Who's riding again after a blood clot?

shinobishoryuken

Hi,

Five weeks ago I was diagnosed with a DVT in my calf which ground my training to a halt. I am on the required drugs and now have a full-thigh length compression stocking to aid my recovery.

Has anyone else been through this, or know of any cycling friends or family that have worked around this condition to get back on their bikes?

I have been advised to not exercise yet, to prevent any complications, and to definitely not ride a bike on the roads (or at all) for the next 6 months as I may bleed to death (or internally) if I was struck by a car or fell.

My pain has subsided, but I am desperate to have a gentle spin (indoors on a trainer) but not sure if this is beneficial?

Are there any known complications to DVT sufferers in regard to cycling?

napoleond

Been riding 4 years since mine. No probs. just make sure I'm hydrated...

ddmrcp

If your pain has settled and swellings gone down and your blood thinning med has settled to a therapeutic level it should not be a problem.
Mainly if the swellings gone down completely then thats usually a good indicator that the circulation is going back to normal plus a month is a good time for your body to have started breaking down the clot.
The risk of vigorous exercise is that the clot can dislodge and move within the veins to lodge further up in the body- usually the lungs- causing a pulmonary embolism- but no exercise at all is probably a bit overkill too.
Dont know what your definition of 'gentle spin on turbo' is, but take it in stages. Of course your own doctor is in a better position to answer the questions posed, but good luck.

keef66

What's going on with you young, fit types developing DVT? I thought it was the exclusive preserve of sedentary, elderly types on long-haul flights :shock:

Brommers76

Why no cycling on the road for 6 months? Is that purely down to the Warfarin - or whatever blood thinners you are on? If it is then that doesn't make any sense. I take it you are advised not to drive anywhere in case you have a car accident and bleed to death?

napoleond

I was told by the doctor that I was ok to ride after i'd had 6 weeks of warfarin.

shinobishoryuken

To be honest I'm bewildered and fed up with the contradictory advice / non-advice I get from INR clinic staff, doctor, ward staff etc. My GP is bordering on useless and appears to be more naive and uneducated on DVT than I was before i got this.

May I ask those that still ride post-DVT if they did so whilst wearing their compression stockings, or if you took them off for the ride and put them back on afterwards?

Mine are thigh-high and I am now awaiting a new pair / type as they keep falling down and bunching up at the top of my knee.

cyco2

If you google 'pulmonary embolism' it may find you as very interesting. My wife died from it. I reckon your doctor has no idea what to advise you and for why? Because they only deal with sedimentary types where gentle exercise would be a step to far. After a prostrate operation I was advised not to drive my car in case of the need for an emergency stop. So I went by bus which was involved in a crash. So, when a Doctor advises something like don't ride your bike ask them to qualify it and analyse it carefully.

richk

I had a dvt/pe a year ago. Was told to 'take it easy' for a couple of weeks only but 'gentle' cycling was encouraged. I didnt discuss what they considered gentle (as I suspect it would have been different from our definition).

At a recent blood test, I was advised that I only need to wear stockings when sat still for long periods (& certainly not needed when riding).

brit66

In the past few months my right calf and even ankle has been swelling up quite noticably, particularly after a day sitting down (office job you see).

I went to the doctor and he basically said you haven't got dvt (which I didn't think I had anyway) but he showed little other interest in what the cause might be.

I suspect it's down to a circulation issue (I noticed a varicose vein pop up in that leg about 18 months ago), but a few weeks off the bike and then regular, moderate-paced cycling doesn't appear to be making these symptoms go away.

Annoying!

napoleond

I only wear compression stockings when I'm going to be still for a long time (flights/long car journey)

Eddy S

I contracted a DVT after shattering my femur at the end of 2010.

I used a Wattbike as part of my rehab and was turning my legs over on it (broken leg and all…) about 6 weeks in.

Don’t wear your compression stockings whilst exercising. How long you wear them post dispersal of the clot will be determined by the level of vein damage caused by the original DVT which can be seen on an ultrasound scan – I was told that I would have to wear mine for at least 2 years when not exercising, being active, etc.

shinobishoryuken

Brit66- I initially went to see GP back in December for pain behind my knee in other leg.

I had pain in whole lower left leg which the A&E dept' said was just a sprain even though I could fully move my calf without difficulty. Only going back and demanding some proper tests to be done was I diagnosed with a DVT.
Maybe something to consider if it persists? Drs cant tell by just looking / feeling your legs if you have a DVT (or something completely different).

