In March, my husband is having a relatively new alternative to total knee replacement - called a unicondylar reconstruction - by Dr. Repicci, who pioneered the procedure. He's also having an arthroscope on the other (left) knee.

He'll have to fly from BUF to CLT 4 days postop. The plan is to get him in First Class so he can at least be able to extend his legs. I'm uncertain at this point whether his knee will still be immobolized, but I don't think so by day 4. Nonetheless, he will undoubtedly have significant swelling and will not be able to elevate his leg for the flight duration.

Could one of you MD types opine as to whether we should ask the doc about anticoagulants for the flight?

I can't describe how excited I am about enduring all this http://www.flyertalk.com/forum/smile.gif

BTW - here's the link to info regarding the procedure, if any of you out there are 50 yrs old w/ 80 yr old knees http://www.flyertalk.com/forum/smile.gif :
http://www.repicci.com/default.html

I agree... no one should ever try to self-medicate. Every case is unique and you should discuss your options with a physician that knows you well.

My Condolences!!

My mother suffers from a DTV-related illness that appears to have indeed been caused by a number of longhaul flights over the years. As a somewhat FF (far more than my mother, in fact) this has been something I have spent quite a bit of time thinking about, and as this thread shows it's not about sitting in Y, but sitting full stop. So even if I am in C I try to stretch as much as I can and walk around every few hours, even if that means just standing in an exit area for a bit. Luckily I haven't been hassled by F/A's about it (since 9/11 I mean) - and I believe it is a vaid reason to be stretching/walking during a long haul ride. Luckily I do not seem to have whatever it is my mother has that forms DVT's. UnfortunatelyI can't take asprin due to another condition, so that little trick is out for me, but I consider walking as much as I can, or stretching and keeping the blood flowing to be a good way around it. I also don't drink much on board (booze) so I am sure that helps a bit.

Unfortunately I believe this is a serious issue for flyers that the airlines have paid mostly lip service to.

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RichardMEL, UA 1K
A Star Alliance Member.

My condolences also.

For preventing DVT, how about in-seat exercises? Such as shaking your legs, flexing your ankles, and generally fidgeting your lower extremities? Can that help if you do it often enough?

Kathy

Flying from Los Angeles to Singapore, the FA told me to get back in my seat. No seatbelt lights on! I'd found a narrow cross over aisle where I could sit on the floor for a couple minutes at a time to stretch. This was as far in the rear of the airplane as you could get without sitting in the 'john'.

I also tried walking, small exercises without being a bother; still the FA's weren't pleased.

On other extremely long flights, I've had less luck finding spare space in the cheap end of the plane. Even though I am small, I still feel I don't have enough opportunity to prevent problems.

Especially since 9-11, we are practically captive in our seats. We need help!

My condolances! Sorry about your loss!

My mother developed a serious case of DVT on her latest trans-Pacific flight from AKL-LAX. She boarded at AKL as a healthy person and had a seat in J but to get her off the plane at LAX a wheelchair was needed since she could not feel her legs. However, since she is a fighter she ignored this and after a few days stopover in the US decided to proceed on to her trip to Europe which landed her there for over 3 months since she was almost immobilised and required hospitalisation. The same happened on her trip back to Oz.

Frequent flying can get a bit hazardous if you think about it...

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FWIW, "enteric" essentially means intestine and acetylsalicylic acid is the chemical name for aspiriin! http://www.flyertalk.com/forum/smile.gif

Bufferin, which I actually like yet rarely take, is simply an aspirin designed to be hopefully better absorbed and less irritating due to a bit of marginally effective buffering agent to alter the pH locally and thus enhance its ability to cross biological membranes! http://www.flyertalk.com/forum/smile.gif

Very briefly, in any case if interested, in pharmacologic terms and for pharmacologic purposes most drugs are considered to be either weak acids or weak bases present in solution as both ionized and NONionized moieties.

Diffussion through membrane blayers, largely lipid in nature, means NONionized molecules, usually being more lipid soluable pass more quickly and freely through the membranes to be absorbed and distributed throughout the body. "Like" dissolves "like!" Ionized forms are essentially NOT able to do so.

So distribution of weak electrolytes are effectively determined by the pKa and the pH gradient across the membrane. The ratio of the NONionized to ionized drug at each pH can be calculated from the HH equation. This is however, not a classically organic chemistry definition or application.

So, in any case, priciples that determine absorption/passage from the GI lumen are essentially low degree of ionization, high lipid/water partition coefficient (of a NONionized form), & small atomic (molecular) radii of water soluable substances - all enabling more rapid absorption.

So weak acids are more readily absorbed from the stomach, while weak bases are not. In the intestines (less acidic and more alkaline), weak bases are better absorbed while acids are more poorly so.

In fact the intestinal pH is typically near neutral in the lumen, but at the absorbing surface, a kind of microenvironment with a "virtual pH" of maybe 5-6. Still as pH is increased, bases are better absorbed & acids more poorly. As pH is decreased, acids are better absorbed & bases more poorly absorbed.

There are also, however, [i]many[/b] other factors to consider. For example, a large quantity of food in the stomach impedes gastric emptying delaying absorbtion with lower peak plasma levels resulting. Presence of bicarb or other alkali in the stomach would also slow absorbtion. And so on - and on... http://www.flyertalk.com/forum/wink.gif

Hope this is of some minimal help! http://www.flyertalk.com/forum/smile.gif

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Pam- I'd think there is actually little to be concerned about, in particular if there is a reasonable recovery time, yet I don't really know and you should always check with a "real" expert if still concerned! http://www.flyertalk.com/forum/smile.gif

Thanks Doc for the lecture in pharmaceutics! http://www.flyertalk.com/forum/smile.gif http://www.flyertalk.com/forum/smile.gif You wouldn't wanna post a formulae for making metamphetamine by any chance? http://www.flyertalk.com/forum/smile.gif http://www.flyertalk.com/forum/smile.gif I hear that it can be effectively produced from 'cold & flu' drugs. But jokes aside, one can get just as effective relief from DVT by taking a food supplement called Gingko Biloba which works the same way as aspirin.

the nurse practitioner in my drs office sad the best in seat excercise is to spell the alphabet with each foot several times during a long flight. IT soulds weird to imagine until you try it .

Another trick I sometimes use is to have my toes pick sides for a litle "touch" football! http://www.flyertalk.com/forum/wink.gif

I feel sorry for your friend. I feel sorry for anyone who dies. I also feel sorry for all their friends, family and other survivors as well. This being said..........

(1) Why are not all the (mostly) nice pilots dropping over? How about those poor unfortunate souls in comas for years?

(2) Why do "experts" recommend "surface-mounted" elastic hose when the condition is called DEEPVT ?

(3) Why cant I "self-medicate"? I took ibuprofen for a headache just last night. Did I do wrong?

(4) Was an after-flight autopsy performed? Was it rechecked by independent tests?

(5) Why does "toe wiggling" get the blood outta the DVT bad areas?

(6) Why does booze make me usually feel good? Is it because of its pH? Virtual pH?

(7) Why doesnt Andy Rooney discuss this DVT problem? He knows a lotta answers doesnt he?

MisterNice

Are you being facetious or serious? If you are being serious then check out the links I posted above and they will answer most of your questions.




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Always remember you're unique, just like everyone else.

Why don't long haul pilots die from DVT?

http://www.flyertalk.com/travel/fttr...ML/003487.html

From London Daily Telegraph's website

Dark chocolate may cut DVT risk on long flights

http://shorterlink.com/?HOCS8J