12 hour flight advise

[Hawgwash]

Oh boy...
My God man, don't take a single Aspirin, just jamb a needle of an unknown dosage of something or other into your thigh.

 

[User915]

Don't worry about me.

 

[Hawgwash]

"Don't worry about me."

 

[User915]

"Don't worry about me."

My posts #28 & 30 were just to try to help for your coming 12 hours flight.
I take note of your comments.

 

[Hawgwash]

My posts #28 & 30 were just to try to help for your coming 12 hours flight.
I take note of your comments.

I know.

 

[BruceK]

Mr.Hays is a Medic as well, but I suspect his advice on preventing prostate cancer could be a bit cockeyed.

Could be wrong, but I think dhays is an expert optician, not an MD.
Drifting on aspirin.
Around 25 years ago my Dr. recommended daily low dose aspirin. Not for blood thinning but as a bowel cancer preventative, due to family h/x. In fairness, how it might work was not well explained. Aspirin is,among other things,an anti-inflammatory. Recently I heard that benefit of aspirin announced, yet again.
So far no CVA, no bowel cancer no polyps. Does it work? Not sure. Is it harmful? Not as I know,for me. Would taking 100mg of aspirin before an occasional long flight be harmful? For some? For everyone?
Does DVT risk still apply to less cramped flatbed users renting the extra space on long flights? Is likely better hydration, due to more cabin service, a factor?

 

[Hawgwash]

Oh Bruce.
Bruce, Bruce, Bruce.
This whole thing has become quite humorous and way too serious. But it is fun to play wit you and omc.

Gad I hope the optical urologist line wasn’t wasted on everyone. If so I might as well pack my puns and promptly paddle a punt to Peru.

As for Mr.Hays, I have no idea if he is an expert but I do believe he is seriously credentialed and legitimately attaches “Doctor” to his name.

We’ll let him address that. Or not.

Aspirin, wellI just don’t see how one asprin can do any better than the Insequent glass of wine in post 12.

So thanks to all for the jet lag input, I have to rest now, my belly hurts

 

[BruceK]

Oh Bruce.
Bruce, Bruce, Bruce.
This whole thing has become quite humorous and way too serious. But it is fun to play wit you and omc.

Gad I hope the optical urologist line wasn’t wasted on everyone. If so I might as well pack my puns and promptly paddle a punt to Peru.

You might as well.
Not buying the humor BS, but good try.
You do know there is an international dateline?

 

[Hawgwash]

You do know there is an international dateline?

I do.
See post #1.

 

[johnma]

Before I retired last year I flew from Philadelphia to Dubai several times per year. Total flying time was 14 hours. I noticed that jet lag did not effect me at all on the way over but coming back home i was badly effected for a day or two. strangely enough our Dubai employees were effected the opposite direction.
I do my best to sleep for at least 6 hours while flying. Foam ear plugs, a neck pillow and blinders help a lot. I also will take an over the counter sleep aid. I have found that the brand name products work very well (Unisom, etc) but the generic were terrible.
John

 

[man n black]

1. Fly first class so you can sleep

2. Sleep

3. Drinks lots of water...

Wake up refreshed and be ready to have fun

Ch

 

[Hawgwash]

I noticed that jet lag did not effect me at all on the way over but coming back home i was badly effected for a day or two. strangely enough our Dubai employees were effected the opposite direction.

Thanks John. A few have commented to me about directional effect and most said they suffered more travelling westward, ie. Canada to Asia.

 

[BruceK]

I do.
See post #1.

Good. Go paddle there.

 

[Hawgwash]

Good. Go paddle there.

Waded right into that now didn't I?

 

[AusCan]

I usually do a trip from Australia to the Middle East every 4 weeks.
What I'd suggest is to try to put yourself into the destination time zone as soon as you get on the plane. If it's night there then sleep if possible. If sleep medication is required I would recommend red wine.
If it's day time at your destination then try to be as active as possible. Get up and stretch as much as possible. Make sure you get an aisle seat so you aren't trapped in your chair.
Part of it is psychological IMO. If you are dreAding the flight, you'll get jet lagged. If you are looking forward to it, you'll be fine.

 

[Hawgwash]

What I'd suggest is to try to put yourself into the destination time zone as soon as you get on the plane. If it's night there then sleep if possible.

Boarding at 2am when it is 5pm next day at my destination, I'll have to stay awake for at least a couple hours. Maybe watch Sully.

