Riding on Warfarin

[Kave-Man]

I usually take 8mg, this keeps me within the 2-3 INR range. I find even watching my diet and vitamin K intake, it can still fluctuate. INR seems to be effected my more than diet, I find activity levels, alcohol consumption and dehydration also play a part. These days I don't tend to watch my diet too closely except when it comes to certain things like broccoli (no broccoli smoothies for me ), asparagus and food with heaps of garlic. I also never eat cranberries or drink green tea!

My INR is quite good, I only need to get it checked every 4 weeks (at the moment). But I do like Australia's idea to check it before big rides. I might look into these coagucheck testers.

 

[Kojarena]

Well I came off the drugs two weeks ago. I had a round of DVT scans, another CATScan and a gamma scan. Prognosis was that the lungs were perfectly clear of clots, as were the legs. Lung function is still above average and there has been only minor lung tissue damage and no heart damage. Respiratory surgeon and vascular surgeon both happy with the recovery which I am told I am still only half way through.

Interestingly this week I got the pains in the leg again (without the swelling) and the shortness of breath. Back to see both specialists and have a DVT scan. No clots detected and they feel it is most likely a secondary infection in the lung scar tissue. Leg pain is from me adjusting to life out of a compression stocking after 7 months of wearing one whenever I was not asleep.

Hoping to do a light weights session at the gym tomorrow followed by a brisk walk and then a very light bike ride in Landsdowne Park on Sunday (on the dirt, not the crit circuit). I have put on 2.5kgs in my 7 months on warfarin/in a stocking so its time to swap the tele and snacks for some activity.

I have a thrombophilia scan on Tuesday and get those results in mid-late August but the consensus is the original surgery probably led to the PE. Slowly slowly for me at this point - just taking the next six months gently and building up capacity and strength.

 

[russell1600]

Sitting here reading these posts 2 days after being released from a 1 week stay in hospital due to a pulmonary embolism....
Doctors still unable to find the cause at this stage which may mean that I'll be on Warfarin for the long run...
Re-assuring to see that I'm not alone and there are guys out there still riding after going through similar experiences.
I know it has been a couple of years since the last post but I would be very keen to hear if you (or anyone else on Warfarin) guys are still riding and how you are coping.
I am 38 y/o.
Russ

 

[brisneyland]

For all those people riding on warfarin... I get that you still need to live life (although if you're taking such risks when only taking it for 6 months you really should re-evaluate)...

But think about how your family and significant others would feel if you had a major intra cerebral bleed - not enough to kill you, but enough to turn you into a drooling potato. It's not just about you.

And register as an organ donor. And make an advanced health directive.

 

[russell1600]

For all those people riding on warfarin... I get that you still need to live life (although if you're taking such risks when only taking it for 6 months you really should re-evaluate)...

But think about how your family and significant others would feel if you had a major intra cerebral bleed - not enough to kill you, but enough to turn you into a drooling potato. It's not just about you.

As a father of 2 I couldn't agree more, but as you mention... I also need to live life.
I have no problem hanging the bikes up if I knew it were only for 6 months, or even a year.
Just trying to come to terms with the real possibility of being of Warfarin forever and was after experiences from people out there who are.
I don't ride DH or anything extreme.
Just to make things worse, my son is really getting into mtbing and has been entering some races with me over the last year...which makes this even harder to take...

 

[JASER]

Be carefull.
You don't need to wrap youself in cotton wool (nice to fall on I suppose)
Personally I haven't changed nowt in my life apart from stop riding motorbikes/soccer.

I wouldn't consider stopping riding bikes at all.
Just make sure your inr is at a point stabilized, then get pedalling.

 

[russell1600]

Be carefull.
You don't need to wrap youself in cotton wool (nice to fall on I suppose)
Personally I haven't changed nowt in my life apart from stop riding motorbikes/soccer.

I wouldn't consider stopping riding bikes at all.
Just make sure your inr is at a point stabilized, then get pedalling.

Thanks for the advice JASER, great to hear you still get out and have fun on the bike... it's encouraging.

Any others out there?

 

[Mafra]

As a pharmacist, I'm going to suggest you have a good discussion with your GP/local pharmacist who know you, your medical history and other medications, if you don't have a "regular" GP, but go to the same clinic all the time or most of the time, consider seeing someone in the practice who has an interest in sport medicine if there is someone.

For PE, I presume your target INR is 2-3, discuss with your doctor the risks of aiming towards the lower end of the range - this may become more practical with time after your PE (allowing you to get back to riding after a short break perhaps).
Also, in the short term, your docs may not be so keen on you doing high intensity excercise while the clot is still being dissolved by your body, make sure you have specifically asked these sorts of questions.

If you do back to riding, make sure you make your riding buddies aware of what the potential implications are when you're riding if you have an accident and consider something like a roadID or some sort of medi-alert product so that anyone rendering you care knows you are on warfarin/allergies/other meds etc.

All around, tough call - not sure what I would do, obviously if you decide to keep riding you need to take all practical steps to minimise risks and potential consequences - but I agree, you need keep enjoying your life.

Good luck!

 

[russell1600]

As a pharmacist, I'm going to suggest you have a good discussion with your GP/local pharmacist who know you, your medical history and other medications, if you don't have a "regular" GP, but go to the same clinic all the time or most of the time, consider seeing someone in the practice who has an interest in sport medicine if there is someone.

