Improve circulation during travel: Jun'13

Denise Dallender works in our Dedicated Nurse team. Here she answered your questions about travel and looking after the heart.

Chris asked: Hi, In early July I'm travelling to America, so looking at an 8hour+ flight. I'm a bit apprehensive about this, is there anything I can do before to prepare me in terms of circulation avoiding DVT etc (I'm 56 and not in the best of shape)? Thanks

Denise Dallender, Dedicated Nurse Team answered:  Hi, there are quite a few things you can do to prepare for your holiday to avoid problems particularly with long haul flights. My first suggestion would be to talk through any potential problems with your GP - it would be wise to resolve any urgent health issues if possible (although I appreciate time is limited), then discuss your medication and how your circulation may be affected by your flight. If any changes to your medication are needed then now is the time to discuss this with your GP, especially with potential jet lag and changes in time zones that may affect your usual routine. Compressions stockings can be used for the flight (if you've had surgery then you'll know about these - they're very fetching in white stretchy material - you do have to be measured for them beforehand). Walking and stretching exercises are very useful to get the blood flow going in your calves. There are quite a few exercises on the internet, e.g. stretching your toes outwards and inwards (you can really feel your calf muscles working). When you're on the plane you can tap your feet or lift your heels to get your calf muscles working and increase blood flow, plus walk around at least every hour. Moving your position in the seat is also helpful and not crossing your legs. If you get a chance to book your seat then you may be able to have extra leg room or sit next to the aisle which is helpful if you're long legged. In the days efore you travel try not to start any strenous exercise if it's not part of your usual routine as it will leave you aching and uncomfortable for the flight. The same goes with clothing for the flight, anything restrictive could cause circulation problems. I hope this answers your question - I hope the flight is pleasant and enjoy your holiday!

Chris commented: Thanks a lot Denise, this is really helpful. I'll make sure I take your tips on board (if you forgive the pun)

Heather asked: I've heard that taking an aspirin before a long-haul flight can be beneficial for your heart - is this true?

Denise Dallender, Dedicated Nurse Team answered: Hi Heather. I've heard this too but I would only consider taking it on your GP's advice. If you are currently taking medication Aspirin may not work well with it and could cause you problems - your GP will know if it is safe to take.

Andy_M asked: Could you recommend any light exercises to improve your circulation when you're travelling obviously taking into consideration limited space and places to move

Denise Dallender, Dedicated Nurse Team answered: Hi Andy, I appreciate what you mean about the limited spaces! The best exercises for circulation are those that get your calf muscles working - if you tap your feet/raise your heels, you will work your calf muscles. You can try lifting your toes then heels (holding for 30 seconds in between each) - multiples of three every 1-2 hours. Same with ankle roations, lifting your knees upwards and holding for a few seconds, stretching your toes in and out. This can be done easily in a limited space. Walking around will obviously help - if you keep well hydrated (which is advisable during any flight) you will probably need to use the bathroom more regularly and this will encourage you to get out of your seat more often! Moving around in your seat and not crossing your legs is helpful. Part of the problem (other than immobility) is having your feet flat on the floor for a considerable time, so moving your position and subsequently your feet helps blood flow.

Anonymous116 asked: Are there any illnesses that could reduce your circulation while travelling long-haul and should you be taking extra measures to increase your circulation if so?

Denise Dallender, Dedicated Nurse Team answered: Hello. There are conditions that could be affected by long haul travel; I'm presuming you are referring to air travel rather than long drives etc. It's such a broad subject that I would encourage you to discuss any concerns with your GP first and ask for advice regarding the level of exercise you should be aiming for during the flight and afterwards whilst away from home. Flying does contain you in a low pressure environment which may have an effect on any respiratory conditions and, therefore, cardiac conditions so it's always best to check first with your GP who knows you/your conditions and can give the appropriate individual advice.

Ianto asked: Obviously air travel is the main concern in terms of DVT but is there additional advice for people travelling on coach holidays or long distance by car?

Denise Dallender, Dedicated Nurse Team answered: Hi Ianto. I'm glad you brought this up because it's often overlooked. We don't think of getting in a car for a few hours as being something that can potentially affect our circulation and cause DVT. It's thought that sitting in a car for 4 hours or more can lead to DVT, so, as with flying, I would suggest the same exercises (please see my previous answer to Andy). You can also use compression stockings for the journey. The best thing to do is stop regularly and walk for a short period. This will be good for your general wellbeing as it will help clear your head from driving and help with any drowsiness your may experience. If you are driving on motorways in the UK, there are plenty of places to stop which can be planned in advance, - I recently saw a group of garden centres (found along most of the major UK motorways) that have pleasant green areas to walk and sit (you can take your dogs) plus they offer the usual facitlites. If you're on a coach you won't have the same flexibility but please discuss how often you will be stopping with the holiday/coach company before you travel. These companies are very aware of the importance of your health on long journeys and will be happy to offer advice. As most coaches have bathrooms nowadays, a walk from your seat and back again will help. As you are likely to be holidaying with the people on the coach you could stop off and have a conversation with your travelling companions which will break the ice and help you keep your circulation healthy.