Make sure you get an aisle seat.
Part of it is psychological...If you are looking forward to it, you'll be fine.

Got the aisle, but I'll skip the wine and I am looking forward to it; that's why I want to do everything possible to prevent ass drag when I get there.

Thanks.

 

[Peter B]

Bonsoir Pierre. You already know that I often travel by plane mostly 7 to 12 hours long direct flights, so can you give me your impression about this :
Before all long flights just after boarding, under my family physician's and pharmacist's recommendation (you know who I am talking about) I inject myself an anticoagulant (e.g. Calciparine or similar, I have no idea of the dosage). I should specify that I don't have any health issue.
Merci par avance.

Hi, Olivier, or that should be bonjour. Sorry I am a bit late getting back on this, as I have not checked in every day, we have had so much else going on.

As you say, Calciparine is one brand name for heparin, one of the oldest and still most used true anticoagulants. However, it cannot be taken orally. There are now longer acting derivatives of heparin, one in particular Clexane, (enoxaparin), which is most often used by travellers at risk of DVT, and it can be administered personally when needed, once a day while travelling, via an under the skin injection like insulin. It is very safe, and dosed that way does not need to be monitored by clotting time tests. It is a Godsend when folk who have demonstrated a tendency to get DVTs or PEs, (pulmonary emboli from deep vein clots), have to travel long distances.

Calciparine: Heparin at The Medical Dictionary

 

[Peter B]

Oh boy...
My God man, don't take a single Aspirin, just jamb a needle of an unknown dosage of something or other into your thigh.

I think this issue needs a bit of clarification.

To compare aspirin and heparin type drugs is not comparing apples with apples in this DVT prevention issue. Think of it this way. One, (aspirin), stops blood vessel leaks, the other stops clots.

Aspirin is an anti-platelet drug, that is it reduces the stickiness of the small cell fragments that come from a parent cell called a megakaryocyte, and their function is to plug leaks in vessels. It is also true it appears to aid in the destruction or rejection of some types of cancer cells. However, it does not inhibit clotting to any real extent, which is why it is not recommended now for DVT prevention. Its use in preventing worsening coronary disease is in preventing the build-up of these sticky platelets on the rough plaques which have formed inside lining of the coronary (heart) arteries.

Heparin and its derivatives are anti-clotting drugs, which help prevent slowly moving blood in deep vessels from forming clots, which then might travel to vulnerable places like the lung, where they are called pulmonary emboli, or PEs.

Coming back to jet lag. it does seem to affect some folk more than others, and traveling west, ie with the sun and against the earth's rotation does not seem to affect those who are susceptible as much as going west to east and therefore against the sun, and with the earth's rotation. If you think about it the reason might become apparent. As it's not an issue for me, I just don't worry about it. I just catnap when tired and as others have said, set my watch to destination time and go with the flow. For those who have difficulty getting to sleep because of jet lag, the tabs of melatonin hormone, which is the hormone our pineal gland secretes to adjust us to daylight time, can be helpful, and can be bought under names like Circaden, and melatonin too I guess.

Melatonin for Sleep: Hormone and Supplement Effects on Sleep

Cheers, and just think of how lucky one is to be travelling far enough to actually get jet-lagged. That's gotta mean you have places to go and things to do...right..?

 

[Hawgwash]

I think this issue needs a bit of clarification.

And that you did in spades.
It’s really nice and helpful, when a professional can put things in simple, lay terms. I like your plug the leak, clear the blocked pipe analogy.

Though the reason for the post was not to get medical advice but rather to get a sense of what people do vis a vis jet lag i.e. prep, habits, food and drink, your comments are well received.

Having some experience with platelet counts, DVT, PE, Heparin, Warfarin, PT (time) and most other stuff related to the topic, I still have to ask; how does one know if you are “a traveller at risk of DVT” without a family or personal history of cardiopulmonary or vascular issues?

That was my whole point in cautioning against social media remedies. Kinda like prior, assumption driven comments, about welding fuel tanks.

Thanks for taking the time to lay it out nicely

 

[psneeld]

As a follow on, if there is no way to know if prone to DVT, is it wise to take precautions and what are they?

 

[Hawgwash]

As a follow on, if there is no way to know if prone to DVT, is it wise to take precautions and what are they?

Exactly.

Then there is the whole diagnosis and treatment process.
A family member, who has a very high pain tolerance, developed severe "chest" pains. Went to his GP who diagnosed pleurisy and sent him home to rest...Peter B just fell off his chair, I know.

