Blood thinners

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Blood thinners

Postby triangle » Sat Mar 03, 2012 1:03 pm

A couple of weeks ago I had a stent installed in my left renal artery to correct a significant stenosis. This was diagnosed after I developed high blood pressure a few years ago and which did not respond much to my quitting all my many and terrible vices and cycling two hundred kms a week. It's not major surgery - I had a local and nothing else so that i could watch the whole thing on some monitors they set up for me. I was off the bike for precisely 52 hours after the surgery so no big break.

The vascular surgeon has put me on blood thinners for two months - 75mg of clopidogrel (seriously, who comes up with these ridiculous names??). Since then I feel I have lost some of my fitness. I struggle a bit where i had not previously and I am unable, for example, to put out the same power in threshold intervals that I was managing routinely up until the day before the surgery. The difference is not huge but enough that i feel I have lost some top end power and stamina. This is contrary to my secret hope that I was only one stent away from turning pro ;-) Anyway, anyone know if perhaps the blood thinners are giving me some grief or am i just making excuses? I only have just under six weeks of them left so it's not that big a deal but i am curious ...
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by BNA » Sat Mar 03, 2012 1:15 pm

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Re: Blood thinners

Postby sogood » Sat Mar 03, 2012 1:15 pm

You are making excuses. Placebo effect as far as clopidogrel is concerned. Clopidogrel is an anti-platelet agent, similar to aspirin. :wink:
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Re: Blood thinners

Postby triangle » Sat Mar 03, 2012 1:18 pm

sogood wrote:You are making excuses. Placebo effect as far as clopidogrel is concerned. Clopidogrel is an anti-platelet agent, similar to aspirin. :wink:


LOL! Good to know that I don't need help to be crap. Thank you :-)
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Re: Blood thinners

Postby foo on patrol » Sat Mar 03, 2012 3:02 pm

For what it is worth....... I was watching (yeah I know) Dr Oz on Thursday in between loading and he had a segment on taking blood thinners and it is recommended that, they are taken at 10pm every day because of......hell I can't remember the study facts but it was something to do with how the body
works in cycles. :wink:

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Re: Blood thinners

Postby triangle » Sat Mar 03, 2012 3:23 pm

foo on patrol wrote:For what it is worth....... I was watching (yeah I know) Dr Oz on Thursday in between loading and he had a segment on taking blood thinners and it is recommended that, they are taken at 10pm every day because of......hell I can't remember the study facts but it was something to do with how the body
works in cycles. :wink:


Aha! I take mine first thing in the morning. That must be it .. taking them at wrong time .. experience drop in sustainable power whilst on bicycle. No doubt a common and well documented problem ;-) I feel better now.
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Re: Blood thinners

Postby foo on patrol » Sat Mar 03, 2012 5:00 pm

The reason I posted this, is because they have done studies on x amount of people. So there! :|

Go to the web site and have a look at the general programe for Thursday. It had something to do with diet and eating different types of food! :wink:

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Re: Blood thinners

Postby triangle » Sat Mar 03, 2012 8:47 pm

foo on patrol wrote:The reason I posted this, is because they have done studies on x amount of people. So there! :|

Go to the web site and have a look at the general programe for Thursday. It had something to do with diet and eating different types of food! :wink:



Sorry, mate, i was kidding. I do appreciate your advice :-) Ty ...
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Re: Blood thinners

Postby RonK » Sat Mar 03, 2012 10:37 pm

So, your doctor has no objection to your cycling while using blood thinners?

A friend fractured his pelvis in a crash (wet manhole cover) not long ago - he was put on thinners for several months and forbidden to ride while he was taking them.
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Re: Blood thinners

Postby triangle » Sat Mar 03, 2012 11:07 pm

RonK wrote:So, your doctor has no objection to your cycling while using blood thinners?

A friend fractured his pelvis in a crash (wet manhole cover) not long ago - he was put on thinners for several months and forbidden to ride while he was taking them.


The surgeon told me to wait 48 to 72 hours and then get back on the bike. He just warned me not to cut myself shaving :-)
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Re: Blood thinners

Postby foo on patrol » Sun Mar 04, 2012 10:08 am

That's ok Ty no harm intended. :)

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Re: Blood thinners

Postby U2adam!!! » Tue Mar 06, 2012 1:55 am

I was on a fairly substantial dose of Warfarin for about 6-8 months to remove a DVT from my left calf area. I didn't notice any reduced riding performance and my doctor said there was no problem in riding apart from his warning of 'just don't fall off' which I took as general advice and not 'Warfarin advice'.