Fiona asked: When I go on sun holidays I like to lie on sun loungers for a few hours at a time - should I be worried about circulation?

Denise Dallender, Dedicated Nurse Team answered: Hi Fiona. Please enjoy the sun and enjoy lying on a sun lounger as long as you aren't over exposing yourself to too much sunlight. You're right to bring this up though as any long period of immobility is not great for your circulation. Usually, when sun lounging, we do move around maybe to get a drink, putting on lotion, reading a book, fiddling with our music devices/players etc. This may be enough to keep our circulation going. If you fall asleep then you will move around naturally (as you would at night) which is enough for your circulation. I would suggest making sure that you get up off the sun lounger at least every hour if you are likely to be very still. Please continue to enjoy the sun but do take care of your skin and over exposure!


If you missed our live chat and have any further questions relating to the heart and travelling, then why not ask our panel of experts a question?

Tim.Gomez asked: I am a very fit athlete, regularly training between 10-20hrs a week, Because of this cardio work I have now been diagnosed with a Dysmorphic heart (Enlarged) my resting HR is around 35-50bpm, is this cause for concern when I'm flying?

Denise Dallender, Dedicated Nurse Team answered: Hi Tim. Thanks for your question. I'm sorry to hear your new diagnosis. Would you mind letting me know a little bit more about your symptoms and the extent of your condition? I will then try to answer your query.

Tim.Gomez commented: The excessive exercise has increased my heart size, resulting in a higher blood pressure than expected and a very low heart rate. I have been advised that when I stop racing it should return to a normal size over time. It is certainly not severe as I have no measureable cholesterol and is reverseable. I have yet to look too much into it as the doctors are not particularly concerned about it.

Denise Dallender, Dedicated Nurse Team answered: Hi again Tim, i'm glad to hear that they're not concerned about the changes to your heart and that you've had it checked out to continue your racing. It's certainly not unusual for exceptionally fit people to have a lower than normal resting heart rate but with hypertension I can understand why you would be concerned. Again I would encourage you to discuss the effect of flying with your GP first. People do fly safely with all sorts of heart conditions, but checking your own condition with your health professional first is the most important step. Good luck with the racing and keeping healthy.

Nick1 asked: Is there any risk of long haul flying for a person who may have an irregular heart beat or mumur?

Denise Dallender, Dedicated Nurse Team answered: Hi Nick1. There are different types of murmurs and irregular heart rhythms, so I would encourage you to check with your GP before flying to ensure that you are given the right advice for your condition.

AXA PPP healthcare asked: We've just had a question come through from Michael on Facebook:

"I would like to go skiing, but have had persistent hard problems. I will obviously consult with my GP before the go ahead, but can I do even to help improve my circulation when exposed to lower temperatures?"

Denise Dallender, Dedicated Nurse Team answered: Hi Michael. Thanks for your question. Extremes of hot and cold can have a significant effect on your circulation and you're right to be aware of potential problems. After taking advice from your GP (which you're doing), you can obtain further information about the temperatures of the area that you're visiting via the travel company, the hotel, the country's own web information and forums/chats on the internet. Once you know the extremes of temperature for the time of year you're planning to visit you can also watch out for weather warnings and dips in temperature that may cause problems. Local knowledge is invaluable when you're actually there. It's always good to keep yourself warm by adding layers of clothing which can be removed in response to temperature changes. There is specialised clothing for low temperatures - it can be expensive but highly suitable for winter activities. Do wear a scarf, gloves and hat, the scarf can be used across your nose to keep warmer and avoid getting wet as you will lose more body heat. Do keep your hands and feet moving which will help blood flow and reduce the loss of body heat. Avoid strenuous activities if you are unsure you are fit enough to do them (your GP will help you understand your limits if you're not sure). Avoid alcohol when out in the cold. I would also check the stages of hypothermia (it stars with shivering) so that you are aware that it may be starting. I hope this helps and enjoy your holiday!

AXA PPP healthcare: The live chat has now finished. Thank you for all joining us and your brilliant questions.

Also thank you to Denise and her great answers. We hope they have helped and enjoy your Summer travels.


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