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Old 01-17-14, 02:54 PM   #1
skidder
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Blood Clots / Deep Vein Thrombosis anyone?

Any +50r's ever ahve bllod clots in your leg(s). Irecently cam down witht he condition and its going to knock me off my bicycles for a few months. Anyone ever had this condition and have any input about timelines for getting back in the saddle and on the road? FWIW: My condition was just the natural odds of getting it - no precursor conditions or lifestlye choices that would incease the odds of it occuring (regular exercise/bicycling actually decreses the risk).
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Old 01-17-14, 03:38 PM   #2
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Machka had a serious case of it resulting from a flight from Canada to Australia, as well as having the relevant gene. But she's not 50+, so... can't help.
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Old 01-17-14, 04:16 PM   #3
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An under-50 woman in my spin class got a clot in one calf, the result of a domestic flight during which she was dehydrated. She's a racer, in very good condition. Endurance athletes like cyclists are more susceptible, not less. Good advice here:
How to prevent deep vein thrombosis (DVT) in athletes and traveling sports teams

You can start riding again when the doctor says so - generally when they take you off warfarin.
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Old 01-17-14, 08:46 PM   #4
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Thanks for the responses. I haven't been on an airplane since 2008 ( got fed up with the poor performance of domestic airlines here in the USA), and even on long drives I've always stopped after about two hours. No recent increases in exercise, either miles or intensity, and I've always drank a lot of water, so doctor ruled that out as a factor (as the article Carbonfiberboy linked in his post). And no recent severe injuries/trauma.

Another thing that linked post by the nutritionist missed: There's lots of foods you've got to stay away from - leafy greens (spinach, cabbage, broccoli, letuce) plus some fish and fish oils (the article almost implies they're good for you), and my doctor also mentioned to stay away from multivitamin supplements for now, as some of them can interfere with the anticlotting properties of warfarin.

Being under 50 yo doesn't really mean much, since DVT can stike at any age (as MAchka's occurance shows),. Its just the probability of occurance slowly increases as you get older, and the probabilty really jumps up when you get over 60 years old. (dang, aging sucks!).

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Old 01-18-14, 01:26 AM   #5
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Did the doctors test you for the gene that results in a predisposition for DVT?

I didn't reference Machka because she is under 50, but because you were very specific about asking the 50+ crowd,

You could go to other places to seek advice from those who have had DVT. Training and Nutrition is one forum.

Patentcad, who is cast by many in this 50+ forim as the devil, had a serious case of DVT that ultimately required surgery to correct the long-lasting ulcer in his ankle, even though the issue manifested as a pulmonary thrombosis.

The consequences can range from light -- corrected with large on-going doses of Folic Acid, for example -- to serious, including pulmonary problems and most seriously, death through blockage of the heart arteries.
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Old 01-18-14, 07:14 AM   #6
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Some of the chemical changes that occur in the body when you have cancer can also cause excessive blood clotting. That's what caused mine. Once my cancer was found and removed, my clotting problem went away.
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Old 01-18-14, 09:06 AM   #7
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skidder, I've had issues with this for a few years now. Spent six months off the bike on warfarin (lousy substitute) getting it under control. changed to a vegetarian diet and take two full strength aspirin a day now to keep it under control. Doc says genetics plus my long appendages play the most part in it. For me the worst part is the accompanying edema.
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Old 01-18-14, 11:28 AM   #8
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Suffered a blood clot in my left shoulder from trauma at work in the early part of December/13.
Doctor prescribed Xarelto, which is more expensive than wafarin but you do not need to watch what you eat
or take blood samples to keep your INR between certain numbers, and the doctor said I could also cycle as the aerobic exercise is good for it but do not lift any weights. Have not been on the road yet for me it is too cold so indoor trainer for me.
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Old 01-18-14, 07:10 PM   #9
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Quote:
Originally Posted by skidder View Post
Any +50r's ever ahve bllod clots in your leg(s). Irecently cam down witht he condition and its going to knock me off my bicycles for a few months. Anyone ever had this condition and have any input about timelines for getting back in the saddle and on the road? FWIW: My condition was just the natural odds of getting it - no precursor conditions or lifestlye choices that would incease the odds of it occuring (regular exercise/bicycling actually decreses the risk).
Regarding the timeline ...

I first developed the clot in mid-June 2009, but I didn't know it then. However, I struggled to do even simple tasks and it was getting harder and harder to even walk around our house.

