Hiking with Coumadin

[Rick]

I was recently put on Coumadin for the rest of my life, to thin my blood in conjunction with a new valve in my heart.

I Figured I would just cary extra bandages and such in my 1st aid kit and make them readily available for minor nicks and cuts, however in speaking with my cardilogist, he said I need to be aware of bumps bruises and the likes as well becuase of internal bleeding that can occur.

I am wondering if anyone else in the community is on Coumadin and what their observations are.
Thanks

 

[Rivet]

There is a lot of talk about Coumadin on this forum...

http://www.valvereplacement.com/forums/index.php

Good luck with your new valve.

 

[KMartman]

my dad takes it...and all I know is if you like tap his shoulder..he's bound to have a HUGE bruise there....it SUPER thins the blood...

shame its what I probably have to look forward to one day as it runs in the family..

M

 

[BIGEarl]

It is a big deal if you make it a big deal.

I'm on the drug (it seems for the same reasons you're on the drug). You can get a bump or a bruise just getting out of bed in the morning. Recognizing extra precautions that may be needed and being prepared should take care of it.

A good friend of mine, also on Coumadin due to a valve replacement, works at a local supermarket and has done so for years. He's a meat cutter.

I’ve managed to cut myself quite a few times over the past few months. Once I needed several stitches and the hospital staff was reluctant to even look at the wound before I was in the emergency room. I had the bleeding under control with a rag and some duct tape (handy stuff to have around). In another case I really beat myself up bushwhacking a peak on the NEHH list. It looked really bad. But, with Coumadin it looks worse than it really is.

Eventually, the blood will clot, it just takes a little longer.

My doctor explained the problems from lack of activity were worse than an occasional scratch or cut. His instructions to me, “KEEP HIKING!”.

In my case, it was harder to get those around me to relax.

Good luck to you.

 

[shamples]

I broke my leg up in Pittsburg, NH back in July of '03 and ended up with a blood clot that my Orthopaedic doctor misdiagnosed which could have killed me. Luckily death wasn't in the cards for me quite yet, but once they discovered the clots, I was on coumadin from 12/03 until just this past June '05 I finally was able to get off it. There was a chance that I needed to stay on them for life as well, but thankfully I was able to ditch them.

I hiked throughout the entire 2004 summer on coumadin doing Washington, Moosilaukee, Welch/Dickey, Tecumseh, and Monroe/Franklin Eisenhower. I basically just played it extra careful on the trails, but I didn't pack anything special. I know I probably should have. But yeah, you really gotta be careful as even small cuts can be hard to stop bleeding. I stayed away from any bushwacking, that was for damn sure.

I bruised real easy throughout that time so you don't even want to fall or bump into anything while on that stuff. Internal bleeding can happen from small stuff like that so that can be a little scary. They tell you to wear a bracelet type thing or something to that effect which instantly signals you are on coumadin in cases of an accident/emergency if you were ever out of it so at least people trying to help you would be aware that you need special, quicker attention or you could bleed to death real quick.

In truth, last summer I really put all that bad stuff out of my head and just hiked like I normally hiked, albeit a bit more careful and aware of my footing. I'm sorry to hear you are on it for life. I seriously hated being on it moreso just for the fact I couldn't drink alcohol anymore and more importantly, anytime you need to go on a medication for even the flu or whatever, you'd have to get your blood levels checked and back in line constantly. That was a HUGE pain in the rear. You get used to needles getting stuck in you real quick (which I originally HATED.) I tried not to let it get me down though. My doctor also kept telling me to hit the trails and go hiking as the more excersize you get, the better for the blood flow. In my case, I think that summer of hiking actually helped break down the clots I had. It is a tough thing to deal with though so good luck to ya.

 

[jjmcgo]

On the upside,

if you get bit by a rodent, it will die. Coumadin (warfarin) is the active ingredient in D-Con. Apparently, some mice got into a storage bin of coumadin when the heart drug was new and died from eating it, giving the maker a second use for the product.
Best wishes for a recovery that could eliminate the long-term need.

 

[SAR-EMT40]

Just one comment. All of the things I see are all true (to my knowledge) and again I am not a doctor but the one thing these anecdotal stories are missing is dosage. Some of these people may be on different doses than you. That may make them more prone to some of the problems that they are relating to you. Check with your doctor again for any special things you should be careful about. I agree that the most worrisome thing is going to be internal bleeding. It could be bad enough in your abdominal cavity from injury but really catastrophic if it occurs in your skull. I don't know if there is anything you can take if you suspect a problem in the field. Again, check with your doctor. I would, if I were you, make sure any blow to the chest, abdomen or head that I received I would get out before any symptoms appear. Also, any fractures, no matter how minor I think they might be, especially any involving any of the long bones or pelvis I would also evacuate as soon as possible to get checked.

