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Pregnant women can reduce their blood clot risk on flights – National Post

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(Reuters Health) – Pregnant air travelers face a higher risk of blood clots, but they can reduce their risks by walking airplane aisles, drinking water and doing calf exercises, according to a new review.

For women with additional risk, doctors may recommend compression stockings and injectable blood thinners while traveling, the authors write in the Journal of Travel Medicine.

“Both pregnancy and air travel are risk factors for venous thromboembolism, or a blood clot in the legs or lungs,” said senior author Dr. Leslie Skeith of the University of Calgary, a member of the CanVECTOR Canadian thrombosis research network.

Blood clots affect about one to two per 1,000 nonpregnant people each year and are the third leading cause of vascular death after heart attacks and strokes, the authors note. With more than two billion passengers flying each year, about 150,000 cases of travel-related blood clots are diagnosed annually.

Long-distance flights tend to increase the risk by three-fold, yet travel-related studies either don’t include pregnant women or only include a small number and don’t directly investigate how pregnancy increases the risk.

“There is very little evidence to guide what pregnant and postpartum women should do to prevent blood clots while traveling,” Skeith told Reuters Health by email.

Skeith and her colleagues review the many factors that play into an individual’s risk for a blood clot, including height, weight, recent surgery, pregnancy, use of oral contraceptives, hormone replacement therapy and a family history of clots or diseases that promote clotting.

With pregnancy in particular, they write, the risk is higher because of physiological changes, such as slower blood flow and blood vessel dilation. Pelvic blood vessels may also be compressed as the uterus grows. Starting in early pregnancy, the body starts to become hypercoagulable, or more likely to form blood clots. These risks remain higher until about 12 weeks after giving birth.

Although the average pregnant or postpartum air traveler faces an increased risk of clots, the absolute risk estimate is low at less than 1%, the study found.

Pregnant women with other risk factors, such as inherited blood problems, obesity and recent surgery, may face a higher blood clot risk, however. Although the risk depends on individual factors, women with a history of blood clots tend to have a 4% higher risk while pregnant, and those with hormonal-associated blood clots tend to have a 6% higher risk while pregnant.

For most women with a history of blood clots, the risk during air travel still remains low at just over 1%. At the same time, pregnant women who face these higher risks should consider using more extensive blood clot prevention measures while traveling, such as the injectable blood thinner low-molecular-weight heparin (LMWH).

“It is known that LMWH prophylaxis lowers the risk of recurrent thrombosis in women with previous venous thromboembolism,” said Dr. Ida Martinelli of the University of Milan, who wasn’t involved in the study.

However, some studies show that certain blood conditions and blood thinners can lead to complications during delivery, so it’s best to consult a doctor for individual recommendations.

Skeith and colleagues are now studying whether aspirin can prevent blood clots in postpartum women with risk factors for clots. The pilot randomized trial, called PARTUM, is expected to start in 2020.

“We desperately need more research to better prevent blood clots in pregnant and postpartum women,” Skeith said. “We recommend talking to your doctor about different options.”

SOURCE: https://bit.ly/34YV2cm Journal of Travel Medicine, online December 11, 2019.

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Tips for shopping for Medicare Advantage plans

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Shopping season for Medicare coverage is about to begin. With it comes the annual onslaught of TV ads and choices to consider.

People eligible for the federal government’s Medicare program will have from Oct. 15 to Dec. 7 to sign up for 2025 Medicare Advantage plans, which are privately run versions of the program. They also can add a prescription drug plan to traditional Medicare coverage.

Many people on Medicare Advantage plans will probably have to find new coverage as major insurers cut costs and pull back from markets. Industry experts also predict some price increases for Medicare prescription drug plans.

Shoppers often have dozens of options during this sign-up period. Here are some things to consider.

Don’t put off shopping for Medicare coverage

Start thinking about next year’s coverage before the annual enrollment window begins. Insurers will usually preview their offerings or let customers know about any big changes. That makes anything arriving in the mail from your insurer important to read.

Insurance agents say many people wait until after Thanksgiving to decide coverage plans for the new year. That could be a mistake this year: The holiday falls on Nov. 28, leaving slightly more than a week to decide before the enrollment window closes.

