Cycling and warfarin?

[nuliajuk]

My better half was well on his way to training for two MS Bike Tours this year. Out at least 4 days a week, riding more or less consistently, although he was feeling a bit tired in the evenings. Then he started feeling a tiny bit of pain across his chest while pushing the pace or riding uphill, so his doctor sent him for a treadmill stress test at the hospital. Five minutes into the test he got more than just a tiny bit of pain, so they pulled him off and noted a very irregular heart beat. They checked him in, sent him for an angiogram the next day, and five days later he had bypass surgery along with some repair work on a valve that was a bit leaky. It all happened very fast and was completely unexpected.

Needless to say, he's feeling a bit shell shocked. One day he's feeling pretty good, a few days later he's got a factory reconditioned heart. Worst of all, there's a big warning on the bottle of warfarin tablets that he shouldn't engage in any hazardous sports because he could bleed too much. So now he's afraid he might never be able to ride again due to the possibility that a crash could lead to major blood loss.

Is anyone here using blood thinners such as Warfarin? Has it changed your approach to riding a bike? If you used them after heart surgery, were you eventually able to come off them, or is it a lifetime thing? I gather it's the irregular heartbeat that worries them. They snipped something in his heart that may have been causing this while they were repairing the valve and that's supposed to eventually even out his heart rate.

[Crankin]

My DH's experience was *not* exactly the same, so please don't make comparisons between Warfarin and Plavix. DH had 2 stents put in, in 2005. No by-pass surgery, etc, and nothing else wrong. He stayed on the Plavix until last June, when before his surgery for his broken collarbone, he had to discontinue it, and decided to not re-start. He bruised and swelled with every little bump, but, it didn't stop him. He knew that bleeding would be harder to stop. There were a couple of crashes, but he just dealt with it.
The only thing he did was stop mountain biking, and that was not really because of the Plavix. Doctors will recommend you sit on your *** and do nothing, or they will tell you to walk/swim. DH stopped doing crazy group rides/pacelining, but again, he was quite ready to give that up, not necessarily because of the medication.

[shootingstar]

Nu, hope he gets a 2nd doctor specialist opinion. Is there a hospital that specializes in cardiac rehab for outpatients?

[nuliajuk]

Sorry, I don't understand the question. Second opinion about what?

[Crankin]

I think she meant a second opinion about cycling and being on Warfarin.
You are going to get the party line on that. My DH felt comfortable doing exactly what he had been doing before while taking Plavix, with the exceeption of the mountain biking like a crazy person. He also found a cardiologist for a second opinion on things in general, that was a specialist in working with people who do endurance sports. It is so opposite of what cardiologists usually see, it is hard to find someone who will understand. I would be more concerned that your DH has been cleared to resume endurance activities, or at least building up to his former level.

[OakLeaf]

I would be more concerned that your DH has been cleared to resume endurance activities, or at least building up to his former level.

I would second that. I think it's much more a concern with running than cycling, but there's plenty of evidence that a lot of capillaries get broken during the repetitive micro-trauma of endurance sports, and that would worry me if I were on a blood thinner.

All I really know about warfarin comes from experience with sedentary people - but I do know that it's extremely important to keep one's diet very consistent. Doctors will tell you to do that by eliminating most green vegetables. That at least rules out the possibility that you might accidentally eat more vitamin K rich foods one day and less the next, if you never eat any at all. But I think it's possible to count vitamin K in the same way that diabetics count carbohydrates. That might be more work than either of you has time for though. It's also super important to keep up with the blood testing, twice a week or whatever the doctor recommends.

[nuliajuk]

He has a cardiologist as well as a regular doctor, so I think he's getting good enough advice. His concerns came from reading the literature that came with the Coumadin.
We were also told was that it was important to be consistent about green leafy vegetables to keep the INR the same. We have a small salad everyday, unless I'm adding something like broccoli to a meal.
I suppose, having had a crash in 2011, he's more worried about crashes than most people would be. It will be at least three months before he's likely to be able to ride anyway, but he's already been contacted by someone who runs a cardiac rehab class.
I'm just looking ahead to the future, next spring most likely.