungs, which confirmed the PE. A clot was also evident in the right calf. I was given heparin, started on Coumadin and I required placement of a (clot) filter in the vena cava. Now I have post-phlebitic syndrome.

There is no question that I could have died from this. I am in total agreement that this is a much overlooked occurrence and the frequency I believe is much higher than we suspect.

12/24 Gary Davis, Ph.D. On a USAir flight from Munich to Philadelphia I developed DVT in one leg. The dull ache at the end of the flight felt like a severe muscle pull, almost to the point of not being able to walk. A sonogram confirmed DVT all the way up the leg. All this despite being very fit and on aspirin (cardio prophylactic) therapy! I took extra aspirin before the flight, but it didn't prevent DVT. With little movement during the 8 hour flight, my 6' 5" frame folded into a window seat did me in.

12/1 Fiona: After my wedding July 21 in Dublin we flew to Fiji on American Airlines in business class. In Fiji for a week and then in Aukland, New Zealand, I noticed a small pain in my right calf, but thought I had a pinched nerve or something. Flying home to Boston August 17 I had difficulty breathing. In the emergency room an ultrasound confirmed DVT. A week later I had trouble breathing again and now I am taking a triple dose of warfarin and getting blood tests twice a week but the coagulability levels won't stabilize.

I used to fly every week with my job but now I cannot fly anymore. I used to enjoy kick-boxing but cannot do that anymore either. I think I should be grateful to be alive but I am 30 years old, newly married and I feel like my whole life revolves around this condition.

The doctors say that it was most likely caused by the flight as I do not take birth control pills and there is no history of clotting in my family.

Note: American Airlines could have told Fiona how to avoid this, but instead they insist this a rare problem unlikely to happen to her, since she has no risk factors. So they didn't warn her. They don't warn anyone else, either.

11/6 Janet, Vancouver BC: Seven days after a 13-hour flight from Vancouver, BC, to Dublin, Ireland, I was hiking in the Irish countryside when I developed severe chest pains on my left side. Since I am only 34 and athletic, I knew they couldn't be a heart attack and I wrote them off as muscle spasms. By that evening they had gotten so intense (with shortness of breath) that I went to a hospital in Dublin, where they (fortunately) injected me with heparin immediately and admitted me for one week. Within 24 hours I had collapsed in the hospital with a fainting episode. (Like the symptomless DVT John Scurr found in 10% of air travelers) I had absolutely no leg pain in the previous days. Four weeks after this trauma, I still suffer severe bouts of chest pain and weakness. Specialist here said it is common for PE people to have pain and discomfort for "several weeks", so hopefully it's normal.

10/26 The worst week: This is our worst week yet for contacts from ECS victims. In addition to Margaret Louie and Modesta Blansett, whose young healthy husbands suffered disabling strokes, another woman lost her husband at age 33, victim of a pulmonary embolism after a flight to Paris. She and her husband had heard of ECS and thought they were safe because they exercised their legs at two hour intervals.

10/24 Stroke: My husband was a man with multiple degrees, active and vital in body and mind. He played the string bass and was a gourmet cook. He was an expert in computer science and mathematics with a photographic memory and natural gift for speaking before large groups. He exercised daily, lifting weights and running 45 minutes, extremely fit at 49 and there was no family history of stroke.

In January, 2000, two weeks after knee surgery, he asked the knee surgeon if travel to London would be O.K. He was assured it would be O.K. Early on the second morning in London, he suffered a massive stroke which left him paralyzed on his right side and without speech. Doctors later found a patent foramen ovale, a small hole in the heart which allowed a blood clot to pass from venous to arterial circulation and then to the brain, causing the stroke. The clot was from a DVT caused by air travel.

He still has trouble with his speaking , writing, reading and mathematics. He walks with difficulty and has no use of his right arm. He struggles with the simplest of tasks.

He was an auditor, careful and conservative. He always read travel advisories and would never have gambled or taken any chances with his life or health. You cannot imagine how upside down our lives are now. He is struggling to recover some semblance of his old self. I am struggling to get to know the new man I now find myself married to and caring for. I love him dearly but I don't know that I will ever be able to forgive those people who could have told him how to avoid this but failed to issue warnings. It is unforgivable. What price do you put on your brain? What price on the movement and use of your arms and legs? I know many ECS victims die, but we suffer a daily death.

