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I got a cross bike and was excited about racing next fall in the Chicago area.  i'm a total cross noob but an experienced roadie.  just got diagnosed with a pulmonary embolism and deep vein thrombosis and will be on warfarin for life.  other coumadin/warfarin lifers out there who are racing?  i know how much risk i accept is my decision but would appreciate advice from experienced riders about my chances of serious injury if i'm racing 4a/4b.   thanks. John

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I ahve been on Plavix the last three years, seems to be nothing diff, as far as training and racing

Same here...

Had a stent placed last June, and perscribed Plavix for 12 months from then, and no issues. Doc says the more physical effort the better!



John, first of all plavix is nothing like coumadin.  With coumadin in the doses you will be taking, you will have a propensity to bleed.  Not a big deal if we are talking about a nick when shaving, but huge deal if we are talking about internal bleeding (like a fractured spleen) or worse an intracerebral hemorrhage.  In my opinion, (I'm a pulmonary/critical care physician) it would not be worth the risk.
I have to second Thomas Wilcox's answer. I'm a trauma surgeon / surgical critical care physician (and the 90 hours a week I put in explain my 'cross mediocrity).An emphatic NO to any contact or potential contact sports while anticoagulated with coumadin - even a relatively minor impact could result in a fatal brain injury; as he stated, your risk of a bad outcome from a splenic (or other solid organ) injury is also high. Even in the absence of a major injury, you're going to wind up with a lot of soft tissue hematomas from the usual contact with the bike, etc, even in the absence of a crash. Sorry to be a downer - this is a far different ball game than anti-platelet agents like Plavix where racing is a calculated but not unreasonable risk. Check with your doc - unless you have a hypercoagulability disorder (protein C, protein S or AT III deficiency or similar), you may not need to be on coumadin for life - six months is standard treatment duration for PE. I wish you good health, but no cross !
Thank you Dr. D'Amelio   i will try to appeal my warfarin life sentence.  i'm a two time clotter and the docs are stern.  you and Dr. Wilcox (above) scared me away from CX.  just ran a 50 miler on pavement and am normally sore.  I'll go for an OT freebie on a CX forum:  do the muscle micro-tears caused by ultra distance running pose a serious internal bleeding issue with warfarin?  John
It won't pose any serious risk of injury. I've run a couple of marathons and had a little hematuria (blood in urine) afterwards - it's not unusual for long distance runners, even in the absence of any blood thinners. You won't experience any unusual muscle damage from ultrarunning being on coumadin. If you pee red a day or two, I wouldn't sweat it. If it continues beyond that after an ultrarun, I would check in with your doc to rule out an underlying urologic condition, especially if you're over 50.  Good luck.


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