Another useful site

My HMO provides good information about lab tests -- they even email the results to you, and include links to a glossary of test terms and information about how to evaluate results on a specific test.

If you don't have access to this kind of information from your health plan/doctor, though, this site (Lab Tests Online) can be a big help.

Helpful Vitamin K Resource

One of the awesomely helpful posters on the Yahoo! Thrombosis Group provided this link to USDA nutrition information. It includes the best vitamin k chart I've seen yet. You can even sort alphabetically by food source or by quantity of vitamin k.

USDA Nutrition Info

Compression Stocking Review #2 -- Jobst Open Toe Knee High

I've found a new, versatile pair of compression stockings that I'm really enjoying. They're open-toe knee high stockings from Jobst.

This time I went for the 20-30mmHg pressure ("therapeutic" level support). It makes a big difference. Normally, without stockings, at the end of the day, my DVT leg is up to 2" bigger than my "good" leg. With these knee high stockings, sometimes the swelling doesn't increase at all during the day! (When I wake up in the morning, DVT leg is about an inch bigger than the other.) Aside from feeling great, keeping the swelling in check is psychologically very encouraging, too. And, despite the extra compression, these socks are still reasonably easy to don.

The open toe is not actually more attractive than closed (thought it might be for sandals - but, really, who was I kidding?), but the extra room in the toe is great for comfort, especially for walking.

On the negative side: don't believe their claims that these stockings "look like fine fashion hosiery." Puhleeze. Why do these makers insist on saying these things? It's not like we're buying these products out of vanity! For my leg, also, the top band comes up a little higher than it should -- however, I think my calves are on the relatively short size, so I'm not sure this would affect others. (And I've been able to manage it by just sliding the stocking down a bit on my leg, rather than pulling it all the way up.)

A fellow member of the Yahoo! Thrombosis Group advocates wearing the socks only on the DVT leg -- thereby getting twice the life out of a pair. So far I've been following this advice, but I think after I go off Coumadin (assuming I go off Coumadin -- fingers crossed!), I may wear both. The compression is not so intense that I don't feel I could handle it on my "good" leg, and I'd feel better knowing that the blood was scooting along quickly in both legs.

I bought my Jobst knee-highs at Amazon-- the prices are very good (even some specials), and you can see a large selection if you search on the word Jobst.

However, it can be a little challenging to find exactly what you want (your size, style, etc -- the Jobst section is for some reason a bit disorganized), so if you're interested in these exact stockings, here are links to mediumand largesizes for women.

Next up: Jobst thigh high review. I'm looking forward to giving these a big workout at a trade show!

Hosiery Mate

So ... this is sort of a random post. But maybe helpful.

In the 80s, I used a product called "Hosiery Mate." My grandmother introduced me to it! It is a special wash for nylon hosiery that helps to preserve the fibers.

Before I moved recently, I finally discarded a half dozen bottles of Hosiery Mate -- I hadn't worn pantyhose in about a decade, so I thought it was time. But, I did hold on to one bottle, "just in case." Glad I did! I tapped that last bottle, and it turns out that Hosiery Mate is a great product for caring for compression hose. It washes and conditions the stockings in just one (quick) step -- a huge timesaver. And since the compression stockings cost so much more than pantyhose, it's great to know there's a way to help them last longer.

Even better: I was sure that the company would have gone out of business by now (I mean, how many pantyhose wearers are left?), and that I'd have to resort to finding an eBay seller with a hidden cache. But, I found the company online and apparently they're still going strong.

Find the company and product online here: Hosiery Mate . Seems that a lot of JC Penney stores carry it, too.

Stress and Thrombosis

Learned something new today: stress may be a big risk factor for DVT. Why? Because the "fight or flight" adrenaline response triggered by stress increases the blood coagulability.

I learned of the stress-DVT connection in an article that links DVT and stress during air travel. The author makes the point that passengers are at much greater DVT risk now than ever before, because they feel more stressed than ever (fear of terrorism, more airport hassles). Researchers quoted estimate that as many as 10% of air passengers might be at heightened risk.

It's easy to see, though, how stress could play a role in lots of other situations. For example, is constant stress a contributor to the higher DVT risk cancer patients face?

In my own case, I'm a small business owner who is perenially under the gun -- and felt even more so after being laid up with the minor injury that probably led to my DVT. If only I'd known then what I know now!

More Links About New Netherlands Air Travel Study

It's encouraging to see that the new study correlating air travel and DVT out of Leiden University in Holland is getting more media attention. Most of the coverage is happening in Europe at this point (unfortunately not a surprise), but nonetheless the story appears to be gaining momentum:

Air Cabin Environment Contributes to DVT
Airlines Probe DVT Link

Medic Alert 50th Anniversary Auction

MedicAlert is hosting a fundraising auction as part of their 50th anniversary celebration. They're looking for sports memorabilia and other collectibles for their auction. Donations help MedicAlert continue the great work that keeps us DVT patients safer (they're a non-profit), plus allow them to inform and train the medical community on the use of MedicAlert systems.

More details on the auction (and contributing, if you're inclined):

MedicAlert 50th Anniversary Fundraising Auction

Research: DVT and Air Travel

The connection between DVT and air travel has gotten a fair amount of attention, but the major airlines have been loath to acknowledge it (and so reluctant even to advise passengers how best to minimize their risk).

A new research study from Holland may finally force the airlines to acknowledge what many say the anecdotal evidence has long shown: that air quality on planes greatly increases the risk of a travel-related thrombosis.

