Carrybean

I hope you friend makes a complete recovery. Personally, since aspirin causes me no problems, I plan to start taking one daily for a week or so prior to flying. It can't hurt & these days, medical studies flip-flop back & forth.

unejam1

Please keep in mind that sarcasm does not communicate well in writing, so some of you who are using sarcasm to disagree with the comment that aspirin does not work come across as if you are agreeing. This is confusing. Please, if you have hard facts just say what you mean!

valtor

My husband had this problem two weeks after we return from Thailand (in 2005). He could not breathe; the clot was stopped in his lung. He was in hospital for a week then he had to take Comadin for 9 months. After this the doctor decided that he is ok and said that no need for aspirin before flight.

parisnow

Linda
Sorry to hear about your friend but a learning lesson for anyone reading this.
Do not transport someone yourself to a hospital (unless you can see it out your window). It may appear to take longer to call 911 and get help to your location but they have all the necessary equipment to HELP during transport. If you transport the person whatever the medical emergency (heart attack, gunshot wound, ect.) you may be depriving them of immediate medical care that can save lives on scene or during transport.
INSTEAD, learn your ABC's (Airway, breathing, circulation --CPR), and for open wounds apply pressure to the area. It only takes a day or so at your local red cross type organizations.
And do not remove any objects that may be protruding from a body no matter how scary it may look. I was in a store once and had to physically restrain a mother from removing a wire clothes hanger that somehow was protruding from a small child's eye.

P.S. She did thank me after the doctor informed her that the child would have been blind if someone had attempted to remove the hanger.

lhopp

Also had blood clot which traveled to my lung 6 years ago. As with Valtor's husband, hospitalized for a week and Coumadin for 6 months. I have had extensive workups by a Hematologist to make sure there was no blood disorder or underlying genetic factor that could have caused it, so that should be considered as well.

I have traveled to Europe and China since then, and all of my physicians have recommended to exercise your legs every 30-60 minutes in flight and drink plenty of water. They seem to differ on whether or not aspirin is beneficial though.

annw

Best to get advice from one's own primary care provider.

That said, if you want to know what they tell family members--the DH, a cardiologist, advises me to get up and walk every hour and likes the idea of a baby aspirin. He actually takes one every day regardless of travel. I wear black compression knee high stockings usually (b/c I think they look better than the geeky tan ones); he says I don't need them if I get up and walk every hour.

brookwood

Virtual all of the non steroidal anti inflammatories, which includes asprin, has a thinning effect on the blood.

If someone is on an NSAID for arthritis or other inflammatory process, I don't think adding asprin is a good idea unless a doctor approves of it.

I had hip surgery in 2004 and, when flying or driving for long periods, I wear the standard Ted hose that many surgical patients wear during and after surgery.

The asprin is a good idea too for many people, but there are some conditions which preclude it.

I think anyone who has phlebitis, arthritis, an artificial joint, and/or similar problems should check with his or her doctor before a long flight or automobile trip.

I know I told a friend of mine that I did not try to sleep on trans Atlantic flights. He thought I was nutty. I told him that getting up and moving about the cabin was more vital than sleep. Sleep I can get after I arrive, but I don't want "to get" something like a blood clot.

Sue_xx_yy

Linda431, I'm sorry to hear about your friend and hope she makes a speedy recovery.

I had a DVT sitting at my desk at sea level, I wasn't anywhere near a plane at the time.

I suspect your friend's doctors were interested in the trip just taken because Hawaii is a fairly long distance away from most people, and someone flying to/from would be seated for a long time. How cramped it is isn't necessarily a factor, since as others have pointed out, people can get DVTs in business class as well. The risk decreases if one stretches and moves one's legs reasonably often - this at least is what my haemotologist advised me to do. He didn't recommend any special stockings or, more significantly, aspirin.

Regarding the mechanism of blood clotting and how to prevent a DVT: This is a complicated subject, in part because there are two systems involved in blood clotting. One system involves cells called platelets that circulate in the blood and act to form a plug over damaged blood vessels. This is the system upon which aspirin works - it inhibits the formation of platelet plugs.

