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Riding with blood thinners

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Riding with blood thinners

Old 02-06-15, 06:42 PM
  #26  
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Originally Posted by indyfabz View Post
Hmmmm...I thought I might have been imagining it, but for the last few years I have been feeling like I have become somewhat of a "cold weenie." Maybe it's not all in my mind but rather I have developed that side effect relatively recently.

BTW...Did you ever read about how Sodium Warfarin was discovered and how it was once used as rat poison? Interesting story.
It is still used as a rat poison. We have had mice in a couple places we've lived ... tried trapping them, but these are sneaky things, so we decided to go the poison route. You can get rat/mice poison with warfarin as it's main ingredient, or with another poison.


I developed the cold intolerance about 6 months in. I've ridden in all sorts of conditions, and all of a sudden you couldn't convince me to go out for a ride when it was a bit chilly and drizzly. I'd get home after work and lie on the sofa wrapped in a blanket.
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Old 02-07-15, 07:55 AM
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I thought it had been largely replaced as a rat poison by more powerful chemicals, and least here in the U.S.

No. 8 gives the history. The "warf" in warfarin is an acronym for the Wisconsin Agricultural Research Foundation:

Warfarin - Wikipedia, the free encyclopedia
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Old 03-21-18, 07:01 AM
  #28  
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Blood thinners

Disclaimer: CONSULT YOUR PHYSICIAN - DON'T BE A GOOGLE PATIENT!
That being said, not all blood thinners are created equal. The common denominator is that they interfere with blood clotting and that is the desired effect.
On any blood thinner you are going to bleed longer and more abundant, but especially on the heavy hitters like Coumadin or warfarin or the new ones like Eliquis, Xarelta, Pradaxa, etc...
On the heavy hitters, a low speed fall on your leg can turn into a bleeding inside the knee joint, but my biggest concern is a head bump. Helmet and everything one could end up with a intracranial bleed...
The biggest medical condition in my mind is A. Fib, why? Because you feel absolutely fine. There is usually no effect on exercise tolerance, etc etc... perhaps change your riding style. Triathlons are an interesting choice because you take the peloton proximity out of the picture. On the other hand a tri bike is inherently less stable than a road bike.
No single answer fits everyone.
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Old 03-21-18, 12:45 PM
  #29  
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Riding with blood thinners (and aspirin) didn't bother me at all until I crashed and had some minor bleeding in the brain. It freaked the ER doctor out to find out I was on Plavix. No problems after they took me off it.

I cut out the beta blockers about a year earlier and was much less tired after that. Cardiologist loves me on the bike.
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Old 03-23-18, 05:29 AM
  #30  
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I'm on warfarin for the duration due to a history of DVT in my left leg. As others have suggested, I think that the warfarin makes my blood "more normal". I also have family history of less than great veins in my legs.

My experience is virtually no side effects from the medication. I'd never heard of the 'feeling cold' phenomenon as related to warfarin. As long as I dress properly I don't get cold when I ride. In doors is another matter. I get cold when sitting around in doors during the winter. It's been that way since I was a child. I'm 62 years old and riding stronger than ever.
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Old 03-23-18, 05:51 AM
  #31  
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Originally Posted by on the path View Post
I'd never heard of the 'feeling cold' phenomenon as related to warfarin. As long as I dress properly I don't get cold when I ride. In doors is another matter. I get cold when sitting around in doors during the winter. It's been that way since I was a child.
The cold feeling has no scientific basis. Warfarin does not make one's blood any less viscous than people not on the drug. The "thinner" in "blood thinner" refers to extended clotting time.

BTW...I just started home monitoring on Monday. It's really easy an less expensive than having it done in a lab. Anyone on long-term therapy should investigate it.
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Old 03-23-18, 06:49 AM
  #32  
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Originally Posted by indyfabz View Post
The "thinner" in "blood thinner" refers to extended clotting time.
As we know, "blood thinner" is a misnomer. Anti-coagulant is more correct.

