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by Tyler Booker

February 12, 2006 . . . A day I had been anticipating since about ’96, from when I first started following the Bujinkan in high-school. It was the day I would finally study with Hatsumi-sensei. I can’t even put into words the way I felt, since I stayed up the whole night on the 12th. Little did I know that this very trip would begin a very subtle unrecognized fight for my own life…

I am a survivor of a very fatal condition that results from a DVT in extended air travel: a (Bilateral) Pulmonary Embolism. Take a football stadium full of 40,000 people, multiply that five times and you’ll get 200,000. That’s the number of people who die from PE each year, higher than the number who die from breast cancer and AIDS combined.

Before I really get into what a Pulmonary Embolism is, and how I contracted it. I want to talk about ‘”D.V.T.” (Deep Vein Thrombosis), which came before my Pulmonary Embolism diagnosis. You see, for those that don’t know, a DVT is simply a blood clot that develops within your body, most commonly the lower extremities of the body (e.g. the calf). But this clotting is normal, of course, because without normal clotting taking place in the body it would take longer for us to heal when cut or other injuries occur. Fact is, DVT is not at all dangerous . . . it is when your body does not dissolve the clot that it becomes dangerous.

But if you develop a DVT in the calf due to a long period of immobilization, it can turn extremely fatal if not gotten to in time, resulting in a Pulmonary Embolism (you don’t wanna play with that, kids!). That is when the clot breaks off from a wall in one of your deep veins in the leg, and travels to either the heart, lungs, or brain, which needless to say can result in stroke or instant death………yeah. Most commonly, it travels to the lungs.

How does this happen? There are many factors, such as specific past surgical procedures, family history (as far as inherited blood disorders), pregnancy and childbirth, even smoking when combined with other risk factors. There is even speculation that low-air pressure and reduced oxygen levels on flights are linked to this condition, though some sources disagree. I’m not an expert on all of this completly, but common sense would say that basically you should know the health of your body, because of course it can contribute to your blood flow and overall being.

So the thicker your blood is, either from being dehydrated or other factors, the more you can be at risk. Some people swear by using Aspirin before a long flight, which can thin the blood…But I’m not too big on any medication that’s not really natural.. I’d rather a homeopathic alternative, and the good news is that there are many. One of these is nattokinase (a fibrinolytic enzyme isolated from the japanese food Natto, which has the ability to dissolve thrombus…in other words…a budoka’s best friend!) which you’ll read more later.

In my case there were three ways in which the D.V.T. manifested (and I believe these are some of the major ways, with prior medical history not included). Particularly in my case, since this was my first trip overseas, I had never been on a flight for more than 2 to 3 hours. And I had no prior awareness of what can happen on a trip of such a long magnitude, you know? Surprisingly, many people don’t, and have never even heard of such a thing when I tell them. So upon knowing that, I felt a little less like I was the only person uninformed.

One, before the trip, I was completely dehydrated. I hardly ever drink water that much, really. Irony is, before the trip, I suddenly was becoming very, very health conscious, reading all sorts of material. When I think back on the amounts of soda I would consume monthly, it kinda just make’s me sick…actually it does…(sorry Sprite . . . no I’m not, lol). Not saying soda was a direct cause of this. But it’s junk food you know? Really, to an extent, too much of anything is no good for you, of course, right? You have to be conscious of what you put into your body. So the dehydration was one factor, causing poor blood circulation.

Two (and this one seems impossible), but you know when you get pretty relaxed in a Lazy Boy-type of chair, or any chair for that matter, and you end up subtly overlapping your calves, in a light ankle-to-ankle crossed fashion (we all do it). Well……please…don’t do that on long flights. It is not so much crossing your legs which will cause a DVT, it’s the length of time your your legs are in that position (in my opinion though…when I head back to japan Im not doing any type of leg crossing, ::insert grin here::). But really, just avoid any prolonged awkward or cramped hip, leg, or knee positioning while in your seat. Why? You’re simply exerting small pressure to the veins of the leg, (more specifically the “deep vein,” which is responsible for carrying blood back to the heart), and the longer your in that position, the higher the risk can go up. It all has to do with the length of time, I would say. I personally had fallen asleep on the flight while my calves were gently overlapped for many hours, but even so, I didn’t feel cramped at all.

And lastly three, and undoubtedly THE most important thing you MUST do while on the flight is the simplest…GET UP AND WALK! It’s important to get up every now and then to get your normal circulation going.