For PE, I presume your target INR is 2-3, discuss with your doctor the risks of aiming towards the lower end of the range - this may become more practical with time after your PE (allowing you to get back to riding after a short break perhaps).
Also, in the short term, your docs may not be so keen on you doing high intensity excercise while the clot is still being dissolved by your body, make sure you have specifically asked these sorts of questions.

If you do back to riding, make sure you make your riding buddies aware of what the potential implications are when you're riding if you have an accident and consider something like a roadID or some sort of medi-alert product so that anyone rendering you care knows you are on warfarin/allergies/other meds etc.

All around, tough call - not sure what I would do, obviously if you decide to keep riding you need to take all practical steps to minimise risks and potential consequences - but I agree, you need keep enjoying your life.

Good luck!

Yes my target INR is 2-3. I already asked about aiming for the lower end of 2 to minimise bleed in the event of an injury. They said they'd like me to stay in the mid 2's, that way if my level fluctuates a little I won't drop below 2...just re-read your post...yes maybe once I recover from my PE and my INR's are stable they might let me aim for the lower 2's. I will ask in a few weeks.

I won't be doing any high intensity exercise for a while. Initially I thought if they were discharging me from hospital, the clot must be gone. But the doc's explained (as you have) that the clot takes some time disolve...so definitely kicking back for a while..

Have been looking into the medi-alert products, originally was going to get the sports/velcro type bracelet but one of the nurses made a good point that I should get the neck lace (hate wearing neck laces!!) because the first thing a paramedic will do in an emergency is tear your shirt open...they may not notice a bracelet for 15 minutes which may be too late..

Talking to someone in sports medicine is something I hadn't considered...

Thank you for the informative post....much appreciated.

 

[PedalPhil]

Glad I found this thread.

Had five DVTs hit me last May, Left Knee, Groin and 3 x abdomen. A bit of medical incompetence later and I am still around, back riding last October.

Just ordered a Medic Alert bracelet after reading this.

On 12mg of Warfarin to target INR 2-3 (pretty steady for last two months around 2.4-2.5). 6' 100kg (up 8kg since the incident), and working on dropping back down.

I ride like a bit of a granny now, I use shin and elbow guards (G-Forms) purely because I ride past a branch and I cut, and the Missus had an issue with too make cuts and abrasions. Left leg feels like its "heavy" and once it is pushed for 30 secs on a climb pretty much gives up the ghost, my riding mates are pretty tolerant, I am just happy to still be around to enjoy it.

 

[JTmofo]

I'm 35 now, been on warfarin for 21 years...... I've had many bouts of DVTs and PEs, but nothing since 2005.
I'm cautious but not overly with regards to sports and getting bashed around. I played a high contact sport into my early 30's, raced short circuit motorbikes for 5years and now I ride MTB. If I rapped myself up my life would have passed me by, so I do everything I want (within reasonable limits) and so far, so good.
My INR target is 2.5-3.5, been on 8mg daily for the last number of years.
It really doesn't affect my life on a day to day basis, and I never think about it while riding.

 

[JTmofo]

Glad I found this thread.

Had five DVTs hit me last May, Left Knee, Groin and 3 x abdomen. A bit of medical incompetence later and I am still around, back riding last October.

Just ordered a Medic Alert bracelet after reading this.

On 12mg of Warfarin to target INR 2-3 (pretty steady for last two months around 2.4-2.5). 6' 100kg (up 8kg since the incident), and working on dropping back down.

I ride like a bit of a granny now, I use shin and elbow guards (G-Forms) purely because I ride past a branch and I cut, and the Missus had an issue with too make cuts and abrasions. Left leg feels like its "heavy" and once it is pushed for 30 secs on a climb pretty much gives up the ghost, my riding mates are pretty tolerant, I am just happy to still be around to enjoy it.

Did your haematologist suggest you wear a compression sock?
I had quite a bad DVT in my left leg, from my knee to groin. I struggled with swelling and dead pain for a long time after, but a high quality ($200+ Venosan) compression sock made a huge difference.

 

[PedalPhil]

Did your haematologist suggest you wear a compression sock?
I had quite a bad DVT in my left leg, from my knee to groin. I struggled with swelling and dead pain for a long time after, but a high quality ($200+ Venosan) compression sock made a huge difference.

Yes, I have a pair (Sigvaris though) , its was more like $100 for a pair from the Haematolgy Clinic, as the Haematologist was pretty keen on getting my calf down. Venosan - eh? Worth the extra $s? or same-same?

Best thing I have bought was one of the Zero Gravity chairs (from Backcare on my last trip to Melbourne - as if they have them in Perth..) - half an hour in that when I get home and I am back to a skinny ankle after a day at work.

 

[JTmofo]

Yes, I have a pair (Sigvaris though) , its was more like $100 for a pair from the Haematolgy Clinic, as the Haematologist was pretty keen on getting my calf down. Venosan - eh? Worth the extra $s? or same-same?

Best thing I have bought was one of the Zero Gravity chairs (from Backcare on my last trip to Melbourne - as if they have them in Perth..) - half an hour in that when I get home and I am back to a skinny ankle after a day at work.

Never had/tried the Sigvaris, but saying that its a long time since i bought a Venosan either (so prices may be different now). You buy the Venosan's in singles, i originally had a full length ( toe to groin) which i wore everyday for about 2 years. Then swapped to the toe to calf (http://www.venosan.com.au/compression-stockings - 5000 series class III). I havent worn one in a few years now but they helped my fluid retention greatly. I still get swollen leg, but never aches or throbbing.