Again, run this past your doctor to see what he says. This isn't to scare you. Hopefully your doctor will say, "don't worry. Ignore the talk by the non-doctors (including me)".

I also agree with "shamples" get a medic alert bracelet and wear it.

Best of luck to you,
Keith

 

[JohnL]

if you get bit by a rodent, it will die. Coumadin (warfarin) is the active ingredient in D-Con.

Not quite sure it works that way. The rodent will die if it eats enough of the warfarin, not because it bites a person taking Warfarin Sodium (Coumadin). It would have to eat enough to raise its INR level to a point where it bleeds internally. The same is true of a human. If you take too much of it you could bleed to death from internal bleeding. Hence, if you don't remember if you took your daily dose, don't take another dose. You are better off skipping a day than by double dosing.

JohnL

 

[jjmcgo]

JohnL is right, of course. As coroners say, the poison is in the dosage. I was just trying to inject a bit of humor in the face of a very disappointing diagnosis and course of treatment.
Whistling past the graveyard and trying to look on the bright side of life.

 

[BIGEarl]

Rick,

Out of curiosity, just one question….. Pig or plastic?

If the replacement valve is a mechanical device, such as a St. Jude valve (that’s what I’ve got), it is my understanding there is only one way to get off Coumadin. It seems to me there is a possibility to get away from Coumadin with a natural (Pig) valve, (but, I could be wrong).

I agree with Keith, we are probably taking different doses. The final objective is probably a relatively equivalent INR level in each of us, however, and this drives the dosage amount. As I’m sure you know, there are many variables that affect the INR level coming from a particular dosage amount. I don’t know about you but I’m going in for testing every couple weeks to be sure the proper therapeutic level is in my system. My dosage is regularly adjusted to keep me in the target zone. I wouldn’t be surprised to learn that your target INR range is similar, or even identical, to mine. I’d bet your dosage is different.



And another thing..... I recognized the humor from JJMCGO.

 

[Rick]

Thanks for the comments and PMs. I appreciate it.

The irony of this situation is that I grew up in a family Pest Control Business and was a NYS licensed Pest Control Operator for 21 years. Funny, I remember as a kid mixing 50 lb burlap bags of cornmeal and measuring our Warfarin powder to mix in and then putting everything in 5 gallon buckets to carry around. Used to breathe that stuff constantly. now it is a necessity.

I think all those rats and mice I terminated back then are having a final laugh.

Big Earl, I now have a mechanical kevlar St jude Valve ( It think it is kevlar). I had a pig put in 3.5 years ago, but it fell apart disasterously in the past 8 months, cauing an emergency surgery for the new valve and synthetic aortic root.

I am feeling great and ready to get on the trail in teh next 60 days, but after hearing all the dire warnings form my health care professionals, I admit I was a but worried.
I am feeling much less worried now, but still will remain cautious.
Thanks

 

[Neil]

I am feeling great and ready to get on the trail in teh next 60 days, but after hearing all the dire warnings form my health care professionals, I admit I was a but worried.
I am feeling much less worried now, but still will remain cautious.
Thanks

My bet is that all those health care professionals care about is not getting RED SQUARED.... I mean sued.

Obviously, an artificial heart valve is very heavy duty medical intervention. I send you my most sincere best wishes for a long and fulfilling continuation of your hiking life (not to mention life - period).

 

[skidoc22]

The level of anticoagulation and hence one of the major factors in bleeding is not the dosage but the INR. The target range for those with mechanical valves is somewhat higher than for most others (eg. those with blood clots) making the risk of bleeding also somewhat higher. Other factors associated with bleeding and risks to you from hiking would be your age, other medical problems, other drugs which can affect clotting such as aspirin, ibuprofen and others. Your physicians are certainly in the best position to assess your risks and to give you advice on the safety of various activities. After that it is obviously up to you to decide what risks you are willing to take, as it is for all of us. I agree that the major risks are those of internal bleeding - most dangerous in the head because there isn't room for much else than our brains in there. Certainly being cautious is important. All that said, I don't know how I would react if I were in your situation. I wish you good health and safety whatever you decide.

 

[coldfeet]

My wife is also on the same medicine for the past 2 years (she had a maze done and her valve was fixed, she knows she'll need a replacement around 2020) I didn't even think about it when we went on our Maine trip 2 weeks ago. I guess when your having fun you forget about meds and symptons, hope u feel better soon and enjoy the outdoors.

 

[Rick]

What would really make me feel better is finding a pair of those VFFT sunglasses that have shown up in Neil's new Avatar !!!