Blood thinners and cycling

[onekgguy]

I'm writing this from a hospital bed where i've been for the last 48 hours since being diagnosed with two pulmonary embolisms (one in each lung) and a non occluded blockage in my right thigh. There's a good possibility that I've been having a little too much fun on my Mukluk with the many spills I've taken on it since buying it one month ago.

I'll be on blood thinners for the next 6 to 9 months. My doctor feels I should stay off the bike during that time (obviously no more falls). Does anyone have any experience in this area? I'm content to take his advice considering what i'm going through. I just thought id throw this out to hear what others have to say.

Thanks for anything you may have to offer.

Kevin g

[thwart]

Sorry to hear about it.

Same thing happened to Chris Horner after his injury in the TdF. I kinda doubt he was off the bike that long.

But if you fall you will bleed/bruise more... and if that happens inside your skull... things get really ugly fast.

[Wilkinson4]

Yikes! I am sure there are a few medical professionals amongst us, but I would heed your Doc's advice. Live to fight another day! If you took a fall while on the thinners that could be a scary thing.

Go hiking, ride your trainer and build strength, etc... Get better!

mIKE

[Louis]

Sorry to hear that Kevin. But my buddy at work who had the same thing says that the rat poison (Coumadin) they give you works pretty well. It takes a while to get the dosage right, but they should get that straightened out soon.

Good luck

[wc1934]

Sorry to hear that Kevin. But my buddy at work who had the same thing says that the rat poison (Coumadin) they give you works pretty well. It takes a while to get the dosage right, but they should get that straightened out soon.

Good luck

Hey KG
Sorry to hear this - just follows docs orders and you will be fine - as stated above, the meds work wonders - need to follow the diet as well - something about certain green vegetables interfering with the coumadin.
Get well soon.

[friessco]

Received the same advice from my doc who is a dedicated triathlete and thus understands the instinct to keep riding. Follow the advice and stay off the bike.

[Chance]

Must have missed where OP stated he'll be taking coumadin. :confused:

Regardless of blood thinner type the danger is probably very similar. It's probably an excellent idea to follow doctor's request.

[Chance]

P.S. -- Friend of mine under similar condition continued to train but on trainer where he couldn't fall and crash. May want to ask your doctor if that's OK.

[onekgguy]

I'm on a combination of Lovenox and coumadin until the coumadin gets up to speed.

Yeah, you're all telling me what I need to hear. hopefully I can ride my rollers until I put this behind me.

Kevin g

[Chance]

Yeah, you're all telling me what I need to hear. hopefully I can ride my rollers until I put this behind me.

Kevin g
You know rollers can be dangerous too, right? And on top of that many riders don't use a helmet while on rollers indoors. You really need to protect your head. If you don't have one you may consider borrowing a stationary or trainer.

[luigi22]

to the OP - honestly not clear to me why you're asking this forum for such major medical advice. i'd say follow your doc's orders, and if you don't trust him or want a second opinion, then get one - from another physician.

[slowgoing]

Glad you're doing OK.

So if you don't mind explaining, what were your symptoms?

[Ti Designs]

I've coached a few riders with clotting disorders, it's tricky. On the one hand there's no reason you can't remain active - any really you need to, on the other hand crashing is out. My advice it to stick to the safe side of cycling, work on the skills you need to never get taken down, assess the risks in anything you do on the bike and don't trust riders you don't know in groups or pacelines. The other good advice is to start getting bloodwork done on a regular basis, maybe every two months, and track changes. This is important because almost every clinical test of a population on coumadin has been relatively inactive. A good friend of mine competed in triathlons after having a heart valve replaced and saw large and sometimes rapid changes. His doctor asked if he was getting at least 15 minutes of exercise twice a week, he said "no, I'm winning my age group this season". Diet, hydration levels, iron intake and things you wouldn't think of like the amount of time you spend in the sun will all have to me monitored, but these things don't have to stand in the way of riding.

And having your spleen removed is NOT an acceptable method of weight loss.

[biker72]

You need to follow your doctors advice.
That said, I rode for 5 months while I was on coumadin. The doc said "just don't fall".

I have a co-worker that has atrial fib and is on coumadin. He rides as much as ever but very careful about avoiding situations where he might fall.

[Dekonick]

If you fall, absolutely go get a follow up evaluation. I would not take up boxing...

