Blood thinners/ Advice needed

Quoted message said:

Hello all. I've been a RBR lurker for years. I feel like i almost
know many of you. Anyhow, I'm hoping to get some input from other
cyclists who may have encountered similar problems to what I'm facing.
Here's the scoop.

I'm a relatively fit 36 yr old cyclist that rides a fair amount
(approx. 5,000 miles last year). Last week I ended up in the ER with a
small blood clot in my lung. Currently, I'm on the shelf but would
like to return to a good exercise routine as soon as possible. I've
started on Coumadin for the next 3-6 months and must avoid all contact
sports. From the information I can gather, cycling is okay, crashing
is not. The local pulmonologist is not a sports guy and I can't find
the info I'm looking for on the web.

Here are my ?'s-

1. Will I be able to do high intensity training at any point while on
the Meds?

2. Can there be an issue with internal bleeding due to prolonged time
on the saddle (5 hr rides?)?

3. Do any of you know of a good resource related to sports & blood
thinners? I've tried the general & company sites related to drugs but
come up empty.

Any input is appreciated. (Even a "Dumbass" from Kurgan)
Scott

Nice Troll

In article <[email hidden]>,

Quoted message said:

Hello all. I've been a RBR lurker for years. I feel like i almost
know many of you.

And you still asked the question? (heh)

--
tanx,
Howard

Butter is love.

remove YOUR SHOES to reply, ok?

Howard Kveck said:

In article <[email hidden]>,

Quoted message said:

Hello all. I've been a RBR lurker for years. I feel like i almost
know many of you.

And you still asked the question? (heh)

--
tanx,
Howard

Butter is love.

remove YOUR SHOES to reply, ok?

I suppose he could be hoping that Andy might actually be still wasting
his time lurking or that one of those rare events happen and someone
else is helpful and actually knowledgeable.
Bill C

Quoted message said:

Here are my ?'s-

1. Will I be able to do high intensity training at any point while on
the Meds?

2. Can there be an issue with internal bleeding due to prolonged time
on the saddle (5 hr rides?)?

3. Do any of you know of a good resource related to sports & blood
thinners? I've tried the general & company sites related to drugs but
come up empty.

I have exactly one experience with blood thinners when a doctor
misdiagnosed a bad case of tendonitis for rheumatoid arthritis. Kept
riding and ended up in the emergency room without an accident of any
type - just a major case of internal bleeding. I'm not sure I would do
anything while on blood thinners unless I had a long conversation with
a knowledgeable doctor I trusted. BTW, I can give you the name of one
that can get you killed...

(Also BTW, he got more money from the IPA for telling me how he almost
got me killed and telling me not to take any more of the medicine that
he prescribed - and I didn't even get money back on the prescription.)

Curtis L. Russell
Odenton, MD (USA)
Just someone on two wheels...

Curtis L. Russell said:

I'm not sure I would do
anything while on blood thinners unless I had a long conversation with
a knowledgeable doctor I trusted. BTW, I can give you the name of one
that can get you killed...

Blood thinners are no more dangerous than orange juice.

--
Firefox Web Browser - Rediscover the web - http://getffox.com/
Thunderbird E-mail and Newsgroups - http://gettbird.com/

Ewoud Dronkert said:

Blood thinners are no more dangerous than orange juice.

This is why I try to stick to bourbon and beer. And the occasional
bottle of wine.

Orange juice is only safe if you add enough vodka to kill the more
dangerous properties and additives. 'Pulp' never did sound very safe
to me.

Curtis L. Russell
Odenton, MD (USA)
Just someone on two wheels...

<[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

1. Will I be able to do high intensity training at any point while on
the Meds?

2. Can there be an issue with internal bleeding due to prolonged time
on the saddle (5 hr rides?)?

3. Do any of you know of a good resource related to sports & blood
thinners? I've tried the general & company sites related to drugs but
come up empty.

