# DVT and Still MTB?



## fred-da-trog (Oct 28, 2003)

I'm looking for advice from those experienced. I was released from the hospital a few days ago with blood thinners and pain meds. My initial thoughts are start slow, ride mild terrain and cover the normally exposed arms and legs. Thoughts?


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## SWriverstone (Sep 3, 2009)

Wow, tough question Fred! Not sure anyone here is qualified to answer...but starting slow, riding mild terrain, and covering the exposed arms and legs sounds reasonable to me.
Scott


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## Boomchakabowwow (Sep 8, 2015)

my boss is an avid cyclist and runner. he suffered this.

i vote you do exactly what the doctor says. i know he took it easy for a while. but he's back. he is running the NYC marathon coming up.


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## coyotegulch (Jun 25, 2008)

I am in the medical field and say +1 to following your doctor's advice.


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## Velobike (Jun 23, 2007)

fred-da-trog said:


> I'm looking for advice from those experienced. I was released from the hospital a few days ago with blood thinners and pain meds. My initial thoughts are start slow, ride mild terrain and cover the normally exposed arms and legs. Thoughts?


I've had 2 serious episodes shortly after long haul flights resulting in ambulance trips, sirens etc, intensive care, and cardiac ward. (I don't do long haul flights anymore!)

After the second episode I was put on blood thinners permanently, and so far so good.

Firstly do what your doc says, but make sure he's a cyclist. 

The blood thinners seemed to work really well and I was itching to get out and at it very quickly.

I asked the doc if it was ok to do a bit of cycling, and he felt exercise was good, just don't fall off onto anything sharp or get internal injuries. (I forgot to mention what "a bit of cycling" meant in my case)

So I did a 24 hour race 6 weeks after my first hospitalisation, and 2 months after the second.

I do take a bit more care in my riding now, and avoid high speed descents to minimise the chances of a serious impact. I bleed like a stuck pig if I hit thorns - it looks very dramatic. 

But again, check with your doctor. I was in pretty good condition before the flights so maybe my recovery was easier.


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## Eric Malcolm (Dec 18, 2011)

Velo, I am sure you did not explain to your doctor precisely the scale of what you cycle!!

I would think he was expecting you to ride down to the local to shop and return home while wrapped up in cotton wool.

Eric


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## Miker J (Nov 4, 2003)

Assuming it's something like Coumadin, Xarelto, etc...

No mountain biking.


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## Velobike (Jun 23, 2007)

Miker J said:


> Assuming it's something like Coumadin, Xarelto, etc...
> 
> No mountain biking.


I'm on Xarelto.


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## Miker J (Nov 4, 2003)

Velobike said:


> I'm on Xarelto.


Hopefully you'll be off the thinner in 3-6 months, then return.

In the meantime, work on the motor with less hazardous activities. Winter is coming up anyway.


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## Velobike (Jun 23, 2007)

Miker J said:


> Hopefully you'll be off the thinner in 3-6 months, then return.
> 
> In the meantime, work on the motor with less hazardous activities. Winter is coming up anyway.


I'm on it for life.

Turns out I have a genetic propensity to clots.

Is there medical evidence to suggest I shouldn't be riding?


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## Miker J (Nov 4, 2003)

Velobike said:


> I'm on it for life.
> 
> Turns out I have a genetic propensity to clots.
> 
> Is there medical evidence to suggest I shouldn't be riding?


Sorry to hear that.

There is a clear concensus in health care that contact sports should be avoided while taking anticoagulants. Google "anticoagulants and contact sports". This recommendation is based on very sound medical rationale. It is unlikely that well controlled studies have been conducted on this issue however. Still, this is advice I strongly believe in. I manage patients with bleeds almost every week who are on anticoagulants.

So, do we consider mountain biking a "contact sport"? Injuries sustained during real mountain biking likely compare, if not exceed, those inccured during traditional contact sports as far as I can tell. I'd guess there are studies out there that may give you the frequency with which significant injuries occur during different sports. Anecdotally I can say that while significant trauma does not occur as frequently with mountain biking as it may with American football, or boxing, or other martial arts, when it does, it is often more serious. Personally I've done a lot of heavy contact sports, and my worst injuries have come from mountain biking. Maybe if your mountain biking style was very non-aggressive you might feel differently.