That night he could stand it no more so went to the ER where they told him, at 35, he was too young for it to be anything serious and sent him home with pain killers...Peter climbed back on the chair and promptly fell off again.

Half way home he insisted he be taken back to ER and while in the waiting room, collapsed. That got their attention. Among other things they did blood gasses that were so out of whack they weren't believed. Only on a retest did they jump to attention. Both lungs had clots, the left one was loaded to the rafters.

DVT?
Inconclusive.
They did every test possible short of an autopsy and found no source.

The saga does not end there either.

 

[Peter B]

And that you did in spades.
It’s really nice and helpful, when a professional can put things in simple, lay terms. I like your plug the leak, clear the blocked pipe analogy.

Though the reason for the post was not to get medical advice but rather to get a sense of what people do vis a vis jet lag i.e. prep, habits, food and drink, your comments are well received.

Having some experience with platelet counts, DVT, PE, Heparin, Warfarin, PT (time) and most other stuff related to the topic, I still have to ask; how does one know if you are “a traveller at risk of DVT” without a family or personal history of cardiopulmonary or vascular issues?

That was my whole point in cautioning against social media remedies. Kinda like prior, assumption driven comments, about welding fuel tanks.

Thanks for taking the time to lay it out nicely

As a follow on, if there is no way to know if prone to DVT, is it wise to take precautions and what are they?

Exactly.

Then there is the whole diagnosis and treatment process.
A family member, who has a very high pain tolerance, developed severe "chest" pains. Went to his GP who diagnosed pleurisy and sent him home to rest...Peter B just fell off his chair, I know.

That night he could stand it no more so went to the ER where they told him, at 35, he was too young for it to be anything serious and sent him home with pain killers...Peter climbed back on the chair and promptly fell off again.

Half way home he insisted he be taken back to ER and while in the waiting room, collapsed. That got their attention. Among other things they did blood gasses that were so out of whack they weren't believed. Only on a retest did they jump to attention. Both lungs had clots, the left one was loaded to the rafters.

DVT?
Inconclusive.
They did every test possible short of an autopsy and found no source.

The saga does not end there either.

There is a simple answer to all the above. If there is a family or personal history of DVT, PE, or as a result of the above in a relative, genetic blood tests done show a known risk ,then at the very least that person should travel covered by the heparin type anticoagulant, such as Clexane, as discussed above in response to Olivier.

For anyone else, there is no way to tell who is at risk, so basically all are potentially, so best to take the precautions I listed previously. Just being healthy, and with no known risk factors is no guarantee, sorry to say. And yes, I have a patient with no known risk factors, even by genetic testing, who still, like your 35 yr old Hawg, went straight to multiple PEs.

 

[Hawgwash]

There is a simple answer to all the above. If there is a family or personal history of DVT, PE, or as a result of the above in a relative, genetic blood tests done show a known risk ,then at the very least that person should travel covered by the heparin type anticoagulant, such as Clexane, as discussed above in response to Olivier.

For anyone else, there is no way to tell who is at risk, so basically all are potentially, so best to take the precautions I listed previously. Just being healthy, and with no known risk factors is no guarantee, sorry to say. And yes, I have a patient with no known risk factors, even by genetic testing, who still, like your 35 yr old Hawg, went straight to multiple PEs.

Great exchange, Peter. Easy to follow and educational. So, one more question;

I am curious about the use of syringes, especially on planes, when there may be oral alternatives. Do not Clexane, by needle and Rivaroxaban (Xarelto) orally, accomplish the same thing?

 

[User915]

Hi, Olivier, or that should be bonjour. Sorry I am a bit late getting back on this, as I have not checked in every day, we have had so much else going on.

As you say, Calciparine is one brand name for heparin, one of the oldest and still most used true anticoagulants. However, it cannot be taken orally. There are now longer acting derivatives of heparin, one in particular Clexane, (enoxaparin), which is most often used by travellers at risk of DVT, and it can be administered personally when needed, once a day while travelling, via an under the skin injection like insulin. It is very safe, and dosed that way does not need to be monitored by clotting time tests. It is a Godsend when folk who have demonstrated a tendency to get DVTs or PEs, (pulmonary emboli from deep vein clots), have to travel long distances.

Calciparine: Heparin at The Medical Dictionary

Merci mon ami pour ton temps, c'était très instructif et intéressant, comme toujours avec toi.