Look beyond the premium

Many Medicare Advantage plans promote a $0 premium. That may sound attractive, but price is only one variable to consider.

Shoppers should look at whether their doctors are in the plan’s coverage network and how prescriptions would be covered. They also should know the maximum amount under the plan that they’d have to pay if a serious health issue emerges.

Plans offer many supplemental benefits, including help paying food or utility bills. Don’t let those distract from understanding the core coverage, said Danielle Roberts, co-founder of the Fort Worth, Texas, insurance agency Boomer Benefits.

“Remember that we buy health insurance for the big things, not the frills,” she said.

How to get help shopping for plans

The federal government operates a plan finder that lets people compare options. The State Health Insurance Assistance Program can be another resource. Insurance brokers or agents also guide customers through searches.

Sometimes a plan’s coverage doesn’t work as expected. If that happens, there’s another enrollment window in the first three-months of each year where some shoppers may be able to make a change.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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The US is mailing Americans COVID tests again. Here’s how to get them

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WASHINGTON (AP) — Americans can once again order COVID-19 tests, without being charged, sent straight to their homes.

The U.S. government reopened the program on Thursday, allowing any household to order up to four at-home COVID nasal swab kits through the website, covidtests.gov. The tests will begin shipping, via the United States Postal Service, as soon as next week.

The website has been reopened on the heels of a summer COVID-19 virus wave and heading into the fall and winter respiratory virus season, with health officials urging Americans to get an updated COVID-19 booster and their yearly flu shot.

“Before you visit with your family and friends this holiday season, take a quick test and help keep them safe from COVID-19,” U.S. Health and Human Services Assistant Secretary for Preparedness and Response Dawn O’Connell said in a statement.

U.S. regulators approved an updated COVID-19 vaccine that is designed to combat the recent virus strains and, they hope, forthcoming winter ones, too. Vaccine uptake is waning, however. Most Americans have some immunity from prior infections or vaccinations, but under a quarter of U.S. adults took last fall’s COVID-19 shot.

Using the swab, people can detect current virus strains ahead of the fall and winter respiratory virus season and the holidays. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year. Insurers are no longer required to cover the cost of the tests.

Before using any existing at-home COVID-19 tests, you should check the expiration date. Many of the tests have been given an extended expiration from the date listed on the box. You can check on the Food and Drug Administration’s website to see if that’s the case for any of your remaining tests at home.

Since COVID-19 first began its spread in 2020, U.S. taxpayers have poured billions of dollars into developing and purchasing COVID-19 tests as well as vaccines. The Biden administration has given out 1.8 billion COVID-19 tests, including half distributed to households by mail. It’s unclear how many tests the government still has on hand.

The Canadian Press. All rights reserved.

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Free COVID tests are back. Here’s how to order a test to your home

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WASHINGTON (AP) — Americans can once again order free COVID-19 tests sent straight to their homes.

The U.S. government reopened the program on Thursday, allowing any household to order up to four at-home COVID nasal swab kits through the website, covidtests.gov. The tests will begin shipping, via the United States Postal Service, as soon as next week.

The website has been reopened on the heels of a summer COVID-19 virus wave and heading into the fall and winter respiratory virus season, with health officials urging Americans to get an updated COVID-19 booster and their yearly flu shot.

U.S. regulators approved an updated COVID-19 vaccine that is designed to combat the recent virus strains and, they hope, forthcoming winter ones, too. Vaccine uptake is waning, however. Most Americans have some immunity from prior infections or vaccinations, but under a quarter of U.S. adults took last fall’s COVID-19 shot.

Using the swab, people can detect current virus strains ahead of the fall and winter respiratory virus season and the holidays. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year. Insurers are no longer required to cover the cost of the tests.

Since COVID-19 first began its spread in 2020, U.S. taxpayers have poured billions of dollars into developing and purchasing COVID-19 tests as well as vaccines. The Biden administration has given out 1.8 billion COVID-19 tests, including half distributed to households by mail. It’s unclear how many tests the government still has on hand.

The Canadian Press. All rights reserved.

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