Rock musician Tom Petty was right when he sang “the waiting is the hardest part.”
In fact, the sitting and waiting people do during the holidays – in terminals, buses, airplanes, trains and cars – can be downright dangerous, says Dr. Ole Peloso, a phlebologist, general vascular surgeon and director of the Vein Center of New Mexico.
Extended periods of immobility can lead to the formation of blood clots, particularly in the lower extremities. Known as a venous thromboembolism or deep vein thrombosis, these clots can partially or fully cut off the venous blood flow coming out of the leg and can be accompanied by discomfort or pain, Peloso says. “If the clot travels to a lung, it’s called a pulmonary embolism, and that’s very dangerous and can cause death.”
How long is too long for sitting immobile? It varies from person to person, but certainly if you’re sitting for six hours or longer, the risk of clot formation increases, he says.
The Centers for Disease Control and Prevention estimates that 300,000 to 600,000 Americans are hospitalized for deep vein thrombosis and/or pulmonary embolism each year, contributing factors in up to 100,000 deaths.
The people who are at the highest risk, Peloso says, are those with a family or personal history of clotting; pregnant women and women who use estrogen or oral contraceptives; people who are obese, are old, have cancers or congestive heart disease; people who underwent a recent physical trauma or a recent major surgery; those with significant varicose veins; and those who are immobile because of a stroke, spinal cord injury or are in a cast.
The simplest preventive measure is to avoid sitting for long periods, which is easy to do if you’re on road trip in a car. Simply pull over every couple of hours, get out, walk around and stretch. Passengers aboard cramped buses or airplanes can to be more inventive.
How you can prevent it
Dr. Ole Peloso, director of the Vein Center of New Mexico, offers tips for holiday travelers to help prevent clotting as a result of protracted immobility.
- Do exercises in your seat: Flex and extend your knees and ankles; point your toes to the ground and squeeze and tighten your calves.
- Where possible, elevate your feet 6-12 inches above your heart for short periods to drain the legs and get the venous blood moving.
- Avoid crossing your legs for extended amounts of time because that increases venous pressure and decreases blood flow in the calf.
- Where you have to travel aboard crowded mass transportation, try to book an aisle seat because you’ll be more likely to stand up and move around.
- Avoid wearing constrictive clothing from the waist down, with the exception of compression stockings.
- Stay well-hydrated, even doubling your water intake.
- Avoid alcohol and caffeinated drinks, which have a diuretic effect.
- Do not take sleeping pills, which can further cause immobility.
- Despite anecdotal information, there is no medical literature to support claims that vitamins C and E promote better circulation. Flavonoids, however, have been shown to support and strengthen the venous system. Look for such things as Butcher’s Broom or Horse Chestnut Seed Extract.