The skies seem friendly again

I just got back from my first air trip since my diagnosis in February. (I guess it goes without saying that I survived the trip :) .) I traveled from Sacramento to Texas -- two flights and a total of about seven hours in the air.

It was scary to fly again ... but, after an uneventful outbound trip, I became excited by the prospect of traveling again! I learned a few things, too:

• Sports drinks: yes, the advice to take sports drinks instead of water does seem to make a difference.
  
  For years I've been a frequent traveler (100k+ miles per year in the late 90s), and always a big water drinker while in the air. Generally speaking, the amount of water correlated directly with trips to the bathroom. And although psychologically I felt reassured that I was maintaining the best possible hydration, physically I still felt dehydrated and tired getting off of planes, regardless of how much water I drank.
  
  This time, I decided to take into account the results of some recent research which said that water is actually dehydrating when inside an airplane, and sports drinks work better. I drank only Gatorade and Powerade on my flights to and from Texas.
  
  What a difference! I wasn´t running to the bathroom every ten minutes like I did in the past when I was guzzling water on planes. I noticed I had much more energy, and my feet weren´t swollen like they´d always been in the past (although this last effect may have been due to the compression stockings as well).
  
  The only downer is that the sports drinks have a lot of calories, and, in my opinion, taste kind of gross. Small prices to pay, though.
  
  
• Compression stockings: typically, I wear only one stocking (on my DVT leg). But, for flying, I decided to wear them on both legs. I had read a story recently about a father and daughter who traveled together by air. The father was a previous DVT patient and wore compression stockings on both legs. His twentysomething daughter didn´t wear stockings, but was careful to drink lots of water and walk frequently about the cabin. Sadly and unexpectedly, the daughter suffered a fatal DVT and PE, while her father (who took no other precaution besides wearing the compression stockings) was fine.
  
  The anecdotal medical conclusion from this story was that compression stockings have a very powerful, positive impact on circulation. Compressing the lower leg near the ankle significantly increases the speed of blood flowing from the bottom of the leg back up the body, and this greatly reduces (possibly eliminates) the risk of a clot.
  
  Additionally, as mentioned above, the improved circulation in the legs really helps eliminate the draggy, tired feeling air travel can cause. And no more swollen feet!
  
  I´ve been recommending (like a broken record) that all my high-risk friends consider wearing this hose on planes. And high risk women are more plentiful than you might think, since birth control pills, HRT and varicose veins all contribute significantly to DVT risk.
  
  
• Walking. I recently invested in a pedometer, and took the opportunity to cruise the airport during my layovers. Great way to get the extra steps in ... plus reassure yourself that you´re getting the blood flowing again between flights. I was able to easily get 8,000 steps in during pre-boarding and layover time on my Texas trip.

It feels great to know that I can travel again. When I was first diagnosed, I thought I would be grounded for life. With a few extra precautions, it seems there is no need for my wings to be clipped. (Well, I´m not sure I´m ready to head for any locations without really modern hospitals until I´m off anticoagulants. But that leaves the door open for many of the places I´m eager to visit.)

Compression Stocking Review Round-Up (to date)

	Comfort	Appearance	Effectiveness	Overall Grade	Comments
Jobst Knee High 20-30 (open, natural color)	A-	B-	A	A-	Looks therapeutic. Open toe big comfort advantage.
Jobst Knee High 20-30 (closed, black)	B	B+	A	B+	Looks like regular black opaque knee high.
Jobst Thigh High 20-30 (closed, black)	B-	B+	A-	B	Weak silicon band - lots of pulling up. Looks like regular tight.
Mediven Thigh High 18-20 (closed, natural)	A-	B	A-	B+	Very effective silicon band; somewhat "therapeutic" appearance

Compression Stocking Reviews #3 and #4

Two more compression stocking reviews:

Jobst 20-30 mm Hg Knee High (Closed Toe)

This pair is identical to the other pair of knee-highs I reviewed, except that it has the (normal) closed toe design.

It's fine ... versatile (bought it in black for variety). Does a good job of keeping the blood flowing! But, it's hard not to compare against the open toe version, which really shines both for comfort inside shoes (especially when you're doing a lot of walking) and ease of donning.

Jobst 20-30 mm Hg Thigh High

This is my second thigh high review as well. On the plus side: the look of these (in black) was close to a non-compression tight. I doubt anyone could tell the difference if they didn't already know it was a compression garment. Also, the material is softer and more comfortable than the Medivens I reviewed previously.

There is one big drawback, though -- the silicon band at the top of the Jobst is not nearly as effective as the one used by Mediven. These stockings need to be pulled up frequently -- whether just after showering, with/without lotion, etc. Powder might help (haven't tried that yet). Is this enough of an irritation not to wear them? Probably not -- they'd be great with a skirt (in winter). But, for every day use, I'd go with a knee-high or the Mediven thigh highs.

In sum ... all options did a good job in keeping swelling in check. There were some differences in comfort and appearance that might be important depending on individual needs. And, since it's winter now, I feel it's important to point out that all bets are off when summer comes! I'm still wondering how I'll figure out the whole compression stocking thing when it's 110 in the shade ... more news on that when it comes in.

One important note: you may be wondering whether knee high or thigh high stockings are indicated based on whether your DVT is in the thigh, calf or both. In may case, the DVT is mostly in my thigh, extending a bit to the calf -- but, my doctor pointed out that knee high is sufficient even in my case, because the calf is where the swelling happens. The swelling prevention results have borne this out -- the knee highs were just as effective. Of course, for overall support, the thigh highs do have an advantage (they were great at a trade show -- least tired my legs have ever been!). Then again, appearance and comfort make a difference, too (hard to imagine the thigh highs being tolerable in the Sacramento summer).

Bottom line: if your swelling tends to be in the lower leg only, knee highs may do the trick, but if you have questions, you should of course ask your doctor!

Catching up

Long time, no post. Happily, a mostly-stable INR, diligent use of some excellent compression stockings, and a gradually increasing regimen of daily walking have helped me get most of my strength and energy back. For the past couple of weeks I've been busy catching up on all the work I fell behind on during nearly a month off, and even found the time (and guts) to take a business trip to Texas! More on that later.

I am pleased to report that finally -- nine weeks post-diagnosis -- I'm starting to feel mostly normal again. I still have some pain when sitting more than 30 minutes or so (so it's unfortunately taking me longer to catch up on work than I would like), and, obviously, I've had to adjust my lifestyle to be sure I get the stockings on to an unswollen morning leg, take my meds on time, eat the right amount of vitamin k, etc. But, emotionally, I think that I'm only just starting to realize how low I'd become, as I can see the marked contrast versus how I'm feeling now.

What does it mean? It's interesting to contemplate the mind-body connection. Even within a couple of weeks of diagnosis, I was medically "okay" to resume all my normal activities. But, the energy just wasn't there. This was no doubt due in part to not exercising at all for a good four weeks. But, even after getting up to a couple miles of walking every day a few weeks ago, I still didn't feel really "right." My affected leg felt like it was dragging, and, most notably, I felt so sleepy all the time -- needing a good hour more every night than I've ever needed before.

Can't help but wonder if my body was just saying, look, you don't get it, but I need to heal! I've never been a great one for "listening to my body." It doesn't help when doctors give you a prescription and a pat on the head and tell you you are fine.

If you're reading this and you've recently had a DVT, are depressed or anxious and wondering whether you're overreacting, know that you're not the only one who has experienced it. My sense is that it really takes a lot longer for your body to recover than it might appear, and, while it's recuperating, your mind may need a little pampering, too.