Blood thinners packed for travel

Travel insurance and blood thinners

Are you taking blood thinners? Find out how blood thinners may affect your travel insurance

Planning and preparing for a holiday can be stressful for anyone, but if you’re taking a blood thinner such as Warfarin the entire process can be even trickier. It’s important to determine whether or not your medication will impact your ability to get travel insurance. With the right knowledge of the issues involved and careful preparation, you can enjoy a safe and healthy holiday.

Can I get travel insurance if I'm taking blood thinners?

Sometimes. Your ability to get travel insurance while taking blood thinners depends more on the reason you're taking the medication than the medication itself. You will need to declare any pre-existing conditions prior to travel. During this process you'll generally be asked whether or not you're taking any medication. The travel insurance brand will then access your eligibility for cover.

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What is Warfarin?

Warfarin is a commonly prescribed anti-coagulant designed to prevent dangerous clots forming in your blood vessels. These clots can lead to a stroke, or a blockage in a vein or on your lungs.

Warfarin works by slowing down your liver’s production of Vitamin K, which helps your blood to clot. The slower production means it takes longer for clots to form in your blood vessels. As well as preventing clots from forming in the first place, this anti-coagulant is also used to stop existing blood clots getting bigger (this is what happens in deep vein thrombosis) and to prevent parts of a clot breaking off and being transported to the lungs, resulting in pulmonary embolism.

There are a number of common medical conditions and situations for which Warfarin is prescribed, including:

  • Atrial fibrillation (an irregular heartbeat)
  • Artificial heart valves
  • Deep vein thrombosis
  • Heart attack or ischaemic heart disease
  • Pulmonary embolism
  • Following a stroke
  • The prevention of blood clots for those with blood clotting problems

Warfarin needs to be taken once a day, at the same time, following the instructions given by your medical professional. It can lead to certain side effects such as bleeding and bruising, and Warfarin users will also need to seek advice from their doctor before travelling.

Warfarin is also known under the following brand names: Coumadin, Jantoven, Marevan and Waran.

What do travel insurers say about Warfarin and its use?

Warfarin use has significant implications for the cover available under your travel insurance policy. Most insurers will point to the fact that Warfarin can lead to a range of serious side effects and potential complications, and therefore class Warfarin use as a pre-existing medical condition and exclude it from cover.

This means that if you take Warfarin or any other blood thinning prescription medication, any claims for the resulting medical expenses you incur overseas, not to mention any other expenses connected to your injury or illness, will not be paid. Bleeding complications, strokes and haemorrhages will all not be covered.

With this in mind, if you take Warfarin it’s a good idea to approach a number of insurers to find out whether or not any cover will be available to you.

Why is it important to be healthy when flying?

An overseas flight can be stressful at the best of times, but if you’re in poor health, boarding a flight can not only have serious implications for your own wellbeing but also for the health and safety of your fellow passengers. If you’re suffering from the common cold or a more serious pre-existing medical condition, flying can cause a range of problems and side effects:

  • Air pressure. Air pressure changes during a fight may be little more than a minor annoyance for most travellers, but they can affect your heart and respiratory system. It’s essential that those with pre-existing heart or lung conditions check with their GP before travelling to ensure that they are fit to fly.
  • Confined space. When you’re sharing a confined space with a couple of hundred strangers, it doesn’t take long to become aware that you’re all breathing the same air. If you or someone else is suffering from an airborne virus or carrying harmful bacteria, coughing and sneezing can quickly spread any number of nasties throughout the aircraft cabin.
  • Ear and nose problems. Swallowing, popping your ears by yawning and even chewing gum are all handy tips to help you stay comfortable during flight. Those with nasal or allergy problems could benefit from a decongestant spray, while babies can suck on a breast, a bottle or a dummy while in the air.
  • Pregnancy complications. Once you’ve reached the 26th week of your pregnancy, you’ll need to start being aware of any restrictions or bans airlines impose on international flights. Medical clearance will be required before flying if you’re expecting twins (or more) or if you have any pregnancy complications. Even if you have a normal pregnancy that’s proceeding as planned, check with your GP or obstetrician before flying to make sure you do not have to meet any special travel requirements.

