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Diabetes, Lovenox, and Bathroom Jane Fonda.

The flight to Las Vegas from Boston is a long one – six hours on the way there and five on the way back.  I talked with my doctors before taking the flight, and being pregnant, I’m dealing with an increased threat of deep vein thrombosis.  The Factor V Leiden gene in my body is also a red flag, so these longs flights caused some concern for my medical team.

“We’re not worried so much as we have some rules for when you’re flying. The first is that you need to get up and move around about once every hour to keep your circulation steady and your legs moving.  And the second thing is that we’d like you to take Lovenox on the days that you’re flying.  That will help combat the Factor V risk.”

Take a shot?  No problem.  At least that’s one thing I can commit to without fear.

So about an hour and a half before my flights took off, I snuck into the airport bathroom and pulled out the pre-filled syringe of Lovenox.  Lovenox is an anti-coagulant drug that helps to prevent blood clots.  I don’t know much about it, other that it’s safe for pregnant women to take and it was one of the conditions set forth by Joslin, so I pretty much do what they say these days.  I’ve never taken anything like it before, so Wednesday evening was my first time.

Fellow diabetics, I just need to say that we have it good with our teeny, ultra-fine needles.  This Lovenox needle was clumsy, long, and thick.  “Inject it right into your abdomen, where you’d normally take an insulin injection,” the doctors recommended, so I did just that.  But it sucked a little bit.  One of the side effects of the injection is bruising and soreness, and they’re not kidding.  Within 15 minutes of taking the injection, a deep red thumbprint popped up on my abdomen, tender to the touch.  

But that seems to be the only side-effect I’ve experienced.  Except for a little bit of paranoia.  And now, a few days after the trip, I have the itchiest, red rash at my injection sites. 

Once a doctor tells me that I could be at risk for something, I do what I can to help mitigate that risk.  For these flights to Las Vegas, I took the Lovenox injections and made sure I was up and about once an hour, but I also did something else.

Every time I went into the airplane bathroom, I did some weird kind of calisthenics.  Thanks to BabySparl, the need to pee is hourly (making me test my blood sugar all the time, wondering, “Is this because of Baby or am I high?), so I’d use the ladies’ room and then face the mirror.  And then do this bizarre mix of high knee raises, running in place, and stretching.  Thankfully, being barely 5’4” gives me enough room to move around in there, but I felt like a tool.

“And stretch!  And stretch!”  I heard Jane Fonda in my head as I faux-exercised in the airplane bathroom.   

I prayed that the stewardesses couldn’t hear me thrashing around in there.  How the hell would I explain that?  “I don’t want a blood clot so I’m doing a little dance here in the bathroom.  That's legal, right?”

The itchy frigging rash from the Lovenox injections.
 
The flights were fine.  (If you don’t count the flight from Boston to Las Vegas, which included an extra hour on the trip due to a strong headwind, expired food, not enough meals for passengers, no movie, and no working radios.  US Airways, you sucked it up on that one.)  Lovenox was a success.  And now I feel like I’ve managed to fit in a workout, even at 35,000 feet.  But I’m curious to know if anyone else has ever taken Lovenox, or another kind of anti-coagulant.  And if anyone has ANY tips at all on dealing with this frigging itchy rash.  It's starting to go away, and I know it's just part of the side-effect fun, but it's making me scratchy-crazy. 

It’s all new to me, and I’d appreciate any feedback from someone who’s been there.  (And if you have airplane exercise tips, share those, too.  I’m heading to Florida in two weeks and am wondering how I’m going to embarrass myself on that plane, too!)

Comments

Sorry I can't help you with your Question Kerri But Your bump is cute.

LOL, I do these stretching exercises when I fly to Japan (12 hours from the west coast) too! Except I do them while I'm waiting in line for the bathroom. As far as I know, it's totally legal. ;) Bend over and touch my toes, reach for the sky, etc.

