# any riders on blood thinners?



## saxen (Jun 15, 2009)

long story short,
when i was 11 days old i had open hear sugery for aortic stenosis, since then i have been going to the cardiologist for check ups, a few days ago i had my check up and things wernt looking good, they found an aortic aneruysm on top of that my valve leaking worse than every before. i was told i may have one to three years before i go under the knife- the plan because of the aneruysm was to have a metal valve put in place, because of this i will have to be on blood thinners the rest of my life. i talked to my doctor about my lifestyle and he said i should stop biking after the operation because any fall could put me at risk for internal bleeding- i have always liked road biking but theres just something so much more about mountain biking, its been a huge part of my life for years now and something i just dont know if i can give up, i do xc but really love downhill. 


so, is there any riders on blood thinners? do you have to take any special steps to protect your self? have you ever had any issues because of an accident or in general? anything else i should know. 

i can stop with the hard dowhill, {gaps, 10ft drops, ect,} but the xc downhill kinda sorta mix will be hard. this is more of what i want to keep doing


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## saxen (Jun 15, 2009)

...


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## ants (Jul 29, 2007)

Mate of mine rides on wafarin, get's the odd spectacular bruise but rides harder than me =)


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## Moozh (Jan 20, 2010)

My mother is older and "prone to blood clots", she was on cumadin for a few years. It essentially made her similar in traits like that of a hemophiliac person. Her ability to clot was gone thus a cut would not stop bleeding on it's own and a hard enough bruise could result in hemorrhaging, hard enough in the wrong place and it could very easily be life-threatening. The only way to reverse the effects in a timely enough fashion is a blood transfusion else a week of vitamin K which works to reverse the effects of the cumadin (Heparin is the drip/IV delivery type I believe, cumadin is a pill, wafarin might be the brand...I think).

Alas if I understand this all correctly I fear that your days of living dangerously and seeking adrenaline infused physical adventures might be numbered. Again my mother is old and I have no other references in my personal life so I cant say for certain if it all translates to yourself, but the inability to clot was presented to us as a major deal not to be taken lightly. 

Hopefully someone with more insight and maybe access to a PhD can lend you deeper insight. All the best dude!


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## ssinglesspeed (Apr 17, 2006)

I was on Plavix for a year and a half, and still take a couple aspirin a day. I still rode, but generally had quite a bit of bruising going on. Lots of blood from a scratch, you tend to be a little more careful. Get your Doctors opinion, your situation after you have surgury will be the decider.


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## 0119 (Aug 17, 2005)

Im on 5 heart meds. for high blood pressure including thinners. It doesnt stop you from anything. Only thing that slows me med wise is the water pill. You do have to remind some doctors before procedures like getting an ingrown toenail removed.


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## langford (May 7, 2004)

I've been on cumadin for about 10 years altogether - I had a blood clot in my leg and was on warfarin for 3 years, then went on low dose aspirin for a while then had another clot, so back on the rat poison. At first one doctor said no contact sports so I didn't play hockey for 3 years, Another doctor later said no problem, just don't hurt yourself. I bruise easier and bleed more, but once your levels stabilize and you make sure you take your meds, should be no problem.

So listen to what your doctor says - hopefully it will be Keep riding, but try to not hurt yourself.


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## Moe Ped (Aug 24, 2009)

May we ask how old you are?

My father, a very active dirt biker, was in his early 60's when he was diagnosed with atrial fibrillation caused by acquired valvular heart disease from having suffered rheumatic fever as a child. He probably had AF most of his life but this is when he found out about it.

His doctor recommended Coumadin therapy with the proviso of no risky activities i.e. biking. As other posts have said, you basically become a hemophiliac. Without blood thinners he was told he probably wouldn't live past 70.

He wasn't about ready to give up his passion so he started treating himself with aspirin. His doctor didn't like this approach but agreed it was better than nothing. Long story short, my dad made it to 90 before basically dying from old age.

The downside was that a small scratch would bleed forever, a bruise could take months to heal. The upside was that he rode his dirt bikes until well into his 80s.

Saxen, you need to decide what makes sense for yourself and your family, if you're young and want to "live a normal life", you should follow your doctor's advice.

If you want to live your passion for bikes, do it but acknowledge the risks; you may become one "who died doing what he loved"!


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## 0119 (Aug 17, 2005)

Dr.'s have told me that long term low dose aspirin thins the blood more than script meds do. Neither one has caused me to change anything in my life and I doubt your Dr. will tell you to give up any exercise activity. I was in an extreme high risk career for years with thinners and no dr. ever told me there was any concern. I think its far from being a hemophiliac.


