glc20

Thanks everyone for the discussion. I have gotten medical advice, soooo much, since this happened and am cleared by the docs. My first flight since DVT is Monday and I'm just a little anxious. It's great to hear of others who have resumed some flying, looking to bolster my confidence. I always did the water, moving thing so will keep it up and even more.

BTW-broke ankle hiking, turns out there are many genetic and other clotting factors that influence clots.

thanks again

oldpenny16

Travel well!

Katja

Best of luck!

natalie78

Whilst I am really sad to hear of your situation, it has been proven that the pressurised environment in an airplane can cause blood oxygen to drop - that coupled with the immobility can cause blood clots. I was recently diagnosed with a PE and a DVT, it almost killed me - and guess what? A week before I'd been on a 7 hour flight. This is no joke - 2 years ago, the same thing happened to my dad after a flight - he had a DVT. It isn't the mobility alone - but the flight itself that can cause a DVT - some people are predisposed to blood clots but a friend's daughter who was 24 died of a PE a week after returning from Australia. These are not coincedences. I am happy to be alive and take flying very seriously now - listen to the advice such as leg exercises, abstaining from alcohol and wearing stockings if you can. It is a totally different atmosphere and environment up in the air, totally different than being on the ground.

Pat89339

Welcome to FlyerTalk natalie78!

I recently was hospitalized for DVT. The doctors can't say really what caused it. I also was diagnosed with pulmonary hypertension and the physicians were amazed that I could function with my O2 levels in the 70s. What you are saying about blood oxygen dropping in flight makes a great deal of sense to me. For the past couple of years I would always feel terrible the day following a flight (I'm a 1k on UA so that's a lot of time in the air). I'd have horrific headaches and generally just felt crummy for at least 24 hours. I also started to sleep on planes when I never had been able to before. My doc told me that wasn't sleep that I was passing out. I am lucky to be alive.

I had none of the symptoms of DVT. I never experienced pain in the leg.

My first flight is next week, but since I have to fly with O2 that should take care of things. I can't wear the stockings until the clot is resolved. I'm also on coumadin.

I have to say that I am terribly frustrated with United. All other legacy carriers allow the use of portable oxygen concentrators on their flights. United has yet to comply with the federal mandate, but they say they will by the time it is required on May 13, 2009. Isn't that special! In the meantime they charge $125 per segment for in-flight O2.

travelmad478

Bumping this up to see if there are any other FTers' experiences lately. I was diagnosed with a DVT this week--it showed up the morning after I flew CPH-LHR-PHL, so either the flight was the culprit or there was a pretty giant random coincidence.

I was supposed to be flying PHL-ORD-PHL tomorrow and Sunday, but I have been advised by my GP and vascular surgeon to cancel that, so I did. I am still on the combination Lovenox injection-Warfarin pills for the next week or so, after which I will be on Warfarin for 9 months.

I did ask about future flights and they said no problem, just don't take any sleep aids--including alcohol, do get up and walk or otherwise move around every hour, maybe take an aspirin pre-flight, and maybe wear compression socks (I now have a prescription pair).

Any other thoughts? I am pretty stunned/disturbed by the whole thing. I had no clue what was going on, just leg pain, and waited 9 days before going to the doctor about it. They sent me for an ultrasound and then to the ER immediately. I am otherwise 100% healthy, nonsmoker, fit, all that. Feeling a bit morbid now. Or should I say mortal.

Pat89339

Just chiming in that I have been DVT free for nearly 3 years, although I continue to fly about 150K a year. I do follow the instructions you were given about no sleep aids, aspirin pre-flight, compression socks, and I do get up frequently to walk--that is most important in my opinion. The only other thing I have added to my daily routine is 2000 mg of fish oil a day.

Good luck with your recovery and happy flying!

travelmad478

Thank you, Pat89339. That makes me feel better!

Lancelot

Interesting thread all and thanks for the input.

I first developed a blood clot after a bout of pneumonia which was preceded by a flight from Toronto to the Canary Islands. I was admitted to hospital in La Palma where I stayed until the pneumonia resolved at the end of which I developed the DVT while still in hospital. That was Dec/07-Jan/08.

This year we spent several weeks in Puerto Vallarta over the winter and I developed bronchitis. After returning home flying from PVR to YHZ I again got pneumonia followed by another DVT for which I still take warfarin. My MD told me that super-infections (presumably like pneumonia) can cause/contribute to DVT development. There is also a family history of DVT. I am planning a trip to California this fall which involves transcon flights and we are also returning to PVR for the winter. I will continue the warfarin treatment while away. You can buy a medical device that lets you self-test your INR so you know whether to vary your dose of the drug. I also have compression stockings which I will wear while flying.