Have you tried aloe vera for the irritation? My mom had a plant and she'd break off a piece and smear the sap all over the itchy part. It usually works for me, better than lotions.

Safe travels to Florida!

well, not sure if this is going to be helpful or not..but my dad has taken it..mostly when he's been hospitalized. A funny: My mom confused novalog and lovenox and insisted that the insulin my dad took was novalox ..so it's not helpful to you in any way shape or form but your rash looks a little bit like lox. Anyway, on planes, he just gets up and walks up and down. From the amount of people walking up and down the aisles..I think it's pretty common. Usually I will book our seats either in the very back..or very front, so that he's got the greater walking distance to go - I don't know why that matters, it's the same distance if you start from the middle but it makes me feel like I'm doing my part for dad.

I am glad you have such a good team. My previous doctor told me that I was only to come to him for diabetes realted concerns. I was confused bc I thought diabetes messed with everything. :) I switched doctors right away. I have never used Lovenox. I did have to have minor surgery to cut off one vein in my leg that kept swelling after my second child was born. It was very simple. I was told to do lots of walking and stretching to prevent any further problems. So your stretches in the bathroom were right on :)

After I had my first baby I had some mild TIA's (mini strokes, not as dramatic as it sounds) and it was discovered that I had Protein S Deficiency, which is an anti-coagulant in the blood. I had to take Cumadin for several months and slowly weened off.

When I became pregnant with my second, they immediately put me on Lovenox injections and yes, they SUCKED in comparison to insulin needles. I had to take them every morning and by the end of my pregnancy by entire stomach was black and blue. I didn't really notice any other side effects, and I did NOT have a rash like that. Much easier pregnancy and delivery with my second, so YAAAY for your medical and for you knowing about your risks the first time around. :)

I had pre eclampsia both time around. Type 1's have a 20% higher risk of this condition so do some research on this too.... totally not trying to freak you out (I hated it when people told me their pregnancy horror stories when I was preggo) but really great to know the symptoms so you can catch it EARLY. :)

I was given an anti-coagulant while in the ICU last year. I remember the shot hurting and the nurse making a comment about how I should be used to needles.

I fly from the east coast to the west coast several times a year but it used to be a more often. In my seat I do ankle circles and bend my knee and then stretch it out straight. Anything to keep moving. I think between doing little things like that at your seat and getting up to walk around (not to mention the anti-coagulant) you should be good.

Your bump is so cute!

Shes not diabetic, but I think Aliza at Babyfruit wrote about taking Lovenox. Her site is http://babyfruit.typepad.com/baby/

FLORIDA!!!

(I have nothing helpful to add, so I just wanted to express my excitement about your upcoming trip!!) :D

They have me on Lovenox every time I'm in the hospital and bedridden for over a day (most of my stays were like 10 to 15 days back then).

The rash should go away almost a week after the brusing does.

I was told to use lanocane when I got out of the hospital for it, but I never felt the itching in the hospital most likely because I was so down and out due to the heart problems or really really sick.

I would get the stuff every day so brusing for me was huge.

I wish you well

Robert

Kerri, haven't had a chance to read your blog in a while - CONGRATULATIONS!!!!

I have no advice, nor am I preggers, but I can tell you that I'm having sympathy itching just looking at that rash! *scritch scritch*

I think the vlog - shot with a cell phone - Jane Fonda-esque - workout in the airplane blue room could be a big hit on YouTube.

It could be even funnier if it was Larry doing the workout and smashing into walls....

Maybe Chris can work that into a script.

I wear knee high elasticated support stockings when I fly and actually wore them every day in the last few months of pregnancy. Helps with any ankle swelling and achy legs as the bump gets bigger.

I'm T2 and got those same itchy lumps after injecting myself with Byetta. My doctor said it was a localized reaction to the carrier solution. It didn't happen with the samples she gave me, just with the prescription that I began using 60 days later. They must have changed the carrier solution in between, because Byetta really worked for me, but I couldn't take the daily itchy welts. They drove me nutso! I'm so glad you don't have to take Lovenox daily.