What is deep vein thrombosis and what are the risks when flying?

Deep vein thrombosis (DVT) is caused by blood clotting, most commonly in the large veins of the calf muscles. In early 2016, Australian cricket coach Darren Lehmann made headlines when he was hospitalised with DVT. Unable to fly while he recovered, he missed part of the Australian team’s tour to New Zealand.

DVT occurs as a result of slow blood flow, often as a result of inactivity, with dehydration also a factor. In some cases the clots that form can break free and travel to other parts of the body, for example the heart or lungs. If those clots become trapped in the arteries of the lungs they can result in pulmonary embolism, which can be fatal.

Although DVT has long been seen as a problem for those who are immobile or confined to bed, it’s also a significant risk when flying. Not only are you sitting still in a cramped space for a long period of time, but you also need to contend with the dehydrating effects of flying.

Up to 400 people die each year in Australia as a result of pulmonary embolism, with a small portion of those deaths associated with flying.

Facts about blood thinners

  • They don’t actually thin your blood. Although they’re referred to as blood thinners, anti-coagulants don’t actually affect the thickness of your blood — they stop it from clotting.
  • They’re different to aspirin. While low-dose aspiring may be referred to as an anti-clotting medication, it works in a completely different way to an anti-coagulant like Warfarin. Aspirin is an anti-platelet medicine that stops certain types of blood cells binding together.
  • They affect your diet. While some people believe you need to avoid green leafy vegetables when on a blood thinner, this is not true. However, because these types of vegies are rich in Vitamin K, which helps your blood to clot, you’ll need to eat the same amount each week to keep your INR (International Normalised Ratio) stable.
  • They need to be taken consistently. It’s vital that you take your blood thinning medication at the same time every day, as prescribed by your doctor. If you forget to take a dose, contact your doctor for advice — never take a double dose.
  • They actually increase your risk of bleeding. You might think that taking an anti-coagulant would lower the risk of bleeding, but the opposite is true. Nosebleeds, internal bleeding and bruises are all common side effects when taking blood thinning medication. Any signs of blood in your urine or stools should be reported to your doctor immediately.

Who is at risk of DVT?

There are a number of factors that can increase your risk of suffering from DVT when travelling, including:

  • Increased age
  • Being overweight
  • Smoking
  • Being pregnant
  • Using oral contraceptives
  • Undergoing hormone replacement therapy
  • Having had DVT or a pulmonary embolism before
  • Having a family history of DVT
  • If you suffer from a blood clotting disorder, for example thrombophilia
  • Being either very tall or very short
  • Cancer
  • Having undergone surgery in the past two months
  • Suffering from an injury to a lower limb
  • Having recently suffered a severe illness, such as pneumonia or a heart attack

Tips for flying

Keep the following tips in mind to help reduce the risk of DVT when you fly:

  • Drink plenty of fluids during flights — avoid alcohol
  • Coffee and tea can also have a dehydrating effect so minimise your consumption
  • Regularly massage your calves
  • Wear loose clothing that will not restrict movement or blood flow
  • Don’t take sleeping tablets — they lead to immobility
  • Consider wearing elastic compression stockings
  • Take a short walk immediately after your journey to get your blood flowing once again
  • If you’re a high-risk patient, your doctor might advise you to have a heparin injection before flying
  • Exercise your calf and foot muscles regularly when you fly. You can:
    • While seated, bend and straighten your legs, feet and toes every half an hour
    • Walk up and down the aisle one an hour (as long as the flight crew say it is safe to do so)
    • Press the bottom of your feet down hard into the floor or foot rest every now and then to increase blood flow
    • Don’t put bags under the seat in front of you — give yourself as much foot and legroom as possible
    • Get up and stretch your legs whenever possible, including if you have a brief airport stopover

By keeping these tips in mind and remaining vigilant, you can ensure that you stay safe and healthy on even the longest of international flights — leaving you free to simply relax and enjoy your holiday.

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Richard Laycock

Richard is the senior insurance writer at finder.com.au and is on a mission to make insurance easier to understand.

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