The night prior to the trip, I had stayed up the whole night — one, because I was excited, and two, because I looked at the length of the flight, I figured I would just sleep the whole way. Why not? It would be daytime when I’d get there anyway. IÂ slept practically the entire trip to Japan without getting up once, except to use the restroom one time. Coming back to the states however, I slept the whole way.

Yes, this was stupid. I’m not afraid of the humiliation…but how could I have known? If you’re on a flight for 4 or more hours, you must get up. A few of the guys at the dojo I told this to said they were gonna start doing jumping jacks on the next trip to japan. But really, just stand up, stretch your legs or even stretch your legs while seated- some ankle rotations with the feet elevated or even just stand up and do ankle raises where the heels leave the ground on your toes, drink plenty of water, and you should be fine.

Remember, every time your leg muscles move, you are helping to push blood back up to the heart. In the deep vein there are these one-way valves which promote the pumping of blood. When blood becomes backed up within the valves do to a lack of movement, it will settle, and this is how the blood clot forms (there is a video in one of the links I’ve provided of how this occurs). You can learn from my mistakes. I’m trying not to make this sound too frightening, but, well…It is what it is. It was a combination of these three factors that contributed to me contracting DVT. Know that DVT doesn’t necessarily come from extended flight travel. It can come from just plain inactivity. Many people in hospitals locked to their bed from injuries have gotten DVT as well.

I remember one night in Central Park when Rob showed us a technique where a light kick is applied to the back of the calf approximately between the gastrocnemius muscles, if I can give somewhat of a pin-point area…somewhere in the back of the middle of the calf. The kick was a slight nick with the heel. Doesn’t seem horrible, but believe me…It’s VERY VERY painful, especially when done over and over and over and over and over again. I really don’t even like thinking about that damn technique. My DVT pain felt twice as bad as that though, and it was consistent. Like an extremely stiff muscle. I had that pain for at least one full week, 2 weeks after I had gotten back from the trip, and it never went away. I just passed it off for nothing in class and kept training. The pain would kind of fade away the more I trained on it, so I continued. But in the morning, or after I got back home from class, the same story — very stiff and painful to stand on.

Due to the fact it was the beginning of March, and the weather was cold, I thought that the frozen weather had something to do with the muscle stiffness. God forbid, if anyone should ever develop these tell-tale signs of pains, you can stop a Pulmonary Embolism from occuring. I have to note, though, that a percentage of people do not have symptoms at all of DVT or even PE (Pulmonary Embolism). I really believe that while some people have symptoms, they’re just so subtle that it seems undetectable. Your body knows when something is wrong, the same as intent training, you just have to perceive it.

What I was specifically diagnosed with was a Bilateral Pulmonary Embolism. What that means is that the clot from my calf had broken up and not only posed the danger of going to my brain or lung, but went to both lungs. When I asked the doc how many clots did he see on the CT-scan, he told me that there were too many to count. This is very very rare. About a week or two before I was admitted I had these dull abrupt pains in my heart area. This was after the calf pain-phase had vanished. Im so used to paying no attention to small injuries in class though. So when these pains started occuring in random one-time intervals, I had just figured I was pushing myself too hard early mournings making up classes in school.

Typically the way this condition is taken care of is with a medication called coumadin (or warfarin). An anticoagulant which thins the blood. It is NOT a clot dissolver however. The method is to simply wait out a time frame (usually 6 months or more depending on different people), and let the body naturally dissolve all clots. Yet in my studies while sitting up in a hospital bed for one month, I had come to find a natural clot dissolving agent (an isolated enzyme) found in a traditional Japanese food called Natto. Natto has high amounts of vitamin K (which adversely have contraindications with a drug like coumadin). So basically if I were to eat a lot of natto while on this medication, it would decrease the Warfarin potency. Good news is, for those of you who hate the taste of natto….::coughing:: a horghh hoorrggh ‘Rob’-horrggh horrgh!! You can get the benefits of Natto in a tasteless pill form- Nattokinase…weakling, ::laughs::. Keep in mind though that there are different brands of Nattokinase, of course. On my part, I am within the process of purchasing a Nattokinase brand stripped of the high vitamin K content naturally found in Natto- the fermented soybean food. Also ,while in overseas one thing I drank a lot of was green tea. I think I drunk that way more than the other guys. For those that don’t know, green tea also has high amounts of Vitamin K which contributes to normal blood clotting. It has not been considered a factor in my condition, but when you think about it, it makes sense. So also the high amounts of green tea I was consuming while in japan, and even when I got back to the states, may have lent a hand in this condition I have as the 4th factor. Even on both plane trips I chose to have green tea accompanied with my meals

Well, I can write more but I think I have already given a substantial amount of information on the subject. And since the japan trip is coming up again soon it was a must I put my other work aside and get this article to you all. Plus there are a few links I’ve added for people wishing to further go into either DVT, Pulmonary Embolism, or Nattokinase.