10/22 Modesta Blansett: On a June 17 flight to London my husband dozed off for 5 to 6 hours. When he awoke, he was dizzy, couldn't stand, and began vomiting. The flight attendants gave him oxygen and called for an ambulance to meet the plane. At East Surrey Hospital they were perplexed; he had weakness on his right side but they did not immediately diagnose stroke, which would be unusual in a healthy 36 year old. I purchased a ticket, flew to his side, and after 6 1/2 weeks brought him home to our children who are 3 and 6.

Back in Houston, during an echocardiogram, they discovered a significant hole in his heart. Further studies proved that he had developed a DVT in his calf which passed through the hole and went to his brain. He still remains in a rehab facility. He is scheduled to be released in 3 weeks to have the hole repaired. Then he will return home for out-patient rehab. The stroke affected his balance, coordination, speech and right side, but I am grateful that he has not lost any cognitive reasoning or memory.

My husband has been traveling for business for 12 years. He has flown to Europe and Asia, and no one ever told him about the risk of DVT. He would never have slept had he known the dangers. I have lost respect for the airline industry because they knowingly allow passengers to board and never tell them of this horrible danger.

10/14 Retired French Pilot: For commercial reasons airline management hides the truth. We say in French: " Il n'est pire aveugle que celui qui ne veut pas voir, et pire sourd que celui qui ne veut pas entendre." (None are so blind as those who will not see and none so deaf as those who will not hear.) This applies to the administrations in charge of air transportation as well as to airline managements and pilots unions.

10/7 Pat H, Exeter: On September 1 we took a two-hour flight from England to Spain. I had my 10 month old grandson on my lap for a lot of the journey. A few days later my left leg was large and solid and uncomfortable. Ultrasound scan identified a DVT and they told me I couldn't fly home. Now I am on a daily dose of 7 mgs of Warfarin with regular weekly blood tests but it is too early to tell if I will make a full recovery. I hope this is another bit of evidence to get the airlines to take the problem more seriously.

10/3 Death in Holland: My Father and I went to Holland last year and sadly, he passed away the day after we returned. He did complain of some pain in his leg and he got up once during the 9 hour flight to stretch and go to the bathroom. However, if the airline would have made some kind of 'air-health' announcement before or during the flight, my family might still have my Father. We did not know of this threat to health.

10/3 Healthy physician: I just returned from a harrowing week with my father, a healthy physician who suffered multiple pulmonary embolisms after a flight from Arkansas to Idaho. The pulmonologist says the DVT developed on the flight. Then clots started breaking off and traveling to his lungs. His right lung was completely blocked and he had only 25% perfusion in the left. Now he is afraid to ever stop the warfarin for fear it could happen again.

9/19 Montreal to Pheonix: I had been working out in a gym 5-6 times a week, and had lost 30 pounds in 7 months. I felt great! After extensive air travel in July the pain started August 2. I didn't think anything was wrong more than a perhaps pulled muscle in my calf. On August 4, returning from Jacksonville, the pain was severe, feeling like a tightly knotted spasm. The leg was swollen. Two large DVT's were found in my right leg. I remained on heparin for 5 days, and started warfarin, another blood thinner. The pain grew and the swelling did not go down much. Another DVT developed and they concluded that I was resistant to the warfarin. Now I take heparin shots daily. The pain continues at times and I will be off work as a teacher for the foreseeable future.

Bad News Susan's 9/18 message is bad news. He doctor had told her to flex her feet and she did, but still suffered massive DVT. Perhaps without also flexing the thighs (sliding your feet forward and back on the floor), foot flexing is not enough. Also, the half-hour interval may be too long. One physician recommends five minute intervals. Susan has none of the risk factors and no Factor V Leiden, no activated protein C, nothing but air travel to blame for her thrombosis.

9/18 Susan: I had an annual physical shortly before our trip from LA to New Zealand. My GP said she'd just read something about long trips and that it is important to move around, including flexing feet, to avoid blood clots.

I was in a window seat and the person in the aisle seat slept the entire trip in a position that made it it nearly impossible to pass. I did flex my feet at about half hour intervals and managed to walk up and down a few times. However upon arrival I had classic symptoms of blood clots although I did not recognize them at the time. The leg was swollen, red and sore. It was difficult to walk.

