| 1. Allow extra time at airports and use porter services to avoid anxiety and stress of hurried departures, transfers, and long walks with baggage. |
| 2. Preboard if extra time or assistance is needed. |
| 3. Carry on sufficient supply of medications for entire trip. Bring a fresh supply of sublingual nitroglycerin if applicable. Carry medications in carry-on baggage. |
| 4. Bring a list of medications and prescriptions, kept separately from the medications themselves. |
| 5. Take medications on schedule or adjust drug regimen when travel requires crossing multiple time zones. |
| 6. Carry a copy of most recent electrocardiogram (ECG), with and without pacemaker activation, and a pacemaker or defibrillator card, if applicable. |
| 7. Request special meals (low salt, low cholesterol). |
| 8. Avoid placing baggage in the space under the seat in front if that reduces the ability to move the legs. Flying first class or better designed aircrafts seats are considerations. |
| 9. Exercise legs at regular intervals while seated to improve venous flow, eg, strong alternating stretching and flexing of the feet. |
| 10. Change position frequently and do not sleep in cramped position. |
| 11. Walk in cabin aisle every hour. |
| 12. Avoid hypnotic drugs, because veins can be damaged by unrecognized compression. Sleep also promotes muscular relaxation, which can lead to stasis. |
| 13. Drink adequate fluids before and during the flight. Alcohol should be avoided on long trips due to diuretic and vasodilating effects. |
| 14. Consider elastic support stocking in patients with mild deep vein thromboembolism (DVT) risk. |
| 15. Consider pharmacologic prophylaxis before boarding in patients with moderate DVT risk. |
| 16. Consider full oral anticoagulation or low molecular weight heparin in patients with high DVT risk. |
| 17. Consider purchasing medical evacuation insurance if health insurance does not cover medical evacuation. |
| 18. Carry a letter from caregiver(s) explaining condition, medications, allergies, and devices (such as pacemaker or implantable cardioverter defibrillator). |