I forgot to mention also, for those that are interested, you can buy graduated compression stockings, which have also been used to reduce the risk of symptomless DVT in air passengers.

There are some airlines that will give you spoken awareness about this sort of thing before the flight, mine unfortunately — and fortunately — did not. I say “fortunately,” because this whole thing has made me a much more stronger person…a blessing, and a curse, you could say. But you learn from everything, and I see it as though this happened for a reason. I may not be able to see the reason now, but this was for the betterment of my growth not only as a budoka, but as a man. I hope everything I’ve provided can be of a benefit to all who are unaware of DVT and Pulmonary Embolism. Peace and safety to everyone.

DVT links:

http://www.dvt.net/Â (this site contains the very informative deep vein video)

http://news.scotsman.com/topics.cfm?tid=633&id=360802006

http://hcd2.bupa.co.uk/fact_sheets/mosby_factsheets/Deep_Vein_Thrombosis.html

http://www.dvt.net/docs/pdf/InFlightFitness.pdf

Compression Stockings: (I have not had the chance to do further study on these, but I understand that there are different compression levels for the person wanting to use the stockings..you’ll have to talk with your doctor about which level is right for you.)

http://www.mydr.com.au/default.asp?Article=3208

http://www.medicalnewstoday.com/medicalnews.php?newsid=41885

http://www.car-travel-games.co.uk/SHOP/DVT.html

Natto (Nattokinase):

http://en.wikipedia.org/wiki/Natto

http://www.pureprescriptions.com/nattokinase.asp

(Highly recommended — there are many different nattokinase’s on the market now. This however is one of the best, as endorsed by the discoverer- Dr. Hiroyuki Sumi. This also has no vitamin K)

(Originally published in Muzosa Journal 10/06/06 and 11/03/06. Author retains all copyrights.)

by Tyler Booker

February 12, 2006 . . . A day I had been anticipating since about ’96, from when I first started following the Bujinkan in high-school. It was the day I would finally study with Hatsumi-sensei. I can’t even put into words the way I felt, since I stayed up the whole night on the 12th. Little did I know that this very trip would begin a very subtle unrecognized fight for my own life…

I am a survivor of a very fatal condition that results from a DVT in extended air travel: a (Bilateral) Pulmonary Embolism. Take a football stadium full of 40,000 people, multiply that five times and you’ll get 200,000. That’s the number of people who die from PE each year, higher than the number who die from breast cancer and AIDS combined.

Before I really get into what a Pulmonary Embolism is, and how I contracted it. I want to talk about ‘”D.V.T.” (Deep Vein Thrombosis), which came before my Pulmonary Embolism diagnosis. You see, for those that don’t know, a DVT is simply a blood clot that develops within your body, most commonly the lower extremities of the body (e.g. the calf). But this clotting is normal, of course, because without normal clotting taking place in the body it would take longer for us to heal when cut or other injuries occur. Fact is, DVT is not at all dangerous . . . it is when your body does not dissolve the clot that it becomes dangerous.

But if you develop a DVT in the calf due to a long period of immobilization, it can turn extremely fatal if not gotten to in time, resulting in a Pulmonary Embolism (you don’t wanna play with that, kids!). That is when the clot breaks off from a wall in one of your deep veins in the leg, and travels to either the heart, lungs, or brain, which needless to say can result in stroke or instant death………yeah. Most commonly, it travels to the lungs.

How does this happen? There are many factors, such as specific past surgical procedures, family history (as far as inherited blood disorders), pregnancy and childbirth, even smoking when combined with other risk factors. There is even speculation that low-air pressure and reduced oxygen levels on flights are linked to this condition, though some sources disagree. I’m not an expert on all of this completly, but common sense would say that basically you should know the health of your body, because of course it can contribute to your blood flow and overall being.

So the thicker your blood is, either from being dehydrated or other factors, the more you can be at risk. Some people swear by using Aspirin before a long flight, which can thin the blood…But I’m not too big on any medication that’s not really natural.. I’d rather a homeopathic alternative, and the good news is that there are many. One of these is nattokinase (a fibrinolytic enzyme isolated from the japanese food Natto, which has the ability to dissolve thrombus…in other words…a budoka’s best friend!) which you’ll read more later.

