PSA: A travel risk that impacted us. "Economy Class Syndrome"

Today, I'm writing for fellow travelers who might not be aware of the travel-related risks of blood clots, deep vein thrombosis, pulmonary embolisms, and a colloquial condition called "Economy Class Syndrome."

Context: While my wife, Priya Saiprasad , was touring Australia and Singapore for her new fund, an unexpected medical emergency unfolded. She was rushed to the ER in Singapore due to worsening shortness of breath, high heart rate, and lightheadedness. After four doctors examined her and multiple scans later, they concluded that she had a perfect storm of "economy class syndrome" and needed several days of life-saving treatment in the ICU.

This came as a huge surprise for Priya and me. Back at home, she had consulted a specialist about the risks of traveling and even brought them advice from doctor friends about the risk of blood clots. The specialist assured her that it was safe to travel.

Now, we've learned that it was quite the opposite. Being in a knee brace and confined to an economy class seat for 15 hours was a recipe for deep vein thrombosis (DVT; a 2-ft blood clot formed in her leg) and a pulmonary embolism (the blood clot moving up through the heart and blocking her lungs). This led to higher blood pressure, an increased heart rate, and an enlarged heart to compensate.

Latest Update: With the administration of blood thinners, she is now better and discharged from the hospital after a week. Luckily the least invasive option (blood thinners) is yielding positive results.

Initially her options were:

1. Open heart surgery. Remove the clot in an emergency life saving procedure. Last-minute option
2. Flush her circulation with a clot busting drug (thrombolytic; drano for circulation; 90% effective but bad complications including bleeding in the brain)
3. Inserting a tube through her main vein to the clot and then sucking out the clot (suction thrombectomy)
4. Strongest blood thinners available

Reality Check: Blood clots are normal; our bodies are in a constant state of creating clots and breaking them down. Our lungs excel at this process. Hospitalization becomes necessary when clots reach a certain size, location, and cause significant blockage.

Recommendation: This is information we wish we had known earlier, and we hope it can benefit you as well. There are numerous reliable sources available for learning more about this risk and how to prevent/manage it.

Useful table for later:

Risk Categories for Economy Class Syndrome

Low:

• Age over 40 years
• Obesity
• Inflammatory disease
• Recent minor surgery (within three days)

Moderate:

• Varicose veins
• Decompensated heart failure
• Recent acute myocardial infarction (within six weeks)
• Hormone therapy (including contraceptives)
• Pregnancy or the postpartum period
• Lower limb hemiparesis
• Lower limb trauma (within six weeks)

High:

• Previous venous thromboembolism
• Known thrombophilia
• Recent major surgery (within six weeks)
• Prior stroke
• Cancer
• Family history of venous thromboembolism.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693389/

Useful info and video here: https://www.nhlbi.nih.gov/health/venous-thromboembolism