Anti-coagulation and accidents

[Sjoerd]

My aortic-heartvalve needs to be replaced. Most likely by a mechanical valve. I will leave the details out, because I would like this thread to answer one question regarding anti-coagulation. This website has been helpfull so far, but it hasn't answered this question:

When you have an accident, what is the difference if you use anti-coagulation or not.
(I would like to phrase it better, but this is as good as I can get it.)

Because you will fall sometimes. You will have smaller and/or bigger accidents during your life. You will get hurt sometimes. And I?m 29 now. And I?m planning to stay around for a long time.

I will explain why I ask this question. My passion is motorcycles. I ride them on the road, off-road (?dual sporting?) and on the racetrack (just for fun, not races, but so-called trackdays). For next year I'm planning to start with drifting cars and riding them on the racetrack (no races, just fun). I also do some mountainbiking and I was planning to pick up horse-riding again.
How is that for a list of things you might better not do when you use anti-coagulation?

I understand that anti-coagulation doesn't cause you to bleed more quickly, but that only the bleeding lasts longer. But that doesn?t answer the question.

Let?s use some examples.
1. I've done all of the below and was not hurt in any way. What would happen when you use anti-coagulation?
- You're skiing and fall down.
- You fall from your pushbike.
- In a curve your motorcycle looses grip and you end up sliding down the road (not hitting anything)
- Your horse throws you off.
2. In the following cases the imaginary accidents cause broken bones for a person not using anti-coagulation. What are the extra risks when you are?
- Your motorcycle looses grip, then suddenly regains traction causing a so-called high-sider. It sends you flying through the air. This very likely causes broken bones.
- You get involved in a (not life-threatening) car-accident.
3.
Discussing life-threatening accidents isn?t very usefull I guess. As it would be life-threatening wether you are on anti-coagulation or not. Please correct me if I?m wrong.

I?m a person who is in general pretty careful by nature. I always wear protective gear when I?m on the motorcycle (Which I do daily). But when doing mountainbiking and when riding a motorcycle offroad you will fall from time to time. Not necessarily often, but it happens. It?s part of the game. Then you pick up the bike or motorcycle and get back on and continue. Normally you don?t get hurt. What happens when you use anti-coagulation?
Riding a motorcycle on a racetrack sounds dangerous. But on the racetrack there are no trees and oncoming traffic. Important factors in case you go down. I don?t race, but just ride fast on the track. Still, a small slide will probably happen at one time or another. Would it be plain stupid to keep doing this when using anti-coagulation?

Let me finish by saying that I am happy it is possible to replace heart valves. Otherwise I would not have been alive today. (I have been through heart-valve operations in the past.)

 

[dick0236]

I've not been on a motorcycle since I was a teenager so I really can't fully answer your biking questions. I've been in a couple of serious auto accidents without negative consequences. I've done a lot of manual labor and worked around power tools alot without consequenses. However, if I had been unfortunate to cut my arm or leg seriosly with a power saw, I would have had a serious problem.

If your hobbies and avocations with bikes, racing, etc is as you describe, I think that you and an anti-coagulant are NOT going to get along. You may have to rethink your valve choice or "accept" that you will have to back off on your hobby.

Good luck with your surgery.

 

[Ross]

Sojoerd welcome.

The best way to answer all of your questions is this, if your hurt seriously enough to have internal injuries, your in trouble whether your on Coumadin or not. Coumadin can be reversed in an emergency with 2 units of Plasma or 2MG Vitamin K IV pushed.

Many of us refuse to stop our previous lifestyles because of this drug. Some choose to limit themselves more then others. You have to become familiar with the drug, realize that about 85 to 90% of the stuff you hear about it is myth or untrue, and see how it works for you and become comfortable with it. Once you've done that, common sense should prevail in safety. If your riding horse, cycle, bike, wear head protection. Do the normal precautions, be aware of potential problems, avoid them and enjoy life.

You may wish to get a professional education on Coumadin/Warfarin. Check out, and please do read all that you can at www.warfarinfo.com It is run by Al Lodwick, a certified anticoagulation expert and pharmacist. He is a member here also, but lately has been touring the U.S. teaching seminars, so he doesn't stop in as much anymore.

Welcome to the forums!

 

[zipper2]

My aortic-heartvalve needs to be replaced. Most likely by a mechanical valve. I will leave the details out, because I would like this thread to answer one question regarding anti-coagulation. This website has been helpfull so far, but it hasn't answered this question:

When you have an accident, what is the difference if you use anti-coagulation or not.
(I would like to phrase it better, but this is as good as I can get it.)

Because you will fall sometimes. You will have smaller and/or bigger accidents during your life. You will get hurt sometimes. And I?m 29 now. And I?m planning to stay around for a long time.

