MTB and Warfarin

Stav_98

Morning all,

I had a good search and poke about the MTB forums last night to see there has been a small number of formites who have suffered DVT and/or Pulmonary Embolism; I've a history of both and will therefore be taking Warfarin for the rest of my life as there's no known cause.

I was wondering whether anybody else is taking Warfarin and riding MTB or has done for shorter periods of anti coagulation therapy. Beyond the obvious helmet and gloves are there any other precautions you take?

I'll be limiting myself to relatively simple trail type riding and will be avoiding flats in an attempt not to shred my shins!

Cheers,
Stav

brianbee

[url=http://www.bikeradar.com/forums/viewtopic.php?p=19754202#p19754202]Stav_98[/url] wrote:

Morning all,

I had a good search and poke about the MTB forums last night to see there has been a small number of formites who have suffered DVT and/or Pulmonary Embolism; I've a history of both and will therefore be taking Warfarin for the rest of my life as there's no known cause.

I was wondering whether anybody else is taking Warfarin and riding MTB or has done for shorter periods of anti coagulation therapy. Beyond the obvious helmet and gloves are there any other precautions you take?

I'll be limiting myself to relatively simple trail type riding and will be avoiding flats in an attempt not to shred my shins!

Cheers,
Stav

I think you ought to be asking your doctor if taking part in a sport where you are quite likely to sustain low level cuts and scrapes is a good idea.

My understanding for the little its worth, is that warthin should not be thinning your blood to the point your likely to bleed out and therefore it shouldn't be any sort of issue, but then that's dependent on dose So ask a medical professional, who knows the detail of your condition and medication

warreng

I'm on Rivaroxaban which is used for the same reasons as Warfarin but with the added kicker that there is no "antidote" to it in the event of trauma.

I haven't yet been on the bike (road or MTB) since my PEs but it really does concern me that I'll come off in a remote place and do some damage - as I understand it cuts on the arms and legs (or wounds that bleed outwards) should be ok if they are small and they can be compressed but internal wounds are really bad news (the consultant's words were "it'll be game over")

I did some googling to look at what would happen in the event of a trauma on Rivaroxaban and essentially you just bleed until the drug wears off. The consultant said that even if an antidote was available that the time between accident and treatment would be too long)

So with that in mind I'm knocking serious MTB on the head and sticking to cross-country and certainly going to become more circumspect when I'm back on the roads

Ironically, since I've been on these tablets I've managed to cut myself half a dozen times - once on the bloody tablet foil

natrix

To some extent it will depend on your INR. Mine is 2.5 which means that my blood takes two and a half times as long to clot as it would without warfarin i.e. a cut which would have stopped bleeding after 10 mins would now bleed for 25 mins.

I've been riding on warfarin for a year now, no jumps or crazy trails, just fun singletrack and forest trails withthe family. I wear helmet and gloves and most of the time also wear long trousers and long sleeves as there's a lot of gorse in my local area.

My consultant suggested just sticking to riding indoors on a turbo trainer, however I think that the benefits of cycling outdoors outweighs the risks.

warreng

And true to form I had my first off yesterday and cut my arm. Lots and lots of blood but it did stop eventually.

Brommers76

I take Warfarin due to a mechanical heart valve. INR is 2.5.

I ride mainly on the road but do CX and a bit of XC riding. I am of the opinion you just need to get on with what you are passionate about. The advice to only ride indoors is very OTT but what I won't do is any competitive road racing because I think that the likelihood of hitting the deck is so high.

For new Warfarin users it can be a bit worrying but now, after a few years taking it, it doesn't impact any decisions I make on a day to day basis. I have cut myself - I didn't 'bleed out', I have hurt myself and I just bruise a little easier and it takes longer for the bruise to go.

natrix

On a similar theme, does anybody go skiing on warfarin?? I keep toying with the idea, but the thought of a broken limb type accident puts me off. My consultant said that it would be fine so long as I didn't fall over.............

Brommers76

I would happily go skiing. I think I would wear a helmet but other than that I wouldn't give it a second thought. If you break your leg or twist your knee skiing then being on warfarin isn't such a big deal. I put myself at far greater risk doing DIY, climbing ladders and even driving my car.

Ultimately it is about your attitude to risk.

My fit and healthy 40yr old neighbour (great BMX rider) suffered a stroke in the middle of the night and is now trying to recover the use of his left arm. My mum died of cancer a year after retiring. IMO - get out there and do the things you want to do.

natrix

Thanks for that Brommers, I just need to convince the wife now

warreng

natrix wrote:

Thanks for that Brommers, I just need to convince the wife now

ah yes. My wife is a complete couch potato (tbf she works really hard!!) and cannot understand my desire to get back on the bike.

Hairylegs66

Late entrance to this thread, only just seen it. I'd like to share my experience in the hope that it might be helpful to other cyclists in similar circumstances.
I've been on Warfarin for 17 months after having unprovoked bilateral PE's . I have been told that I will have to continue to take it indefinitely. My INR range is between 2 & 3. I returned to mountain biking after about 3 months to regain my fitness, it helped me with my recovery, especially my aerobic fitness. My biggest concern when I ride is a crash related head injury which could result in a brain bleed; I was advised that any significant blow to my head should be treated as potentially very serious and I should go immediately to A & E for a brain scan. I'm less concerned about external bleeding but to mitigate minor cuts and grazes I also wear lightweight body armour (Nukeproof Critical) and Fox Enduro knee pads, for what its worth.
I have asked about alternative anti-coagulation and had the same warning from a Hematology Consultant that WarrenG has already stated - the antidote to Warfarin is readily available to reverse its effects, not so much for the alternatives. I've stuck with the rat poison because I holiday in to out of the way places where medical care is pretty basic and/or not quickly available. I wear a medical ID bracelet and tags identifying myself as a warfarin user for the benefit of medics if I can't tell them myself. In my experience the medical profession won't be chuffed to learn that you intend to get back on your bike, they are extremely risk averse (hence the turbo trainer advice as another poster mentioned); swimming was suggested to me. I hate swimming.
Ultimately it is up to you to decide how much risk you are prepared to accept by continuing to cycle whilst taking Warfarin whilst understanding the implications that it has for partners, family, children etc.if something goes badly wrong.
Thanks for reading and hope you stay healthy and on the bike

warreng

Hairylegs (it felt odd typing that)

When I was in hospital I had dozens and dozens of blood tests and they came to the conclusion that my PEs were unprovoked. There were some oddities in the Lupus tests (which is nothing to do with Lupus) and I'm being retested for that in June.

I've been out on the bike and I feel ok - lacking fitness obviously - but I'm just feeling my way back in.

EricPilot

Another late entry to this, sorry. Has been interesting reading what people have to say. Been taking Warfarin for 16 years now, since I had a Mechanical Aeortic valve fitted when I was 28, range was 3-4. I have been riding MTB for 4 years now. I had a stupid crash due to clipping a pedal on a rock while pedaling at speed (on a flat section) got thrown sideways and landed on my right thigh. Ended up spending a week in Hospital due to a massive haematoma in my thigh, and a fair amount of worry for my wife and kids. I always wear hard shell knee and elbow/arm pads like for downhill, but don't wear any hardshell padded undershorts (like Motocross ones). When I was admitted to hospital they found my INR was 4.5 which is quite high for me. I'm sure if i was wearing good undershorts protection and my INR wasn't so high I wouldn't have been in such a mess. Anyway i'm going to get back out on my bike, take it easy, get some decent thigh protection, and will probably take fewer risks. But cycling has always been my passion for fun and fitness.