;)

Good news you survived the double pulmonary emboli. Many don't get a second chance.

Good luck!

[LouDeeter]

I ride Monday, Wednesday and Friday with a 73 year old man who had a stroke in 2007. He takes blood thinners. Since his stroke, he has ridden 25,000 miles, all road, hitting the 25K mark in early Dec 2011. He also has a pacemaker. His speech was affected by the stroke, but his cycling is fine. Still, I would tend to follow my doctor's orders.

[zap]

Wow, you are one lucky fellow.

I got a clot due to a broken foot 11 months ago and posted here at the time seeking advice. I was fortunate that the clot did not leave the lower leg.

Anyhow, I was on Lovenox for 3.5 weeks and rat poison for 3 months (primary doc said 6 months-vascular surgeon said 3 months). Took that long for the docs to get my inr up (active folks have higher metabolism than docs are used to seeing) to therapy level. If you need advice regarding Lovenox injection tricks let me know.

Also, once your inr level is stable, you will probably need it checked every 2 weeks. Print off a list of foods you can't eat.

Now riding.

I had little faith in the primary doc I was seeing at the time. Seeing the vascular doc was the best thing I did (more imaging to confirm initial report) and he went into details (confirming what fellow formites here posted) and told me it was ok to exercise.

Once the embolism is taken care of I bet the docs will clear you to exercise. Considering what you have gone through, trainer is probably best.

I rode while I was on blood thinners but I rode solo on my mtb. I knew there was a risk if I crashed but there was no way in hell I was riding on the trainer for any length of time.

[bargainguy]

Not a doctor but worked in the medical field for 30 years, so take this all with a grain of salt.

Are you young and healthy, or older with multiple medical issues?

If you're young and healthy, there are two possibilities.

1. You suffered some sort of trauma, esp. to the lower legs, which then caused a thrombosis (clot that doesn't move) which turned into an embolism (clot that does move) which moved through your vena cava (big vein) and into your lungs. Good thing this didn't kill you, because it easily could have.

2. You have something called hypercoagulable disorder, where your blood is a little thicker than normal and can clot on its own without any external trauma.

If you're older with multiple medical issues, the two issues above become a little more ominous, because the body is less able to recover when things like hypertension, peripheral vascular disease, heart disease etc. are already present.

Believe it or not, there is an invasive procedure called a vena caval filter (also known as a Greenfield filter) if you're prone to clots. Think of a tiny wire colander that's deployed in your vena cava permanently via the venous system. This won't stop clots from forming, but it will catch them before they make it to the lungs.

Otherwise blood thinners (Lovenox, coumadin, Pradaxa) and regular blood work is the way to go. Exercise while on thinners is +/- - you don't want to incur any traumas because now the risk swings the other way -- excessive bleeding rather than clotting.

Hope this helps, and good luck in your recovery.

Don

[malcolm]

Haven't posted in a good while but felt compelled here. As an ER doc I would suggest you stay off the bike while anticoagulated. From reading your post it seems as if this will be for a limited time, the usual 6-9 months for those with clots wtihout a coagulation anomaly.

This is a very short time given an avg life span. Anyone who has resuscitated an anticoagulated patient will tell you seemingly minor trauma can become fatal and major trauma is an absolute nightmare.

Again this is a relatively short period of time, just don't do it. Like running across the street with your eyes closed you might make it but if you don't it could be the end.

By the way sorry to hear about your situation and good luck and speedy recovery

[dziehr]

You have something called hypercoagulable disorder

One need not be hypercoagulable at baseline in order to have a PE, especially if bedridden after trauma or surgery. If you had a coagulopathy, your family history or recent bloodwork would very likely make it apparent.

Good luck with the recovery.

[bargainguy]

Only mentioned as part of the differential, if you read carefully.

Don

[Fixed]

get better first
then get strong
take your time
cheers

[norcalbiker]

Received the same advice from my doc who is a dedicated triathlete and thus understands the instinct to keep riding. Follow the advice and stay off the bike.


+1000000000000000000000000000


Good luck to you and hope for your quick recovery.

[onekgguy]

I'm back home from the hospital now and so grateful to be able to say that. I can't imagine having this problem occur while out of the country or not able to access the level of care that was provided me.