So common factors for me have been infection and flying in both instances (along with genetics).

kukukajoo

Have you been tested for hereditary clotting disorders? Two that are often overlooked but easy to test for (a few vials of blood) are factor V Leiden and Antiphospholipid Syndrome, APS- (known as Hughe's syndrome in the UK). I have APS. Its really way more common than people think. If you have it, the knowledge may save another family members life (yours should be good as I assume you will prob be on warfarin or another anticoagulant for life). Do you ever cover with any type of heparin when flying long distances?

Lancelot

Hi Kukukajoo:

Interesting info you've provided. I have not been tested for hereditary clotting disorders but this is perhaps something I should talk to my doctor about. Your point about heparin when flying is also of interest. Is that something you do? Can it be taken any way other than the abdominal injections I have had when first starting therapy? Are you on anticoagulants for APS?

Thanks

kukukajoo

I do cover myself on flights if I know I will be sitting longer than 3 hrs, just to be safe. I do a shot day of flight, then day after with same on return. I can't take warfarin as my INR too unstable and an INR of 16 (from 1.8 day prior!) is scarier than worrying about clotting! I take Plavix and lately aspirin as well. I think you should be safe as long as INR is theraputic but with some of what I mentioned above many pts need higher INR to be safe. No other way to take Heparins outside a hospital setting. Also a new med called Arixtra I have taken but still a SQ shot in leg or abdomen.... stings less though.

tridoc927

I am a physician, an active person, but at 42 after a short flight back from Boulder CO I experienced a DVT. My family history is not positive for DVTs per se but my dad side has terrible varicose veins and venous insufficiency. I was 42 at the time and still on birth control but never had issue before. Interestingly I always had tendency to swell however on planes so I always wore compression socks and this one time I forgot them!

After extensive testing and such, no for sure clearly abnormal clotting issues (borderline Protein S deficiency) inherited or acquired risk for DVT. My risk factors then were my age, birth control, flight, and no socks. I did extensive review of all the literature I could find at that time (2010) and this is the advice based on what we knew at that moment:

1. Drink fluid with electrolytes and no diuretic properties. Drink not plain water, need lots of fluids but must have electrolytes as well. So you need to bring a packet of gatorade or something or drink a non-caffeinated soda so that you get salt. Caffeine and alcohol are diuretics (increase water excretion more than you took in).
2. THE BEST prevention was not any blood thinners per se but wearing compression socks or flight socks or hose of some sort. Most people 8-15 mmHg or 15-20 mmHg should be plenty. If you have a tendency to swell might as well do the 15-20. They're also great for improving circulation if you have varicose vein tendencies.
3. Review current medications with your doctor for those that increase risk. Aspirin will not help. It prevents events on the arterial side and not the venous side. Interestingly Crestor, a cholesterol lowering drug, happened to have a reduction in DVTs and none of the others did. But this is not a medication you could take one time and have any preventive benefit. If you take birth control, hormone replacement therapy, Evista, Arimidex, Tamoxifen, you would be better off with your doctor's supervision stopping any time you are going to be immobile for few days around the event. So not taking for instance 3-4 days before flight, during stay, and back. Again discuss this with doctor first. The only medication you could use with success just for flying would be Lovenox injection day of flight or Arixtra. It's worth considering if you had DVT.
4. Moving every hour and not sleeping too long. I have always slept better on a plane then I do anywhere else. Learned behavior I suppose so I go on plane and go into coma basically. Not good. When you sleep your breathing slows, less deep, and above 5,000 feet enough reduction in air pressure that your oxygen saturation drops. It is this phenomenon that if superimposed on dehydration, hormonal therapies, cramped quarters, lack of movement and any unknown inherited risk factor (there are so many small little defects a person could have that we don't even know if they're clincally significant) sets you up for a DVT.

I hope this helps everyone avoid a DVT. I only had to do Lovenox and coumadin together 5 days and then coumadin for 3 months because mine was all below the knee but it was shocking how painful a DVT is and being on blood thinner I later fell and had horrible facial injury... and long story short any illness is worth preventing since you never know how one problem can lead to another.

Rebecca Knight, MD

DeafFlyer

I'm wondering where I can buy compression socks?

Doc Savage

Many drug stores or medical supply shops.