I was hospitalised at the end of July for 2 weeks. My left calf was full of clots from top to bottom, and there were some in the thigh as well. During that time, the nurses encouraged me to go for daily walks, and at first, I had to rest about every 50 steps.

Mid-August we went to Tasmania for 3 weeks, and I walked whenever possible, determined to get back some strength.

At the beginning of September, I got back on my bicycle again. Some people warned me about the potential for bleeding with the Warfarin, but my Dr explained that my blood clots quickly and the Warfarin would just bring it back to what most people consider normal. So he encouraged me to cycle, walk, and do whatever sports I wanted to do.

It was slow going, but I did my first 100 km ride since June in November. Unfortunately, after that, I found doing longer distances to be quite a challenge although I did manage to do some centuries, a 200K or two, and a 300K over the next few months, and I made several attempts at more, but had to DNF. We attempted a 400K, but I just couldn't do that distance.

I was on the Warfarin a full year ... it took a while for my INR level to stabilise and because I have a genetic predisposition toward developing clots my Dr wanted to be sure it was all taken care of. About a year later, I saw a blood specialist, and fortunately he recommended that I go off Warfarin.

What a difference!! While on Warfarin, I felt like I was moving through deep water all the time. When I went off, my energy levels improved immensely and I felt so much better.


Since then ... I need to keep active. I am not supposed to sit anywhere for more than about 1 hour. I'm supposed to walk lots because walking flexes my ankles and encourages the blood to flow. Cycling is fine too, but the walking is important to include as well. So I've been walking anywhere from about 10 to 30 km/week.

I need to use compression stockings if I'm going to be sitting or standing for long periods of time. So when I fly, I wear the compression stockings.

I need to have Clexane injections when I fly, which has changed how we travel a little bit. We still travel, but the Clexane knocks me around quite badly, and for 2 days after we arrive anywhere, I'm useless. So we can't hit the ground running anymore.

And I do have ongoing issues with my left ankle swelling. It wasn't too bad for a couple years, but has started to become more of a concern lately.
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Old 01-18-14, 07:50 PM   #10
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Yes, twice.

The first was after a lengthy flight (I am a pilot). I went to a hospital for treatment and was prescribed warfarin. After a week on the drug, I felt horrible, had no energy and started passing blood. Went to the hospital again and the INR had jumped to 13.4 which was causing internal hemorrhaging. A couple of weeks in ICU and 27 units of blood and I was back in business.

Second time I was hit by a car riding which led to achilles surgery and a lengthy period in an air cast. Developed a DVT in the leg that affected 3 veins. That has been treated with Xarelto and took about a year to start feeling better. Started with low molecular warfarin but had an anaphylactic reaction. Still have daily aches in the affected leg but otherwise feel pretty good.

Machka, as you know, swelling may be caused by permanent damage to the vein valves. Not much they can do about that but check with your doc.

For those on warfarin, pay attention to that INR and how you feel. Don't mess around with signs of bleeding.

For those on Xarelto, great drug but INR no longer applies. There is also no immediate reversal. It takes 24 hours to reduce the effectiveness so if you have a bleed, get to a hospital.
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Old 01-18-14, 08:16 PM   #11
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Machka, as you know, swelling may be caused by permanent damage to the vein valves. Not much they can do about that but check with your doc.
I was in talking with my cardiologist about another issue last Monday. He had a look at my ankle, which was all puffy at the time, and said I've very likely got permanent damage to my veins or the vein valves.

The only thing he could suggest was that I put on my compression stockings when I notice the swelling.
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Old 01-18-14, 08:55 PM   #12
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I've had issues that started in the spring of 2010. I was 55 at the time. Clots in my lungs and lower legs.
Over a period of a few weeks my wind fell off dramatically, hence I spent a few days in hospital while they sorted things out and I have been on warfarin ever since. They want me to keep my INR in the high 2s. I feel better when the numbers are up, but the risk for me is probably not letting it fall, rather than get too high. I get a full bunch of tests once a year, and they've never given me a reason why it all came about. They keep telling me they are looking for me to develop pulmonary hypertension but I keep proving them wrong. PH is real ugly, so I'm in the process of really increasing my cardio in hopes of warding it off, hence the new roadbike. I don't feel I've ever really had decent cardio capacity, but I'm determined to get it the best its ever been at age 59. For me, it just seems the more I do, the better I get. I haven't run up against a wall yet, but I'm a real lump of coal on a bike.
My history is three prior strokes but they aren't linking the new 'lung clots' thing to them.