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## Moe Ped (Aug 24, 2009)

All depends...


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## Jim Beam (Dec 22, 2003)

saxen said:


> so, is there any riders on blood thinners? do you have to take any special steps to protect your self? have you ever had any issues because of an accident or in general? anything else i should know.


I've been on Warfarin (Coumadin) for 4-5 years due to having an extra genetic clotting factor that can cause deep vein thrombosis (blood clots). I have had no problem with bleeding or cuts not clotting up.

YMMV


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## pnoy (Mar 2, 2009)

I take Ziac and Aspirin everyday.


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## saxen (Jun 15, 2009)

thanks for the advice guys, its seems like everything is so far one one side or the other, people saying they are fine, others saying to give it up, im just a bit, well, overwellmed and worried about it, 

im currently 22, 

everyone talks about aspirin but with a metal valve in my heart idk if i could get away with it. 


on the same topic if i had an inch cut, enough to break the skin how long will it bleed? how much blood, how do you stop it?


thanks for the help guys


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## Moe Ped (Aug 24, 2009)

Hey Saxen,
Sounds like you've got a fairly complicated medical situation, I'd go with your doctor"s recommendations but be sure to tell him/her that you'd really like to stay active on a bicycle. They may be able to prescribe an appropriate dosage level accordingly.

As far as falling down, you can slip on a banana peel and fall down, it's not like you're just learning how to ride a bike.  But forget about big air, etc.....

Doctors seem to like Coumadin over aspirin because they can finely tune the dosage rates, also high-dosage aspirin can have serious long-term side effects.

You should take a first-aid course, this kind of knowledge is alway good to have---it may help answer some of your questions about cuts, etc.

And do you have a Medic-Alert bracelet???


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## saxen (Jun 15, 2009)

i do not wear a medic alert bracelet, however i do wear a road id pretty much all the time except at work {people know my contacts}

the real problem is the reason the doc wants me to stop riding after the operation is the risk of falling and bleeding internal or a large cut/gash external. after the operation i should "should" be healthy enough to do physical things like run, its more the risk of falling


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## traildoc (Mar 5, 2007)

I had a DVT five months ago in my left lower leg behind the knee, which progressed to a PE. I didn't know I had a DVT or I would have gone to my doctor earlier and skipped the PE. If you ever have a PE you will know what they are talking about concerning unbearable chest pain. I thought for sure it was the end. 

Fortunately I was in the CCC unit when the chest pain hit, otherwise I am almost certain I would not have made it. That being said I am still mountain biking, but I am much more careful then I use to be, and I wear shin guards. 

To keep my Warfin level in the 2.5 range, I purchased my own blood test analyzer on Ebay so I could do blood tests for about $6.00 every week. My hope is that a 2.5 level will clot better than a higher level.

Since I love biking and am over 60, I pretend I have lived a wonderful life. If mountaiin biking kills me I will have no regrets (I think), Since I was so close to dying due to the PE, I figure I am living on borrowed time anyway.


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## gmats (Apr 15, 2005)

I too have had DVT (twice now). The first time was last year (discovered in April of 2009). After about 1 year of being on warfin, I got taken off. In May of 2010, I cut my leg really bad (dropped my bike on my left leg - Chainring cut it). The ER stitched it up REAL tight and I then (no one will say whether it was related or not) a week later I had blood clots in my left leg. The pain is excruciating (almost like the remnants of the worst leg cramps you ever had) and luckily I didn't have any shortness of breath or chest pains.

In both cases, I was just told by the doctor to "be careful". External bleeding probably not going to be an issue but internal bleeding is a concern.

I now carry Celox in my pack just in case.
http://www.celoxmedical.com/

Your situation sounds a bit more complicated, maybe you should seek a second opinion from the real medical guys.

Good luck with that.

g

P.S. Traildoc, that's interesting call on the blood analyzer off of ebay..........I'll have to look into that further.


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## 11053 (Sep 19, 2009)

I'm on anticoagulants for life.
Been riding on them for a while now.
It can take some mental work to get your head around things.
There are REAL risks to riding on the drugs.

If you are going to be on them for life, it should not be too much of a hassle to get insurance to cover you for a home INR monitor.
Or, you can pay for one out of pocket. 
Either way, it will give you way more control of the situation than heading to the clinic/lab to get your blood checked.

It isn't the standard cuts and brusies you need to worry about.
It's the injuries and trauma that would cause you real trouble anyways that cause the big problems when you're on the anticoagulants.
You're just going to have to keep the snapped femurs, shattered pelvises, ruptured spleens, and head trauma to a minimum from here on out.