And - congrats on Baby Sparl! The baby will be so lucky to have you for its Mom. :-)

Hey, Kerri, just a few tips for you from an RN who gives Lovenox all the time... (Also, my bff has Factor V Leiden, and she has told me I give the shots better than anyone LOL.) There is a little gas bubble in your Lovenox syringe on purpose; you should hold the syringe with the needle down and flick it with your fingernail to get ALL of the gas bubble to the side where the plunger is. After you've cleaned with alcohol, get a good pinch of skin, insert the needle quickly (like throwing a dart) and inject slowly. (I've been told it burns if you do it too fast.) Since your little gas bubble is the last thing in, it kinda seals the medicine into the subQ area, which really decreases the bruising and rash that can come later. Those are my best tips! Good luck! I love your blog.

I took Lovenox, Heparin and other injectable blood thinners every day twice a day for each of my three pregnancies. (And when I was pregnant with the third I had just been diagnosed with diabetes and was MDI so I was taking at least 7 shots per day. (two blood thinners, two lantus, three novolog for meals.) Yeah, fun.) I used my thighs, though. I don't remember getting itchy, but was definitely black and blue. Had to eventually move the shots to my rump and my husband gave them to me. He used to say, "Honey, your butt looks like Beirut."

Lovenox - I had knee replacement June 24th and had to do Lovenox shots for 10 days after leaving hospital. Bent one of the needles still got the shot in

Ugh, I had to take lovenox when we were doing the IVF. My stomach looked like a war zone it was so black and blue. But hey, it beats PIO shots in the butt...

No tips for making it more bearable, but the end result is worth it!

I had to take several things for clotting while I was pregnant. For the itchy spots try an ice cube on it or a really cold rag. Cortizone cream works wonders as well but I can't remember if I used it while I was pregnant.
I also get those same kinds of areas sometimes from my pump sites.

Make sure the alcohol you use to clean your abdomen is completely dry prior to injecting Lovenox. Also, try to resist the urge to rub the injection site after you give yourself the shot. As far as itching- I don't think there would be any contraindication to applying hydrocortisone cream.

Keeping it moisturized will help (and will help with stretch marks too). Just wanted to share my story with you quickly. We have so much in common! I am a T1 diagnosed at age 12 and have elevated Factor VIII numbers. I don't want to scare you, but I'm so glad you are taking the Lovenox. It burns when you inject it and it gives you crappy rashes, but its worth it, trust me. I had a stroke at age 28 and it was attributed to birth control pills and my factor VIII levels. You're doing the right thing being ultra-aware and on top of things, so good for you. Isn't it so much easier to take care of yourself when you know that its not just you you're taking care of? You're doing great! Keep it up! :) Any questions, please email me!

Well, you could always join the mile high club...

OMGosh, I just snorted. Don't post this if you find it at all offensive, but it just made me laugh.

Bethanne - DING DING! I was waiting for that comment. :)

Omg it sounds crazy but I dont think you have to hide in the bathroom to do the cals, was on a flight from africa once and I asked the stewardess if I could walk around in the cabin every few hours and she was cool with it, after I explained I was diabetic. I think they would understand plus the cute baby belly syndrome, you should work that to the maximum. CONGRATS by the way.

My mother would be so proud. ;-) Hope your abdomen is feeling better soon.

Hi Kerri,

I read your blog all the time. I'm not diabetic, but I appreciate what you have to say about living with a chronic illness so much, and you encourage me to be healthy too. I'm 29 and I have a congenital heart condition which I found out about 3 years ago. I now have a pacemaker, which makes airports fun (can't go through the metal detector). After my first heart surgery I had to take blood thinners (plavix with aspirin). It help my migraines (which are weird), so i think my doctors are concerned about blood clots too. So now I still take plavix. I bruise really easily, but I'm so used to it it's kind of funny, as my bruises tend to freak other people out and I just shrug. Other than that, unless I get a paper cut, the side effects aren't so bad. I hope the itching stops though. Itching is the worst.