Originally Posted by indyfabz View Post
BTW...I just started home monitoring on Monday. It's really easy an less expensive than having it done in a lab. Anyone on long-term therapy should investigate it.
My numbers are so stable that my dosage has stayed the same for years (I'm rather consistent with my diet) and now I have my PT INR tested every 2 months. Last I checked, the cost of the test strips was prohibitive. If that has changed I'll research it and re-evaluate.
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Old 03-23-18, 06:56 AM
  #33  
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Originally Posted by on the path View Post
My numbers are so stable that my dosage has stayed the same for years (I'm rather consistent with my diet) and now I have my PT INR tested every 2 months. Last I checked, the cost of the test strips was prohibitive. If that has changed I'll research it and re-evaluate.
If you only need monitoring that infrequently, doing it at home probably doesn't make sense. The strips are pretty inexpensive, but to get coverage my insurance requires at least two tests per month. The testing company, of course, wants you to do it every week.
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Old 03-14-19, 11:01 AM
  #34  
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nothing has changed

Just joined up and saw this thread.

I am a lifer on Xarelto. I am homozygous Factor V Leiden and very aggressive. Semi-rare, I inherited a mutated gene from BOTH parents. Suffered a near fatal pulmonary embolism in 2017 and have had 4 dvts. The PE was caused by medical incompetence. I'm FVL yes, but doctor error produced the clot. My mother died from massive PE in 1984. I'm very familiar with clots. As far as anticoagulants (not "thinner" as blood consistency does not change), I started on Warfrat (pet name for Warfarin) and clotted 3 times. It was worthless to me. Thank God for Xarelto, which has kept me above ground. I actually prefer Eliquis, but taking 2x daily consistently does not fit my occupation or lifestyle and I have no wiggle room when it comes to consistency. I can't forget a dose.

My PE was 5 inches long, passed through my heart and into my lung. I do have some scarring on my lung which will never heal. Once dead, it's dead.

As far as riding, I ride more now then pre near fatal clot. I did my first solo century ride 4 weeks after leaving ER. I am in better shape now than before I was diagnosed with the clotting disorder. I have fallen and tore 3 of 4 rotator cuff muscles plus CRACKED my helmet. I had no brain issues or bleeding issues. Its' different for everyone, just like side effects and recovery time.

Wear the damn helmet. Wear the ROAD ID. Bike with a friend if worried. Stay hydrated. Really, biking on anticoagulants is a piece of cake once you have recovered.

It's Blood Clot Awareness Month. Good time to wake up. One person dies in the United States every six minutes from a clot. 274 on average daily. Oh, hear me now? The Formula One race director died a few days ago from PE and sudden death. Luke Perry just died from a brain blood clot/stroke. The list goes on.

I started a team of PE survivors locally. Survivors can do anything. I whitewater kayak/canoe (job is instructor) and run, skydive and mountain bike. Not living my life wrapped in bubble wrap. Use your head, so-to-speak, and be careful like always.

I can't post a pic of my Clot survivor jersey until after 10 posts. crap. Oh well.

Last edited by streamdreamer; 03-14-19 at 11:11 AM.
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Old 03-14-19, 11:08 AM
  #35  
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Originally Posted by on the path View Post
As we know, "blood thinner" is a misnomer. Anti-coagulant is more correct.
They need to remove it from clot vocabulary. People actually think their blood is like water and thin or thick like ketchup. The point is, it is not accurate.
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Old 03-14-19, 11:18 AM
  #36  
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Originally Posted by mrotmd View Post
Disclaimer: CONSULT YOUR PHYSICIAN - DON'T BE A GOOGLE PATIENT!On any blood thinner you are going to bleed longer and more abundant, but especially on the heavy hitters like Coumadin or warfarin or the new ones like Eliquis, Xarelta, Pradaxa.
Not necessarily. I've been on all and have never bled more than normal, nor had a hard time stopping the bleed. For my surgeries or tooth extractions, I am sometimes off one day, but because of my aggressive disorder and ability to not have out of control blood flow, I also have not even come off anticoagulants at times like for my hernia and shoulder surgery. Now, before I became my own advocate, my idiot first doctor stooped my Xarelto for THREE days for a simple colonoscopy. WTF. I nearly died eleven days later from the massive PE. True, the procedure saved my ass because they found 4 pre cancerous polyps. But I could have easily died and my colon would have had nothing to do with it. LOLOLOL!
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Old 03-14-19, 11:22 AM
  #37  
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Originally Posted by Machka View Post
It is still used as a rat poison
And it all started with a bunch of dead cows lol! Which is why my pet name for it is Warfrat. Hate that stuff but it works for many. Long term use they say may increase the chance for Alzheimer in the elderly.
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Old 03-14-19, 01:51 PM
  #38  
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Originally Posted by streamdreamer View Post
Long term use they say may increase the chance for Alzheimer in the elderly.
Have you any sources or references for this?
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Old 03-17-19, 09:04 PM
  #39  
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Originally Posted by on the path View Post
As we know, "blood thinner" is a misnomer. Anti-coagulant is more correct.