I suppose my main concern is when did people feel safe enough to attempt to exercise on the bike again?
I dont want to risk the clot breaking up via a sudden increase in blood flow.

Maybe I'm just ultra-paranoid!!

ddmrcp

The clot breaking up depends on things like how big it is for example, ( and can occur with any exertion, not just cycling). Also the possibility of it happening is more when you are first diagnosed. Things change once treatment is started- and the body automatically starts to 'clear' the clot.
I suspect if your warfarin has been within range, swellings gone, and you are now a good six weeks or so down the line- you should be ok for exercise and can ramp it up in stages. Good luck

brit66

shinobishoryuken - yes, I agree, the most cursory of examinations, which culminated in the measuring of both my calf muscles... and that was the diagnosis. This despite all the symptoms pointing to a possible clot - pain, swelling, discolouration of lower leg.

Anyway, I''ll get it checked out properly as you did.

shinobishoryuken

Brit66- any news or change to your diagnosis?

For those that are interested, this past week I've done 15-25 mins on indoor spin bike at moderate intensity four times on alternate days. I also braved the busy roads on Saturday and cycled 6 miles.

Any advice on how long to wait before something a bit more like a 20 miler?

Above comments regarding stockings are the polar opposite to what I've been told. I heard that I must wear my thigh length compression stocking at all times ESPECIALLY when exercising / cycling. Obviously frustrating as it creeps down and bunches behind my knee due to muscular contraction.

What's peoples advice on thigh length vs below knee compression? Do below knee stay in place during exercise and everyday activity?

markp80

I've been reading this thread with interest, as last week I was also diagnosed with a DVT in my thigh.

I went to my Dr complaining of pain and swelling in my calf and the first thing she did was start treatment for DVT, booked me in for an ultrasound, even though she said she thought this was an unlikely cause. The ultrasound scan did unfortunately show a clot.

No specific cause has been found for my clot. I have always kept fit but had to stop in Oct 2010 following a relatively bad knee injury (to the other leg). My second and final op was back in January though (ACL reconstruction), so that's outside the timescale for being the culprit apparently. The injury was my initial reason for taking up cycling seriously, and I can't believe how much I'm enjoying it.

So at the moment my bike sits there folornly too. At the moment I struggle to walk more than 100m without my calf really cramping up, so it's probably too early to get back in the saddle. Interestingly I haven't been advised to wear TED stockings, although rather than warfarin injections I've been put on a new tablet treatment (rivaroxaban) - not a new drug but newly approved for treating DVT as a warfarin replacement.

Having read up a little about DVTs and PEs I do feel very fortunate to have had an early and correct diagnosis.

Cheers,
MarkP

ColinJ

I suffered a DVT and a massive PE this summer. I have been on Warfarin for nearly 6 weeks and I can still only walk 250 metres before I run out of breath and my bad leg starts to throb. I am making slow progress, but I think it will probably be the end of the year before I can do any riding again, and at first I will stick to the gym bike.

After my recent near-death experience (3.5 hours unconscious on the floor before I came round and was able to crawl to a phone to get help!), I suggest that you take heed of the warnings about the dangers of DVT! Keep your legs moving when travelling or sat in front of the computer/TV. Keep your weight down, don't overdo the alcohol, eat a healthy balanced diet, and drink plenty of water. Avoid overtight clothing.

t.m.h.n.e.t

ColinJ wrote:

I suffered a DVT and a massive PE this summer. I have been on Warfarin for nearly 6 weeks and I can still only walk 250 metres before I run out of breath and my bad leg starts to throb. I am making slow progress, but I think it will probably be the end of the year before I can do any riding again, and at first I will stick to the gym bike.

After my recent near-death experience (3.5 hours unconscious on the floor before I came round and was able to crawl to a phone to get help!), I suggest that you take heed of the warnings about the dangers of DVT! Keep your legs moving when travelling or sat in front of the computer/TV. Keep your weight down, don't overdo the alcohol, eat a healthy balanced diet, and drink plenty of water. Avoid overtight clothing.

And stretch post ride/exercise. Preferably as low to the ground as possible

ColinJ

T.M.H.N.E.T wrote:

And stretch post ride/exercise. Preferably as low to the ground as possible

In the context of DVT - how does that help? That's one piece of advice that I hadn't seen before!

