Blood thinners and riding

[AliCat518]

Yesterday, SO and I were in the ER all day, and he was diagnosed with a Pulmonary Embolism. This is his second PE in 6 years, so he’s been through all of this before. (He has Factor 5 Liden).

The ER doc told him no riding. He’s on twice daily shots of Lovenox and once daily Coumadin, if that matters. He will most likely only be on the Lovenox for about a week, but since this is his second PE, he will likely be on Coumadin forever.

Obviously, a fall could result in internal bleeding, which could result in death. SO has already said that he’s going to keep riding regardless of what the doc says (i’ve tried to argue this with him, but hes just too stubborn and wont listen). He doesnt EVER wear a helmet when riding, so im going to see if I can at least change that.

Has anyone else dealt with this? This is an especially rough time to be going through this–I had a seizure recently and wasnt allowed to ride for awhile/cant ride alone at all, and now the Dr is telling him he cant ride either. 2011 isnt fantastic for riding so far…

[Kwill]

I have never been through this, but it sounds like your SO wants to enjoy life and not be an invalid. So he’s going to ignore his doctor’s prudent advice.

Obviously, he shouldn’t be riding. But id he must, at least minimize your risk factors … make sure he has a very quiet horse, and just walks around an arena. Otherwise, a fall is fairly inevitable, and sounds like it would be fatal! That would be tragic.

Maybe you guys could enjoy horses another way, such as being involved in rescue, helping out with horse shows, or owning a show horse someone else competes?

I think I would tell your SO that you would like to grow old with him, and despite the fact he wants to deny that he can’t do everything he wants any more, he needs to face facts if he wants to be around help take care of YOU and your health problems!

[Zenyatta]

It’s very dangerous to be riding, while taking anti-coagulants.
A minor fall can turn into a disaster! Jeez Louise you’re not even allowed to use a razor, while on these meds.
The risk of bleeding out is way too high, please listen to your doctor.:eek::eek:

[bcody]

I am sure you and your SO want to grow old together. How unhappy would he be not riding? Yes, riding is more dongerous for him (I would insist on the helmet), but so is driving, a slight bump could set off that air bag and that could be serious. Shaving, falling. My husband is on coumadin. At 41 he gave up riding, we gave up the farm (they are a dangerous place to be), he quit martial arts (he is a 4th degreee). But you see, you give all that up and you are not the same person. You grow old, you gain weight, and that is not good either. Yes, coumadin makes a differance, and needs to be a factor in things when you decide what to do. It is hard to regulate. Diet, weight, the way the wind is blowing all seem to effect it. But it can be control (my husband checks his at home, and works very close with his doctor.) It has been 8 years since everything happened with him. He has started riding my kid safe gelding, with a helmet. He does martial arts again, but only spars with me (I am a 2nd degree). He lives, just takes extra care. I love my husband. I want to retire together and sit on the porch in our rockers. I also want him to live, and enjoy life. The two of you need to decide what the risks are, how to lower the risks and what chances not to take. Good luck, I hope 2011 improves for you and your family.

[rizzodm]

Friend of a friend went through this. He said he would not give up ridng either. He rode for a while but the bruising was so bad, just from sitting in the saddle, that he did relent and stopped riding. He still enjoyed his horses but not from the saddle.
Sorry you have to deal with this, I wish they could come up with something better than coumadin. The drug companys have tried several times and have fallen short.

[sdlbredfan]

Ask the doctor if he can take the new drug Pradaxa? That is currently being given for people with AF (atrial fibrillation) so I do not know if it helps with PE issues or not. Jingles for some solution to be found, but for heaven’s sake make that guy wear a freakin’ helmet! What is the point of taking a drug to prolong his life if he is not willing to do what is easily within his power to prevent a TBI!? Sheesh…

[heatherny2]

I also have Factor V Leiden…had several DVT’s and numerous PE’s …I am on coumadin (warfarin) for life (the almost highest dosage possible actually, 10 mg 4 days a week and 12.5 mg 3 days a week)…I continue to ride regularly :yes:…Yes, I wear a helmet EVERY TIME…and I always make sure someone is around should something happen.and I also made sure everyone knows I am on the blood thinners…I have even fallen off a couple times and while my mother panicked, I said well, I might get a bruise, and I was fine (not even a bruise)…I even talked to both my dr’s about it (my primary and my hemotologist) and they both said I could continue to ride as long as I took the necessary precautions, which I do. I will.not. let it define me or limit my happiness.
As long as he wears a helmet and his PT/INR’s are not outrageously high (i.e. 9 and above), he should be fine to ride…
NOTE: not a medical opinion, just a fellow coumadin taking rider’s insight.