Some of this advice is anecdotal and I do encourage you to speak with other trained people. I wish you the best of luck. Medicine is always moving forward and developing treatments and cures. Keep your fingers crossed something better will come along.

Take care.


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## Velobike (Jun 23, 2007)

Miker J said:


> ...Anecdotally I can say that while significant trauma does not occur as frequently with mountain biking as it may with American football, or boxing, or other martial arts, when it does, it is often more serious. Personally I've done a lot of heavy contact sports, and my worst injuries have come from mountain biking. Maybe if your mountain biking style was very non-aggressive you might feel differently...


Thanks for that info. I'm pretty cautious.

Since going on to the bloodthinners I have become very much a wheels on the ground sort of rider. I'd describe my riding as more cross country than exciting.

My 24 hour races rely more on steady progress than heroics. I assess the course beforehand and any section that is likely to have me off when I'm tired is preselected for run-walking (and that usually works out faster). My big secret is pass them in the pits, ie don't stop for rests.

Thinking back over the last few years my worst fall has been on the road at low speed when a pedestrian decided to cross without looking.

Probably the worst effect of the bloodthinners (if they are to blame) is I get tired more easily, and that's just something I have to manage by adjusting my pace.


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## DaHeckler (Jan 18, 2009)

I've had two clots (DVT) and a pulmonary embolism during the first one. After about 9 months I was all clear but when I got the 2nd clot put me on Coumadin for life. I sold my dirt bikes but still have a dual sport and continue to mountain bike UCSC, Demo etc. if I see sections I am not certain I can clear I walk it, or sections where going down could cut you up good I walk it. Basically I've chosen to continue to live my life and do what I enjoy doing but don't going as hard as I might have in the past...

I agree you have to listen to your doctor, mine supports me riding as long as I understand the risk and smart about taking to many chances .....

I have gone down few times while being on Coumedin, and get a little more bruised up. 

My INR is supposed to be between 2 and 3, I try and stay in the low 2s....hope this helps


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## fred-da-trog (Oct 28, 2003)

Thanks everyone for the advice and affirmation.


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## chazpat (Sep 23, 2006)

I've also had two DVTs and am on Coumadin for life. I always knew I'd have a second one at some point as I also have a genetic propensity to clot (protein S deficiency). I would advise you to take it very easy, if at all, until your Coumadin dosage is established and keeping you in your target range (assuming you are on Coumadin).

I am more of an XC rider and mostly keep my tires on the ground. I ride pretty conservatively, trying to keep the risk of crashing low. I try to be more about endurance than speed and just enjoy being out in the woods. I also carry a blood clotter (Adventure Medical Kits QuikClot) in case I manage to cut myself bad.

Medically, I don't think we are supposed to be mountain biking. But I think as long as you keep the risks down, the benefit of exercising outweighs the risks (but I am not a doctor!)


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## UPSed (Dec 26, 2010)

I had DVT 6 years ago which ultimately resulted in a pulmonary embolism. Was in the hospital for 5 days. I was on warfarin and was told to take it easy. The biggest concern was falling and having head trauma. Started doing easy rides two weeks after I was released from the hospital. The first time I crashed I bled a little more than normal but not as bad as I thought I would. I did notice the more I tried not to crash the more I would. Thankfully I was only on the medication for six months and have since returned to normal. My DVT was caused by a foot injury followed by a long trip. Only you along with the advice of your doctor knows what's best. Good luck to you.


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## GraniteRash (Jun 3, 2006)

Me too. Factor V Leiden. I've had 3 DVTs, the last about 20 years ago. Lifetime coumadin after the last one. I've been mountain biking for 10+ years and skiing for the same amount of time. No serious injuries, a broken rib this year being the worst, but I'm not that aggressive a rider or skier.

I can't agree with Miker J about no riding. I think you can still ride fairly technical trails and be OK. Just be careful, limit the jumping and the speed, like DaHeckler says.

Clotting disorders are fairly common, if you have had a few episodes and haven't tried to figure out if you have a genetic propensity, you probably should.


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## pursuiter (May 28, 2008)

I'm a factor 5 clotter with 2 major episodes. I'm on warfarin for life now, age 54. First, don't use a GP for this, go to a hemotologist and have him handle your condition. I was misdiagnosed by several ER and GP physicians. My hemotologist prescribed my own INR machine and I test myself weekly. Now I'm never out of range and don't get those nasty bruises. 

