Deep Vein Thrombosis: Scary and (mostly) Preventable
By Natasha Reid
I went for the trip of a lifetime in 2008, and came home with DVT.
My travels took my through NYC, to islands of the Caribbean, to watch the Aussie cricket team play against the West Indies. I included a side trip to Cuba, and then returned home via London. That’s 13 flights in 5 weeks, given that these islands are not the easiest to get to. Let alone the complicated flight paths to get to Cuba!
Looking back, post-diagnosis, I remember having a cramp in my calf in Cuba, which I assumed was dehydration as we couldn’t drink the water. But maybe that had nothing to do with it. I had a bit of Barbados-belly for a week, and maybe this too had something to do with the clot formation. Who knows! I definitely had leg cramps in London, and was limping. But I didn’t really think much of it. I had places to see and people to catch up with!
So, so tired at the end of this amazing trip, I slept on the flights home, which is a rarity for me. I also had my legs crossed. This definitely was a factor in my DVT. I barely got up and walked around the whole last flight, and clearly the blood was pooling.
Once I was home I needed to get on and back to work. I actually walked the almost hour to get into the office, which I had been doing in the lead up to my trip. Thinking I was stretching out the awful cramp, I pushed through. But as the day progressed, the calf cramp, and distinct unusual hardness of my left calf, bothered me more and more.
With the advice of colleagues around me, I sought out a consult with the nearby Travel Doctor. Sadly unhelpful, my insistence for an ultrasound however saved my life. Atypical presentation, the Travel Doctor defended his inaction, stating that without heat or discolouration in my calf, he could not detect. But the Doppler ultrasound showed that I had a 10cm clot in my calf and a 15cm segment just above my knee. Further scans in the ER found a “fleck” on my lung, suggesting the clot was breaking up and starting to travel making it very dangerous.
The incidence of DVT in my age group at the time was 1 in 3000, without genetic factors present, which I do not have. The travel was the main contributor, along with the contraceptive pill. Being sedentary for my flights, the number of flights, and the dehydration, all possible factors. And just dumb luck!
Treatment of DVT
Once diagnosed, and the presence of that “fleck”, or pulmonary embolism, I was injected with Clexane immediately to thin my blood and further over the coming days, as Warfarin was introduced as the medication regime for the next 6 months. This medication is made from the same stuff as RatSack, and requires close monitoring of therapeutic levels with blood tests, fortnightly eventually. Compression stockings, thigh high due to the segment above the knee, were also given, and a week as an in-patient, and then life resumed. Blood tests and trying to be consistent with my diet, avoiding things high in Vitamin K in large quantities and also careful about food and alcohol with blood thinning properties.
So after my six months of treatment, I was good to go. I just need to give myself an injection of Clexane before and after every long haul flight from now on – this has not cured the travel bug! I mean, what ever it takes!
Prevention is the key now, so I impart this message to every traveller, as a lesson learnt: walk regularly during a flight, every couple of hours; keep hydrated; don’t cross your legs or allow any circulation issues when trying to get comfortable; red wine has thinning properties; maybe wear these ugly stockings that I now have to with every flight. But more importantly, if you have an inkling, or gut feeling, there is something wrong, get it checked out. Better than the scary alternative!