My numbers are so stable that my dosage has stayed the same for years (I'm rather consistent with my diet) and now I have my PT INR tested every 2 months. Last I checked, the cost of the test strips was prohibitive. If that has changed I'll research it and re-evaluate.
What "numbers" measure the effectiveness of anti-coagulants?
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Old 03-18-19, 06:41 AM
  #40  
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Originally Posted by GeneO View Post
What "numbers" measure the effectiveness of anti-coagulants?
When I mentioned "numbers" I was referring to PT INR, which is a value (number) that expresses the length of time it takes for the blood to coagulate. That is a simplification, and I welcome any amendments or corrections. Anyone taking coumadin/warfarin regularly might want to become familiar with all things PT INR.
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Old 03-18-19, 07:23 AM
  #41  
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Originally Posted by GeneO View Post
What "numbers" measure the effectiveness of anti-coagulants?
As noted, these days what's known as an INR is measured. It used to be PT, which is Prothombin Time. IIRC, INR was adopted as some international standard. INR is an acronym for "International Normalized Ratio."

Your therapeutic INR may be different from someone else's depending on why you are taking an anticoagulant. I have a St. Jude aortic valve prosthesis that was installed in 1990. It's a relatively high clotting risk valve. My therapeutic INR is supposed to be between 2 and 3. (1.1 or below is considered normal). I have been within that range for many consecutive tests so now I only get tested once/month. I'm in and out in 10 min. For a while I was doing it myself at home, but I didn't like the company, and it was not any less expensive (and possibly more expensive) because I was required to tests myself every two weeks. I have a specific nurse who monitors my INR. Pop in before work at 8:30 the last Friday of every month.
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Old 03-18-19, 07:34 AM
  #42  
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I had heart surgery in 2014 to fix a leaking mitral valve. I was on Warfarin for 3 months then stopped. I was warned not to fall down, etc. to prevent internal bleeding so I was off my bike for that time. Since then I've had Atrial Fib. maybe due to the surgery? My cardiologist last month said to change from 1 aspirin to Pradaxa. I've been very reluctant to start it because of the earlier Warfarin warnings. Reading this thread has relieved some of the fears, but reading about Pradaxa, which does seem better than Warfarin, it says that if you quit taking it, you increase the chance of stroke.
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Old 03-18-19, 07:35 AM
  #43  
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Originally Posted by rpenmanparker View Post
Sounds like he may be taking Plavix or Eliquis as an anti-coagulant. I would guess he had angioplasty with the placement of a stent(s). The anti-coagulants are necessary to prevent clot formation especially in the regions around the stents. They can cause fatigue. But with all due respect, what can you hope to accomplish asking a question like this on a cycling forum? Your brother is surely under the close care of a cardiologist. Why isn't HE asking his doctor the question?

Survivors of a heart attack are also frequently prescribed a combination of drugs for control of blood pressure and heart function such as a beta-blocker and an ACE inhibitor. The beta-blocker can have a significant effect on exercise performance since it limits the heart rate besides controlling blood pressure.

Finally the damage done to the heart, resulting scar tissue, and loss of heart performance are likely themselves responsible for some or all of your brother's lack of energy and poor cycling capability. I know that the heart damage and drugs combined caused me about a 20% loss in average speed (from 20+ mph to 16 mph) after my heart attack 17 years ago. Nevertheless I feel normal in my everyday activities, and have no problem cycling on a regular basis within these limitations.

The medications prescribed for heart attack patients are critical to their long term survival. I credit them with keeping me alive all these years since my attack. The drug cocktail used by heart attack survivors is very important for keeping the heart from further degenerating due to a phenomenon called "remodeling" which eventually can result in congestive heart failure. I recommend you counsel your brother to work with his cardiologist to tailor his medications in a way that will still be effective without causing him such unpleasant side effects. This is nothing to play around with. Unilaterally changing or stopping one's medication is a dangerous course to embark on with any disease, none more so than with heart disease.
Your advice and information are spot on. I currently have seven stents in place and can vouch for the accuracy of your information.

The biggest concern with anti-coagulants like Effient, is the high risk of uncontrollable bleeding in case of a major injury. That is a real risk and cause for concern.