I joked with my husband that I probably had a blood clot and he would have to figure out how to get a body back from NZ. The following day we spent the afternoon hiking in the mountains. I fell behind my companions frequently. Knowing what I do now, it's a miracle I didn't die on that mountain. A month later, in the hospital, when the physician said he'd never seen such an extensive clot and warned me I may not live through the night, it wasn't a joke anymore!

After a week's hospitalization and coumadin for three months, I was taken off the coumadin. Only to find a month later through ultrasound that either more clots had developed or the original clot was breaking up into smaller, moving clots. I have been on coumadin 16 months and expect to remain on it the rest of my life.

I had none of the risk factors for DVT. I was 45 years old. I have since undergone extensive blood testing to see if I have any chemical or genetic predisposition to clotting. None has been found. I had a hard time accepting that the blood clot(s) could be caused just by a trip on an airplane.

8/28 JH: I flew JMC from Montego Bay, Jamaica to London Gatwick on 23 July, a 10 hour flight. 8 days later, I noticed breathlessness and a tight chest initially- then painful breathing and inability to breathe. At Royal Sussex County Hospital an initial test showed a low level of oxygen. Subsequent tests and scans over the next 2 days indicated that I had suffered several pulmonary embolisms. The doctors said it was caused by air travel; I don't have any of the risk factors other than being overweight. Hope this helps- it has been a really awful experience!

Note: another victim of symptomless DVT, the kind John Scurr found in 10% of air travelers. There were no leg symptoms at all, but multiple pulmonary embolisms.

8/24 Sandra Chiodo: It was my mum, Valerie May Ryan, that got the DVT and died from it on the 11th of June 2001. Mum was on a trip of a lifetime around the word. She flew with Qantas from Melbourne to Singapore to London and had traveled around Europe for 31 days. I spoke to her 2 hours before she died and she was fine. It has been such a big shock to know that mum is not coming home from this wonderful holiday that I planned for her.

8/13 Mike, US Airways pilot: After a two-day trip I had a very sore leg which I though was an injury as I lift weights on a regular basis. I attempted 'self aid' with ice packs, heating pads, Motrin and massages. Eventually went to the doctor and ultrasound confirmed clotting in the superficial vein structure of the right calf. A baby aspirin was prescribed and follow-on ultrasound. I now make it a point to physically get up out of my seat during cruise, at least every 90 minutes and walk back to the cabin for a coffee.

8/3 Ron Coalson, FEDEX pilot: On a Thursday flight from Pheonix to Indianapolis my calf hurt and aspirin relieved it. The following Monday in San Francisco ultrasound identified a DVT. It is improving with warfarin treatment but as of the last ultrasound it is still there. Apparently the peripheral veins are taking up the load. I don't lead a sedentary life. I have played competitive tennis for years and my wife and I were tournament water skiers for ten years. I have no genetic predisposal that I know of, no injuries, no surgeries, nothing other than flying to explain the DVT.

8/3 Dr. David B, MD: I have recommended your web site to two of my clients who are currently formulating policies relating to risk reduction amongst staff who are flying on business. I will continue to monitor your site regularly. (I suffered a flight-induced DVT myself in 1994.)

8/1 Mark: :On a flight from Osaka to Seattle, we had our one-year-old with us in a bassinet attached to the bulkhead. This sat right over my legs making it more difficult to get in and out, and thus reducing the number of times that I got up and moved around. About five days later my lower left calf started to swell and became quite painful. At first I thought I had strained it and didn't go to the doctor for about another 4 days. Then ultrasound identified DVT. I took warfarin for three months and stopped, but my leg began to swell again. Now I am faced with taking warfarin for the rest of my life (I am 39 years old). This does not please me at all and I am not yet resigned to this course of action.

7/31 Fred R. Zieman, Chicot County Judge: Not so long after completing all the long and difficult steps to become an airline pilot, I suffered DVT and had to stop flying in 1980. After running out of sick leave, I was denied disability because I was still able to work (at farming.) After ten years I tried for recertification to fly but it was denied. Now I have chronic circulation problems that require elevating the leg until the swelling subsides, which can take a long time. DVT is not something that goes away quickly after you take a few pills.