I had daily blood tests for about 10 days so they could get the dosage just right and apart from just being extra careful not to bumble into things like lawn movers and whipper snippers I didn't have any trouble. Razor cuts and other little dings did take longer to stop bleeding but the doc dismissed any reports of bleeding to death after falling off the bike as being 'rubbish'.

Hope it all works out well for you.

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Re: Blood thinners

Postby sogood » Tue Mar 06, 2012 9:15 am

RonK wrote:So, your doctor has no objection to your cycling while using blood thinners?

A friend fractured his pelvis in a crash (wet manhole cover) not long ago - he was put on thinners for several months and forbidden to ride while he was taking them.

There are "blood thinners" and "blood thinners", and different levels of "thinning". In general, a fall or fracture whilst on blood thinner will make the bruise/blood clot worse, but it's not a specific contraindication for exercises. So adjust one's risk level accordingly. Along this scale, one will need to take more care whilst on warfarin as it's only used in situations where "serious thinning" is needed. Pelvic fracture is also a special condition and there's good justification for a major risk reduction.
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Re: Blood thinners

Postby Aushiker » Wed Mar 07, 2012 3:24 pm

I have a pace maker and ride .... take a beta blocker and a aspirin as well ... Cardio (Professor at UWA) made an interesting comment yesterday about aspirin ... seems he is forming the view it is more placebo than it is effective.

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So my vote is for an excuse :)

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Re: Blood thinners

Postby triangle » Thu Mar 08, 2012 10:28 pm

Yeah, I have had a bit of a rest week and much of my power has returned. I'm still a few watts shy of the peak I reached just before my stent went in but that's probably neither here nor there. Must remember to rest more in the future :-)
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Re: Blood thinners

Postby jules21 » Fri Mar 09, 2012 10:35 am

i thought the risk of riding while taking blood thinners was of more severe haemmoraging in a crash?

i was on clexane for a couple of weeks after a clot and i wasn't permitted to do anything strenuous for a short while - i believe this had more to do with not provoking the clot into dislodging and allowing it to be gradually reabsorbed into the blood stream.
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Re: Blood thinners

Postby ValleyForge » Fri Mar 09, 2012 3:06 pm

jules21 wrote:i thought the risk of riding while taking blood thinners was of more severe haemmoraging in a crash?

i was on clexane for a couple of weeks after a clot and i wasn't permitted to do anything strenuous for a short while - i believe this had more to do with not provoking the clot into dislodging and allowing it to be gradually reabsorbed into the blood stream.


Yup - none of that advice was based on science...

Five common "blood thinners" are used.

Heparin (Clexane\Fragmin...) is given by injection and lasts about 12hrs. It's the primary treatment of clotting (DVTs) or preventing them (around the time of surgery).
Aspirin which has no significant effect on blood loss and a minor but important effect on preventing clots in arteries (heart).
Warfarin which is a tablet which alters blood clotting by starving your body of a vitamin necessary to make clotting factors.
Pradaxa is a new tablet which has a similar effect to warfarin but is easier to monitor and at this stage, considered as safe as warfarin.
Clopidogrel is a tablet that paralyses platelet initiated clotting. It's used for preventing stents in arteriers (carotids, heart, kidneys) blocking.

Of these, low-dose Clexane will not increase bleeding, but a standard dose will increase bleeding, usually not dangerously. If the dose is a "therapeutic" one or incorrect it can be life-threatening.
Taking warfarin and exercising is mostly studied in older patients and is considered safe. Safe for the demographic is probably pulling a shopping trolley, not MTBing.
Pradaxa - probably too early to tell.
Clopidogrel - about half the people taking it will have marked increase in bleeding time (time to clot). Otherwise there is no change in clotting.

And there endeth the lesson....

So it's mostly safe.
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Re: Blood thinners

Postby sogood » Fri Mar 09, 2012 3:24 pm

jules21 wrote:i thought the risk of riding while taking blood thinners was of more severe haemmoraging in a crash?

That's a reasonable understanding of the risks involved. With it comes with increased risk and severity of bruising and haematoma formation when enclosed. Excess bleeding when there's open wound.
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