Jogging on Santa Monica’s beach, a
traveler twisted his ankle. He went to a clinic where an X-ray revealed no
fracture.
That was two days ago, he
informed me, and the ankle was healing. He was to fly home tomorrow, and his
doctor in Switzerland
had suggested he get an injection to prevent a blood clot. I receive a
sprinkling of these requests, all from foreign travelers. They began a few
years ago when the media began reporting clots in travelers after long plane
flights. The risk in healthy people is tiny but not zero and concentrated among
those who fly more than four hours.
Drugs to thin the blood
such as Coumadin and heparin have been around for decades but are too dangerous
for healthy people. In 1993, the FDA approved Lovenox, a refined form of heparin,
safe enough for use outside a hospital. My wife gave me six weeks of daily
injections after I broke my leg in 2003. It was still under patent and wildly
expensive, but generics have appeared, so it may soon become fashionable to get
a shot before a long flight.
So far no Americans have
mentioned the subject, and I give foreigners the traditional advice: walk
around and drink plenty of fluids. Techniques that don’t work include
compression stockings (unless fitted by a professional they may make things
worse) and taking aspirin. Aspirin prevents clots in arteries, but clots from
immobility occur in veins.
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