7/28 Missy Two days after a 15-hour flight to Africa, my dad passed out. The doctors said he was fine but after returning to Denver he had flu symptoms. Mom asked the doctor to check for pulmonary embolism (PE). But the doctor thought it was pneumonia and he was released from the hospital on oxygen and antibiotics. Mom took him to a pulmonologist who said the pneumonia was caused by PE and started blood thinners. After three weeks he is still on oxygen and blood thinners and gradually gaining strength. Why won't the airlines inform people of this risk and show them how to do the simple exercises to prevent it? We don't need to hear how to fasten a seat belt!

7/20 UYF : Upon arrival at SF airport I got up and started walking, feeling weak and dizzy. At the terminal I sat down and ask a security to get me some medical help. Then I fainted, I don't know for how long. When I opened my eyes I was on the floor on my face, my glasses were broken and my nose hurt. An ambulance took me to the hospital where I was told that I developed a blood clot on my right leg because of sitting on the plane. After treatment I still live in fear. Whenever I have a funny feeling on my leg, or dizziness, I panic. I can not sleep and I feel tired and depressed all the time.

7/17 Name withheld: One wonders where they find enough (airline employees) willing to lie in a person's face, with total disregard as to whether they cause a person's death, or the ruination of the rest of a person's life. They are despicable scum, and I can think of no more appropriate punishment than for them to be publicly stoned to death by the relatives of those who died while these lowlifes knew all along about the problems.

7/16 BC: Two days after a flight from Charlotte to LA I went running with my girlfriend. I had run 10-k's and was in good shape. I couldn't run more than a half mile. I was out of breath, my legs felt heavy and my back hurt. After misdiagnosis and a week of ineffective treatment I got two more weeks of correct treatment. Now, four years later, I still suffer from post-phlebetic syndrome. I had leg ulcerations but compression hosiery has been effective in treating the ulcers. There are still scars from the ulcers. My leg still swells somewhat. I am still taking coumadin.

7/12 HD, retired pilot: Four days after a flight from Washington, DC to Paris, my wife had severe pain and swelling in the legs and was hospitalized in Salzburg, Austria. Small clots had formed in both lower legs. She received excellent care and was released after a week of hospitalization. We feel extremely fortunate that the symptoms were recognized and treated so quickly and efficiently. (I wonder if the outcome would have been the same in the states?) We are not pleased that we now have to avoid long flights or take extra precautions.

7/12 Richard: The next day after returning to Chicago from Tel Aviv, my wife noticed that my left leg was red and swollen . I thought I had sprained my ankle. At the hospital an ultrasound identified a clot in my left thigh and they started IV blood thinners.

If I had known that sitting for several hours at high altitude would cause this problem, I definitely would have walked up and down the aisles. But nobody warned me about the potential dangers, neither the airline nor my employer. Now I am forced to take warfarin for the rest of my life, as well as getting my blood tested once or twice each month at a considerable cost to me. In addition, because of this, I have days of depression, and a lack of desire/motivation.

7/11 Diane: My father was 69 and very healthy. His death was devastating for us all. He had arrived home from his vacation on November 8, 2000. Swelling and bruising behind his knee were perplexing but we had no idea that it was life threatening. He suffered the stroke on November 12. For a time, he actually seemed to be making a strong recovery--he had even started physical and occupational therapy--when something went terribly wrong. He died on November 22.

7/10 Darlene Steel The day that I returned home I felt a swelling behind my left knee. It never occurred to me that it was a blood clot. A week later that I felt pain up my thigh and went to the Portsmouth, NH hospital . Ultra sound scan discovered the clot. I was in the hospital for 5 days and injected (stomach) with blood thinner and given Warfarin. I am still taking Warfarin and still have a lot of discomfort in the left leg. What is upsetting is that no one ever told me about the risks of flying. I believe the Airlines, especially now that they know air travel can cause blood clots, have a responsibility to discuss ( either in writing or before take-off) the risk of blood clots and precautions to be taken.

7/1 L.O., airline pilot: On the third day after the last flight my leg felt like I had torn a muscle. The doctor wasn't available and the nurse/practitioner ordered Xray for possible fracture. Couldn't get an ultrasound for two weeks. Finally Doppler scan definitely confirmed clot.

