Defying Death

Death Defying Act

Travel is always a death defying act. I am not afraid of terrorist. The chances of being attacked by a terrorist are roughly 1 in 20 million. I am not afraid of dying in a plane crash as the odds are 1 in 11 million. Most Americans have more to fear from a bath, where the likelihood of drowning is 1 in 800,000, than they do from travel. My fear comes from within my own body where my blood waits to clot during any period of prolonged inactivity such as my upcoming transpacific flight. For me a silent deep vein thrombosis (DVT) is far more real and far more likely than any terrorist attack, plane crash, or the threat of a bathtub full of water.

Protein S and Protein C are both natural substances in the blood that help keep the blood from clotting. They act like natural anticoagulants or natural blood thinners. Most people never give these a second thought. Actually, most people probably do not give them any thought but if you are deficient in one or both of these proteins, you are at an increased risk of developing DVT’s.  While many people suffer DVT’s every year, the best known fatality might well be the NBC reporter David Bloom. He was traveling with the U.S. Third Infantry Division in Iraq in 2003 when he suddenly died due to a pulmonary embolism after a DVT. For a brief period of time, DVT discussions filled the news.

DVT’s are not just a theoretical possibility for me. I have had four major DVTs and one surface level clot. The surface vein burst leaving an ugly reminder under the skin of my left leg. The usual treatment is heparin injections followed by a lifetime of warfarin. You may recognize warfarin as the ingredient in some rat poisons. After several years of trying, I stopped taking warfarin. My travel and diet made it impossible to find a proper dosage. When your dosage is off, internal bleeding is one result.  No one likes to see their urine fill the bowl changing the water to the color of a fine Malbec.

Before any travel involving a flight, I start to prepare for the threath of the trip. My preparation ritual might be useful to you. As soon as I can select a seat, I select an aisle seat. This makes it easier to walk up and down the aisle every hour. If I cannot select an aisle seat, I still get up every hour. I do tell the person beside me what I am doing so they are aware that I will be asking them to move every hour to let me out of the window seat.

The week prior to the flight I double my daily aspirin dosage. My normal dose is two full strength aspirin tablets. The week of  the flight I increase this to four full strength aspirin per day. I go back to the regular two per day dose during the trip. I again increase to four per day in preparation for the return flight.

I drink heavily before and during a flight but never drink alcohol. I begin to hydrate the day before the flight. At the airport, I like to buy a bottle of water after I clear security. This makes drinking on the plane easier and the flight attendant will often refill the bottle for you. During the flight I ask for tonic water. Normally you can have the entire can as it is not a popular beverage.

Many airlines now have seat cards with recommended exercises designed to help prevent DVT’s. You can also find examples online if you have not seen one on your regular airline.  I no longer need a card. I do a series of movements between walks. I probably do too many but I like to keep the blood moving. I also wear compression stockings and remove my shoes while seated. This helps with blood flow.

While travel is a death defying act, it is also an incredibly life affirming act. The thrill of cycling in the shadow of Mount Ventoux, standing in front of a Botticelli in Florence, or retracing Paul Revere’s steps in Boston cannot be felt from reading a book or watching a video. Guinness does taste better in Dublin, Pad Thai is best eaten in Bangkok, and Nanaimo bars seem plain outside British Columbia. Knowing that you cheated death makes each trip more thrilling, each taste sweeter, and each sound more musical.

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