Flying After Stroke: How Long to Wait + Tips for Safe Travel

Flying after stroke is a common concern for many stroke survivors. A stroke is a serious medical event often accompanied by many secondary effects. Stroke can lead to changes in physical function, decreased mobility, and fear of experiencing another cerebrovascular event. As a result, stroke survivors may have concerns about air travel in the future and questions about flying after stroke such as:

How long after a stroke can I fly? What medical conditions make flying unsafe? Does flying increase my risk of another stroke, and what happens in the worst-case scenario?

These are all valid questions for anyone hoping to fly after a stroke. Thankfully, there are some general guidelines for stroke survivors interested in flying to ensure safety and increase peace of mind. To help prepare you for safe travel, this article will review these guidelines for flying after a stroke as well as provide helpful tips and tricks to make your journey as stress-free as possible.

Guidelines for Flying After Stroke

Stroke survivors often ask, how soon is it safe to fly after a stroke? According to the Stroke Association, it is best to wait at least two weeks to fly following a stroke. This is because a person is at an increased risk of a second stroke after suffering a TIA (transient ischemic attack) or stroke.

In the event of a second stroke, it is advisable to be close to emergency medical interventions that can reverse the stroke effects, such as the administration of medications like TPA.  Lastly, sometimes new post-stroke medical conditions may arise within a few months of the initial stroke. In this case, it is best to be near your medical providers to receive medical attention if needed.

Every stroke is different, so getting clearance from your doctor before you fly is important. They can determine if you are medically stable enough to participate in air travel. Otherwise, it’s best to remain near home, where medical attention is quickly and easily accessible. If your travel plans are flexible, waiting 1-3 months to travel after a stroke is best.

Risks to Consider Before Flying After Stroke

By understanding the risks of flying after a stroke, you can have an informed discussion with your doctor about when it’s safe to fly again. Here are some complications that can accompany flying after stroke.

Hypercoagulability (Excessive Blood Clotting)

Hypercoagulability is an increased tendency for your blood to form clots.  Flying increases your body’s tendency to form clots. These clots are the cause of ischemic stroke which takes place when an artery in the brain becomes blocked by a blood clot.

The risk of developing a blood clot is increased during and after air travel, according to many research studies. In fact, long flights can elevate clot risk by 26%.

Inactivity in cramped spaces on flights can lead to blood clots developing in the legs. A deep vein thrombosis (DVT) is an example of this and occurs when a blood clot forms in the leg. Small pieces of this clot can also break loose and travel to clog an artery in the lungs, causing a life-threatening condition called pulmonary embolism, or it can travel to the brain, causing a stroke.

Reduced Oxygen Levels

The air pressure is lower on a plane, which means less oxygen is available to fuel your body, including the brain. During stroke recovery, oxygen is critical for recovery (see: oxygen therapy for stroke), so it’s best to avoid sitting in an environment with less oxygen for prolonged periods of time.

Although reduced oxygen levels while flying are unlikely to pose a risk for survivors of stroke, this can be an issue for those with comorbidities such as breathing difficulties or a heart condition. Again, it is best to speak with your doctor to determine if flying is a safe option for you.

Delayed Medical Treatment

If you were to experience a stroke on a plane, the pilot may attempt to make an emergency landing to get you the emergency medical attention you need. Although lives have been saved by emergency landings before, the time it takes for you to receive appropriate treatment may still be prolonged.

Some of the interventions for stroke such as TPA (tissue plasminogen activator) must be administered promptly.  This is why many doctors suggest waiting for a certain period before flying after a stroke.

Overall, the incidence of stroke while flying is low, but it is still important to exercise caution and follow the advice of your medical team. Now that we have reviewed the flying risks, let’s discuss how to make your trip as safe as possible if you decide to fly after stroke.

Tips for Flying After Stroke

Although travel is exciting and creates new opportunities, it can be stressful or overwhelming at times. This may be especially true for survivors of stroke, especially if you’ve experienced changes in mobility or are concerned about the risks of flying.

However, there are many things you can do when flying to help decrease the risk of developing a clot and reduce travel stress. If you have been cleared to fly after stroke, here are some tips to improve your safety and well-being:

• Contact the airline to arrange special assistance (72 hours to one week in advance). This may include vision assistance, hearing assistance, wheelchair service, and mobility and medical device transport. Additionally, airports have assistance points where you can request transportation assistance to help you navigate the airport if your mobility is limited.
• Travel with a companion if possible so that someone can assist you if you need help. This can give you peace of mind when traveling, especially your first time flying after a stroke.
• Get travel insurance so your trip is protected. This can help you avoid issues if your flights or other travel plans need to be refunded or rescheduled. Additionally, medical care abroad can be extremely expensive, so ensure you know how your health coverage will work at your destination.
• Give yourself an extra hour to get through security and walk to your terminal. This ensures you have time to check or transport all necessary baggage and equipment without additional stress. It is also important to allow yourself sufficient time to rest when creating your travel itinerary.
• Keep medication in your carry-on bag so it is easily available. Be sure not to accidentally leave it in your checked bag, as this poses a risk of inaccessible medication if your baggage is lost in transit. Additionally, make sure you bring enough medication to last your entire trip.
• Carry medical documentation and declare medication upon arrival in a new country. Some countries may confiscate undeclared medication, so make sure you know your destination’s specific requirements before leaving.
• Wear compression socks as they are excellent at improving circulation in your legs and preventing blood clots from forming. Be sure your compression socks have adequate compression and are at least knee-high in length.  Compression levels range from 7mmHg to 50 mmHg pressure.  Check your garment and choose a stocking that is closer to 20-30mmHg for the best compression. 
• Walk around as movement helps prevent blood clotting, so when the fasten seatbelt light is off, and it is safe to do so, get up and walk around the cabin. If you cannot walk around due to turbulence or other reasons, perform leg exercises while seated (march in place, extend your knees, pump ankles, etc.)
• Be mindful of what you eat and drink since this can have a direct effect on blood pressure, an important stroke risk factor. Staying hydrated and avoiding excessive salty snacks can help you feel better and avoid elevated blood pressure.

Flying After Stroke: An Overview

Although the risk of a recurrent stroke is a concern for all survivors, flying increases this risk and should be considered carefully, especially in the first 6 months to a year after a stroke. Overall, it’s up to your doctor to decide if and when it is safe for you to fly after a stroke. Everyone has different risk factors and medical complications that may require a greater waiting period before flying.

When you receive medical clearance, make sure you are prepared for travel and are aware of airline and destination guidelines regarding your health status and medications. Take precautions like wearing compression stockings, moving frequently, and allowing for additional time to reach your gate.  These give you peace of mind so you can enjoy your trip.

We hope this article has helped educate you on the risks of flying after a stroke, the importance of consulting your medical team, and different tips to help keep you safe during travel. Your health is the most important factor, so exercise good judgment and enjoy your travels.