I'm on Acenacoumarol (also a blood thinner) since 1999, and I will be for
the rest of my life because I have some hereditary anomalies in my blood. I
have spoken to a couple of MDs about 6 hour rides and they have told me that
apart from falling there should be no problems / internal bleeding etc..
This weekend I will be riding the Amstel Gold Race for the third time (the
cyclotourist version on saturday!! NOT the race on sunday) and I have never
had any problems with riding my bike for 7 hours in a row or for a couple of
weeks every day in a row.

I think I should point out that the Netherlands (where I am located) is one
of a very few countries in the world where people who take bloodthinners are
checked frequently (once every 2 - 3 weeks) to prevent internal bleedings
etc caused by taking too much bloodthinners...
So if you're not 100% certain that the INR
(http://www.hemosense.com/patient/pt_inr.html) of your blood
has the correct value, there is a very high risk of internal bleedings....

Since a couple of months I can do the checking of my blood at home in a few
seconds so I know that the risks for me are reduced to a minumum.

The only problem I have is that I can't get a license to race because of the
high risk of bleeding to death when I fall... And of course you're saying to
yourself when you're going down a mountain with 80km/h "if I fall...." but
apart from that, the bloodthinners are not stopping me from riding 7.000kms
a year..

patrick
(p.s. male, 27)

Quoted message said:

Hello all. I've been a RBR lurker for years. I feel like i almost
know many of you. Anyhow, I'm hoping to get some input from other
cyclists who may have encountered similar problems to what I'm

facing.

Quoted message said:

Here's the scoop.

I'm a relatively fit 36 yr old cyclist that rides a fair amount
(approx. 5,000 miles last year). Last week I ended up in the ER with

a

Quoted message said:

small blood clot in my lung. Currently, I'm on the shelf but would
like to return to a good exercise routine as soon as possible. I've
started on Coumadin for the next 3-6 months and must avoid all

contact

Quoted message said:

sports. From the information I can gather, cycling is okay, crashing
is not. The local pulmonologist is not a sports guy and I can't find
the info I'm looking for on the web.

Here are my ?'s-

1. Will I be able to do high intensity training at any point while

on

Quoted message said:

the Meds?

2. Can there be an issue with internal bleeding due to prolonged

time

Quoted message said:

on the saddle (5 hr rides?)?

3. Do any of you know of a good resource related to sports & blood
thinners? I've tried the general & company sites related to drugs

but

Quoted message said:

come up empty.

Any input is appreciated. (Even a "Dumbass" from Kurgan)
Scott

Hi Scott

Congratulations on surviving a pulmonary embolism. 1/3 do not.

I was diagnosed with a calf to thigh dvt in October and was on coumadin
for 4 months. DVT is considered a disease of the elderly or sedentary
so you will find little informaiton out there related to exercising and
dvt and coumadin. I coudl only find one research on exercising after
dvt and that was just on getting people to walk and not have them on
bed rest. Most doctors don't know much either and I have found the best
information to come from the experience of others.

A few things:
1. I would wait about 2-3 weeks before beginning any exercise. It takes
a blood clot about 10 or so days to harden and become scar tissue (if
it still remains). Until then, there is still danger of it becoming an
embolus. And when you do start, start slowly.

2. Exercise will lower your INR. Let your doc or coumadin clinic know
that you are beginning an exercise program so they can adjust your
dosage accordingly. My INR dropped from 2.2 to 1.5 after the first week
of exercising and my dosage had to be almost doubled. If you keep your
exercise consistent, your INR should hold steady.

3. Exercising on coumadin will not hurt you (except for crashing). It
can lower your red blood cell count (more so in women than men) and so
you may feel more fatigued. I imagine the damage to your lung will also
have some effect. Also, coumadin makes recovery a little more
difficult. All of those little muscle tears that happen as a result of
heavy exercising take longer to "heal" because they bleed into your
muscles longer.

4. Exercising is the best thing you can do to recover from a dvt. If
you caused any damage to your veins from the clot, the exercise will
strengthen your veins or encourage collatoral veins to pick up the work
of any damaged veins. PLus it just makes you feel good.

