DVT

[Ghery]

5 years ago I had 3 clots in my right lung that appeared to have come from the surgery site (prostatectomy). 6 months on Warfarin, didn't bother with an SI and then back in the air when I got the SI for PC. Got in the air again, completed my IR and all has been well.

One of the fears of those who spend too much time riding in pressurized aluminum mailing tubes around the world is DVT (Deep Vein Thrombosis). Too much time sitting and you might get a clot in one of your legs. Well, in the past 5 weeks I was home 1 week. 4 trips by air. Shortest to Denver, longest to Brussels. Got back from Brussels last Friday night. Got up Saturday morning with some of the biggest, unexplained, bruises on my left foot and ankle you'd ever not want to see. Pretty good swelling, too. Pain in a lot of the area as well.

Went to the lab Monday morning for a PSA test (5 years post-op) and then figured as long as I was in the area I'd cross the parking lot to my PCP's office and see if they could take a walk-in and see why my foot, ankle and leg were so swollen. Well, that took care of the morning. The doctor looked at what I had been doing and what he saw and had me go immediately to the hospital for Doppler ultrasounds of my leg. Yup, clot behind the knee. So, back on the Warfarin for 3 months. I remember the drill from 5 years ago, and with this only being 3 months I'll just ground myself for the time being, rather than deal with the SI stuff. After 3 months the doctor wants to run tests to see why I developed these clots. Oh, and last time I wound up in the ICU, so I didn't have to give myself the heparin shots. Do it myself this go-around. I hate needles, but a guy has to do what a guy has to do. 2 down, 3 or 4 more to go.

Football season has begun. I had a plane reserved for the trip across the state this weekend. I guess we're driving. All season.

So, Bruce, what do I do after I'm off the rat poison? Or is this looking more like light sport time is my future? This isn't fun, but at least I'm still on the right side of the grass.

 

[denverpilot]

Damn. I have another friend who's fighting DVT. Similar trigger (long airline flights overseas for business trips).

I guess I will continue to **** off people on really long flights if I don't get the requested aisle seat and work my way out to stand up. My back can't take an airline seat for more than a few hours straight anyway and if the legs start hurting, I'm up if it isn't turbulent.

Humans just weren't built to sit for hours and hours on end. I'll continue pacing around the office with the excellent wireless headset on conference calls, too. Too many IT buddies with various "sitting too long in a chair staring at a monitor" types of injuries.

Sorry to hear this G, but glad you're not dealing with it lodged in a lung, or dead.

 

[denverpilot]

Oh by the way. That car trip? Get used to and get the family used to stopping at a minimum every two hours and walking around.

 

[docmirror]

Sounds like me. Eventually we found that I had a defect in one of my clotting agents. You may wind up taking a huge battery of blood tests that check for about a dozen odd things. One of those dozen odd things was my gotcha.

I'm working toward recert now, and it's a slow process, but there is light at the end of the tunnel so I've been told. Doc Bruce will give you the low down. For now, the advice I have for you is to keep EVERY scrap of paper you get from your time spent with the various docs, including your lab work. You will need basically everything from the time you first got the DVT diagnosis.

 

[Lawreston]

Sorry to hear; hope it subsides quickly.

HR

 

[Jr Hampton]

I don't post vey often, but this is a subject I'm more than familiar with. I can share my story just in case you think flying is all over. I am currently a lifelong warfarin user. I have had my SI since 2008 and just got my renewal for AASI last year this month. I'm good 'til 2017. Although I think I'll go do another medical at 39. I'm 37 years old and have had 2 DVT events. Unfortunatly, I have had hemotologists do all the blood work only to find nothing. And no causal event for the DVTs. My PCP said generally after the second event you're pretty much on it for life. That was long before I became a pilot. Yeah, I got to do all the lovenox shots in the belly at home. Beats being in hospital. With much help and guidance from Dr Bruce, here on this board, it is now pretty easy to go in every year for my AME assisted special issuance. Just have to keep good med records. Finding an AME to do this was rather difficult though. There are not many like Bruce left. And they are dissapearing fast. Make sure you keep all your reports and get a last dopplar showing all clear. If you get stuck on lifelong anticoagulant, It's not really a flying killer. Managing your INRs is not really that difficult (think diet). There are a couple of hoops to jump through, but nothing insurmountable .Of course I say that, but I've been doing it for over 10 years now. Hope this helps and may give you a little sigh of relief.

