Economy class syndrome

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Editor, – There has recently been a multitude of communications in the media describing 'economy class' syndrome. I believe it is important to know that this disease is not exclusive and can also occur in upper class travellers. They also need prophylactic measures. Here is a brief case history:

A 72-year-old man in good health and without varicose veins flew business class to Sicily. He had a one hour stop in Bangkok and two hours in Rome. On descending in Rome, he felt a 'discomfort in his foot'. Some two days later, a Sicilian doctor diagnosed a deep vein thrombosis. The patient was given daily injections in his 'abdomen' for two weeks to 'thin the blood'. His symptoms soon subsided and on his return to Sydney two months later, no clinical signs remained and sonogram showed free venous flow in the leg.

This case history has justified my policy of handing my patients a small article on the venous circulation and thrombosis before their trip. I advise on hydration and mobilisation of legs, suggest anti-embolism stockings, particularly for women on oral contraceptives and/or hormone replacement therapy, and prescribe low-dose aspirin for two day before and a day after the trip.

George Weisz
Orthopaedic Surgeon
Bondi Junction, NSW