When it Comes to Weight Loss: to Fly or Not to Fly?
Every day, people cross the borders into other countries for a myriad of reasons that range from business to pleasure. But, a large portion of them are choosing to do so because of what is called “Medical Tourism,” which is defined as traveling to another country specifically seeking medical care. From lower costs to fewer restrictions—and even getting to take a vacation while you recover—there are a number of reasons why the idea sounds appealing. But, the old adage “you get what you pay for” definitely plays its part here and, regardless of the reasons, the real question remains: is cheaper better when it comes to medical care?
For weight-loss treatment, including bariatric surgery, when a person is considering traveling long distances for treatment there are multiple things they need to consider, including the pre-operative and post-operative requirements. In 2012, the American College of Chest Physicians released a report that states virtually all bariatric surgery patients are at least at a moderate risk of venous thromboembolism (VTE), with many patients being at a high risk for VTE complications. VTE, which affects up to 600,000 Americans each year and is the third leading vascular diagnosis after heart attack and stroke, refers to a blood clot that starts in a vein and can lead to additional required surgeries and, at worst, death.
There are many factors that can place patients into a higher risk category for VTE following bariatric surgery, such as congestive heart failure, shortness of breath at rest, a body mass index greater than 50 or other weight loss procedures beyond an adjustable gastric band. Research has shown that 70% of VTE events occurred after a patient is discharged, with the greatest risk being within the first 30 days.
Additionally, following surgery, when you combine already being at a moderate risk with a thinning of air and reduction of oxygen at higher altitudes, being less mobile in the previous days due to having anesthesia and post-surgery pain, as well as being immobile on a plane and not being adequately hydrated due to the decreased size of the new stomach, you have a perfect breeding ground for a potential VTE. The decreased walking leads to the blood collecting in the lower extremities, resulting in a clot in the leg which could potentially travel to the heart and/or lung, commonly referred to as a pulmonary embolism (PE), and could potentially be fatal. A PE is still the most common cause of mortality after weight-loss surgery.
The Centers for Disease Control and Prevention (CDC) states that people may increase the likelihood of a VTE when they accompany long-distance travel with one or more of the following risks:
- Older age (risk increases after age 40)
- Obesity (body mass index [BMI] greater than 30kg/m2)
- Recent surgery or injury (within 3 months)
- Use of estrogen-containing contraceptives (for example, birth control pills, rings, patches)
- Hormone replacement therapy (medical treatment in which hormones are given to reduce the effects of menopause)
- Pregnancy and the postpartum period (up to 3 months after childbirth)
- Previous blood clot or a family history of blood clots
- Active cancer or recent cancer treatment
- Limited mobility (for example, a leg cast)
- Catheter placed in a large vein
- Varicose veins
VTE is one of the main reasons that, as a patient of the bariatric program at Lafayette General Medical Center, we recommend post-operative travel not be greater than two hours by car and advise against flying for 30 days after surgery. The safety of our patients is our number one priority and, while we may not be able to give you scenic beaches to relax on while you recover, our accredited experts do everything they can to ensure your eventual getaway isn’t ruined by post-operative complications, including VTE.