I began walking after two weeks and riding after 4. My calf hurt a lot
especially when I first started, so I'm not certain what effect you
will feel in your lungs. I worked my way up to 4 and 5 hour days and
the only effect was additional fatigue and additional time needed for
muscle recovery. I did just about everything I normally would do,
including mountain biking. I just descended very slowly and avoided
sketchy group rides.

I have a friend who is a coumadin lifer and he continues to race and
train for road, mountain bike and cross racing. So exercise is entirely
achievable while on coumadin. Just be careful.

There is a yahoogroups with other dvt/pe people
http://health.groups.yahoo.com/group/thrombosis
good general info can come out of that, but not a lot of athletes in
the group.

happy healing

Sabine
www.velobella.org

Ewoud Dronkert said:

Blood thinners are no more dangerous than orange juice.

And if they don't work, try beta Blockers and then Psychomotor Stimulants

--
Regards,
Ila Kutcherkokoff
(Lorena's Cousin)

http://www.arthurandrew.com/neprinol

Should not be taken with prescription blood thinners without doctor's
permission. The blood thinning properties are good for healthy
athletes as well by optimizing blood viscosity.

Quoted message said:

Hello all. I've been a RBR lurker for years. I feel like i almost
know many of you. Anyhow, I'm hoping to get some input from other
cyclists who may have encountered similar problems to what I'm facing.
Here's the scoop.

I'm a relatively fit 36 yr old cyclist that rides a fair amount
(approx. 5,000 miles last year). Last week I ended up in the ER with a
small blood clot in my lung. Currently, I'm on the shelf but would
like to return to a good exercise routine as soon as possible. I've
started on Coumadin for the next 3-6 months and must avoid all contact
sports. From the information I can gather, cycling is okay, crashing
is not. The local pulmonologist is not a sports guy and I can't find
the info I'm looking for on the web.

Here are my ?'s-

1. Will I be able to do high intensity training at any point while on
the Meds?

2. Can there be an issue with internal bleeding due to prolonged time
on the saddle (5 hr rides?)?

3. Do any of you know of a good resource related to sports & blood
thinners? I've tried the general & company sites related to drugs but
come up empty.

Any input is appreciated. (Even a "Dumbass" from Kurgan)
Scott

Thanks to you folks for the thoughtful replies. I'm definately
swearing off orange juice! Anyhow, you've definately given me food for
thought. The more I think about it, the luckier I feel for getting
through this pretty unscathed. It's frustrating to have a season lost
but there are certainly more important things to worry about. I'm
happy to hear that people have been able to bike without problems while
on coumadin. It doesn't sound like trauma from sitting on the seat is
that big an issue. I've been considering a recumbent to put on the
trainer to eliminate the risk of bruising from the seat. Again, thanks
for the info.
Scott

Someone has paged me to join this thread so I guess I should.

As usual others have posted some advice, most good and some bad. Some of
the bad has been related to confusion about what a "blood thinner" is. The
term is a common usage slang to refer to drugs that inhibit blood clotting.
Since blood does not clot because it is "thick" the term is a misnomer.

To answer the questions posted:

1. Yes, you can do high intensity training while on Coumadin.

2. All bleeding is more likely while on Coumadin. This risk can be
decreased but not eliminated by frequent monitoring of coagulation status
with regular PT and INR measurements as should be done with all patients on
Coumadin. There is normally not any bleeding associated with prolonged
saddle time in patients not on Coumadin. It is not likely that there would
be any problem with patients taking Coumadin.