I will explain why I ask this question. My passion is motorcycles. I ride them on the road, off-road (?dual sporting?) and on the racetrack (just for fun, not races, but so-called trackdays). For next year I'm planning to start with drifting cars and riding them on the racetrack (no races, just fun). I also do some mountainbiking and I was planning to pick up horse-riding again.
How is that for a list of things you might better not do when you use anti-coagulation?

I understand that anti-coagulation doesn't cause you to bleed more quickly, but that only the bleeding lasts longer. But that doesn?t answer the question.

Let?s use some examples.
1. I've done all of the below and was not hurt in any way. What would happen when you use anti-coagulation?
- You're skiing and fall down.
- You fall from your pushbike.
- In a curve your motorcycle looses grip and you end up sliding down the road (not hitting anything)
- Your horse throws you off.
2. In the following cases the imaginary accidents cause broken bones for a person not using anti-coagulation. What are the extra risks when you are?
- Your motorcycle looses grip, then suddenly regains traction causing a so-called high-sider. It sends you flying through the air. This very likely causes broken bones.
- You get involved in a (not life-threatening) car-accident.
3.
Discussing life-threatening accidents isn?t very usefull I guess. As it would be life-threatening wether you are on anti-coagulation or not. Please correct me if I?m wrong.

I?m a person who is in general pretty careful by nature. I always wear protective gear when I?m on the motorcycle (Which I do daily). But when doing mountainbiking and when riding a motorcycle offroad you will fall from time to time. Not necessarily often, but it happens. It?s part of the game. Then you pick up the bike or motorcycle and get back on and continue. Normally you don?t get hurt. What happens when you use anti-coagulation?
Riding a motorcycle on a racetrack sounds dangerous. But on the racetrack there are no trees and oncoming traffic. Important factors in case you go down. I don?t race, but just ride fast on the track. Still, a small slide will probably happen at one time or another. Would it be plain stupid to keep doing this when using anti-coagulation?

Let me finish by saying that I am happy it is possible to replace heart valves. Otherwise I would not have been alive today. (I have been through heart-valve operations in the past.)

Sjored welcome and hello,

I guess i can give you an example of motorcycles and warfarin
My brother in B.Columbia and his family owned harleys and he had
his motorcycle fixed the brakes on it were fixed and he took it out
for a drive and the brakes failed he went over 180 feet with the
harley,this was in 2001.He was on warfarin for different reasons
for his heart and when he went 180 feet over he lived angels i say
were all around him that day.I know they had to quickly put a chest
tube into his lungs and from that day he was hospitalised for a month
got the ambulance to drive him home so he could have a stiff drink.
All he managed was a bad leg where they were possibly going to
amputate in 2006,but he had 2 heart attacks and a massive stroke
took his life from us that day.
His wife and kids still have their own harleys and his too and they
ride their bikes even after the 180 foot drop he got back on his
bike with bad painful leg and rode,we thought he'd never ride again
for fear of his failed brakes,but he always rode and rode the last
time before his stroke to see our mom and dad that was his last
bike ride as he passed away shortly after.I don't feel the coumadin
caused him any grief with that fall he was very lucky to live through
that and how we don't know.

I am on coumadin for 16 years and stitches galore i got stabbed in
the buttock awesome it bled bul i had coworkers apply pressure
till i got medical attention i have hooked my head and stitched also
from a big len thompson hook that was worse than my butt.
I was in British columbia and got hit by drunk driver in 1995 headon
i was in treatment for therapy for 3 years but it didnot effect my
uses of coumadin and my first surgery was for aortic 16 years ago
i just have a problem with seeing blood even a little freaks me out.
but i havent freaked out from any incidences i've had from any type
of issues may have dealt with on my coumadin.My brother was a
bloody mess but 180 foot fall on a harley says little for coumadin
causing the blood.Don't know what else to tell you ,everyday we
chances in life just crossing the sidewalk,driving,sking,motorcycling
camping and a bear shows upeverydays a risk at some point
and coumadin is my friend for always.Sorry i made this so long but
these are afew experiences i know of God bless.

zipper2 (DEB)

 

[Sjoerd]

Thank you all for your responses. At the moment, it is most likely I will choose for the mechanical valve anyway (because of my medical history). But it is important, mentally, to know what to expect beforehand. The fear of the unknown. And that is why it’s nice to hear from personal experiece (as you probably already know). Which hobbies I will keep doing and which I will stop doing I don’t know yet. I think I will learn from personal experience as well and use common sense. And I will try to learn about the drugs so I known something about it in case I get ill, need surgery for something or need to go to the dentist.
What I fear the most is that you’re life depends on these drugs when you have a mechanical valve.

 

[dick0236]

What I fear the most is that you?re life depends on these drugs when you have a mechanical valve.

Warfarin will not rule your life, but you have to learn to coexist with it. It is a powerful drug that does its job well. If you try to fight it, the odds are that you will lose.

