About 3 weeks ago I was put on Warfarin (6 mg a day) because I got 4 pulminary emboli in my lungs. It is making me dizzy, light headed, giving me head aches and makes me feel weak all the time with some chills and tingling in my fingers. I was hoping to get back to training next week. However, I just do no see how I’m going to train feeling like this. I hate this stuff. It is making me miserable and I just don’t trust training while on it. Is anyone else on either of these drugs and if so are you training while on them? I’m suppose to do IM Canada in August and I just don’t see myself being able to train while on this junk. My blood clots are all cleaned out and all my labs came back negative for blood clotting diseases or genetic defects. They say the clots were caused by excessive training followed by prolonged sitting and dehydration. I’m thinking of just coming off the blood thinners after a couple months but I thought I would get others thoughts to see if it got any better or if they took things or did things to help with the side effects. Plus, I also find myself feeling more depressed lately but that might also be the lack of ability to train. Anybody’s thoughts would be greatly appreciated.
Well…that sound like a terrible idea, unless you want to, well, maybe die.
The american college of chest physicians, and the vascular surgeons, recommend that you are on 6 months to a year of coumadin (and potentially lifelong since you had a PE) to prevent future dvt and propagation to your lungs, potentially causing heart failure and death. Even though you don’t have any genetic causes you are obviously predisposed, and have likely had DVT before.
I understand that you want to train, but give it some time on the coumadin. More likely you body is still dissolving some of the micro clot in your lungs and legs and/or pelvis, and that immune response is making you feel poorly.
There will be several that will respond to this thread.
But … Jordan/Dan - do we need a sticky regarding deep vein thrombosis/pulmonary emboli in endurance athletes? This is STILL not in the mainstream medical literature, but sure seems prevalent on this forum. Enough so (and with possible dire consequences and treatments) that perhaps some further investigation may come from ST
My buddy is on that and he trains like a wildman.
Well, I don’t want to die. That is for sure. However, I know I don’t want to feel like this for the rest of my life. It’s been over 3 weeks now so I would think they would be completly disolved by now. I also need to find a Pulmonist who is much better at explaining things to me. He does a horrible job at explaining why to me with everything. Thanks for the thoughts and help!!
I would love to hear the wildman’s thoughts and what precautions he takes. Does training help make him feel better?
I’ve never heard him mention the symptoms you discuss. Maybe you should chat with your doc.
Well, I don’t want to die. That is for sure. However, I know I don’t want to feel like this for the rest of my life. It’s been over 3 weeks now so I would think they would be completly disolved by now. I also need to find a Pulmonist who is much better at explaining things to me. He does a horrible job at explaining why to me with everything. Thanks for the thoughts and help!!
Had multiple PEs diagnosed in July 2009. Warfarin for 6 months, off for three, more clots, now warfarin for life.
I agree with rroof, seems every 6 months or so someone here gets DVTs/PE, I know several athletes that have had them.
I am not a doc, but from everything I know, there’s no way your clots dissolved in 3 weeks. Have you had a followup CT scan to confirm this? That would be the only way to know. These things do a number on your lungs, it was months before I felt 100%, but I was training within a few weeks, ramping back up slowly.
I am going to guess that the reason you feel like shit is because your lungs have just gone through some serious trauma. Blocked blood flow, potential infarction. The first 3 weeks I was lucky to be able to walk slowly with my wife
I was also tested and found no genetic tendency to clot. I suspect mine came from Wildflower long course, drinking (dehydration) and the long drive home. But then they came back, so who knows?
No way in hell I’d take myself off the meds. I really can’t stand being on it because it creates additional issues, but I can’t stand the potential alternative more
I had Pulmonay Emboli in January this year. Search under my name and you’ll see the story.
You are probably on too high a dose. Are you getting your blood checked regularly? Is a qualified Doc reading those numbers? I too had light headedness and dizziness symptoms at first but they went away when my dosage came down. Now I’m on 3mg of Warfarin daily until next check later this month. As others have said, be patient, this is recoverable and you will be able to train at fulll strength soon. But, don’t gamble with your life. These can and do kill a lot of people (300,000 annualy in the US alone).