Melissa

I, too, was a concern to my doctors for blood clots, so I was to start taking baby asprin every day. Then at around 12 weeks, the doctor put me on Fragmin (injected once daily). I could inject them in my arms, thighs or abdomin. And yes, the bruising!! These little suckers were expensive, too. Approx $12/shot... per day... plus all the other meds for high blood pressure and diabetic supplies... Then I had to stay on the Fragmin for 6 weeks post pregnancy. These were a pre-filled syringe with a spring loaded needle. A lot of my nurses never even saw them before, once I went into hospital, and I had to show them how to use them. It was funny.... But as for the blood thinners... totally worth it, bruises and all! You're lucky if you only have to take them while you fly!!!!

Kerri,
Haven't been reading too many blogs lately, so imagine my suprise and happiness when I found out today that you are expecting. I am so excited for you!!!!!!

I got a blood clot in my first pregnancy when I was about 13 weeks pregant. I was on Heparin (also an injection) for the rest of the pregnancy. (Heparin is horrible and hard to regulate. Had to have blood drawn every other day to keep the levels right. Be glad Lovenox was invented.)

The second pregnancy (Riley) I was put on Lovenox as a prophylactic to avoid getting another nasty blood clot. I took it the entire pregnancy. So, I know how you feel. I too, experienced a lot of bruising and some itchy rashes here and there. Not to mention, it burned like a mofo every time I used it.

Don't have any advice on what to do about it, just wanted to let you know I've been there and yes, it does suck. Also, to let you know that I had no complications whatsoever from taking it while I was pregnant.

I take lovenox everyday and i had just about every side effect brusing swelling shortness of breathe you name it, but when i stopped doing the injections in my stomach and started doing them in my inner upper thigh it all got better. I wish i new i could have done it there from the beginning its less painful and suprisingly no side effects now.

did taking lovenox affect your blood sugar levels?

I have had to inject myself with lovenox for 14 days now..it sucks!! I just started to get the itchy rash and bruising/bumps...I feel for you!

The first is that you need to get up and move around about once every hour to keep your circulation steady and your legs moving. That will help combat the Factor V risk. Except for a little bit of paranoia. And if anyone has ANY tips at all on dealing with this frigging itchy rash. From the amount of people walking up and down the aisles. Usually I will book our seats either in the very back. My previous doctor told me that I was only to come to him for diabetes realted concerns. I was confused bc I thought diabetes messed with everything. I did have to have minor surgery to cut off one vein in my leg that kept swelling after my second child was born. I was told to do lots of walking and stretching to prevent any further problems. I had to take Cumadin for several months and slowly weened off. I remember the shot hurting and the nurse making a comment about how I should be used to needles. In my seat I do ankle circles and bend my knee and then stretch it out straight. Helps with any ankle swelling and achy legs as the bump gets bigger. My doctor said it was a localized reaction to the carrier solution. Had to eventually move the shots to my rump and my husband gave them to me. My stomach looked like a war zone it was so black and blue. For the itchy spots try an ice cube on it or a really cold rag. Just wanted to share my story with you quickly. I hope the itching stops though. plus all the other meds for high blood pressure and diabetic supplies. Had to have blood drawn every other day to keep the levels right. I took it the entire pregnancy. I wish i new i could have done it there from the beginning its less painful and suprisingly no side effects now.Greetings I am so glad I found your site, I really found you by accident, while I was browsing on Bing for something else, Regardless I am here now and would just like to say thanks for a fantastic post and a all round enjoyable blog (I also love the theme/design), I don’t have time to browse it all at the moment but I have bookmarked it and also added in your RSS feeds, so when I have time I will be back to read more, Please do keep up the superb work.

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