Flying long-distance after having a stroke

I’ve just arrived in the UK for some Japan friends’ wedding on New Year’s Day. I always get a bit anxious before flying long-distance, especially since my strokes. Before the hole in my heart (PFO) was found, I suffered from deep vein thrombosis years ago after a long flight, and ever since then I have always felt a bit anxious before flying. It starts a couple of weeks before I fly, when I start worrying about leaving the dogs, traveling around England to see everyone, stressing about leaving my work (which I really love and have never felt the need to take a break from); and there is the underlying worry about my health and the flight itself.

I have what my husband calls a “30-minute-meltdown” on the morning of the actual flight, just before we leave the house, which is always quite entertaining for our friends who stay in our house with the dogs while we are away. (Very wisely this time my husband disappeared for 30 minutes, claiming he had to do some last-minute errands.) And as soon as we leave the house I go into the next stage of anxiety, which is worrying about my heparin injection.

After you’ve had a stroke you need to do several things to minimize the risk of having another stroke, and long-distance flights increase the risk. I’ve had the hole in my heart surgically closed with a titanium implant, so it would be highly unlikely for any blood clots that may form during a flight to make their way to my brain; but despite the PFO closure I am still at risk of a pulmonary embolism. A side effect of the PFO closure has been almost daily migraines since the implant took effect in the autumn of 2007; aspirin every morning and a couple of glasses of red wine in the evening keep the migraines away for the most part, and also reduce the likelihood of clots forming. For a PFO to be life-threatening, as mine was, the person also needs to have a blood-clotting disorder. 10% of people have a PFO without it ever causing them any problems; unfortunately I also have a blood-clotting disorder hence the multiple strokes.

You would think that the PFO closure, daily aspirin, red wine, and surgical stockings (the most unattractive of attire that eliminates the possibility of me ever joining the mile-high club) would all be enough for a stroke survivor to fly with confidence, but there is one final preventative measure that people with blood-clotting disorders need to do within an hour or so before they get on a plane: the heparin injection.

The right amount of heparin will prevent blood from clotting for about 12 hours, just about the right time to get to London from Tokyo. The heparin comes in small syringes so that you can take along an injection and ask an airport clinic to have someone administer it for you, or you can inject yourself. The first time I had to take it I got the airport clinic to administer it (¥7,000!) then the next few times I got my husband to do it for me, which I think he quite enjoyed. It’s actually really easy: you pinch a bit of skin just to one side of your belly button, swab the area clean, take off the safety cover of the needle, and push the needle in sideways, then push down on the stopper. It’s quick and doesn’t hurt at all; it’s the thought of doing it to yourself that is more disconcerting than the actual injecting. And finding the appropriate place in an airport to inject yourself is always amusing … I will write another time about what happened in Bangkok!

For me, as soon as I’ve injected myself, all my anxieties about flying disappear. And if you are a stroke survivor, or someone with a blood-clotting disorder, there really isn’t any need to worry about flying long-distance if you are following all of the aforementioned precautions. And if you’re flying on Virgin Atlantic, my all-time absolute favourite airline and the only way to travel, then you can sit back (or lie down if you are in Upper Class) and enjoy a wonderful 12-hour journey.

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