Flying after surgery

So before I ruptured my Achilles, I had plans to take a 3-hour flight on March 20. But when I asked my surgeon, he recommended waiting a couple of months after surgery before flying. This is in part because he thought it would be difficult to navigate airport security and a cramped airplane while non-weight bearing (he takes the conservative route). But it is also due to the elevated risk of blood clots and DVT while flying.

Has anyone else received similar advice? My surgery was on March 2, so the flight would be less than three weeks post-op. I certainly don’t want to risk DVT, but it seems as if my surgeon is being extremely cautious about this. I have read that others have flown within a few weeks after surgery, and it seems like precautions could be taken to prevent clotting. Thoughts?

15 Responses to “Flying after surgery”

  1. Some airlines have a no fly policy with leg casts for this reason. I remember a while back someone getting his cast off and into a boot in order to fly. Yes there are drugs to prevent clots and they can be prescribed by another doctor like your GP. Managing the airport should be easy as many now have wheelchairs and you can book them in advance. My concern would be the length of the flight and much better if you have someone going with you to assist but certainly would not do it without anti-clotting drugs. It really comes down to the risks and whether you are prepared to take them. I would not rely on simply on others have done it so it should be OK.

  2. achillias- Your comment is getting me nervous…..

    I actually got injured 2-1/2 weeks ago while away in Florida for the winter. I had surgery 1-1/2 weeks ago. All along I told my surgeon that I was scheduled to fly back to NJ on 3/13 ( which is Friday), which is only about two weeks post surgery.

    Initially, he thought it might be early to go home (though not sure why). However, when I was there last week and 1 week post op- he thought my incision looked really good and he said as long as everything looks good this week when he takes out stitches I can fly back as planned. This is a 2-1/2 hour flight.

    I am 51 female and they did not treat me for blood clot risk factors at any point during the surgery or recovery ( though I see others are treated with asprin or some other method post surgery).

    I had asked about blood clot risk prior to my surgery and they said because I am only in a 1/2 knee cast and I can be mobile on my knee scooter and wiggle my toes- I guess they really didn’t see that as a real risk factor.

    Now I am curious about others and flying so soon after surgery. I can change my plans if I need to, but my doctor never brought up blood clot risk and I think it more had to do with the incision and infection than blood clots.

  3. I just called the airline - United and they do not have any policy about leg casts, so I am OK to fly from their perspective. I am also in the non weight bearing phase so it is going to be challenging. Also, the airline reserved a wheel chair for me when I arrive at airport. I do have a travel companion, so I will have help. However, I am also traveling with my cat which will be a lot to juggle. I asked about reserving a seat with extra leg room- and they said that I needed to handle that when I arrive at the airport. I will ask my doctor about the blood clot risk when I see him Thursday and see if he wants to prescribe something for me.

  4. LindaF, I’m sorry for making you nervous. Like I said, I kind of think my doctor is being overly cautious and conservative about this. From what I have read, two weeks is the general guideline, and the risk is highest on long international flights. It sounds like you will be fine, especially if you move around and stay hydrated during the flight. I wish I hadn’t cancelled my travel plans already!

  5. I agree with Stuart not only for this question but for a lot of the information you find on this site…I wouldn’t do it just because others have.

    May I suggest to both of you to call your general practitioner to get another opinion? The doctor that cares for you regularly that really knows you and your health. That way you’ll feel better going or know to change your plans.

    If you google “flying after surgery” you’ll get lots of information. From what I read it is OK after two weeks. It does seem mainly to do with blood clots. There are things you can do to lessen your chance of a blood clot such as compression socks and asprin.

    Getting over the worry may be the first step in answering the question both of you have; “should I fly so soon after surgery?”

  6. My Dr. told me even before I had surgery that I should take 1 aspirin every day. That’s the only thing he said I should take other than pain meds if I need them. I know of other Drs. That recommend the same. I am seeing my Dr. tomorrow and will ask him what he thinks about flying soon after surgery.