FM

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Old 01-18-14, 10:17 PM   #13
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Originally Posted by skidder View Post
Another thing that linked post by the nutritionist missed: There's lots of foods you've got to stay away from - leafy greens (spinach, cabbage, broccoli, letuce) plus some fish and fish oils (the article almost implies they're good for you), and my doctor also mentioned to stay away from multivitamin supplements for now, as some of them can interfere with the anticlotting properties of warfarin.
(
Current education for patients on warfarin in many US hospitals includes the advice to eat a consistent amount of vitamin K-containing foods (the leafy greens mentioned above).. Avoiding them is ok if done consistently. Sometimes simpler to just avoid them.

http://www.ahrq.gov/patients-consume...ls/btpills.pdf
http://www.stoptheclot.org/news/article197.htm
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Old 01-18-14, 10:41 PM   #14
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Quote:
Originally Posted by Machka View Post
I need to have Clexane injections when I fly, which has changed how we travel a little bit. We still travel, but the Clexane knocks me around quite badly, and for 2 days after we arrive anywhere, I'm useless. So we can't hit the ground running anymore.
Clexane is a brand of enoxaparin; the most common (only ?) American brand is Lovenox. Enoxaparin is one of the recommended treatments for prevention of venous thromboembolism (DVT and PE) in hospitalized patients - or for non-hospitalized people.
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Old 01-19-14, 12:29 PM   #15
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Thanks for all the responses and posting the different situations everyone experienced; it might be helpful to others who come down with strange leg/breathing symptoms. Mine started as (what I thought was) an extreme muscle pull in my calf about a week before Christmas. After a week of rest it didnít feel like it was healing up, and it was swelling, so I went to the doctor. After an ultrasound and a chest x-ray (clear), I ended up in the emergency room for a few hours while getting the initial doses of heparin and warfarin. Iím now getting regular blood tests to fine tune the warfarin dose, and it seems the swelling and soreness are receding. Iím not experiencing and negative effects from the warfarin. Doctor said to expect to be on it for at least 6 months. And I haven't had any breathing difficulties.

One good thing about this Ė when the ER doctor was reviewing my vital signs before releasing me , he commented that he doesnít see a lot of 30 year olds with blood pressure/heart rate/O2 levels as good as mine (55 years old). Weight is also good (about 15 lbs/7kg over my high school weight).

My doctor also had a few extra blood tests done to check for any other abnormalities in my biochemistry (indicators of other diseases or cancers), but I have no family history of cancer, ulcers, etc. Test results should come back this week. Heís not doing the genetic test right now since thereís no history of blood clots either.
Doctor wants me to get walking (I already do that at work since Iím outdoors half the day, bosses have let me kinda slack off the last few weeks ), but Iíll have to ask him about bicycling and how much I can do; I definately donít want to overdo it and have a relapse or pulmonary clot! Damn, this sucks!!!
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Old 01-19-14, 01:56 PM   #16
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I was in talking with my cardiologist about another issue last Monday. He had a look at my ankle, which was all puffy at the time, and said I've very likely got permanent damage to my veins or the vein valves.

The only thing he could suggest was that I put on my compression stockings when I notice the swelling.
I have 2 genetic mutations that contribute to abnormal clotting as well so in addition to the Xarelto, I wear compression calf sleeves at work. It does keep the swelling down. With the genetic issues and career, I will be taking anticoagulants for the rest of my life.
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Old 01-19-14, 02:39 PM   #17
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LONG BIKE RIDES-
Especially in drops-bent over
Dehydrated
Plus you folks are middle aged and older
Surprised it isn't more common

Shorter rides-stop every 15-20 minutes.
Don't ride BENT OVER- increases pressure in veins-dilates them
Lots of fluids
take aspirin if you can tolerate it.

Serena Williams had a SERIOUS PROBLEM-DVT- and pulmonary embolism- maybe related to air travel very fit people do get DVT-

It would be interesting to do a quick survey-
to see just how many DVT cases here-especially distance and drops use
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Old 01-19-14, 03:51 PM   #18
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[QUOTE=phoebeisis;16424014]
Dehydrated
Plus you folks are middle aged and older
Surprised it isn't more common

Lots of fluids

My experience is that you can't over estimate the importance of hydrating even though we all know how important it is, and yet many of us don't attend to it like we ought to.....myself included.
Two of my 3 strokes came right on the heels of returning from long motorcycle tours in hot weather with not near enough effort to keep hydrated, plus lots of beer consumption off the bike. The 'first' one just might have resulted from dehydration as well, but it occurred during sleep and was so minor that I exhibited little or no symptoms afterwards. (when I had an MRI after my second one I was informed there were signs I'd had a previous stroke at some point in time)

FM

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Old 01-19-14, 04:51 PM   #19
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I don't have any clots in my legs, as it moved to my lung. And there it resides. They installed an IVC permanent filter to catch any more, if they form. IVC = a wire basket inside inside my Vena Cava.

