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Rob's Travel Information Page

travel

Travel, we do so much of it for our work and (much less) for fun. Here is a my collection of favorite sites for all aspects of travel.

Quick Links:

  1. Essential links (IMHO)
  2. Things Austrian/German
  3. Airlines
  4. Rail Travel
  5. Car Rentals
  6. Hotel info and booking
  7. Travel guides
  8. Camping and National Parks
  9. Maps
  10. Travel Health
  11. Miscellaneous travel tips
  12. Products
  13. University of Utah links

The Essential Links

Travel Agency links

Airlines/Flight Booking and Flying Info

Rail Travel

Car Rentals

Hotel Booking

Travel Guides

National Parks and Camping/Hiking

Maps

Travel Health

This topic took on special importance when I experienced a deep vein thrombosis (DVT) and pulmonary embolism (PE) in August 2013. I recovered fine but it could have been a whole lot worse and it increased my awarenes of the risks and options for prevention. Many thanks to Matt Rondina, MD,, Co-Director of the University of Utah Thrombosis Center, for his help and his providing these pointers.

Take this risk seriously, it can happen to you.

There are other medical topic related to travel and here are some that might be useful for you:

NPR Stories related to clots, DVT, and PE

The Bottom Line?

Annette always tells me to stop being a professor and "Get to the bottom line!" With DVTs and travel, the bottom line is not so clear but the clearest summary for me is as follows:

  1. Prevalence/Risk:
    • Overall the prevalence of DVTs from travel is low in people without risk factors. 0.5% according to one of the sources.
    • Risk of pulmonary embolism is even lower, extremely rare in flights of less than 8 hours, 5 per million in flights over 12 hours.
    • Genetic risk factors: there is, as with all things, genetic risk and evaluating this is costly and may not be conclusive. This has to happen on an individual basis, under the guidance of a specialist. ( Matt Rondina, MD, would be a great place to start).
    • Acquired risk factors:
      • Pregnancy or recent delivery within 6 weeks
      • Congestive heart failure, pneumonia, chronic obstructive lung disease.
      • Leg varicosities
      • Obesity (body mass index > 30 kg/m2)
      • Tall (> 185 cm or 73 inches) or short (< 165 cm or 65 inches) stature.
      • Prior DVT with ongoing risks
      • Age: Older age, with increasing risk after age 40.
  2. Prevention:
    • Moving around during flight is clearly a good idea. Walking around the plane, flexing leg muscles, etc. all seems to help.
    • A related concern is that sleep through the flights for long periods, especially when upright, may be a risk. Some suggest we should only nap on flights and not use alcohol or sleep medications to encourage sleep. Leave the sleeping for a bed after arrival.
    • Hydration does NOT seem to matter, other than perhaps indirectly by increasing frequency of trips to the WC. But there is no evidence of dehydration being a causal factor to DVTs. Everyone recommends it but there is no evidence that it helps for DVTs.
    • Similarly, Aspirin is not recommended as it is not effective for the prevention of venous thrombosis.
    • Compression stockings (below the knee, 20-40 mm Hg) are NOT indicated for general use, but seem to be effective. Again, unless there is risk, there is no indication for their general use, certainly not for flights of less than 3 hours. The selection of these is bewildering but this site is recommended by some, here is another.
    • Prophylactic medications: this one is controversial and should only happen after consulting with your physician. The good news is that modern anti-coagulants like Xarelto (Rivaroxaban) exist and are easy to take. Most other approaches involve injections (Enoxaparin (Lovenox)) or ramp up over a week and careful control through blood tests (Warfarin (Coumadin)). But this really is not a place for self-medication!

So what is my bottom line? I am at elevated risk because of previous DVT and PE and I am going to take Xarelto before any long (> 3 hours) flights. I am going to make a point to get up from my seat more often and to exercise my legs during the flight. My previous risk factors were age (a depressingly recurring theme) and some small, previous varicosities. This is not much risk in the overall scheme of things but clearly enough. My DVT came on a flight to Glasgow, Scotland via Minneapolis and Amsterdam and I was upgraded to first class on the first two legs, slept for a few hours. DVTs are not restricted to coach class. In the subsequent ultrasound scan of my legs, there was evidence of a previous DVT in the other leg.

Miscelaneous Travel Tips

Travel Products

University of Utah travel sites


Last modified: Sat May 5 12:58:00 MDT 2018