I have had two hemotologists in the last decade, both OK'ed mountain/road biking with a good helmet and a RoadID. These isn't any reason you can't bike, get a hemotologist, GPs are clueless about this condition.


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## GraniteRash (Jun 3, 2006)

great advice pursuiter. clotting, or not, is really, really complicated-- a hematologist is a must.


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## pursuiter (May 28, 2008)

Miker J said:


> I manage patients with bleeds almost every week who are on anticoagulants.
> 
> So, do we consider mountain biking a "contact sport"?....


What is your training and professional background?

Who is the "we" you're referencing when you discuss contact sports?

Do you consider yourself as expert as my hemotologists, esp my current one who is an ex USCF roadie? He says riding is fine with proper helmet and RoadID.


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## Miker J (Nov 4, 2003)

By "we" I was referring to those here in the thread discussing the issue.

Again, medical literature, in general, advises those on anti-coagulants to not participate in contact sports.

Thus, I suggest "we", the OP and those in thread, decide if mountain biking could be as traumatic as your typical contact sport, and apply the advice above to mountain biking.


Should a mountain biker decide to keep it very mellow perhaps you'd not apply the "contact sport" comparative. But, when giving general advice, it's best to err on the side of safety and assume the rider may not intend to keep it mellow. I don't think the OP made the distinction until after I offered my opinion.

Hematologists are great at clinching the diagnosis of a particular bleeding disorder and prescribing treatment. However, they have little training/experience in assessing trauma, or assessing or managing acute traumatic hemorrhage. They may also not know how traumatic aggressive mountain biking can be. We don't know if their idea of mountain biking may be a dirt road ride. I would sooner take an emergency room physician's advice on this one. Especially if they mountain bike.

There is likely no right or wrong answer here and sedentary lifestyle is causing more morbidity than Coumadin and biking. So keep moving. It is up to the individual to educate themselves best as possible, weigh the pros and cons, and make an informed decision.

This is not the place to discuss my professional credentials and I don't know your hematologist's credentials/experience so I'm not comparing, but sounds like things are going well for you.


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## pursuiter (May 28, 2008)

I'll never forget the ER and GP physicians that mis-diagnosed me and almost killed me, twice...They felt as if they were well credentialed. It's very common, two of my fellow cycle club members had the same issue with their GP/ER physicans. And we all cycle and mountain bike without any issues. 

If you've been diagnosed with a DVT, my advice is to not use any GP or ER physician for anything related to treatment, they're clueless and very willing to display it. Get to a hemotologist right away for a proper root-cause analysis and treatment. If you're going to be a lifer, get a home INR machine, which can only be prescribed by a hemotologist. The GPs want to keep you coming in for a monthly test, it's good revenue.


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## GraniteRash (Jun 3, 2006)

have you ever had trouble with the home INR machine? are they pricey?


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## 11053 (Sep 19, 2009)

http://forums.mtbr.com/passion/any-riders-blood-thinners-640507.html

Still rolling on blood thinners 5 years after the above posts.


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## lkfoster (Apr 2, 2004)

I've been on Eliquis blood thinner amongst a few other meds for A Fib for a year now. Other than some strange vision effects after long rides at first no issues. Speed has dropped a bit but that can other factors.


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## jeffscott (May 10, 2006)

No experience

But if I was too stop riding then my cholesterol which is excellent would almost certainly begin to get worse and worse...

This would start the inflammation process and calcification in the arteries would start...

Then I my risk of dying from an heart attack would increase....

Just saying need to balance life....


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## lkfoster (Apr 2, 2004)

lkfoster said:


> I've been on Eliquis blood thinner amongst a few other meds for A Fib for a year now. Other than some strange vision effects after long rides at first no issues. Speed has dropped a bit but that can other factors.


I should add that I spend a lot of time on 12+ transcontinental flights and the DVT bit hasn't bothered my cardiologist.


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## Fisty (Sep 19, 2005)

I had a dvt in the left maon leg vein a few years back due to ecpnomy class syndrome. My advice is push it as hard and as soon as you can to gain volume in the regrowth once your doc clears you. I think if I would have ide have better retirn. As it is it doesnt bother me at all but my left calf is noticeably larger. I do wear.compression sport socks for excercise now.


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