I lost 15% of my lung capacity; but, honestly, don't notice it. I am not on any drugs for this, and hopefully won't need any.

Good luck in your recovery, and get back on that bike.
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Old 01-19-14, 04:57 PM   #20
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Fluids-right.

"Some" of the long distance air travel increased DVT risk is from dehydration.
Most might be from sitting-legs hanging-veins dilated-slow blood flow velocity-no muscle pumping-
But folks don't drink much on planes-and in the past the air wasn't humidified-except by human breath.

I wouldn't be surprised to discover a study showing exercise itself "activates" platelets a bit(pure guess).
If I look maybe I could find it.
Slight decreases in blood volume-perhaps might slightly activate platelets(pure guess).
Increases in blood flow velocity-same story(pure guess)

Bike riders at a moderate pace mild temps probably lose 3- 4 lbs of water per hour.
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Old 01-20-14, 03:19 AM   #21
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Thanks for all the responses and posting the different situations everyone experienced; it might be helpful to others who come down with strange leg/breathing symptoms.
Mine started on a flight from Los Angeles to Melbourne. I had the misfortune of sitting by the window, hemmed in by two large men who had bladders the size of the pacific, and in the 18 hours I was on that plane, I got up once to use the toilet ... annoying the two men.

One hour before landing, it felt like there was a little cramp in my left calf.

I didn't think much of it because I had been sitting on that plane for a long time ... I figured I would just walk it off. But no amount of stretch and walking seemed to help at all.

About 4 weeks later, the pain changed. It wasn't as intense in the one spot, but I ached badly from my hip to my foot. I figured it was getting better, so I ignored it. But I started to notice that I was having trouble breathing and that everything was becoming so difficult to do.

I had been walking to meet Rowan on his way home from work, but just about the 6 week point, I couldn't walk properly anymore. I was dragging my left leg along and I couldn't breathe.

And then I noticed that my left leg was about twice the size of my right. And the next day I was in the Dr office.



What I find interesting is that I've had this genetic predisposition to clotting all my life, and I've flown many times ... but that one time ...
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Old 01-20-14, 06:29 AM   #22
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Homans sign-might be mis-spelled
Old fashioned indicator of deep vein thrombosis
Lie on back or occasionally sit on table with legs hanging-straight leg was "better"
The examiner asks patient to relax leg and foot
Specifically let the foot hang loose toe down
Examiner then pulls/pushes the foot UP- toes up
Pain deep in the calf-indicator of DVT-
But ultrasound-much much better-the old physical diagnosis "tricks" were frequently wrong in both directions-hardly mattered straight or hanging-wrong answer both ways was common
Positive with no DVT and negative with DVT

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Old 01-20-14, 06:33 AM   #23
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They use Doppler ultrasound now.

You can actually see the clots in the image ... exactly where they are, how big they are, how many there are.
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Old 01-20-14, 07:05 AM   #24
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I don't have any clots in my legs, as it moved to my lung. And there it resides. They installed an IVC permanent filter to catch any more, if they form. IVC = a wire basket inside inside my Vena Cava.

I lost 15% of my lung capacity; but, honestly, don't notice it. I am not on any drugs for this, and hopefully won't need any.

Good luck in your recovery, and get back on that bike.
That's one of the scary things about DVT's: they travel , sometimes moving into the lungs and cutting off oxygen. One of mine did and it felt like I couldn't catch my breadth. To compensate my resting heart rate went to 130bpm. Luckily, I was already in the hospital at the time where I was treated with heavy duty medicine to dissolve it. After that, I also got an IVC. I had to go six months without a DVT before my heart doctor would take me off of coumadin.

I still wear compression socks whenever I go for a long drive.
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Old 01-20-14, 09:06 AM   #25
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My doctor also had a few extra blood tests done to check for any other abnormalities in my biochemistry (indicators of other diseases or cancers), but I have no family history of cancer, ulcers, etc. Test results should come back this week.
I'm going to hazard a guess that you might have a mutation in a clotting factor called Factor V Leiden. Your test results will confirm this yea or nay.
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