The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.
Letter to the Editor
Editor, – I refer to the article 'Flying and thromboembolism' (Aust Prescr 2009;32:148-50) and the patient's perspective on the same topic (Aust Prescr 2009;32:150-1).
I recall with relish the media exposure the 'economy class syndrome' had at the turn of the millennium and the impact this had on the airline industry in terms of seating standards and raising consumer awareness. The article revisited the relevance of both mechanical and chemical prophylaxis in different at-risk groups. However, it failed to address the more controversial issues about practical management of patients with treated venous thromboembolism particularly with advice on mobilisation and flying which was elegantly illustrated by the patient's perspective article.
Even with available research showing the benefits of early mobilisation in deep vein thrombosis with no significant risk in pulmonary embolism, there is still hesitation in the medical community in recommending continuing mobilisation in massive deep vein thrombosis, particularly those proximal to the femoral veins. Practical advice on flying and other activities after deep vein thrombosis should be addressed early in conjunction with patient handouts.
Ms Hannah Baird should be congratulated for her remarkable ability to manage her deep vein thrombosis in spite of the limited support she received. I wonder what would be the outcome if she was neither well-informed nor motivated to take charge of her condition.
Shyan Lii Goh
Dubbo Base Hospital, NSW