DVT and blood thinning

Discussion in 'Open Discussion' started by Kymbo, Aug 31, 2007.

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  1. Kymbo

    Kymbo Newbie

    Aug 31, 2007
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    Hi,
    I'll be travelling to Europe in the next four weeks and was told by a doctor that I had 'sticky' blood and if I was ever to take a long haul flight I should take aspro's to remedy this.
    What is your reccommendation?
    Cheers,
    Kymbo
     

  2. NM

    NM
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    Aug 27, 2004
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    My recommendation is to follow the advice provided by a qualified medical professional and not frequent flyers (except perhaps those few AFF members who are also qualified medical professionals). And if you are not satisfied with the advice from you qualified medical professions, seek a second opinion from another qualified medical professional.
     
  3. smithym

    smithym Intern

    Jun 3, 2006
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    Go back and see your GP. 'Sticky Blood' is a fairly generic term and there are allot of underlying causes that may potentially cause clots. There are also a lot treatment regimes that target those specific underlying causes. It is not as simple as taking a simple aspirin for the week leading up to your flight as this might not target the cause of your 'sticky blood'. I wouldn't recommend 'just risking it' as it is very easy for your GP to manage before you commence your travels.
     
  4. drron

    drron Enthusiast

    Jul 4, 2002
    17,721
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    Sunshine Coast
    Great advice.Sticky blood may have been a throwaway line or meaning you have a potentially serious inherited clotting problem.You need to know exactly what he meant.Certainly aspirin may be of some help but some problems need a blood thinning injection prior to flying.
    Also do not forget to get up and walk around,move your legs and contract your calf muscles whilst seated as well as keeping well hydrated-water not ETOH.
    Up here on the Sunshine Coast DVT's were known as Victorian pensioners disease well before economy class syndrome was thought of.This is because they would hop in their cars and drive straight through to sunny Qld. at the first sign of winter.
    So get to your local doc and find out just what he meant.
    .
     
  5. rhjames

    rhjames Member

    Jun 5, 2006
    353
    15
    Sydney
    I've had a suspected DVT after a long haul flight. I sat with my seat upright beacause that was the only position that allowed me to breath deeply enough to get enough oxygen. Very unpleasant. By way of background, I'm a martial arts instructor, very fit, only travel business class on long haul, and have always used an isle seat so I can regularly get up and exercise. I was therefore surprised that I copped a DVT. My blood showed no indications of abnormal coagulation. Anyway, I recovered ok, but don't plan to ever risk it happening again. Following this, I did a lot of research on the subject. I'm happy to share all this, but won't go into it all here, unless anyone asks.

    I fully support the advice of following a doctor's suggestion, but in talking to others, I've found that some GPs don't have that much experience with this, particularly outside Australia. (We probably do more long haul flights from here).

    There is medication you can use. Aspirin is a mild anticoagulant, and in my opinion is a good idea and sufficient for the average person doing long haul. I'd follow the same directions as for headache. You can get better pills on prescription. Personally, because of my one incidence, I take either a pill provided by my doctor (Iscover), or give myself a clexane injection (very simple). I've done many problem free long hauls since.

    So my recommendation is :

    1. If you have no history of problems, take aspirin as your doctor suggested, and do lots of exercise on the flight, particularly legs and feet.

    2. If you have any related history, talk to your doctor about clexane or an equivalent pill (some people don't like sticking needles into themselves - no big deal after the first one)

    3. Try to get an isle seat, so you can stand up easily and regularly.

    4. Don't take a sleeping pill on the flight. Preferably, take one at your destination at about 10pm if needed. or if you wake up before 1am.

    5. Go easy on the alcohol - lots of water.
     
  6. rhjames

    rhjames Member

    Jun 5, 2006
    353
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    I've just re-read your post - forgot that your doctory said you had "sticky" blood. Stupid term. Doctors think we're all idiots. As others have mentioned, it usually means your blood has a tendency to coagulate faster than normal. It sounds like you have a condition or history that should be treated as significant. I would therefore follow up with talking to a doctor about something better than aspirin (see my earlier post). If your GP isn't clued up on DVT and flying, ask him to refer you to one that is. In your case, aspirin may be enough - depends on why the doctor said you have "sticky" blood.
     
  7. Get a referral to a haematologist and get the issue sorted out by a specialist, who will be able to be more precise than "sticky blood", and give you advice based on the most up-to-date evidence and guidelines.
     
  8. Hawkeye

    Hawkeye Member

    Nov 4, 2006
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    BNE
    As a physician, can I echo the sentiments expressed above - you need formal consultation with a medical specialist.

    The risk of veno thromboembolic disease with long-haul air flights is poorly defined in the literature, and the necessary precautions will be influenced strongly by your underlying pro-coagulant disorder (if you indeed have one). The choice between anti-platelet therapy (i.e. aspirin), formal anticoagulation (e.g. clexane injections) and compression stockings is a prudent assessment of relative risks v benefits for your situation.

    There are more far-reaching implications of "sticky blood" that also need to be discussed with you e.g. risks during future surgical procedures, life-time risk of spontaneous thrombosis, and genetic counselling (as most of these disorders are familial rather than acquired).

    Not all doctors treat all patients like idiots - if you are unhappy with your current medical care, seek an alternative opinion.
     
  9. rhjames

    rhjames Member

    Jun 5, 2006
    353
    15
    Sydney
    I fully agree - I was probably over generalising with my comment on this. Luckily I have two GP that I use who explain things at a technical level that I can understand. Some assume that you wouldn't understand, and tell very little, or something over simplified.