In my case there were three ways in which the D.V.T. manifested (and I believe these are some of the major ways, with prior medical history not included). Particularly in my case, since this was my first trip overseas, I had never been on a flight for more than 2 to 3 hours. And I had no prior awareness of what can happen on a trip of such a long magnitude, you know? Surprisingly, many people don’t, and have never even heard of such a thing when I tell them. So upon knowing that, I felt a little less like I was the only person uninformed.

One, before the trip, I was completely dehydrated. I hardly ever drink water that much, really. Irony is, before the trip, I suddenly was becoming very, very health conscious, reading all sorts of material. When I think back on the amounts of soda I would consume monthly, it kinda just make’s me sick…actually it does…(sorry Sprite . . . no I’m not, lol). Not saying soda was a direct cause of this. But it’s junk food you know? Really, to an extent, too much of anything is no good for you, of course, right? You have to be conscious of what you put into your body. So the dehydration was one factor, causing poor blood circulation.

Two (and this one seems impossible), but you know when you get pretty relaxed in a Lazy Boy-type of chair, or any chair for that matter, and you end up subtly overlapping your calves, in a light ankle-to-ankle crossed fashion (we all do it). Well……please…don’t do that on long flights. It is not so much crossing your legs which will cause a DVT, it’s the length of time your your legs are in that position (in my opinion though…when I head back to japan Im not doing any type of leg crossing, ::insert grin here::). But really, just avoid any prolonged awkward or cramped hip, leg, or knee positioning while in your seat. Why? You’re simply exerting small pressure to the veins of the leg, (more specifically the “deep vein,” which is responsible for carrying blood back to the heart), and the longer your in that position, the higher the risk can go up. It all has to do with the length of time, I would say. I personally had fallen asleep on the flight while my calves were gently overlapped for many hours, but even so, I didn’t feel cramped at all.

And lastly three, and undoubtedly THE most important thing you MUST do while on the flight is the simplest…GET UP AND WALK! It’s important to get up every now and then to get your normal circulation going.

The night prior to the trip, I had stayed up the whole night — one, because I was excited, and two, because I looked at the length of the flight, I figured I would just sleep the whole way. Why not? It would be daytime when I’d get there anyway. IÂ slept practically the entire trip to Japan without getting up once, except to use the restroom one time. Coming back to the states however, I slept the whole way.

Yes, this was stupid. I’m not afraid of the humiliation…but how could I have known? If you’re on a flight for 4 or more hours, you must get up. A few of the guys at the dojo I told this to said they were gonna start doing jumping jacks on the next trip to japan. But really, just stand up, stretch your legs or even stretch your legs while seated- some ankle rotations with the feet elevated or even just stand up and do ankle raises where the heels leave the ground on your toes, drink plenty of water, and you should be fine.

Remember, every time your leg muscles move, you are helping to push blood back up to the heart. In the deep vein there are these one-way valves which promote the pumping of blood. When blood becomes backed up within the valves do to a lack of movement, it will settle, and this is how the blood clot forms (there is a video in one of the links I’ve provided of how this occurs). You can learn from my mistakes. I’m trying not to make this sound too frightening, but, well…It is what it is. It was a combination of these three factors that contributed to me contracting DVT. Know that DVT doesn’t necessarily come from extended flight travel. It can come from just plain inactivity. Many people in hospitals locked to their bed from injuries have gotten DVT as well.

I remember one night in Central Park when Rob showed us a technique where a light kick is applied to the back of the calf approximately between the gastrocnemius muscles, if I can give somewhat of a pin-point area…somewhere in the back of the middle of the calf. The kick was a slight nick with the heel. Doesn’t seem horrible, but believe me…It’s VERY VERY painful, especially when done over and over and over and over and over again. I really don’t even like thinking about that damn technique. My DVT pain felt twice as bad as that though, and it was consistent. Like an extremely stiff muscle. I had that pain for at least one full week, 2 weeks after I had gotten back from the trip, and it never went away. I just passed it off for nothing in class and kept training. The pain would kind of fade away the more I trained on it, so I continued. But in the morning, or after I got back home from class, the same story — very stiff and painful to stand on.