I'm putting my legs up on a footstool now whenever watching TV for any length of time, and also when using my laptop (now, f'instance) or tablet rather than sitting at my desk and using my desktop PC. That definitely reduces blood pooling. When I started on the Warfarin, I could only keep my legs down for a few seconds but they were fine up on the stool.

t.m.h.n.e.t

ColinJ wrote:

T.M.H.N.E.T wrote:

And stretch post ride/exercise. Preferably as low to the ground as possible

In the context of DVT - how does that help? That's one piece of advice that I hadn't seen before!

I'm putting my legs up on a footstool now whenever watching TV for any length of time, and also when using my laptop (now, f'instance) or tablet rather than sitting at my desk and using my desktop PC. That definitely reduces blood pooling. When I started on the Warfarin, I could only keep my legs down for a few seconds but they were fine up on the stool.

Post workout - blood needs to return to the heart via veins controlled by valves. Warming down gently with a low COG,and stretching assists this process. Veins on which valves do not close allows gravity to pull blood back causing pooling (chronic venous insufficiency/chronic venous disease) leading to weakening of the veins and thus varicose veins(commonly)

Those who have varicose veins which are an early indicator of vein problems - are prone to DVT. DVT can also be the cause of CVD/CVI.

Yet the obese,inactive,cancer patients and smokers are high on the list for DVT/CVD and CVI also.

ColinJ

Thanks T.M.H.N.E.T.

Being 3 stone overweight and spending too much time sat in front of the computer or TV were factors for me.

I have lost 1.5 stone since getting ill and expect to get the rest of the excess weight off by the time my 6 months on Warfarin is over. Most of my weight gain was due to excess beer consumption. (I was told I could drink alcohol within the UK government guidelines, but I decided a long break made more sense in the circumstances!)

t.m.h.n.e.t

ColinJ wrote:

Thanks T.M.H.N.E.T.

Being 3 stone overweight and spending too much time sat in front of the computer or TV were factors for me.

I have lost 1.5 stone since getting ill and expect to get the rest of the excess weight off by the time my 6 months on Warfarin is over. Most of my weight gain was due to excess beer consumption. (I was told I could drink alcohol within the UK government guidelines, but I decided a long break made more sense in the circumstances!)

No problem

willhub

Is large blue veins in the calves and then every so often the odd occurrence of tight feeling calves that sting or hurt when you touch them or tense them up a bad sign? Is that anything to do with bad circulation or just normal fatigue?

t.m.h.n.e.t

willhub wrote:

Is large blue veins in the calves and then every so often the odd occurrence of tight feeling calves that sting or hurt when you touch them or tense them up a bad sign? Is that anything to do with bad circulation or just normal fatigue?

Depends on the shape of the veins.. Twisted veins are indicative of CVI which itself can be responsible for heavy feeling legs, aching and cramping (Generally via restless leg syndrome) and tightness.

Symtoms which are also indicative of fatigue. The shape of your veins is the clue as to which.

willhub

Some of them are just generally huge and sort of meander like the average river, not extreme, but there is like a lump which is a vein that sort of sticks out I think. Not been so bad as of late but sometimes I find on the bike I'm struggling to stop my calve muscles from tensing up. Probably might as well go to doctors, I'm falling apart.

t.m.h.n.e.t

willhub wrote:

Some of them are just generally huge and sort of meander like the average river, not extreme, but there is like a lump which is a vein that sort of sticks out I think. Not been so bad as of late but sometimes I find on the bike I'm struggling to stop my calve muscles from tensing up. Probably might as well go to doctors, I'm falling apart.

I would agree if anything for peace of mind.

shinobishoryuken

I've just checked back in on this topic and thought I'd provide a quick update on my DVT situation.

I am happy to say I am now feeling more normal than when I initially wrote the post. I am back at work and have been for the last 5 months. No special treatment or phase back. I do have a strange tight / swollen feeling at the end of most days (I stand or sit during the day but with plenty of walking around etc) but no visible swelling.

I have small visible hair-line veins on the surface of the ankle-meets foot area of my DVT leg but other than that all looks fine.

I have had a load of expensive scans recently at my own cost- I desperately needed the piece of mind as the NHS were not going to re-scan me.

The clot that began in my popliteal vein and extended up into my femoral vein is almost completely clear, with little bit of residual clot and subsequent back flow still behind the knee. This may always be present.