    Below is some information on what to look out for, based on my experience. Note that I have no medical training, but have been through it. Hawkeye and others may like to add more, or correct me, with better authority than me.

    DVT is caused by relative stagnant blood in the leg veins coagulating/clotting. This can lead to local discomfort, swelling, or no symptons. If the clot breaks loose, the next stop is the lungs (pulmonary embolism). The veins branch into multiple smaller veins as they spread through the lungs. If a major branch gets blocked, it severely limits the ability to transfer oxygen between the lungs and the blood. It may also result in permanent lung damage, or death. If a small area is blocked, it may cause discomfort, and temporary lung damage.

    Symptoms are chest pain (fairly low), sensation of fever, nausea. Possible difficulty in breathing deeply enough to get sufficient air (due to pain).

    If you have these symptons on a flight, don't hesitate to ask for oxygen if needed (note that pressing the button to call someone usually has no effect). Get checked ASAP by a doctor or hospital - I suggest hospital emergency, as they have the facilities available, and your GP may send you there anyway. This can be fatal, result in permanent lung damage, or may have no long term effect. There is a test caller D-dimer. This will indicate if there has been a recent blood clot. It can also be backed up with ultrasound on the legs, and lung scan.

    Treatment normally involves daily injections of clexane (or similar) for a few days, with simultaneous warfarin (or similar) tablets until the warfarin is effective. Regular blood checks (INR) are then needed (weekly to monthly depending on circumstances) to monitor the warfarin dose. This will continue for a few months. Every time you cut yourself, it takes forever to stop the bleeding. There is an increased risk of complications from internal bleeding (I don't think this is too high).

    Overall, it's a big nuisance, particularly if you die, and if some medication can help avoid it, I'm all for it.
     
  10. yo yo ma

    yo yo ma Active Member

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  11. kingpiemaker

    kingpiemaker Newbie

    Sep 28, 2007
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    0
    Yes I got it and it doesn't have to be long haul!!

    On a flight back from Bali to Syd, I managed to score the whole middle row of four and lie down and snooze the whole flight. The trouble is I like to cross my ankles when I'm sitting or sleeping like that.

    A couple of days later my leg swelled up all the way to my feet and was painful for about a week. Being a typical bloke I didn't go to see a Gp and having only flown from Bali, DVT was not even on my mind as I was pretty fit and only 78Kg.

    The swelling disappeared and all was well for a couple of months, when I noticed that I was becoming very short of breath with only small efforts.
    I visited the doctor In Cooma and he did what was about the equivelant of a Pilot medical and basically gave me a clean bill of health.

    That weekend I went waterskiing and nearly drowned as I couldn't swim the few metres to shore.

    I saw another GP a couple of days later and after an ECG, he said I was having right sided heart attacks and sent me off for a CT scan.
    This Doctor came out with the exrays in his hand and said "stay there, do not move until you are in an ambulance."

    I went straight to Pambula hospital with oxygen at 63 and BP at 66/47. The sister said that they were the lowest figures she had seen on anyone still allive!

    I had massive pulmonary embolisms.
    Straight to Canberra H for two weeks of several blood samples every day, wafarin for 18 months and kidney failure.

    Take it seriously. It can happen to you. Now I have to have an injection every time I fly.
     
  12. rhjames

    rhjames Member

    Jun 5, 2006
    353
    15
    Sydney
    That's pretty extreme. I suspect that your blood may have an inherited clotting problem. Did you have this tested? As I understand it, this may not relate to physical fitness etc. As you said, it may happen to anyone. In my case, there was no problem detected with my blood.
     
  13. MelUser

    MelUser Established Member

    Aug 6, 2007
    1,677
    110
    Melbourne
    This is a serious issue.

    A friend of mine (31) died 2 years ago from a blood clot which he received on a UA flight - New York-LAX-SYD-MEL.

    He normally travelled business class but on this occasion was in economy as didn't quite have enough points to upgrade.

    He died suddenly about two weeks after returning to MEL. It was very sad and a real shock.

    Only advice is that if you have leg or chest pains or shortness of breath after a flight see a GP immediately. Also, a clot can take some time to develop - ie don't assume that if you are OK 2 days after a flight that all is well - it can take a while to develop.
     
  14. rhjames

    rhjames Member

    Jun 5, 2006
    353
    15
    Sydney
    I can't help believing that there is an effect from being in an airplane, other than inactivity. eg reduced air pressure. From what I've read, this isn't scientifically supported, but I'm not so sure. Does anyone have any ideas on this?
     
  15. jasonja3

    jasonja3 Member

    Sep 12, 2005
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    SYD
    Did your kidneys recover?
     
  16. straitman

    Moderator

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    Did you look at the link in post #10 above :?:

    There is a lot more to it than just blaming airline travel. The problem can come from ANY travel where you have been inactive for a long period of time & some individuals are more prone than others.
     
  17. straitman

    Moderator

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    Kymbo and kingpiemaker,

    Welcome to AFF all be it a little late. :oops: :cool: :shock:
     
  18. rhjames

    rhjames Member

    Jun 5, 2006
    353
    15
    Sydney
    From what I've seen, the occurrance after airline travel seems higher than other situations - eg people who live in wheel chairs due to things like paraplegia don't seem to have the same degree of risk, even though the activity level is much less.
     
  19. straitman

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    I did have a copy of a medical study (can't find it just at the moment) and it actually leant away from airline travel as being any worse than any other means of getting around.
     
  20. rhjames

    rhjames Member

    Jun 5, 2006
    353
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    Sydney
    Please let me know if you find it. I'm not sure that there has been enough research in this area.
     
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