Due to the fact it was the beginning of March, and the weather was cold, I thought that the frozen weather had something to do with the muscle stiffness. God forbid, if anyone should ever develop these tell-tale signs of pains, you can stop a Pulmonary Embolism from occuring. I have to note, though, that a percentage of people do not have symptoms at all of DVT or even PE (Pulmonary Embolism). I really believe that while some people have symptoms, they’re just so subtle that it seems undetectable. Your body knows when something is wrong, the same as intent training, you just have to perceive it.

What I was specifically diagnosed with was a Bilateral Pulmonary Embolism. What that means is that the clot from my calf had broken up and not only posed the danger of going to my brain or lung, but went to both lungs. When I asked the doc how many clots did he see on the CT-scan, he told me that there were too many to count. This is very very rare. About a week or two before I was admitted I had these dull abrupt pains in my heart area. This was after the calf pain-phase had vanished. Im so used to paying no attention to small injuries in class though. So when these pains started occuring in random one-time intervals, I had just figured I was pushing myself too hard early mournings making up classes in school.

Typically the way this condition is taken care of is with a medication called coumadin (or warfarin). An anticoagulant which thins the blood. It is NOT a clot dissolver however. The method is to simply wait out a time frame (usually 6 months or more depending on different people), and let the body naturally dissolve all clots. Yet in my studies while sitting up in a hospital bed for one month, I had come to find a natural clot dissolving agent (an isolated enzyme) found in a traditional Japanese food called Natto. Natto has high amounts of vitamin K (which adversely have contraindications with a drug like coumadin). So basically if I were to eat a lot of natto while on this medication, it would decrease the Warfarin potency. Good news is, for those of you who hate the taste of natto….::coughing:: a horghh hoorrggh ‘Rob’-horrggh horrgh!! You can get the benefits of Natto in a tasteless pill form- Nattokinase…weakling, ::laughs::. Keep in mind though that there are different brands of Nattokinase, of course. On my part, I am within the process of purchasing a Nattokinase brand stripped of the high vitamin K content naturally found in Natto- the fermented soybean food. Also ,while in overseas one thing I drank a lot of was green tea. I think I drunk that way more than the other guys. For those that don’t know, green tea also has high amounts of Vitamin K which contributes to normal blood clotting. It has not been considered a factor in my condition, but when you think about it, it makes sense. So also the high amounts of green tea I was consuming while in japan, and even when I got back to the states, may have lent a hand in this condition I have as the 4th factor. Even on both plane trips I chose to have green tea accompanied with my meals

Well, I can write more but I think I have already given a substantial amount of information on the subject. And since the japan trip is coming up again soon it was a must I put my other work aside and get this article to you all. Plus there are a few links I’ve added for people wishing to further go into either DVT, Pulmonary Embolism, or Nattokinase.

I forgot to mention also, for those that are interested, you can buy graduated compression stockings, which have also been used to reduce the risk of symptomless DVT in air passengers.

There are some airlines that will give you spoken awareness about this sort of thing before the flight, mine unfortunately — and fortunately — did not. I say “fortunately,” because this whole thing has made me a much more stronger person…a blessing, and a curse, you could say. But you learn from everything, and I see it as though this happened for a reason. I may not be able to see the reason now, but this was for the betterment of my growth not only as a budoka, but as a man. I hope everything I’ve provided can be of a benefit to all who are unaware of DVT and Pulmonary Embolism. Peace and safety to everyone.

DVT links:

http://www.dvt.net/Â (this site contains the very informative deep vein video)

http://news.scotsman.com/topics.cfm?tid=633&id=360802006

http://hcd2.bupa.co.uk/fact_sheets/mosby_factsheets/Deep_Vein_Thrombosis.html

http://www.dvt.net/docs/pdf/InFlightFitness.pdf

Compression Stockings: (I have not had the chance to do further study on these, but I understand that there are different compression levels for the person wanting to use the stockings..you’ll have to talk with your doctor about which level is right for you.)

http://www.mydr.com.au/default.asp?Article=3208

http://www.medicalnewstoday.com/medicalnews.php?newsid=41885

http://www.car-travel-games.co.uk/SHOP/DVT.html

Natto (Nattokinase):

http://en.wikipedia.org/wiki/Natto

http://www.pureprescriptions.com/nattokinase.asp

(Highly recommended — there are many different nattokinase’s on the market now. This however is one of the best, as endorsed by the discoverer- Dr. Hiroyuki Sumi. This also has no vitamin K)

(Originally published in Muzosa Journal 10/06/06 and 11/03/06. Author retains all copyrights.)

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