On my way to the Thai Embassy to pick my visa, I had to turn back with a very painful leg – this was diagnosed as an extensive deep vein thrombosis. There followed a two-year period when I could go nowhere and was very limited in what I could do. I was constantly in and out of the warfarin clinic getting my blood cheked. At one of my visits someone mentioned a monitoring machine, so I investigated it immediately and needed no convincing of its worth. About two months later, with my machine in my backpack, I headed off to South East Asia on a long overdue trip!
On arrival in Bangkok, the first thing to hit me was the intense heat. It was a relief to head south to the islands, where I stayed in very basic bungalow huts – often without electricity. A main component in the journey was the jungle – where I went on a three-day trek, visiting remote tribal villages. Walking in such extreme heat and humidity can seriously dehydrate you, which in turn can effect your INR, so it is vital to dring lots of water.
The other challenge when travelling around South East Asia was keeping the strips cool, and one becomes very inventive about cool storage sulutions! I encountered such a challenge on a four-day boat trip in Indonesia. With no electricity, I had to resort to the beer cooler for storage. After about two days all the ice had melted, but remember that your strips are more resilient than you think.
I have prepared a few points to bear in mind if you are thinking of travelling with a monitoring machine.
Be sure to carry a letter from your doctor explaining waht the monitoring machine and strips are needed for. Discuss the possibility of carrying Vitamin K with your doctor. Should your blood become to thin this could come in useful. Be sure to have some sort of cool-bag with you to keep your test strips cool. Be sure to have enough strips. You may find that, being abroad, your INR may fluctuate more than usual. New foods and dehydration can affect your INR. Drink plenty of (bottled) water. Have confidence in your own ability to self-test. Remember that nobody knows your body better than you do!
Marianne Gill/ United Kingdom
INReview Issue 2, Spring 2002, pages 6 and 7