It's all about risk tolerance, risk assesment, risk vs reward, and quality of life.

You'd never know I was on the meds if you were riding with me at the bike park or on technical trails that I have dialed. I'm fast, bold, and smooth on the trails I know well.
It's a different story on technical trails or "high risk" sections that I don't know or are new to me. It's got to be a "sure" thing, or I won't go for it.

No more hitting big jumps, drops, or rock gardens at speed and then trying to figure it out on the way down or at top speed. 
What I do now is "work" those sections until I have them dialed, or else just do the calculation of risk vs reward and take a walk.

So, the weird thing is I'm a much better technical rider now than I ever was before. I've been riding about 25 years. The gains I've made since going on the meds are a big deal for me.
I've been going back and riding trails that I have ridden for over 15 years and this year I was able to confidently ride and clean sections that I wasn't able to do when I was younger, bolder, and med free.

So, depending on how you look at it and the work you are willing to put in, you can "safely" ride whatever you want. Just need to be honestly aware of the risks and make your peace with the possible outcomes.

Hitting your head hard when no one else is around could leave you dead on the trail, on machines in the hospital, or having to relearn the alphabet. Those risks are real.
Reality is you have a loaded gun pointed at your head when you are riding on anticoagulants. It takes a while to adjust to that.

You'll bruise a lot. Especially so if you're riding DH and jumping the bike. Never realized how much contact I made with the frame in general DH riding till I started on the anticoagulants.

On epic pedal rides, you can generate a brusied ass that would shame a baboon in heat.

So, it's not the end of the world or your riding career. It's just a different path you'll be taking compared to other riders. You can do it, but will probably need to work harder physically and mentally to keep your game up.

BTW, I know several people on coumadin who ride hard and ride a lot. You'd never know there was anything wrong with us if you weren't part of the club.

Med bracelet/Road ID, or a BIG tattoo that says " I'm the baddest motherf**ker on the trails cause I'm still out here getting it done with an aftermarket heart valve and a blood system full of coumadin" would be a good idea.


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## saxen (Jun 15, 2009)

hahaha i love it!!!!!!!!!!!!!!!! thanks for the support guys, i know its a risk, looks like i will be talking to another doctor about the risks and really looking into this, like i said above, the drops, gaps, all that i can live with out doing, its the xc/dh mix that i really like. 


its nice to see people riding on the thinners, i was really thinking it may have to just be the end, i will have to get talk to another doc and adjust how i ride, hopefully this is a few years away, but really i want to know everything before i go under the knife, cant know to much!


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## drag_slick (Sep 24, 2004)

Norman Clydesdale's post is excellant.

The only thing I would clarify is the hassle getting insurance to cover the home INR monitor. Mine is a pain in the butt.. They only want to cover it if I'm in a rural area with no convenient access to a lab.

So for me, it's once a month to have somebody else prick my finger. At least the test is only a few bucks after insurance, and after 23 years of getting my arm stuck once a month, a finger stick is a welcome change.


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## Dry Cownty Brewer (Aug 21, 2008)

Wow, I was looking for a post like this over a year ago when I had my incident. I spent 11 days in the hospital after an undiscovered DVT turned into bilateral PE's. I was fortunate enough to know something wasn't right with my body, even though I was a stubborn 27 year old who figured I just needed to excercise harder - as if I just needed to push my cardio.

I have now been on an average of 12mg of warfarin for over a year. I still ride my mountain bike and told my doctor that I do it on my last check up. Like mentioned before, it is a risk and reward issue. On the one hand, the added weight of knowing you can not have a major wipe out leads to increased alertness and somewhat safer decision making. Also, bumps and bruises, for the most part will heal, especially while you are young. It is the significant impacts leading to head trauma or organ trauma that can be the ultimate concern. 

Most everything has been said on here, but my last input is this: Do what you love, Don't let these meds affect your lifestyle.


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## 11053 (Sep 19, 2009)

There is an upside to all this:

"The bike park IS a controlled environment. I'll get a season pass so you'll always know that I'm riding with people around"

"Wow, the geometry of the 2010 bikes makes me feel sooooo much safer"

" Increased tavel would greatly reduce the chances of crashing, and it just so happens that Fox has 180 single crowns out this year."

" Looks like there have been huge advances in helmet technology lately."

"I'm sorry my bruised ass upsets you. I'll promise to buy better riding shorts right now."

" I love you so much. I'd feel irresponsible not being as safe as possible out on the trails. I do not want you worrying about me excessively. Responsibility and my love for you requires me to take advantage of the latest developments in the bike industry."