7/1/01 Jamil Satchu: My parents were on a Cathay Pacific flight from Hong Kong to Bahrain, a 9 hour flight. An hour before landing my mother began to complain of terrible headaches, started vomiting and lost consciousness, all in about 15 minutes. As soon as the flight landed in Bahrain, she was rushed to the hospital where tests showed that she had suffered a severe stroke. She passed away about 36 hours later. This has been extremely difficult for my whole family. My mother was 62, fit, active and very healthy, the sort of person I was convinced would live into her nineties.

6/29 Farrell Friedland, Scottsdale, AZ: I fly frequently within the west coast. Nine months ago I had four pulmonary embolisms affecting both lungs. I drove myself to the emergency room and was admitted on the spot. After 7 days in intensive care, I had to go back to the hospital daily for a week for blood tests and a shot in my stomach. I suffered PTSS and could not sleep for fear I would not awake. I am still on coumadin. The Airlines need to warn passengers and show warning videos. You most certainly can share my message.

6/28 RP: The day after after a London-Frankfurt-Moscow flight I was gasping for breath. I thought it was pneumonia and the hospital, where the most advanced diagnostic equipment was an X-ray, began terrifying antibiotic injections. Due to the primitive conditions, I checked myself out, ambulanced to the airport, then a long flight (with delays) to London, then ambulanced to University College and from there to Middlesex Hospital. (Later I learned I was incredibly lucky to survive this journey.) At Middlesex they began treating for pneumonia but then a lung scan showed multiple pulmonary embolisms in both lungs. I did six months on warfarin and then was very very tired in the weeks following a five-week research trip by train through Germany.

6/27 MD, Oak Park, Illinois : Four days after a flight from Utah to Chicago in May I had discomfort like a muscle strain. Then swelling the next day. After hospital treatment, I am taking warfarin and I go for regular blood tests. The leg is somewhat sore but seems to be coming back.

6/26 Jennie Cook: I was flying Delta from S.F. to Atlanta every other week. On a Friday the back of my leg started to swell. It became very warm and hard to the touch It also hurt. I really thought I had bruised it. However it didn't get any better and on Monday my doctor sent me to the hospital for an ultrasound scan which showed a deep blood clot about 14 inches long. I was immediately admitted and spent the next 10 days flat on my back on an IV of heparin and other medications. The doctors told me I was lucky to come out of it alive.

6/21 SJ: I should have done something to avoid getting a DVT, but I was unaware of the risk involved. I am surprised that this is not considered a public health issue and that more people are not speaking out. I would be willing to participate in any type of organization to get this issue out. I missed a trip because I could not fly after they found the clot. So I am really mad that this happened to me!

6/21 Ernesto Perez Balladares I flew from Madrid to Bogota on May 20, a 13 hour flight, first class. Three weeks later I woke up at midnight with a terrible pain in my right leg. I thought it was from exercise; I jog and do weights regularly. After three days I called my doctor who ordered me to the hospital where I spent six days, three in the ICU. I am currently at home, advised to stay in bed with my leg held up at a 45 degree angle for a week. My doctors (all U.S. trained specialists) have determined that the injury was due to the long flight as they have ruled out all other possible causes. I am on my way to recovery but I will have to follow a strict control with anticoagulants, less strenuous exercise and regular blood checks for at least six months.

6/18 Twelve hours from Puerto Rico Right after the trip I had a bad cramp in my leg and couldn't bear any weight. Doppler didn't show anything. In the next 4 months I was examined again and again and diagnosed as leg sprain, bronchitis (with coughing up blood,) arthritis, strained chest muscle, eating too much salt, autoimmune disease. I had a lung scan that was negative. A week and a half later I collapsed at the ER window and then they finally made the correct diagnosis after a new doctor ordered a blood oxygen test and then another lung scan. I had blood clots in both lungs. It was blamed on air travel; I have no risk factors, no other reason to develop a blood clot. Note: we recommend insisting on a blood oxygen test if you have PE symptoms but the diagnosis is for something else, such as bronchitis.

6/14 Ronja I am a fit and healthy woman, age 30. I love to run and I have never smoked and I don't take the birth control pill. On May 9, 2001 I returned to Australia from San Francisco via United Airlines in Business Class. Saturday (three days after my arrival) I went for a short run. At the end, I had difficulty breathing, like a sudden shutdown of my lungs. I went to the Emergency Room where they found nothing, said I had an anxiety attack and sent me home. Wednesday after a walk on the beach, I started having difficulty breathing again and I was unable to walk at all without collapse. An ambulance took me to the hospital again where I was admitted for seven days. I will take Warfarin for three months. Please ensure that people know that the pain in the legs does not need to be isolated. It can be spread all over the leg. Also, I had no visible swelling in the leg; that also confused the doctors. I wish they had done an ultrasound scan.