 

[mnewb1]

I don't post vey often, but this is a subject I'm more than familiar with. I can share my story just in case you think flying is all over. I am currently a lifelong warfarin user. I have had my SI since 2008 and just got my renewal for AASI last year this month. I'm good 'til 2017. Although I think I'll go do another medical at 39. I'm 37 years old and have had 2 DVT events. Unfortunatly, I have had hemotologists do all the blood work only to find nothing. And no causal event for the DVTs. My PCP said generally after the second event you're pretty much on it for life. That was long before I became a pilot. Yeah, I got to do all the lovenox shots in the belly at home. Beats being in hospital. With much help and guidance from Dr Bruce, here on this board, it is now pretty easy to go in every year for my AME assisted special issuance. Just have to keep good med records. Finding an AME to do this was rather difficult though. There are not many like Bruce left. And they are dissapearing fast. Make sure you keep all your reports and get a last dopplar showing all clear. If you get stuck on lifelong anticoagulant, It's not really a flying killer. Managing your INRs is not really that difficult (think diet). There are a couple of hoops to jump through, but nothing insurmountable .Of course I say that, but I've been doing it for over 10 years now. Hope this helps and may give you a little sigh of relief.

I am going to Oklahoma in October to train for an AME designation. I have been reading all the "Dr. Bruce" posts I can to help round out the knowledge I will need. I hope I can be as effective and helpful as Dr. Bruce is...I have a lot to learn, but I will work to make sure AMEs in his mold do not disappear.

 

[AcroBoy]

People with a solid tumour like prostate cancer are generally at higher risk for DVT. In combination with prolonged immobilization or sitting with your legs dependent this is really a setup for DVT and PE. You also might have protein C or protein S deficiency, or factor V Leiden, all of which would further increase your risks. You should be talking with your internist.

 

[Ghery]

People with a solid tumour like prostate cancer are generally at higher risk for DVT. In combination with prolonged immobilization or sitting with your legs dependent this is really a setup for DVT and PE. You also might have protein C or protein S deficiency, or factor V Leiden, all of which would further increase your risks. You should be talking with your internist.

I'm seeing him again in the morning after visiting the vampire. The prostatectomy was 5 years ago. PE 4 weeks after that. My job and professional society duties have me riding the airlines too much, but there hadn't been any problems in the intervening 5 years. We'll see what we find out. My PCP wants to run tests to figure out what is going on after 3 months on the rat poison are over.

Fortunately, my AME is a Senior AME who is very proactive in working with his pilots. Plus he's a member of our club and it learning to fly himself. When the time comes I know he'll work with me to get me back in the air.

 

[Everskyward]

Sorry you are having this medical issue, Ghery. I don't really know much about DVT other than it can be triggered by sitting for a long time. I think it's also what those inflatable socks they put on you in the hospital are supposed to prevent. Too bad there is not a portable version for airplanes, but you would need a continuos source of air. I'm also not sure how well they work when you are sitting up rather than lying down.

 

[bbchien]

Ghery, that Orthopedic surgeon Jim N (acroboy) is dead on.
He has some knowledge because clots RUIN otherwise perfect outcomes for the ortho guys.

If your Internist has not obtained Protein A, C and S assays, get thee to a hematologist or somebody who understands clotting.

I have a local Caterpillar exec aviator who has just decided, "hey I'm staying on this stuff. It's not worth getting off. Tell me what to do".

 

[docmirror]

I am goiThank you, ng to Oklahoma in October to train for an AME designation. I have been reading all the "Dr. Bruce" posts I can to help round out the knowledge I will need. I hope I can be as effective and helpful as Dr. Bruce is...I have a lot to learn, but I will work to make sure AMEs in his mold do not disappear.

Thank you, Thank you, Thank you, Thank you, Thank you, Thank you, Thank you, Thank you, Thank youuuuuuuuu!

 

[Papa Foxtrot]

I am going to Oklahoma in October to train for an AME designation. I have been reading all the "Dr. Bruce" posts I can to help round out the knowledge I will need. I hope I can be as effective and helpful as Dr. Bruce is...I have a lot to learn, but I will work to make sure AMEs in his mold do not disappear.

Atlanta is a wonderful place to live and practice!!

Seriously - thank you!!

 

[denverpilot]

Gerry is probably going to get to learn why his wife has always hated pantyhose.

Compression socks are probably in your future, G!

 

[Ghery]

Gerry is probably going to get to learn why his wife has always hated pantyhose.

Compression socks are probably in your future, G!

They are a pain to put on. I have enough trouble reaching down to put on regular socks. Flexibility isn't my long suit.

 

[denverpilot]

We can get ya some boot jacks at the country store.