Embrace it. Work it.


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## slacker52 (Jan 13, 2009)

Aspirin and rat poison (warfarin) are different in the way they prevent clotting and not necessarily interchangeable for a given situation.

I still ride. Just don't crash.


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## 11053 (Sep 19, 2009)

But........you CAN still crash!

I've had a few since going on the drugs. In my opinion, minor crashes are no big deal....yet.

Still, it's best to avoid the helmet crushing crashes that result in concussion.

I used to say "Concussions are like calluses. You just need to keep laying them on one right on top of the other till you build up a resistance." Not so casual about head injuries anymore.

Took a BIG tumble down DC10 at Mammoth today. The trail has one STEEEEEP and super rocky section. Went into it with full confidence and carrying maybe wee bit too much speed. Really bad move on my part, but I really believed I had it in the bag.

Should have walked. 20/20 hindsight. Thought I had it. Oooops.

Rag doll, but no sudden stop. Lots of blood, but it didn't put an end to the day.

Anticoagulant meds aren't the end of the world. Accidents still happen. Keep riding and you will crash.

All should be good. Not expecting to wake up dead tomorrow. 

Really don't think the general cuts and bruises and minor bumps are the cause for concern that the docs say.

Only reason I was riding super aggressively today was that the level of meds in my blood was a bit lower than usual and I was almost "normal."

Since I have a home INR monitor, I will admit that on days when the meds are at lower levels and I'm not at a big risk for bleeding, I view that as an opportunity to push it on the bike. 

It's all a game.

I could sit at home worrying about throwing off a clot, having a stroke, another DVT, another massive PE, or I could take "advantage" of the situation and get after it on the bike.

Easy choice to make.


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## Koppuh Klyde (Jul 13, 2010)

Great thread. Im just getting back into MTBing after ~20 years off. Ive been on warfarin for about 3 years for repetitive DVTs in my left leg. Ive been admitted to the hospital on 3 different occasions in the last year. All for DVT. I recently had a "procedure" done where they closed off my main (deep) viens with some sort of catheter dohicky. I still have one more to do. Have any of you guys had this? Do you guys that have had DVT use any extra padding/protection on your legs?


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## 11053 (Sep 19, 2009)

KK,

No additonal padding or protection on the legs for me for general riding.

Downhill/bike park-knee protection is a standard. However, I'm very particular about pad fit on the damaged leg.

I've had a few DVTs in one leg, some of the vein valves are trashed, and blood flow is not optimal.

I can still feel the "knot" behind my knee of the unresolved clot and damaged area depending on how I move/bend the leg.

However, cycling is great and it makes the leg feel much better. 

A few days off the bike and sitting on my ass and the effects of Post Thrombotic Syndrome make an appearance. I'm lucky right now because I'm keeping it in check with riding a lot.

I know a few other riders who have gone through the whole DVT experince and one of them really had a bad go of it with both legs. Their veins are trashed. They don't spend a ton of time in the saddle without standing to pedal or out of the seat for the downhills.

It's funny what all the vein funk makes you aware of.

I looked into what I thought were several treatment options for the condition, and the best thing that I could come up with and which seems to do the most good is to keep moving and don't stop riding.


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## bing! (Jul 8, 2010)

Stick with what the doctor recommends for now. Find a doctor that specializes in sports medicine or something that covers your condition and an active lifestyle. Get clearance to ride. With an a-ok, ride and listen to your body. 

Most doctors are way to cautious, but I wouldnt try and second guess a potential aneurysm without a professional opinion. Too much risk vs. benefit.


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## MtbRN (Jun 8, 2006)

The mechanical heart valve means coumadin is necessary. Sorry, but aspirin won't cut it. Unless you like the idea of having a stroke in your 20's. 

The upside is that once the leaky valve is repaired, you will probably have better stamina. 

Being on coumadin definitely makes trauma more risky. You do need to have a serious conversation with your cardiologist about participating in sports where the risk of injury is high. Be up front with your doctor, and if he is any good he'll try to work with you as much as possible.


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## kojarena (Oct 4, 2009)

Holy thread revival batman.... I used the search button and thought it pointless to start a whole new thread...

I had some varicose veins out of my right leg back in November last year. About two weeks later, during recovery, I developed DVT in the same leg and a week later that progressed to a bilateral pulmonary embolism - 66% blockage of both lungs from clots.

After eight days in hospital I ended up on Warfarin. Doctor reckons six months on the meds plus wearing a pressure stocking and then, depending on my lungs I should be okay to go off the drugs.