The study tracked a key clotting protein level in the blood after an eight hour flight, then two weeks later after an eight hour movie marathon, then after eight hours of regular activity in the third component of the experiment.

The results showed dramatic (astonishing, really) increases in the clotting factor after the eight hour flight -- and small decreases after the movie marathon and normal activity periods.

For more information:

Study: Cabin Air Quality Leads to Clotting Risk

Compression Stocking Review #1 -- Mediven Thigh-High

They're here! My first pair of compression stockings (by Mediven). I went for the thigh highs, as I thought this would provide the best combination of versatility and comfort. The pressure I selected for this first pair is 16-20 mmHg -- the initial "medical" level of compression. This might ultimately turn out to be a little too light, given that I have a DVT and am not just looking to prevent one (or support varicose veins); I've ordered some other options in 20-30 mmHg which I will review once I try them.

My review:

• Overall, I recommend trying these (or any) compression stockings to any DVT patient (with doctor's recommendation/advice, of course). I've definitely experienced less pain and swelling during the two days I've worn the stockings (I mentioned previously that I've luckily had a lot less pain than many DVT patients. But, lately I have had some aching, and the stockings definitely help.)
• On many of the sites I shopped for compression hose, there were companion products to help you put them on ("donners"). I didn't initially understand why these might be needed ... but, now I know. They're hard to put on! If you're not strong, or your condition limits your flexibility, the devices for putting on the stockings might be helpful. I suspect that the pantyhose might be especially challenging, since you'll have to somehow pull both legs on simultaneously, so I'm going to skip those for now (besides, I haven't worn them in about 10 years, and I'm not excited by the idea of becoming unliberated in that way again anyway!).
• Thigh high option: I've seen posts on various sites complaining that thigh high compression stockings can be annoying because they don't stay up. I haven't had that experience so far with Mediven - the silicon band works well to hold them up. I also like the idea that I've got support on my entire leg, since my DVT runs through my entire thigh.
• On the negative side: DON'T believe the marketing-speak that "no one will know they're support hose." The light stockings I have look thick and elastic ... clearly support hose. I'm going to try black next, in the hope they'll pass for tights. (I'm sure it goes without saying that this minor vanity issue is not a reason not to wear compression hose!)
• They're hot ... I'm already dreading the Sacramento summer. I will probably switch to footless/knee high options at that point. (And hope for an unseasonably cool summer!)
  

I got my pair from an online site called TheMedicalSupplyHouse.com. Had a chance to speak with the owner when I placed my order! Her name is Estee and she's been in the maternity products business for about 15 years. (As you probably know, support hose is often recommended for pregnant women.) I liked the idea of helping out another small business with my order.

Considering Plastic Surgery?

No ... I'm not. But, as my friends all join me in middle age, I know many of them are. Consequently, the information I've been reading about air travel after surgery has interested me greatly.

Given that surgery is one of the biggest risk factors for DVT, and air travel is believed to be a very significant risk factor as well, it's no surprise that combining them is not a good idea. But, are patients being informed? I know of a number of people who have considered traveling to LA or NYC to have plastic surgery from "the best" -- are they aware of the need to stay put after surgery? And then there are those news reports of patients traveling to places as far as South America or Asia to save money on plastic surgery ... are they even informed of the risk of a fatal clot?

Here are some recent links on the subject:

Health Tourists Sign Up for Sun, Sea and Surgery
Risks of Cut-Rate Plastic Surgery

Leeches?

A bizarre way to treat DVT - then again, if my leg were extremely ulcerated as described in the article, I might try anything!

Leech Therapy for Glaucoma, Elephantiasis, Deep Vein Thrombosis

DVT Awareness Month Kick Line Kick-Off

DVT Awareness Month is kicking off with an attempt to break the Guinness record for world's longest kick line. Sufferers, survivors, supporters and others will gather in New York's Time Square to lock arms and raise awareness of DVT (deep vein thrombosis).

The kick line happens March 7, 2006. Similar events will be held concurrently in Miami, FL and Washington, DC.

More info here:

DVT Awareness Month Kicks Off with Kick Line

Yahoo! Thrombosis Group

If you've been diagnosed with DVT or any kind of thrombosis, the Yahoo! Thrombosis Group is a lifeline. Speak frankly with other patients (or just lurk and listen), pose questions you're having a tough time getting answered, and realize you're not going crazy and you're not alone.

Click for Yahoo! Thrombosis Group

Dehydration paradox

Experts are beginning to disseminate an idea that seems radical, but could save lives: drinking large amounts of water on airplanes could increase blood viscosity (and increase the likelihood of a clot forming). In other words, drinking lots of plain water on planes can increase dehydration and make the blood thicker, stickier, and more likely to clot.

Why? It's not entirely clear, but cabin pressure and low oxygen content of airplane air may cause dehydration to be more acute. What the research does show, though, is that drinking plain water can actually be worse than not drinking at all, since it causes more frequent urination and leads to more dehydration.

The experts leading the efforts to disseminate this information point out that sports drinks that contain electrolytes are a good solution.

To simplify traveling with enough for one 8-ounce glass per hour, sports drinks are available in powdered form. Just don't use the airplane tank water! Be sure to mix the powder into bottled water (thankfully usually available on planes these days).

More info on this:

Hydration Info from AirHealth.org
Summary of Travel Thrombosis Info from Your Health Base