I am training fairly well, and with the only caveat being, I can’t crash! So no Mountain biking, and no pace lines for awhile. I just ride alone or in a two man group, or on the wind trainer. I will get tested again at six months in July, to see if the clots reappear after being off the meds for a few weeks. If they do, then I’m on them the rest of my life. Lots of peoeple are you know. It’s not the end of the world. Also, did you get a genetic markers test? I did, it’s very helpful to know if you have a genetic predisposition to PE. I am one of two (mom or dad). This means I have a heightened risk, but not necessarily a life time of blood thinners. This will be re tested again in July.
Watch your risk factors, don’t do long sitting episdoes without moving around, stay hydrated, wear compression socks as often as is reasonable.
Good luck and hang in there. IMC is still an option, just get your INR tests dialed in to give you the right dosage.
I’m 4 weeks out now and did my first training ride today. We did 20 miles and I felt ok during the ride. Definitely not where I was 4 weeks ago. I switched my Warfarin to evening doses and that has seemed to help. The only thing was that it seems that little 20 mile ride took a crap load out of me. My sitting HR is still at 65 and its over 9 hours since the ride. My usual sitting HR was around 45 so that kind of sucks. No, I have not been in for an updated CAT scan. The doctors gave me the all clear to start training again. I can tell I’m not going to be really hitting it hard for awhile and am going to have to get use to long and slow.
It turns out that I’m positive for something called “Factor 5.” I’m not really sure what that exactly means. However, my clots were caused by me getting cuts in my arteries which lead to the lungs overcoagulating (if that is a word). So basically it looks like I’m going to be on Warfarin for as long as I am training. I’ve spoken to a few other people and they say the body starts to get use to it and all the side effects I’m feeling will go away over time so, like you said, its better than the alternatives.
I think that much of this can be avoided with physicals every 6 months along with blood labs and a d-diemer. My guess is that not enough of us are checked out enough regularly for things things and that is why so many people are having issues with it.
Factor five is the hyper coagulation you have. I have the same thing. Again, not a big deal, just know your risk factors. Might be worth going to a Hematologist, if you continue to have issues with the meds.
Wow, sounds like exactly what happened to me. So about the sitting. What is considered “long” and if you laying watching tv do you raise your legs? What about sleeping? I have my CEPs on now as I watch tv. I also have some zoot compression pants I’ll be wearing more often.
Anticoagulation is very important at this stage. We will skip talking about any issues about cycling on the road on a blood thinner. Clots take time to dissolve. There is a constant process of adding and subtracting to the clot. You don’t want to “add” anymore.
In my experience side effects from properly dosed coumadin is rare. The alternative is very expensive - utilizing a low molecular weight heparin injection either once or twice daily.
There are some coumadin alternatives coming down the pike that do not require PT checks. Fixed doses. But are not available in the US as of yet.
As for FVL ( factor 5 ) a hematologist is a great place to start. Depends how many of the genes you carry. They can also screen the family.
Good luck.
The mice at our cottage are on a steady diet of Wafarin every fall, when they think they can take over the place after we leave! They don’t like it! 
I had a PE 3/07. Was on comadin from 3/07-09/07 and was trying to train for IMCDA & IMWISC. If I knew then what I know now, I would have withdrawn from both CDA & WISC while I could still get some money back. After completing WISC in the rain in 2006, I DNF’D on both. I found my training suffered. I never really got into a good training groove. As with you, I don’t know if it was physical or mental. I was depressed. All my docs told me that the PE is hard on your body. It takes time to recover. It is also dangerous to bike or do anything where you might get injured while on comadin. A blow to the head might start a brain bleed which could be fatal. All of this interferes with the mindset you bring to your training. However, going off the comadin, in my opinion, would be a VERY bad choice.
It sucks. But your choices are limited. Get well & good luck.