Last week I rode an intermediate MTB course and later that week did a 10mile brisk walk. I had gradually been building distance with walking over the past four months and to be honest I felt so good after the ride and again after the walk. On Good Friday I had some breathing difficulty and pain in the chest.

Ended up in hospital yesterday and the day before - had all the tests again (DVT scan, CAT scans, INR, coronary, sugars, blood gases (I hate that one the most) and the diagnosis is that I didnt have another PE, it wasnt a stroke or a heart attack.

They reckon it is a muscle strain across my chest causing pain and shortness of breath (each time my chest expands it hurts). I am 41 and in reasonable health, dont smoke, drink, I eat mainly a vege based diet, dont do drugs etc.

So the doctor is asking me what I did to stress the muscles and I told him. Two hours later he comes back with the rest of the vascular team and tells me I am NOT to ride a bike whilst I am on warfarin because if I come off and sustain an internal bleed it will not stop and I will eventually bleed to death - either a bleed on the brain or in the abdomen will be pretty bad. Also riding and coming off can cause clots to dislodge.

THe good news is that almost all the clots in my right leg are gone, as are the ones in my lungs so I am very likely to come off Warfarin next month. I had my lungs tested in Feb and came back at 110% of an average person's capacity which is great. Specialist reckons it must have been up around 140% before the PE to return the result I did with the amount of clot still in the lungs back in Feb.

So to those of you who are on Warfarin or Coumadin and ride and HAVE COME OFF what is the worst that happened to you?

They said I can ride on a trainer, walk, run, swim, gym etc but no contact sports or activities where I could sustain a fall or impact.

What gives?
t


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## Leopold Porkstacker (Apr 21, 2010)

> any riders on blood thinners?


I drink beer every day, alcohol is known to thin blood. Does that count? :eekster:


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## Bro (Dec 20, 2010)

kojarena said:


> They reckon it is a muscle strain across my chest causing pain and shortness of breath (each time my chest expands it hurts). I am 41 and in reasonable health, dont smoke, drink, I eat mainly a vege based diet, dont do drugs etc.


Nice to know that muscle strains can cause those sort of symptoms. I had chest pain, difficulty with breathing last September, went into ER, found elevated troponoin levels indicating damage to something. They suspected pericarditis, did a cardiac catheterization, found nothing, sent me home.

After all these tests, I wasn't entirely convinced that it was really pericarditis, and was in fact some sort of skeletal muscle problem. So now I'm going to continue with the assumption that it's just muscle strain, because they found nothing after all those blood examinations but the pain has continued.


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## boardguru (Oct 3, 2009)

Had open heart surgery last May for blocked arteries. I've been Mt. biking since the '70s.
Was back on my Mt. bike 60 days later ,Dr. recommended 120 days off, just couldn't wait that long.
At my 6 month checkup I told by both my cardiologist and heart surgeon about starting to bike sooner than they recommended, both of them replied after giving me a high five "I figured that of all my patients that you would push it as soon as possible".

I'm not suggesting that everyone do the same thing, just that I wanted to get back on the mountain as soon as possible.

Ater seeing them both again 3 weeks ago I said that I'd had a great Mt. bike season last year with a season ending trip to Moab for a week in November, and that I had gotten to ride my snowboards for 80 days this year. Once again they both said that they wished they had mor heart patients more like me insteas of the ones that just give up and become sedentary.

I'd definately check with another Doctor, since I'm on blood thinners and heart meds for the rest of my life also, and my Doctors are encouraging me to keep it up. You are only 22 and they want you to chill? I'm 59 and got a second chance that I'm not about to take a pass on.
Good luck


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## mummer43 (Jan 28, 2004)

If you do need a new valve, ask about having an On-X valve used. They typically require a smaller anticoagulant dose than traditional mechanical valves. Also think about a tissue valve. They don't last as long, but you don't need to be anti-coagulated. Do what's best for you and your lifestyle.

http://www.onxlti.com/


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## ROBOLOCO (Jan 22, 2007)

I had DVT and two PE'S 6 months apart. This all started with a leg injury 16 months ago. The PE's were scary as hell, but I feel that if my heart wasn't as strong due to riding my bikes and skiing etc. I would not be able to make the choice and continue to do the things I enjoy, just at a more cautious level. Yeah , being on coumadin sucks , but, there are way worse things.


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## Noclutch (Jun 20, 2010)

No purpose prescribed thinners, but periodically I ramp up my NSAIDs (after a big weekend or whatnot) enough to thin me out to about 5 wt or so. My canary(cardinal?) in the coal mine, so to speak, is my nose. No picky :nono: LOL And naproxen seems to do it the least for/to me, maybe YMMV


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