Note: Symptomless DVT's (like those found in 10% of air travelers by John Scurr) are NOT harmless. Many PE victims (myself included) had no leg symptoms.

6/13 Chris Jones was stricken so severely last year that he resigned at age 45 from his post as head of J Walter Thompson advertising. In an article written for the London Times, he said that the worst part of his ordeal was the deep depression that followed. Other victims also report depression and/or post-traumatic stress disorder (PTSD).

6/8 Janina Gojska is a real estate agent in British Columbia, Canada. Her lawyer, Mr. Hartley Cramer, told

Ms. Gosjka was in very good health for the last 10 years. However, after flying to Poland on December 3, 2000, she noticed that her breath was sharply reduced when she was climbing hills in Poland and in Italy. About three days after her return flight on January 8, she was at home alone suffering from extreme shortness of breath. She collapsed on the floor gasping for air, then managed to crawl to the telephone to call 911 and crawl to the door to open it, laying helplessly and struggling for her life due to the deep vein thrombosis releasing multiple clots which lodged in both lungs.

During her six days in the hospital, the Heparin IV in her arm caused enormous swelling and hematoma of her left arm which, five months later, has still not fully resolved. She also developed post-traumatic stress disorder (PTSD), requiring psychiatric treatment. The DVT in her leg is not fully resolved and this injury has made any future air travel very risky, taking from her the ability to travel freely to visit her daughter and other family members.

5/28 Claire, Dublin to Sydney: It was 32 hours with connections. On the return flight I got a severe pain in my left leg, but assumed it was muscular. It persisted at least ten days. Weeks later I had trouble breathing or doing anything energetic. The doctor thought I had a chest infection but when it persisted after antibiotics he suspected PE. Lung scan confirmed multiple bilateral PE and leg scan confirmed DVT.

Anxiety kept me from going out on my own for fear of breathlessness happening again. Now my leg aches after walks that used to be easy. The doctor says I will be on warfarin for the rest of my life.

5/23 Peg, Chicago to Las Vegas: Unexplained pain began in left leg about an hour after returning home on Sunday, March 18. Believing I had "turned my knee", I rested on Sunday, tried heat overnight. Went to work Monday but had trouble walking. That night the leg was swollen and red and I tried icing it. Tuesday I couldn't put any pressure on it. The doctor's nurse asked me a few questions and sent me for an ultrasound scan which showed DVT. Four hours later I was in the hospital, where I remained for six days.

Prior to this, I walked approximately three miles a day on a treadmill and I have taken an aspirin a day for several years. (For those who think aspirin prevents DVT, this is a striking example of a physically fit aspirin-taker developing DVT in a fairly short flight. - MR)

5/4 Doug: I'm 47 and an avid runner for 15 years, putting in 20 - 25 miles per week . I was diagnosed with DVT after a 4 hour flight from San Juan PR to NY JFK. I had slept for most of the flight. 7 days after flight I became very short of breath while running but thought it was from getting older, warmer weather, etc. 10 days after flight I felt pain in my lower left leg which I guessed was achilles tendonitis. On day 11 there was noticeable swelling in left leg. I went to the doctor, whose first question after looking at my leg was had I been on plane flight. Ultrasound diagnosed clot behind left knee. Interesting that every health care professional (including nurses, PA's, etc.) first asked me if I was on a plane. If this is so common, why does no one tell passengers how to avoid it? I took Lovenox injections for 6 days and now am on Coumadin.

4/28 Victim of American Airlines: Can airline CEO's be criminally prosecuted? People are dying and the airlines know how to prevent it at no cost, but they won't do it. This is worse than reprehensible; it is criminally depraved indifference to human life.

3/26 Chicago/Europe I used to fly out on a Tuesday and return Thursday on the night flight. I slept for most of the flight. The next night after my third trip, I suffered a stroke. I have no risk factors for any such thing, but have since learned that there is a small hole in my heart (very common, apparently one in ten adults have this) and the doctors say a small clot passed through this hole, bypassing the lung circuit, and traveled to my brain. Eight months later I still have numbness on my right side and poor coordination with right hand and leg, more severe when I am tired.

