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Discussion: Clots

in: Swampfox; Swampfox > 2016-05-05

May 6, 2016 4:06 PM # 
My old friend Veinbuster is an avid cyclist whose clotting problems probably arose from years of business air travel combined with a genetic predisposition, rather than a mystery bike crash. Although his situation is different from yours, he has learned a lot about clots over the past couple of decades and might be able to offer some insights. I'll suggest that he stop by here to say hello.
May 6, 2016 5:50 PM # 
I read back from the crash to see if there is anything I can offer. The big clotting event for me was 20+ years ago and might have been influenced by a fall (snowboarding without being locked into the board followed by a mighty fall on ice), but that wasn't the key element, which I won't bore you with.

Also, I should say I don't have a medical background, just observations.

About the clots: they will stop being clots over time, but might not heal completely. By that I mean that the tissue where the clot was might not return to normal. Think of it as scarring. In my case, I permanently have significantly reduced venous capacity. I suspect that there are good odds of complete dissipation in your case - just because the existence was detected and addressed pretty close to the probable inception. This can be checked with a CT scan or even ultrasound if the vessel in question is big enough to get a clear picture. If it doesn't heal completely, that location may be prone to future clotting. There are lots of other factors including a genetic predisposition - I always healed fast, so without blood thinners might try to heal that spot again.

Oxygen intact will come back reasonably quickly. The flow around the lungs is such that they will clean up. I first started using the trainer for about 10 minutes, as you did, and bumped it up gradually. I had to pedal with my arms. By the sounds of your log, you are probably getting to the point where that will progress pretty quickly. Your doctor will probably caution you about how aggressive you are getting back to your preferred state of fitness - trust them. Until the clots are gone, you don't want to get carried away and break bits off that can go flying around. I settled for maintaining decent muscle tone for the summer.

You mentioned alternative blood thinners. I won't comment on specifics, but to me there are two important considerations:
First - I want one that has an antidote; I.e. A clear path to reversing the effect. I needed it when I got hit by a car and want to know that whatever I am taking can be undone if needed.
Second - I like to be able to measure if I'm taking the right amount. This might be less important if you only have to take it for a short period of months, but over a longer period it matters more, at least to me. I have 20 years of charts of doseage and results.

That's probably too much unsolicited from someone you don't know. Good luck. I hope things keep progressing. I'm happy to share any of my thoughts or experience that might be helpful.
May 6, 2016 6:53 PM # 
Thank you very much for taking the time to share your experience--I quite appreciate it.

I have come across some information that alluded to the same thing you mention--that the veins where the clots were might never become entirely "normal" again, because of scarring. That's both interesting and also unwelcome to find out--though it's certainly better to have the facts and the reality of the situation and to deal with it rather than being in ignorance!

I have (belatedly) come to realize as I look forward to potentially returning to orienteering that having a blood thinner at that point in time--if I was still on a blood thinner--which was either reversible or which would clear out quickly would be an important consideration. The blood thinner I am on right now has neither quality, so I am being careful around knives. ; ) Anyway, what you wrote provides additional emphasis to that point.

Of course, my fervent hope is that this will be a one time event, and that once I am healed, I will be done with it. In my favor, the clots are clearly linked to the trauma of the bike crash, and I have no history otherwise with clot problems, or any genetic predisposition to same. I realize it may not be that easy though, and that I may be stuck with concerns about this for a while.

Thanks again!
May 6, 2016 8:06 PM # 
In terms of antidotes, the obvious blood thinner I know of that does have one is Warfarin/Coumadin. This is important because it's also used as rat poison, which household pets sometimes eat. You can get the antidote, vitamin K, at the pet store. Vitamin K is also found in some vegetables, which is why my mother can't eat stuff like kale.

Interesting trivia, and maybe even true!
May 6, 2016 9:17 PM # 
Or soy.
May 6, 2016 9:31 PM # 
If it weren't for unsolicited advice from people we don't know, Attackpoint would be far too quiet. :)
May 6, 2016 11:42 PM # 
An unsolicited anecdote:

My uncle had a deep vein thrombosis about ten years ago from taking long trips to Europe for work.

This may or may not have been a contributing factor, but after a few days in the hospital his doctor gave him a list of foods to avoid for the time being. He looked at the list, mostly green leafy vegetables, and told the doctor that was 80% of his diet. I don't think he's a vegetarian, but he eats meat like once a week.
May 7, 2016 12:26 AM # 
I take Coumadin/warfarin because it is very well understood and is easily reversible. Vitamin K is plentiful in spinach, kale, broccoli, soy beans, chick pea and others but this are the ones I watch for. The direction I got was not so much to avoid them, but eat a consistent diet - so no binging on greens. In my case, a high intake of spinach certainly contributed to the original clot. The vitamin K does work, and quite quickly.

Before setting out for a few days of potentially dangerous activity that could get me hurt where I might be alone for a while I get a blood test to see where I am in the therapeutic range - INR 2-3. I want to be on the low end of that range because the loss of blood is significantly higher at the top end of the range. I did explain my strategy to my doctor along with charts showing exactly how I planned to manage it.

swampfox: as you've described the situation I think you have very good odds that it is a one time event. It is common for it to take 6 months to clear completely. That doesn't mean you won't be back to your normal routine before then.
May 7, 2016 12:35 AM # 
That is my hope (that it will be a one time event)!

And if it should take as long as 6 months for everything to clear away completely, just think of what an awesome walker I will be by then. Probably already by now US Race Walking officials are conferring with eagerness.

Okay, well, probably not. ; )

In the meantime, I can look forward to the earlier day when my shoulder is well enough to take a guitar strap and the weight of a guitar armed with 3 single coil pickups...

Btw, veinbuster, you didn't actually bust any veins, did you?
May 7, 2016 11:28 AM # 
The deep vein in my left leg has permanently reduced capacity. Many surface veins grew to increase the total return capacity and popped out of place. Compression encouraged the ones that can be covered to go back in place.

3 single coils sounds like a stratocaster. I'm quite happy to play sitting so no strap is required, though I'm more likely to play humbuckers or an acoustic.
May 7, 2016 3:48 PM # 
3 single coils does indeed sound like a stratocaster, so full marks. Of course it's possible to play one with it in your lap, but it's just not the same if you're not leaping over sofas and chairs, throwing it off the walls, or laying it down on the floor and yanking energetically on the whammy bar to coax out additional levels of filth. I now my neighbors love me, I know they do. ; )

I had never heard of veins popping out of place. Before this is all said and done, I have the feeling I 'm going to know all sorts of new things I could have gone on quite blissfully before not knowing.

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