  7. To clarify, My Dr. suggested 1 aspirin every day after surgery till further notice.

  8. Yes Andy…I think the way doctors deal with the possibility of DVT and ATR surgery is as individual as protocols. I had to self administer one shot a day in my stomach of Lovenox for three weeks (21days) because of blood clot concerns. My Doctor was pretty adamant about it and his reasoning was sound to me at the time. I also had to wear a compression sock for three weeks on the unaffected leg.

  9. Like donna, I also had to self inject every day with a blood thinner (clexane) although I had to do for 7 weeks my leg was in a cast.

    I was also told to keep wearinh the surgery compression socks for 2 weeks after the operation.

  10. I asked my doctor about flying after surgery and he said his only concern was me not being able to elevate my foot for such a long period of time. Hopefully other than that you’ll be fine. Goodluck!

  11. I did not fly after ATR surgery. But, I flew in a cast and on crutches after an ankle fracture. You can make the logistics work. But, even in my more 20’s, it was EXHAUSTING. If you do it, be sure to get one of those airport carts to drive you around and leave yourself plenty of extra time. I had a layover in Dallas-Fort Worth and that big airport almost did me in! You will also benefit from having as little as possible in terms of baggage. Perhaps you can ship things via FedEx to your final destination so that you can travel with just a back pack.

  12. Hi Achillias,

    here is what i found out when i did my research. Im flying in 3 weeks for 9 hours. I will be 11 weeks post op at that time. Will you be in a cast still or in a boot?

    Long-Distance Travel and How it Relates to Clotting and DVT

    Although it is very rare for a patient to develop DVT from a long flight, Dr. Bass explains that the following factors may contribute to blood clot formation:

    When flying, passengers are normally sedentary and immobilized. This is a problem because it is the contraction of muscles in the legs, normally caused by motion and movement, that allows blood to circulate back to the heart. When the body is immobilized, blood pools in the legs, and this increases the risk of clotting. Additionally, when seated for a lengthy amount of time, the knees remain at a right angle, resulting in a “kink” in the veins of the legs, preventing proper circulation.
    The dryness of the recirculated air on planes can leave its passengers dehydrated. This leads to the blood to become concentrated and more prone to clotting without the proper amount of hydrating fluids.

    Blood Clotting Prevention on Long Flights

    To combat poor circulation on long flights, Dr. Bass recommends standing, stretching, and walking up and down the aisle as frequently as possible to get the blood moving and to “get the kinks out.”
    In addition to exercising, graduated compression stockings are also recommended to help prevent blood pooling in the legs. They can be found at surgical supply stores and pharmacies.
    Prevention of dehydration on flights is as easy as drinking a steady amount of water or other non-alcoholic beverages.

  13. Just wanted to let you know that I flew yesterday- 2 weeks post op in a.cast. When I saw surgeon I inquired about aspirin and after some thought he said it couldn’t hurt so I took 2 night befor and 2 morning of. I had middle seat and was able to prop my cast up on my boyfriends leg who had the aisle seat. I had wheelchair assistance on both ends of flight. Overall it went fine and had no complications or issues. Surgeon said after two weeks blood clots are not likely, but technically could happen at anytime.

  14. I will be 2 weeks post op of ATR. I’m flying with my family to Florida (two 2.5 hour flights with a layover in between. My husband is an orthopedic surgeon and he and my foot/ankle surgeon think it’s fine. I have been taking a baby aspirin daily since surgery and have not needed any pain meds at all during recovery.
    I am to have my first follow up visit 2 days before our flight and will either get a boot or a bivalve cast to ensure no problems with swelling.
    I think traveling for the first 2 weeks should be avoided but if you don’t have any risk factors for DVT you should be fine. I’m fully expecting it to be exhausting but I do not want to deprive my 3 children their spring break vacation!

  15. This is coming from first hand experience, I wouldn’t take the risk. The fracture clinic doctor advised me that I was ok to take a 4 hour flight 3 weeks post Achilles rupture (non surgical healing route), no clot prevention was advised and they had also told me that I didn’t need to continue with Clexane. Less than 2 weeks after I returned, (and after I had been seen by a doctor again at the fracture clinic who failed to pick up on the lack of deterioration in my calf muscle), I suffered a bilateral or saddle pulmonary embolism which almost killed me.

    Please consider the risks and make sure your doctor is on point before you make a decision on flying!

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