In arteries, which are thick-walled and with fast-moving blood, a roughening of the arterial walls (as in arteriosclerosis) causes platelets to stick to the side of the arterial wall, eventually forming a clot. This is why aspirin etc. is used to treat those at risk of stroke or heart disease since these are arterial events, in which platelets are involved, and aspirin works on platelets.

However, veins are thin-walled and with slow-moving blood. The second system of blood clotting predominates in veins - see below. Thus, since platelets do not play a big role in venous clotting, aspirin isn't usually of much use in preventing DVTs.

My DVT was caused, in part, by a blood disorder in the second - the coagulant - system. (Not all DVTs are caused by blood disorders, I'm just describing mine as it is the cause with which I'm obviously most familiar.) To continue: the coagulant system involves a long chain of actions, called a cascade, that is performed by multiple proteins or factors that work together to form a fibrin clot. The genetic mutation - that prior to my DVT I didn't even know I had - is in one of these substances, known as Factor V (or Factor Va in the active form). The Factor Va my body makes doesn't break down as readily as normal Factor Va, and is known as Factor V Leiden. Initially, I was treated with low molecular weight heparin as an anticoagulant while my body got around to breaking down the clot in my leg. Don't bother asking where one can get some, this is serious therapy, not for the do-it-yourselfer, and in any case involves injections, not pills.

Subsequently, I took warfarin for 6 months. Warfarin acts by interfering with Vitamin K which is normally required by the clotting factors involved in the cascade mechanism. Warfarin is also a dangerous drug, one would be insane to take it as a preventative measure against a DVT, should one happen to get a hold of some. It's also a pain in the proverbial butt, as one must follow various dietary restrictions while taking it.

For a lot more, if not everything, one might want to know about blood clotting, but were afraid to ask,

http://tinyurl.com/yfew5h

Underhill

You can buy a calf exerciser at magellans--it's an inflatable "cushion" with two halves that goes on the floor beneath your feet while you are seated. As you push down on one half of the cushion with your foot, air is forced into the other compartment; continued use is a bit like walking.

mikemo

As venous thrombosis is stasis and red cell related rather than the arterial platelet mediated clots, there is little to nothing in the peer reviewed scientific literature to recommend aspirin as prophylaxis for travelers' dvt (the PEP trial did show a reduction in dvt using asa following hip fx).
The description of Linda431's friend's situation sounds unusual: perhaps she has a PFO and had a R-L shunt of a venous clot or she had coronary (artery) spasm.
M (MD; NBME; ABIM; ABNM; ABR)

Sue_xx_yy

If I've understood you correctly, mikemo, what you're pointing out is that normally (if anything about DVTs could be called normal) if a piece of a DVT clot breaks off, the first place it's going to wind up is in the right chamber(s) of the heart, and normally from there it would head to the lungs, i.e. into the pulmonary arteries. There, if it is big enough, it could get stuck, and cause a pulmonary embolism (PE, for acronym-ophiles.) In other words, what this means is that normally a travelling DVT big enough to be dangerous couldn't cause a heart attack because it would always get stuck in the pulmonary (lung) arteries first.

But if Linda's friend has a PFO - which stands for a long Latin name that I think most of us know as a 'hole in the heart' - the clot has an escape hatch from the right side through to the left side of the heart - the R-L shunt you mention - that allows it to bypass going through the pulmonary vessels. So once in the left side of the heart, it could be pumped out to the brain arteries (where it could lodge and cause a stroke) or it could also go to the coronary arteries, where it could cause the heart attack suffered by Linda's friend (except, of course, that Linda tells us the clot was small and had passed through the heart.)

Can you explain a bit more about the coronary artery spasm and how that would work? Are you saying that when the clot went through the coronary arteries, it got stuck, but just temporarily, i.e. long enough to cause the artery to spasm, thereby interrupting oxygen supply to her heart?

mikemo

Obviously, I don't know the specific details. Just speculating given the brief description.
Your physiologic analysis is right on.
M