Someone asked what my symptoms were that caused me to seek help. It began Saturday morning (1-14) when I felt a tightness in my left ribcage. It felt a lot like a pulled muscle and that's what I attributed it to as I'd been gathering firewood the night before for our fireplace. I figured I'd lifted the wrong way. Throughout the week the tightness remained and even got a little worse. It was difficult to find a comfortable position to lay down and the discomfort began to wake me up at night. My resting heart rate is in the low 40s so I discounted my heart as the source of my problem. My wife and I were out to dinner last Friday night. What had been minor discomfort was now quickly becoming acute pain. She suggested we go to the ER and I didin't hesitate.

The ER physician did a test that indicated there was some clotting occurring within my body. He then ordered a CT which revealed the two emboli, one in each lung. Another clot was found the next day in my right thigh through ultrasound. I was one sick puppy at that point. The pain was huge and relentless on my left side. What scared me most was how quickly the pain became so unmanageable.

There will be no riding for me until I'm off blood thinners however long that takes, anywhere from 3-9 months I'm told. I don't think I appreciated early on how fortunate I am to have survived this. Yes, that amount of time is relatively short in the grand scheme so I'll keep that in mind.

No rollers either. I wasn't thinking too clearly when I wrote about using them. Can I say that this forum has some incredible people among its members? I had a person here offer to loan me their cyclops trainer (ship it to me) while I'm off my bike. Just wow!

As to why I'd seek advice here rather than a second opinion from my doctor? Hmm...I wanted to hear what I heard from people who love riding as much as I do...people who understand the passion/addiction/need/love. Hearing them tell me what I needed to hear made me certain beyond any second opinion I may have received.

Thanks to everyone for their comments.

Sincerely,

Kevin g

[martinrjensen]

I am very sorry to hear of your problem but I'm curious. I thought that Mukluk 's were a Eskimo or Inuit boot? You were having fun in your boots? Just curious of course.

[onekgguy]

This is the culprit here...

http://farm8.staticflickr.com/7171/6553709029_8f95db5ca5_b.jpg (http://www.flickr.com/photos/onekgguy/6553709029/)
salsa mukluk (http://www.flickr.com/photos/onekgguy/6553709029/) by onekgguy (http://www.flickr.com/people/onekgguy/), on Flickr

[martinrjensen]

Funny. And I just thought you were stomping around in soft soled leather fancy boots. BTW the boots are really cool looking but attaching cleats would be tough.
Again, hope your recovery goes wellThis is the culprit here...

http://farm8.staticflickr.com/7171/6553709029_8f95db5ca5_b.jpg (http://www.flickr.com/photos/onekgguy/6553709029/)
salsa mukluk (http://www.flickr.com/photos/onekgguy/6553709029/) by onekgguy (http://www.flickr.com/people/onekgguy/), on Flickr

[bargainguy]

That is one serious bike. Reminds me of a Surly Pugsley. I can see how you'd want to be riding it all the time, sounds like a blast.

Don

[Hindmost]

Sorry to hear. I went through a very similar situation a few years back. The first week I bought a trainer and rode it every day. I rerode the TDF several times by watching the DVR while riding the trainer. After about three months the weather got good and I couldn't take much more of the trainer. On the weekends I started doing my regular rides again, solo, with reasonable caution. I was sucessfully off of the coumadin after seven months.

Good luck.

[friessco]

Good luck and kudos on your wise decision.

[Louis]

Kevin, what about just sticking to the rowing machine? (If you still have it.) That's got to be 100% safe, with zero risk of falling or other form of impact injury. As long as they allow you to do vigorous exercise, that may be your best option.

[onekgguy]

Kevin, what about just sticking to the rowing machine? (If you still have it.) That's got to be 100% safe, with zero risk of falling or other form of impact injury. As long as they allow you to do vigorous exercise, that may be your best option.

Louis,

Yes, I still have my C2 and love it but my Mukluk was simply winning out for my attention in a big way. I'm still allowed to do vigorous exercise with the only limitation being that I not hit my head. I can do this for the 3, 6, 9 months or however long they'll have me on the thinners. I'll live to fight/ride another day and that's all that really matters at this point.

For those interested, I sat down last night and described a little about my ordeal in my blog.

http://onekgguy.blogspot.com/2012/01/it-must-be-bike.html

Kevin g