3. I am not aware of any good resources on this subject.

Some general items on the subject:
- Coumadin interacts with many drugs and foods, as I am sure that your care
providers will tell you. Paying careful attention to this is important to
decrease the problems associated with taking Coumadin.
- The information that you have found "cycling is okay, crashing is not" is
good. The issue is that if you bleed you will bleed more when you are
taking Coumadin. If you have an injury in a fall you will bleed more than
you would not on Coumadin. If the injury is a simple abrasion then no big
deal since that will stop eventually. If you break a bone then it ill bleed
more but again this is not often a big deal. If the injury is a bleed in
your brain from a head injury or in the abdomen from abdominal trauma then
it will be a lot bigger deal for you than it would be for a patient not on
Coumadin. On the other hand, a bleed in the brain or the abdomen is a big
deal for anybody.
- Basically you will be at higher risk when doing activities that might
result in trauma compared to people not on Coumadin. This includes bike
riding but also driving in a car, taking a shower, etc. Assessing how much
risk is difficult to do since the probability of injury is difficult to
quantify. Whether you want to accept that risk is up to you.
- If you don't have some risk factor that gave you the clot in your lungs,
and possibly even if you do, you should have an evaluation for disorders
that cause increased clotting. If such a disorder is found it may make some
differences in how long you stay on the Coumadin.

Hopefully this provides some help. If you have any other questions feel
free to contact me directly or in the newsgroup.

--
Mike Murray MD

<[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Hello all. I've been a RBR lurker for years. I feel like i almost
know many of you. Anyhow, I'm hoping to get some input from other
cyclists who may have encountered similar problems to what I'm facing.
Here's the scoop.

I'm a relatively fit 36 yr old cyclist that rides a fair amount
(approx. 5,000 miles last year). Last week I ended up in the ER with a
small blood clot in my lung. Currently, I'm on the shelf but would
like to return to a good exercise routine as soon as possible. I've
started on Coumadin for the next 3-6 months and must avoid all contact
sports. From the information I can gather, cycling is okay, crashing
is not. The local pulmonologist is not a sports guy and I can't find
the info I'm looking for on the web.

Here are my ?'s-

1. Will I be able to do high intensity training at any point while on
the Meds?

2. Can there be an issue with internal bleeding due to prolonged time
on the saddle (5 hr rides?)?

3. Do any of you know of a good resource related to sports & blood
thinners? I've tried the general & company sites related to drugs but
come up empty.

Any input is appreciated. (Even a "Dumbass" from Kurgan)
Scott

Curtis L. Russell said:

Ewoud Dronkert said:

Blood thinners are no more dangerous than orange juice.

This is why I try to stick to bourbon and beer. And the occasional
bottle of wine.

Orange juice is only safe if you add enough vodka to kill the more
dangerous properties and additives. 'Pulp' never did sound very safe
to me.

Right. Did you ever see "Pulp Fiction"? Scary stuff.

Quoted message said:

swearing off orange juice!

I was parafrasing Michele Ferrari, see inset at
http://www.cyclingnews.com/riders/2003/interviews/?id=ferrari03b#equipe

--
Firefox Web Browser - Rediscover the web - http://getffox.com/
Thunderbird E-mail and Newsgroups - http://gettbird.com/

Sabine said:

I have a friend who is a coumadin lifer and he continues to race and
train for road, mountain bike and cross racing. So exercise is entirely
achievable while on coumadin. Just be careful.

There is a yahoogroups with other dvt/pe people
http://health.groups.yahoo.com/group/thrombosis
good general info can come out of that, but not a lot of athletes in
the group.

happy healing

Sabine
www.velobella.org

Great post - a keeper.

I don't have trouble with thrombo, or varicosity afaik, but I do wear knee
length compression socks, 20-30mm/Hg when I ride. I read an article that it
helps with blood return from the feet, and acts like a mini-heart pump.
Don't have the article handy, but could probably dig it up.

Er, generally don't wear them during the summer though. <g> Maybe if I
could find them in 'tan' <hehe>, these are black.

IMO, if you are showing any edema in the lower legs it might be worthwhile.
You can tell by pressing your thumb into your leg and if it makes a
depression, that's 'pitting edema'. My wife has it from time-to-time. I've
had it a couple times - not sure why. (I'm 50-ish)

Good to read that cycling can help improve the veins - had not heard that.

jj

I am a heathy 65 year old male cyclist who got a blood clot in my lungs. I am on blood thinners now. Will that affect my performance? I ride a hundred miles a week. Should I dial it down? Thx Lynn LeMone