3/21 J.S., Hampshire, UK. My DVT was only diagnosed correctly after four trips to the doctor over 2 1/2 months. It kept being discounted as I was only 25 at the time and it was a month after I flew. People need to know that it can strike at any age and a few weeks after flying. The pain went after 2 weeks of treatment, although my leg is a little swollen still. I am able to do non-contact sports now. I've been told to take warfarin for 6 months, which I find restrictive, having to forgo activities like contact sports.

3/20 My wife, Karen Perkins, passed away Sunday January 10, 1999 while on a SCUBA vacation in Belize. She sustained a pulmonary embolism after getting into the water off a dive boat for her first dive. She didn't know that a blood clot had formed in her leg during the flight to Belize. While she was kicking around in the water, preparing to dive, the clot broke free, traveled through her heart to the artery to her lungs and blocked the flow of blood to her lungs. She died instantly.

Bradley S. Perkins
Vice President and General Counsel
Alliance Semiconductor Corporation

3/9/01 Peter Scheerman Weert, The Netherlands: I returned from Hong Kong to Amsterdam last weekend on Cathay Pacific. This flight is a typical "sleeping flight" of approximately 12.5 hours of which I slept 6 hours. After arrival in Amsterdam, as I was getting up from my chair, I felt a "cramp"-like pain in the lower leg. I didn't pay much attention and even though I had to "struggle" my way to our car (my wife picked me up) I still believed it was my muscles causing the pain. When I got home, I undressed and immediately noticed the swelling in my lower leg! I went to the hospital and 2 hours later all checks had been performed and the diagnosis was clear: DVT. I had to stay at the hospital, then give myself injections through the 6th day and will be on medication for the next 3 months. For the first year I will need to wear a compression stocking. Chances are very likely (I am told by my doctor) that there will always be a weak spot in my vein that can cause DVT to re-occur.

3/7 Carol and Neal, Boulder Colorado: My husband flew from Denver to Amsterdam on January 16 and back to Denver from Amsterdam on January 26, and was in the emergency room on Feb. 13 with DVT, the entire length of his left leg. He is 51, an avid bicyclist, in very good shape. The emergency room doc asked him if he'd had any long trips recently. So he was aware of the danger of air travel. We had not been.

3/5 John Walker, Chairman, Aeromedical Committee, Allied Pilots Assn. Mike, we have taken a look at your website and it is terrific. We are putting a link to it on our APA website. Thank you very much for your interest in this topic.

3/5 Australia to North Carolina: I have been given less than 5 years to live. I have pulmonary hypertension caused by blood clots that traveled to my lungs, according to my doctors at Duke Hospital. The symptoms came on suddenly the day after a flight from Australia. I suddenly could barely breath. I'd had sore legs, which I thought was from all the walking we did there, but actually was from the blood clots. This happened in the fall of 1999. They said it was definitely due to the air travel.

3/2 NJ traveler: Factor V test identifies risk for blood clots and the airlines should make every effort to educate the public about this. Even on a carnival ride there are warning signs for anyone with back, heart, or head injury as well as warnings for pregnant women. A Factor V patient's risk increases 20 fold and a pregnant Factor V patient's risk is even higher. The public should be aware, not to cause panic but just to save lives.

2/28 Captain Hank Hoffman, American Airlines: I'll be retiring in a couple of months but I am still determined to see that other pilots don't suffer as I did and my father did. British Airways and Qantas are way ahead of the US Airlines in telling people what they need to know. There is no excuse for the US Airlines to continue to drag their feet. (Capt. Hoffman's email address is available on request to

2/15 K. Buck: I would just like to add my voice to those pleading for education about this syndrome. Certainly I had never thought about it until it happened to my 39 year old husband 5 years ago. It killed my husband. It was a great puzzlement for some time as to what caused his clots. There were no symptoms, no family history, no surgical procedures, nothing else to bring it on. But he made two back-to-back trips from Washington, DC to Sweden and Germany the week before he died. Being in great shape will not save you.