Another potential risk is internal bleeding, that may not be readily noticeable, resulting from an injury. I hit my head and it caused internal bleeding that was not readily apparent. Months later, when the headaches and vomiting began to show up, I was diagnosed with a subdural hematoma.

So if someone is on anti-coagulants be very careful of any injuries or blows to the body that may cause bleeding.

Ride safely.
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Old 03-18-19, 07:45 AM
  #44  
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Originally Posted by Jack Tone View Post
I had heart surgery in 2014 to fix a leaking mitral valve. I was on Warfarin for 3 months then stopped. I was warned not to fall down, etc. to prevent internal bleeding so I was off my bike for that time. Since then I've had Atrial Fib. maybe due to the surgery? My cardiologist last month said to change from 1 aspirin to Pradaxa. I've been very reluctant to start it because of the earlier Warfarin warnings. Reading this thread has relieved some of the fears, but reading about Pradaxa, which does seem better than Warfarin, it says that if you quit taking it, you increase the chance of stroke.
Just ride. The scare stuff they tell you is just to cover their butts. Don't fall down? Srsly? Unless you fall hard and smash your head on something you really don't have to worry about a serious injury from falling down. I was even told I could never drink alcohol again. LOL!.

I have been riding on Warfarin for nearly 29 years. During that time I have fallen and even been hit by cars twice, albeit at relatively slow speeds. I'm still here. Yes. I take precautions, like not going all out on descents. An extra 10 mph. isn't worth the potential consequences. But in general, the fact that I am anticoagulated doesn't even register when I am riding. If you do start, make sure you get something like a Medic-Alert bracelet.
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Old 03-18-19, 08:37 AM
  #45  
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Originally Posted by Jack Tone View Post
I had heart surgery in 2014 to fix a leaking mitral valve. I was on Warfarin for 3 months then stopped. I was warned not to fall down, etc. to prevent internal bleeding so I was off my bike for that time. Since then I've had Atrial Fib. maybe due to the surgery? My cardiologist last month said to change from 1 aspirin to Pradaxa. I've been very reluctant to start it because of the earlier Warfarin warnings. Reading this thread has relieved some of the fears, but reading about Pradaxa, which does seem better than Warfarin, it says that if you quit taking it, you increase the chance of stroke.
Pradaxa may be better as far as convenience, but it is not short term reversible. What I meant by short term reversible is, in the event of a bleed out, administering vitamin K will counter the effect of warfarin, and relatively quickly (I have experienced this in real life.) Warfarin is known as a "vitamin K antagonist." For Pradaxa, et al, the only thing that can be done is to wait for the most recent dose to lose its effect. Pick your poison.
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Old 03-18-19, 09:31 AM
  #46  
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Plavix after a stent to correct a bad artery on the back of my heart. No negatives, in fact I ran a 5K 48 hours post-surgery, have maintained my running and riding schedule over the last year 6 months. Haven't been that interested in continued racing though, I'll leave that to the pre-medicare crowd ... until next year.

I do carry gauze, band aids, tape on my rides. The biggest negative is getting a small cut and having it bleed for hours. I also am wearing a helmet full time (ugh) 'cause as been said a brain bump could escalate into a major problem. Also wear a wrist band "PLAVIX".

All in all, my cardio performance has improved with that extra artery functioning, and the energy level is OK with the med protocol. Of course, I'm a low carb and intermittent fasting guy, so I obviously don't know anything about "real science" so many on the BF seem to espouse so easily..
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Old 03-18-19, 12:59 PM
  #47  
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I would look around for a cardiologist who runs or rides.

A lot of doctors seem to have the “All risk is severe risk, and more drugs are better” outlook. They have no concept of quality of life beyond extending it …. But I bet I will live longer because I still cycle than if I stopped exercising altogether and sat enervated on the couch, and the doctor (and drugs) would have had me.

I was told up front that one of the drugs I needed to take (to “regulate” my heart beat, after my resting rate hit 140-150, requiring ablation) would leave me fatigued. I was not told by the doctor, but rather by his very cool nurse, that there were alternatives which would not leave me enervated (and also would not kill my sex life.) The doctor had his favorite regimen, and “quality of life” was not on his mind at all.

I also asked my doctor (not my cardiologist) about how much I needed the blood thinner. I noticed my “goals” for clotting were far lower than for normal people. Since I had not had any clotting problems, I decided not to take blood thinners. Apparently those are just part of the standard treatment package, prescribed whether they are needed or not (so it is okay that I bleed out from a minor cut to avoid a clot I had no reason to think would ever form?)

