What is Deep Vein Thrombosis DVT

Deep-vein thrombosis, also known as deep-venous thrombosis or DVT, is the formation of a blood clot ("thrombus") in a deep vein. It commonly affects the leg veins, such as the femo...

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Advice:
Help with Clexane injection
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A bit of a backstory, I have been off Coumadin for a year now, and am taking 160mg aspirin every day for the rest of my life. I developed a DVT in my left leg in Jan 2007, then had a re-grown DVT in my ilicia vein, left leg, 3 months after coming off the Coumadin in Oct 2007.

I am going to Hawaii in 3 weeks and my hemotologist told me last year that any overseas trips would require a shot of Clexane (Enoxaparin Sodium) before the flight... which is over 10 hours long.

My question is, what's the maximum time before the flight that I can have the injection? I CANNOT give myself the injection, and will therefore need to find a nurse before the flight, and this would be easier to do before I make my connecting Sydney flight from Canberra. So that means I would have the injection about 4-5 hours before the start of the Hawaiian journey. I will be making a doctors appointment before my holiday to discuss this, but all the doctors I have seen previously have been hopeless with DVTs, and I thought I'd ask the people who know best.... You!

Also, any other advice people can offer me to lower my chances of developing a DVT while flying would be greatly appreciated. I have pressure stockings which I will be wearing for the flight (I don't have to wear them any other time, FYI)
Posted on 10/20/09, 06:10 pm
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Advice:
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Reply #1 - 10/20/09  9:06pm
" Can't help you with the injection but on the flight, plyometric exercises will help. The concept is to work the muscles so that they press against the veins and arteries to ensure that blood keeps moving. This is particularly important if you have had valve damage or impaired flow through the veins. m

Some types of things you can do are:

Alternate pointing your toes straight out and straight up (back at your body)...when doing these focus on contracting and pushing the calf muscle.

From a sitting position, use the thigh muscles to push down on the floor where you are sitting.

Periodically contracting and holding the contraction of the muscles of the leg for several seconds can help too.

If you can manage the room somehow, slowly extend your leg out from a sitting position (like you're kicking some body from a sitting position). I do this for a quick break at the desk every now and then and feels great.

Walk whenever you can, drink tons of water (no booze) and don't go to sleep. It's a long trip to be awake for but the few hours you conk out can be a problem. Particularly if you fall asleep in a position that impairs circulation in the cramped seat.

Have fun in Hawaii! I recommend the Avocado burger at the Kua 'Aina (on the north shore). Then walk across the street for a root beer shave ice with a scoop of vanilla at Matsumotas! "
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Reply #2 - 10/21/09  5:14am
" Well, the sleeping thing has me worried because our flight leaves in the evening. If I stay awake not only will I have killer jetlag to deal with, but I'll be exhausted from having to stay awake all night, as well as all day. "
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Reply #3 - 10/21/09  5:16am
" Also, we're staying on Maui, in Wailea. Anyone have any specific touristy things for me? :P ALSO, a bit off topic, anyone know if there's a ferry connecting Maui and the Big Island? We'd like to do a day trip to the volcanoes on the main island. "
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Reply #4 - 10/21/09  4:03pm
" I think a single shot is good for 12 hours, if it's the same as Lovenox...because when I had to inject 2x a day it was 12 hrs apart. But that's also during an acute DVT - maybe you can do less as a preventive measure.
If you're really worried though, I'll volunteer to take your place....
:)
have a fantastic trip! "
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Reply #5 - 10/21/09  7:48pm
" Eh Jenny!!!
I don't have anything to add, meowatthesun/barkatthemoon :P
covered everything, maybe add drink more water then you can, forces you to walk a lot. Also stay away from coffee, it will dehydrate you, not what you want...
Aside from that, enjoy your trip, IMMENSLY!!!!


*Did you see that, Laura is trying to replace you on that trip, ya gotta watch her... :) "
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Reply #6 - 10/21/09  9:19pm
" I know it's a pain, but I agree with Meowatthesun, that you *DON'T* want to go to sleep. Unless you have someone GUARANTEE to wake you up every hour so that you can get up and stretch your legs for 5 minutes before sitting back down. Fortunately for me, I've NEVER been able to sleep on planes. But those plane seats are HORRID for your circulation, and if you fall asleep for 3 or 4 hours, that could be a big problem. Definitely try to get up & walk every hour or so. It really helps

For Maui, the best thing I have to recommend is going up to the top of Haleakala (a dormant volcano) for sunrise. I usually try to do it my first morning, while I'm still jetlagged, so my body doesn't realize I'm getting up at 4am... There are tour companies you can use that will drive you up & back & stop for breakfast afterwards. Absolutely one of the most phenomenal things I have ever seen. GORGEOUS! Just be warned, it is COLD and WINDY up there, so if nothing else, grab a blanket or two from your hotel room. I took Ekahi Tours, which is run by locals, and they did a really good job.

You also definitely need to check out Lahaina. Touristy shopping area, but really enjoyable, nice restaurants, and the beach right there. There's a show you can catch in Lahaina called "Ulalena" which is a really wonderful multi-media performance of Hawaiian (Maui) music & dance. Warren & Annabelle's magic nightclub is also a very fun thing to do in Lahaina.

If you like to snorkel, take a tour out to Molokini, which is the tip of a sunken volcano, which has wonderful sealife. Last time I was there, Trilogy did great trips there (and other spots)

If you're not staying at the Grand Wailea, you need to go there & check out the grounds. Beautiful place!

Mama's Fish House on the North Shore of Maui is WONDERFUL, very kitschy decor, but GREAT food, and a FABULOUS view of the ocean!

And if you like aquariums, the Maui Ocean Center is really nice.

That's all I can think of off the top of my head. Let me know if you want more detail!

Sayhello "
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Reply #7 - 10/22/09  4:43am
" Wow that was very thorough, thank you! I discussed it with my bf a few minutes ago, my flight leaves at 9:15pm, not well timed for not sleeping. So I'm either going to stay awake for the whole flight, VERY unlikely. Or I'll sleep and have a flight attendant wake me every hour or so. I can't imgaine they'd forget to wake me seeing as I'm a high risk DVT patient!

We're definitely snokelling at Molokini. Probably won't go to Haleakala, but I'll take a note of the tour you went with. if we had our own car we probably would go, but we'll be public transporting it most of the time. Gonna hire a couple mopeds for a day... gonna be fun!

Staying at Outrigger Palms Resort, looks beautiful! "
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Reply #8 - 10/28/09  7:50pm
" So it turns out I have to have three injections before the flight, not one. So I'm having the first one at the doctors surgery, they'll supervise me doing it myself. And then the next two before the flight I have to do myself. "

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