 

[Ross]

Honestly, it's not as bad as many would have you believing. It can be a pain in the arse when it comes to having other surgeries, but outside of that, about all you can't do is sword fight or other medieval challenges or anything where major cutting injuries will likely kill you Coumadin or not.

 

[cindykenward]

Thank you for this post. I am a 50 year old female having Aortic Valve Replacement in two weeks. I ride a Kawasaki Vulcan 500. The doctors have told me to stay off the bike if I chose a mechanical heart valve (and thus Coumadin). I know there is the option of a tissue valve but I don't want another susrgery! If anyone has any further input I would appreciate it. Thanks.

 

[John & Joann]

Joann has been on coumadin for 39 years, 11 months. She did fall down the basement steps and had a mild concussion. Coumadin is not the "bad friend" that everyone talks about. There are risks with coumadin. I probably would not recommend doing the activities that you describe on the bike. Motorcycle on dry payment and good weather are possible.

 

[Bill B]

I have 5 street motorcycles that I ride regularly, and I race my car at over 170 MPH in the Nevada desert. The fact that I am now on warfarin is noted in my medical forms, but I don't see how it changes much. Although warfarin reduces the formation of intravascular thromboemboli, it has less effect on external bleeding and essentially none on superficial bleeding (routine cuts). I shave with a blade razor and nick myself occasionally and it stops like it did before. As long as you are not taking aspirin or other anti-platelet drugs, bleeding times are normal.

 

[chaconne]

I'm a little over 2 weeks post op and I spent the year before that researching valve options. I always leaned toward mechanical, but was concerned about my activity options. What I realized was, letting go of the more risky activities and replacing them with similar but equally fun things was a good option. For example, replace motor cycling with boating, mountain biking with road biking, Downhill skiing with cross country, ball sports with endurance sports etc... You may even like the new ones a lot better.

On the other hand, I think if you are experienced in any given sport, and know how to handle yourself, you do not need to give it up. Just don't push it to the risk limit quite the same. Taking Warfarin does increase the risk, but that doesn't mean you can't do these things, I think you just need to be a little more aware.

-Steve

 

[Bina]

No problems here taking Coumadin/warfarin, but when my doc had previously added Aspirin to the regime there were
more episodes of nose bleeds. Stopped the Aspirin, and all is good.

 

[wcasey5]

I have ridden my Ducati about 13,000 miles since my surgery, bicycles, hiking, skiing, and all the rest. I don't play hockey any more, but I am tempted. Depending on how gonzo you are with the dirt biking and mountain biking, that may be a problem. Drifting is cool and the accidents are fairly minor compared to other forms of motor sport. Just my personal opinion.

 

[Marty]

Advice. If you are taking Pradaxa, don't have an accident!

 

[yotphix]

Advice. If you are taking Pradaxa, don't have an accident!

Agreed. When I was chatting with my surgeon the other day he mentioned Pradaxa as a possibility at some point in the future for me. I mentioned that I ride a motorcycle (second Ducati in this thread) and he agreed that because I am at greater risk of showing up in a trauma centre, I might want to stick with Warfarin, since it is reversible either by Vit K infusion, or just plasma infusion (I think). Back before I took up riding after the surgery I asked the Cardio about it. He suggested that it was very dangerous with or without warfarin, but not markedly more so with.
Warfarin is no big deal, and shouldn't stop you from doing anything except MMA, boxing etc. (too much risk of brain bleeding). Obviously wear quality gear and take what limited increase in fragility you have into consideration. Just for kicks, and comfort, I have a first aid kit under my seat with bandages in it that contain clotting agent.

 

[bstew7890]

I ride a motorcycle too, a Kawasaki Vulcan 750, and I intend to continue. I frequently see patients in my Coumadin clinic wearing riding gear and carrying helmets so I know I'm not alone. My doctor does not approve but has no objections to me riding a bicycle. Ironically, I have lost more blood in bicycle accidents than on the motorcycle.

 

[Bill B]

My surgeon said there would be no restrictions on my activities at all after recovery. I believed him. I have 5 motorcycles that I ride regularly and I road race cars. I work on cars and haven't noticed any change in bleeding time when I cut myself. Go for it.

 

[jorsarge]

Hi all i am a Soldier I do EOD duties ride my motorbike (Fazer) to work each day have 3 children and live a busy busy life. Been on Warfarin for 5 years no problems. Do and pass my work fitness test every year though I missed one the year my valve was replaced. Enjoy life.

Happy Christmas all.

J

 

[markp66]

The only thing I've been told not to do are contact sports... It's a complete myth that being on warfarin stops you having a normal life. I can't drink as much alcohol but apart from that there is nothing I don't do now as before my op.

 

[Herb M]

I do not think it matters which type of valve. Any injury will respond the same to any valve.

The main problem is an injury to the head. Other bleeding injuries can usually be handled easily unless the bleeding is internal. An injury to the head could cause a bleed into the brain.

The injury your would receive would mostly be the same if if you are not on warfarin.