[heatherny2]

Also, OP, if you want any insight as far as the blood thinners, Factor V, or riding with it, etc, feel free to PM me.

[nhhaflngr]

see related thread

http://www.chronofhorse.com/forum/showthread.php?t=299617

[AKB]

I don’t know a lot about this, but wonder if there are some things that could be done to reduce the risk. Not riding is definitely the lowest risk option, but that is his choice. A helmet is definitely in order. Stroke/brain bleed risk should be kept as low as possible. Perhaps an eventing vest would be helpful, maybe even with an inflatable vest. Home monitoring of the INR might be helpful. If he checks his INR and it is up, he shouldn’t ride that day, and should do whatever he is supposed to do to bring it back down. You and your spouse should tell the MDs that he plans to ride. They may decide on a lower target INR because the risk of bleeding goes up as the INR goes up. I know this is confusing, but you are probably fairly knowledgeable about coumadin and INR monitoring after everything you have been through.

[sign_of_Grace]

I was on blood thinners for 5 months. In that 5 months, I came off my horse. Haven’t been off a horse in 15+ years, and it had to be done in that 5 month period?? I had a helmet on, thank God. I hit my head so hard I went deaf for about 5 seconds. Got back on, rode the 3 miles home, then went for a CT Scan just to make sure I didn’t have a brain bleed, which obviously is much more likely when on thinners. I was ok.

Had they not been able to remove my IVC filter (I had PE’s also), that would have put me on life-long coumadin. And I would have kept riding. It’s a personal decision, but I know for me, it was nice to read about others who chose to ride or not to ride, and why. Good luck!

[caffeinated]

I have Factor V Leiden as well, and was on blood thinners for 6 months following my first (diagnosed) PE.

I did ride. I made a few adjustments out of caution - I rode in a safety/eventing vest, and ONLY rode when people were at the barn. There are people on the property all the time, but I only rode when there were people in the barn area (either riding, or doing work within shouting distance). I always wear a helmet, too.

There were certain things I will adjust for safety - since the main risk is in falling, and any fall had to be followed up by a trip to the ER to check for bleeding, I made sure there was always someone around who could take me, should the worst happen.

I am back on lovenox now (booo!) and am making adjustments again. But I do intend to ride as much as possible. There’s something wrong with me, but I’m not dead. And riding is as natural to me as breathing, going even a few days without it turns me into a deranged basketcase. I can’t even imagine a life without it, honestly. It’s a risk (so is getting into the car every day to come to work), but it’s a calculated one and I do my best to mitigate the risk (whether it’s the choice of horse I ride, making sure people are around, or whatever).

I think in your SO’s case, you really need to kick his butt about the helmet. A head injury on blood thinners is far more likely to be very serious, and he should not be messing around with that.

[HOOF123]

THIS in my opinion is a very great thread and important for all horsemen and horsewomen - please bump - spread the word - leave your experiences …

[cadriver]

So I have had PE’s twice and I’m on coumadin for life, or possibly the new drug just come out someone mentioned above, problem with that is it isn’t aproved for PE’s yet. But my Dr. said I’d be a good canidate. The best part is that you don’t have the food and drug interactions with it that you do with Coumadin.

So my feeling is that I am at risk with everything I do… So I’m not giving up horses or driving them. Actually i never even thought about it and my Dr.s didn’t say I couldn’t. The big thing with Coumadin is to get your blood checked regularly so that it doesn’t get to thin. Once you have been on it a while you get to be able to tell if it is to thin.

So that said you should take precautions but everyone should take the same ones as far as I’m concerned. The important part is that you need to have something in your wallet or pocket that says you are on a blood thinner. This is important for emergency personnel whether it is a car accident or horse accident…

So I say keep riding:-)
Diane

[dotneko]

I also have factor v leiden (homozygous).
I have had three PE’s and a DVT. I am on 8mg
coumadin daily and bridge with Lovenox when I
need to have a ‘procedure’ (like a colonoscopy for
my Crohn’s, or work on my portacath).
I ride. I was trampled two years ago by a horse
who was driven insane by the bugs. Was med-
flighted into Boston and had lost a significant amount
of blood into my abdomen due to a severed artery
and underwent a partial colectomy. They gave the
shot (vitamin K???) to reverse the coumadin. What
saved me from bleeding out ironically was my breeches

• they acted as a tourniquet.
  Moral of the story - anything can ‘get’ you. Be sure to
  let the people around you know about the coumadin and
  wear a medic-alert bracelet. Yes, I bruise easily. I always
  wear my helmet, since a ‘brain bleed’ would be disasterous.

