Coumadin and High School Gym Class

[TLangston]

Hi,
I think this might be my first post, I lurked for quite a while last year. Thanks to all for your words which helped me so much in preparing for our daughter's AVR surgery last year. (She was then 16 years old, now 17). She received a St Jude mechanical valve in the Aortic position and now it's eight months post-op. Her INRs are stable.

Now, I plan to talk with her Cardiologist about this, but thought I'd get other valve replacement patients' opinions about activities that she might be able to do. She needs one year of P.E credits to graduate. A complicating factor is that she has a visual-spatial disability that causes motor incoordination. (translation: accident-proneness) Because of this we've banned pretty much every exercise for her except power walking (running and biking seem too risky as far as potential wrecks, falls etc). The problem is, the classes her school offers all include something we deem too hazardous (the survey cardio course includes kickboxing; even the hiking/nature essay course may include some rock climbing).

We haven't gotten to the point of suggesting our daughter try to do an Independent Study or some sort of modified gym class. I'm actually posting this in an attempt to find out if my thinking is too strict and if in fact, we are limiting our daughter too much. We certainly don't want to make her think she's a fragile porcelain figure, and she does need to be in shape cardiac wise. I would just like others' thoughts on what might be appropriate physical activites for a somewhat klutzy kid who's had AVR. We don't know anyone else who is on Coumadin or any other families in our situation.

So, anyone had to face this issue? Anyone accident-prone out there who has figured out a low-risk form of exercise? Or anyone who's modified gym classes or crafted independent studies for high school P.E.? I want to know your story and/or your thoughts on this matter. Thanks in advance.

 

[geebee]

Happy to see you posting.

I think the key is protective gear. If she does rock climbing, make sure she has a helmet and preferably other padded items for body areas that might be injured.

I think kick boxing might be out. The injury chance might be a bit much for novices at such a sport. If we were talking experts who were in tight control, it might be different.

Tough contact sports should probably be avoided but hiking, climbing, etc. should not cause issues. I think the school should have enought PE options other than hard contact sports to keep from requiring independent study.

However, this is just my opinion and I am not a doctor or the mother of a teenager.

 

[Ross]

There is no reason to restrict her. Coumadin really isn't the monster that it's made out to be. If your worried about hits to the head, she should wear protective head gear. Other then that, she's always going to have accidents without you around and yes, she's going to get cut. But you know what? She's not going to bleed to death. Bleeding is treated the same for her as with anyone else. Direct pressure for a little longer time, that's all. Your blood starts to clot in 10 to 12 seconds. Hers should be 24 to 34 seconds. It's not that much of a difference.

 

[gf1962]

I agree with Ross. I am much older then 17 years old and I have a job that is not the safest in the world. As long as she has protective equipment she should be alright. Anti Coag therapy is not a monster as long as it is monitored carefully. I know that it is hard to say I have three children of my own. I worry constantly about them. But in the end you have to let them go.

 

[Philip B]

Pe

Pe

If you don't mind a perspective from two points, here's mine...

First, I'm a high school principal. Your best course regarding physical education activities is to visit with your daughter's cardiologist to see if he/she recommends any restrictions. Move from that conversation to a dialogue with high school staff members about what kinds of physical education activities are appropriate. The school should be able to accommodate her disability issues with little problem.

Over the past couple of years, I've had several students in my high school who have been on coumadin. Being on coumadin never caused any problems for any of them with physical activities. One was a starter on every girls' varsity team we fielded during her senior year. She even placed in the pole vault at our state track meet. She wore no protective equipment at all.

Second, I don't let either being on coumadin or being a klutz stop me from pursuing activities that I enjoy. Yeah, I'd be a little less battered if could keep my mtn bike in an upright position or duck a little more quickly when the boom swings on the sailboat. Odds are pretty good that I'd bruise and bleed even if I wasn't on coumadin.

One doesn't have to engage in full contact sports or extreme sports to stay in decent shape. One doesn't have to subscribe to being an exercise junkie either. Talk to her cardiologist and get his/her perspective.

-Philip

 

[dick0236]

I agree with all the others. Activities like "kick-boxing" (blows to the head) might be out, but I would not be concerned about running, bike riding, climbing, etc. Normal cuts, scrapes or bruising don't put Warfarin users in anymore danger than anyone else. It is a good idea to protect the head from a serious blow, if your on anti-coagulants or not......bikers, boxers, football platyers etc.

Sometimes our "purple badges of courage" are a little more noticiable, but thats about all.

 

[Karlynn]

Anything that would be potentially dangerous for her, would also be potentially dangerous for any other student and the school should require that they wear protective gear. I doubt that any student at a high school would be allowed to get on a rock climbing wall without a helmet. And if they are - the school is being very careless.

I agree with the kickboxing. Too risky for novices. And certainly no dodge ball!!!

The other aspect is making her feel singled out. No one at her age wants to be seen as different or be the kid who is always having to have things modified for them. Sometimes this has to happen. Your cardiologist needs to help you decide what is absolutely necessary and what is being done for parental raw nerves. (I'd be anxious too!)

 

[briansmom]

My son was an off-road motorcycle racer before his surgery. Unfortunately, he has heart damage now, otherwise I know he would still be racing. He is still able to ride a small motorcycle because it doesn't weigh as much or go as fast and he has a big raspberry on his arm right now because of a recent fall. He also drives an off-road car. And, yes, he takes coumadin. (On the other hand, I have practically developed an ulcer from worrying about him.)

I am impressed that you have managed to keep your daughter away from physical sports. My teenagers just roll their eyes at me when I ask them to be careful. (My youngest son races motocross and swears he is going to be a supercross racer )

I really don't think you should worry too much about the coumadin as long as she wears protective gear.