I get some 'pains' / feelings in both my DVT leg and the other one many times daily and this could also be hindered by 'heightened sensitivity' since the DVT. I often awake in the night or early morning feeling pulses in both legs- it is always in the forefront of my mind. My job is in the health / sport industry so there seems to be no escaping the subject.

To keep sane I try and exercise daily, such as 1 mile rows v intense, weights, walks and weekend cycle rides of an hour or so.

Have recommenced weekly WattBike sessions which have been tough but manageable and just this weekend I did a 35miler which is the furthest since I rode the Cheshire Cat sportive in March.

Blood tests have been taken recently to get the ball rolling and I am awaiting a consultation with a haemotologist early 2013. I have now been on the Warfarin for exactly 7 months and to be honest I fear coming off it- without the initial heparin and Warfarin I surely would have died or at least have lost my leg- the pain is something I will never forget and live in fear of it returning.

The stockings (still thigh high) are the bane of my life but I will endeavour to wear them for as long is required. I wear them all day every day including during cycling etc.

I am optimistic that I will improve and I hope this helps others going through a similar ordeal. I know some people never really recover from a DVT- I feel lucky to be able to ride in the rain nowadays!

I am yet to dare to train legs with squats, deadlifts, calf raises etc for fear of excessive loading / pressure in my veins which are damaged. I also don't want to tear down my muscles in case the impeded flow of blood disrupts the happy medium.

I would just like to make clear that the only warning signs I had were a gradual shortness of breath and strange feelings down my shin and 'electric shock' type feelings in my calves, as well as purple toes in the fortnight leading up to my DVT diagnosis. Please seek medical advice if you experience any of these!

markp80

Great to hear things are improving for you.

It was interesting to read that you have paid to have rescans for peace of mind. I was surprised to learn that the NHS do not routinely rescan at the end of anti-coagulant treatment, as I would have thought you would want to know how the breakdown of the clot has progressed. I'm personally half way into my six months of anticoagulant, and I strongly suspect I too will pay for my own rescan if the NHS aren't prepared to do it.

Also like you, coming off the treatment is something I'm a little concerned about. My DVT has no apparent cause, which I think is concerning my GP, so I am also going to be seeing a haematologist, but not until my drug course has completed.

I've been back on the turbo for some time now, in fact my GP saw no reason why I should curtail my training on it provided I was not in discomfort. To be honest, the calf pain/swelling wasn't apparent at all on the bike, only when walking, so it hasn't been a problem in that respect. Having said that, when initially diagnosed I struggled to walk 100 yards without my calf cramping up, but within a month or so it improved dramatically.

Anyway, like I say, good to hear things are improving for you.

Cheers,
MarkP

shinobishoryuken

Thanks Mark.

The cost of the scans has almost ruined Christmas but I desperately needed peace of mind / clarification- my DVT also was 'unprovoked'. I would pay for them again if needed too.

Well done for getting back on the turbo- I took my time getting back into training because of fear of clot moving and the total shock of it all. Also the pain didn't subside for quite a while.

Are you also wearing compression stockings? If so, what brand, type etc?
I have tried several types and am still not happy!

I have read that a lot of people refrain from cycling on the road / trails whilst on warfarin but I have been doing so now for the past few months. Like I said in my previous post DVT is serious and I know some people are unlucky and never make it through one. If its a nice day and I have the time I try and get out and enjoy a quick ride.

My main concerns are my ability to strength train and jog in the future- what advice have you been given regarding fitness training?

shinobishoryuken

Update: This month I have been riding more frequently and feel almost as fit as 'pre-DVT'' with the addition of daily indoor rowing workouts and weight sessions.

As a morale boost for myself and anyone else coming to terms with coping with a DVT I recorded a 30+ seconds improvement on a 10 mile time trial (Watt bike sessions) which incidentally was the final 'hard/intense' ride I did just under a fortnight prior to my DVT diagnosis.

As an honest sideline, I have been getting pains and twinges in both legs (DVT leg and 'good leg') and am putting it down to increase in activity!

Would still like to hear what compression stockings people are wearing / enduring?

Also, would be interesting if people want to share their warfarin dosages, and if anyone is cycling on long-term warfarin treatment?

Personally, I have been on steady dosage of 9mg daily and weigh 127kgs. I do find that on weeks where I exercise less due to work / family life / stresses that my INR shoots upwards of 3.5. Medicinal alcohol also needs to be kept in check these days!