I do have a home test kit - much like the blood sugar testing
machines. It requires a finger-prick. I email the results to my
anticoag clinic who, in return, sends me my weekly dosage.
This was all paid for by my health insurance. They concluded
it was much more cost effective to do it this way than to
have blood work visits on a weekly basis. Every few months
I go in to calibrate the machine. Very easy - especially when
you are bridging and need to test frequently.

Dot

[AliCat518]

Thank you guys SO much for all of the information. I’ve been mentioning and pushing the helmet thing…but hes not easy to persuade. Very frustrating! And when he did give in and say he might wear one, he said he would wear his old, beaten up Troxel. I’m sure its better than NOTHING, but it wouldnt provide enough protection for me to quit the helmet argument! Any suggestions on things I can say to really make him think?

[willowmeadow]

I have a blood-clotting disorder caused by a genetic mutation. I had two heart attacks two years ago at a young age. I am on blood thinners and had a stent placed in an artery. I continue to ride and never even slowed down. I do, however, wear a helmet and try not to take too many risks.

My reasons for wearing a helmet - I want to be around for my family as long as I can be, but I also want to ride. The helmet is a compromise. I won’t give up my hobby, but I WILL be as careful as I can be. As stated above: I refuse to let my health problems define me.

My brother has the same disorder and was in a bad, nearly fatal, motorcycle crash a few years ago. The warfarin was not a good thing, but he survived. I am the only one in my family that not only understood when he got another bike, but encouraged him to ride again. So much of our lives ARE defined by our health issues. We’re told we can’t do this and we can’t do that. We have to take our medicine and we have to go to the doctor. So much of it is out of our control that the urge to have a say in some part of our lives leads us to say “yes” to our dangerous hobbies.

If it weren’t for that little rebellion, and my passion for horses/riding, I think I would just give up and die.

Maybe you could talk to your husband and tell him you understand, but a helmet would make you feel better about his riding. I do wear mine, every time, every ride. I ride with western riders and trail ride. I am probably one out of 40 that regularly wears a helmet. It has become second nature and I simply don’t care what other think…but no one really comments.

[kfildes]

Blood thinners and riding

I was searching online and am so happy to have found this thread. I was just diagnosed with a DVT after having knee surgery last week. I was started on Lovelox last night and will be injecting myself twice per day for the short term. I was also just started on Coumadin (Warfarin) therapy. My doctor had me tested for the Factor V test and I am hoping that it is negative. Regardless, for the next six months I will be on blood thinners.

My doctor immediately cautioned against riding. I happen to have a pony farm with four young ponies in training that I have no intention of just giving up. I left my doctor’s office in tears as he basically told me that riding, especially youngsters and jumping, was far too dangerous for me to do again.

Reading this thread has at least given me some hope. I always wear a helmet and usually do not ride alone, so I am already taking some of the advice included.

As I sat feeling sorry for myself I realized that every day that I drive my car is a risk. I will not give up something that I care this much about because it might be bad for me. I just can’t live my life that way. I am keeping track of all the helpful tips that are posted and will continue to take precautions. Thank you to everyone who included information here and gave me some hope!

[thistleswamp]

I understand that the doc suggested your partner quit riding, and while I agree he should maybe not ride for the first month or so while bridging with Lovenox and figuring out his dose of coumadin, I wouldn’t say he should quit riding forever! Riding is probably beneficial to his overall health in so many ways. You need to make sure you encourage him to take protective measures that are required to stay safe. Helmets, flak jacket if he’ll wear it, riding sane “predictable” horses will help to minimize his risk. A horse can always trip and stumble or spook at a plastic bag flying by and he needs to be aware of that.

By the way, the new drug Pradaxa is only approved for certain indications and PE prevention is not one of them, yet. Also don’t forget, there’s no known antidote for Pradaxa yet.There is an antidote to coumadin however. So in case of emergency, other measures will have to be taken to counteract the effect of Pradaxa.

Many aspects of medicine have to be looked at in terms of risk vs. benefit. It sounds like he thinks the benefits of his horses far outweigh the risk of an accident.

PS. You can definitely shave while on blood thinners… I haven’t noticed any of my patients suddenly growing humongous beards after starting coumadin. Lol

[Simbalism]

I have been on Coumadin for 21 years due to a genetic clotting disorder(Protein C issue). I have had about 3 DVT’s and one PE in the past. Funny enough, I didn’t even know I had a problem until I had a bad fall from a previous horse and broke my hip then I started with the DVT’s(age about 35). I always wear a helmet(did even before I had all the problems). I haven’t jumped too much for a while more due to some fear issues, but I still trail ride and do low level dressage, team penning, parades, whatever I feel like doing. If I started jumping again, I would wear a vest just for safety. I go to my Dr’s office 1-2 times a month to get it checked, but having my own machine- that would be too cool. Will have to check into that when I go for my next Dr. appt.