“Life is what happens while you are planning something else”
How long did it take you to feel comfortable to swim again? I think the hardest thing for me is to know how hard I can push it and the entire comfortability issue. The doctors said I’m ok to start training again but should take it easy for awhile. I did a easy 2 mile run on Saturday and a light 20 mile ride yesterday. Today I’m feeling very weak and kind of light headed so I’m guessing I over did it already so I’m resting today. I’m going to take it slow. I think the biggest issue for me is going to be getting past the fear. When I’m short of breath I start freaking out still that I might have another clot, or when I ride I didn’t go close to any steep downhills or whatever. I think the toughest part is going to be between the ears and getting past the fear of everything. I’m not even going to touch the swimming yet, just in case.
I know you weren’t asking me, but… My pulmonologist said he didn’t want me to go too hard, in case I passed out from the light headedness. Never really felt that. I had some lung infarction though which hampered my performance. This was caused by 5+ weeks of misdiagnoses, from anxiety to EIA.
Looking at my logs, I was released from the hospital July 4. 7/21 swam 1600, 7/23 swam 2500, 7/28 did the full masters 3100 workout and from then on was doing the full distance. 8/9 was my first OWS and even did a 1.25 mile OWS race on 8/16, 6 weeks after discharge. 3 in AG as well.
I was a swimmer so it probaby came back faster for me. Running took longer.
There will be several that will respond to this thread.
But … Jordan/Dan - do we need a sticky regarding deep vein thrombosis/pulmonary emboli in endurance athletes? This is STILL not in the mainstream medical literature, but sure seems prevalent on this forum. Enough so (and with possible dire consequences and treatments) that perhaps some further investigation may come from ST
here here! I think I’ve heard more about DVT/PE than pulmonary edema in triathletes.
We need to get the word out because with the relatively high risk among triathletes they need to be especially alert for shortness of breath and know what they could be dealing with before it’s too late.
IMO, there are also a lot of things that can be done to help prevent it.
I haven’t looked up the known side effects, but I can tell you that in my personal experience there have been no side effects outside of decreased clotting. It works by interfering with vitamin K’s part in the intrinsic blood clotting cascade. I really don’t know why/how this could cause the side effects that you are experiencing.
I’ve heard people call it a ‘poison’ and expect it to make them feel systemically crappy as if they are having chemo treatment. It’s just not so. I think that people that feel this way on coumadin are more likely experiencing imagined symptoms because they think they should.
I was ready to train from the get-go. I went back to training earlier than they wanted me to and NEVER have felt my physical ability hampered by coumadin one bit.
Talk to your Dr. about the side effects because they could just be something else. Perhaps while in the hospital you caught a bug.
I actually have some lung infarction also so this is helping me out greatly!! They said the exact same thing to me about the swimming. It is really good to get an idea of what I should expect to go through and compare notes. My pulmonary doctor is so vague in everything because everyone is so different in how they come back depending on their original health so you are actually helping me more than the doctor is. Would you mind if I PM’d you occasionally to compare notes? I was in the Hospital April 4th and released April 6th and did nothing but long walks up until Saturday which is @ exactly 4 weeks. I did a 2 mile run on Saturday in zone 2 (9:30 pace) and felt totally fine. I felt like I could easily have run 5 or 6. Then I did a 20 mile bike ride with a group yesterday and that was a big mistake! Whenver I ride with a group I totally ignore my vitals and HR so I went way too hard and am feeling the effects today. I’ve noticed a slighly higher sitting HR also. I felt quite short of breath and taxed pretty much all day after the ride even though I felt totally fine during the ride which had me a little scared. Whenever I get even the slightest short of breath I start getting scared wondering if I should go to the hospital. So it will be nice to compare notes so I can start to gain some confidence back that I’m not going to die. By the sounds of it this entire thing is a day to day operation and I’m just going to be forced to be patient. I have a race I’m suppose to do June 5th. It’s an Olympic Triathlon and then I have the Victoria Half Ironman June 20th and then Ironman Canada on August 29th. After seeing everyones notes on this I’m doubting I will make any of those races. I’m wondering if it isn’t smarter to just scratch Canada now so I don’t try and push it too hard too soon. I would have already done that. However, we have our first child due September 20th and I’m not sure I will have the chance to train for an Ironman again for a long time after that.