2/10 Richard: My mom developed DVT on a flight from LAX to LGA with a 2 hour layover in St Louis. She is an RN with BSN and MSN degrees, and is a Certified Registered Nurse Anesthetist and taught at a major University Nursing School. And she lectures the family about DVT from "sitting too long" constantly. At the time she developed DVT, she was wearing surgical hose but she did not walk up and down the aisles because of an inner ear balance problem (she was 80 years young at the time). Shortly after the plane landed at LGA, she realized she had a problem and what the problem was, and she and dad (WW2 bomber pilot) got to the Airport clinic in time; "only" five days in the hospital.

2/10 Joe: After a two-hour Houston to Phoenix flight, the flight from Phoenix to Portland took another four hours, but I was probably trapped in my seat on the second plane for closer to five hours in an unusually small seat behind the crew station. I could not move my feet at all. (Literally!) Being a long-legged six-three, my knees were crammed against that wall as well. The swelling and discomfort in my legs began to increase noticeably shortly after that flight began. The swelling was accompanied by a "crawly" sensation in my lower legs. Shortly after deplaning in Portland, I noticed tightness and a stinging sensation across the top of my left foot, plus an intermittent "pinging" sensation in my left calf.

I saw a hematologist a few days after the flight, on a previously scheduled appointment . Although I told him I suspected blood clots, he didn't think that's what it was. He told me to elevate my legs in the evening to reduce the swelling. The swelling subsided somewhat over the next couple days, but it became more apparent to me that I had blood clots. I then visited my primary care physician, who -- after a brief examination -- sent me directly to the emergency room for ultrasound tests. The tests confirmed that there were several blood clots in my foot and nearly up to my knee.

2/7 Sharon: The discomfort started on my way to London February 5, 2000. Balls of feet hurting, leg sore, leg swollen more than usual, etc. I tried to move as much as I could but things had already been set in motion. On March 6 I realized it was serious. I had to drag myself and my leg to a meeting and then tore my vascular surgeon, who did another doppler and found another DVT. This one is huge...starts in my groin to the knee and branches out to two veins in my calf.

I am still taking Coumadin. I have my own microcoagulation machine and do my own blood work at home. This means I don't have to go to a Coumadin Clinic once a week. I test more frequently and feel in better control of my medication. I interact frequently with my hematologist, vascular surgeon and general practitioner. I will probably never be totally recovered. I cope. Some days are better than others. I remain very grateful to still be alive and that I have the strength to do what I need to do to make my life as meaningful as possible.

2/5 Ed: It was a 2.5-3 hour flight to Miami to get on a cruise ship to the Carribean. . . It wasn't until the next morning while we were out at sea I started getting calf pain. By the 3rd day out the pain was acute. I was taking Motrin every 4 hours, 800mg at a time. I kept it to myself as I did not want my wife to notice as I didn't want to spoil the trip for her. By about the 5th day she started noticing that I was limping around pretty bad so I told her about it. Back home, I was immediately hospitalized for 7 days and was put on Heparin and Coumadin therapy. I did recover but 6 months later I ended up with a Pulmonary Embolus to the left lung and was hospitalized for another 10 days. I guess I was pretty lucky that it wasn't a major clot.

2/4 Bert: (This part is from William) My brother-in-law Robert (Bert) recently suffered a "heart attack" after a 24 hour flight from LA to Thailand. He returned from LA to Phuket about a week before Christmas and his "heart attack" occurred on January 1, 2001. He has a very bright, courageous Thai wife who has saved his life twice. They were at sea in his 38 foot sailboat when it happened and she managed to maneuver through the small islands and other obstructions around Phuket and get him to an ambulance that drove him the 40 miles to the International Hospital in Phuket. He was treated there and is currently renting a small house about 10 minutes from the hospital. ( sent Bert an email about free care in Thailand for ECS victims. Bert hasn't been able to locate doctor Dr. Somchai Bowornkit, who is running the free program, and Bert asked me to put his email address here, in case Dr. Bowornkit should see it:

1/30 Lifer: He came home from work one day 2 1/2 weeks after the flights and his right leg was swollen and hard as a rock. After seeing the doctor that day, he had an angiogram the next day which was negative. Then an ultrasound exam showed a blood clot in his right leg. He was immediately admitted to the hospital and he had to spend 12 days there being on Heparin and blood thinners. It is now 3 years (almost) and he still has the clot and will be on Coumadin the rest of his life. He said to relay the message that he would appreciate it if you would keep him updated as to what is going on and if any medical advances have been made.

For more messages, see
Messages 2003,
Messages 2002,
Messages 2001