I stopped taking all my drugs, eventually, and so long as I watch my diet and keep aware …. I am happy with the results. (I would look like a very sad Jabba the Hutt if I didn’t have cycling in my life.)

For a person with stents, artificial valves, and all that, I would Not recommend that course. As I understand it the foreign matter can cause clots. I’d definitely ask a couple doctors.

And certainly ask about alternative treatments/alternative drugs. Some doctors know one way to do things and keep doing it. It works, as in their patients don’t die … but what if they also don’t live?

Every person is different, and messing with drugs and doses is a gamble. Seeking other opinions From Doctors is only smart. But a doctor who runs or rides will understand differently and care more about helping the patient engage in those activities …. Which are huge helps toward maintaining health if done within sensible limits.

Finally---I second all the people who recommend a bracelet---or something, dog tags, a forehead tattoo, anything---to let first responders and ER docs know that you are taking drugs. You could bleed to death from an internal injury on the way to the hospital when a simple shot of something could save your life, if the EMTs only knew.
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Old 03-18-19, 01:05 PM
  #48  
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Originally Posted by eja_ bottecchia View Post


Your advice and information are spot on. I currently have seven stents in place and can vouch for the accuracy of your information.

The biggest concern with anti-coagulants like Effient, is the high risk of uncontrollable bleeding in case of a major injury. That is a real risk and cause for concern.

Another potential risk is internal bleeding, that may not be readily noticeable, resulting from an injury. I hit my head and it caused internal bleeding that was not readily apparent. Months later, when the headaches and vomiting began to show up, I was diagnosed with a subdural hematoma.

So if someone is on anti-coagulants be very careful of any injuries or blows to the body that may cause bleeding.

Ride safely.
Good points.

Since my Summer from Hell last year, which included a severe lower-leg DVT, I'm now on Fragmin (low dose) for life, probably. Took a bit to get used to self-injecting daily, but piece of cake now.

Fragmin rather than Rat Poison etc. because at the same time I had a major subdural bleed that required surgery. Upshot: another of those would probably kill me, especially if I was on traditional anticoagulants, so Fragmin, which has a short life, for me.

The upshot: life is normal, but I have MedicAlert and now carry a phone and always -- always -- wear a helmet when riding.
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Old 03-18-19, 01:20 PM
  #49  
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Off topic, kinda fun and in no way trying to make light of the situations of others:

I used to get injected with quite literal blood thinners every two weeks. The first time, I got off the machine, rode to a race and won it (with bandages on the insides of both elbows. Didn't do that again.)

I was a platelet donor. The Red Cross would draw 5 pints, one pint at a time from one arm, centrifuge it removing a total of about 5 oz of plasma and a full unit of platelets. then mix in sodium citrate to keep my blood from clotting in the return line. The blood thinner. It would leave me woozy, even near nauseous if I received my thinned blood back too fast but an hour or so later, I felt fine. Got really, really good at judging how fast I could receive my blood back with the thinner in it.

I did many platelet donations, then both platelet and whole blood to reduce the needles, finally stopping when the local Red Cross' best nurse said I should stop; that my arm had seen too many needles. Sad not being able any more. It was a gift for me.

Ben
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Old 03-18-19, 05:23 PM
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eja_ bottecchia
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Originally Posted by badger1 View Post
Good points.

Since my Summer from Hell last year, which included a severe lower-leg DVT, I'm now on Fragmin (low dose) for life, probably. Took a bit to get used to self-injecting daily, but piece of cake now.

Fragmin rather than Rat Poison etc. because at the same time I had a major subdural bleed that required surgery. Upshot: another of those would probably kill me, especially if I was on traditional anticoagulants, so Fragmin, which has a short life, for me.

The upshot: life is normal, but I have MedicAlert and now carry a phone and always -- always -- wear a helmet when riding.
When I told my first cardiologist about my concerns with Effient he told me not to worry about it. When I asked how long post stent placement I would have to take Effient he told me for “the rest of your life.”

After I suffered the subdural hematoma I dropped my first cardio and went with a doctor that has a stellar reputation.

He told that I was right to be concerned about all the effects of Effient and he stopped its use for me.

I am a happy and healthy rider and I no longer worry about bleeding to death on the side of the road following a minor crash.
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