T Nation

Pulmonary Embolism - Coumadin?

Just curious if anyone has had to deal with pulmonary embolism and/or deep vein thrombosis. Also curious if anybody that has taken Coumadin(Warfarin) and Lovenox…and how it affected your diet and working out. Any tidbit will definitely be appreciated.

Yes and yes. I have had a pulmonary embolism and a severe DVT that required a catheter/surgery to keep my leg. I was on coumadin for about 2 years and tried Lovenox for about 6 mo. It def affects diet with having to stay away from vit. C, K, etc. Caffiene too.

Worse than that is working around the vascular injury. My body made new veins to try to make up for the fact that one of the major internal veins in my leg is totally shot from the ankle all the way to the groin. Needless to say, just isnt the same, swells, capillaries leak, inflammation and pain etc. I found that working out w/a antiembolism stocking on leg day and wearing it the day or two after helps a ton.

BTW I’m currently training for figure. I know my training experience may not apply, but give me more details and maybe I can help. I’d like to know your experience as well seeing as how it isn’t common to run into someone training despite this situation.

Yeah I came out of lurking specifically because Ive never run into anyone else with this problem, lol.

nvm, nothing useful to contribute.

[quote]Big_Boss wrote:
Just curious if anyone has had to deal with pulmonary embolism and/or deep vein thrombosis. Also curious if anybody that has taken Coumadin(Warfarin) and Lovenox…and how it affected your diet and working out. Any tidbit will definitely be appreciated. [/quote]

Tomorrow it will be exactly a year since I was rushed to the ER with, as the doctor called it, a ginormous saddle embolus. It was approximately the size of a hand in each lung and straddled both branches of the pulmonary artery. I had been having chest pains and shortess of breath for about twelve hours. I had had knee surgery (ACL/cadaver graft repair and menisectomy) a week before.

I took lovenox the three days I spent in the ICU, but discontinued after I left due to the enormous cost. I did take coumadin for three months after I was discharged. I had to go to a coumadin clinic to check the levels–several times a week initially, then once a week, then every other week. It took awhile of playing with the dosage to stablize things.

Both exercise and diet can affect the INR. The doctor and the pharmacist at the clinical pharmacy gave me lists of foods that would increase or decrease INR. Not to say I could not have certain things, just that I had to know that the INR would be affected if I did.

I had no prohibitions against excercise, but otoh, I had had surgery and my knee was out of commission for a few months. I was doing physical therapy during that time and I did many of the training excercises under supervision. Bruising can be a concern since the meds thin the blood and keep it from clotting. I chose to forego heavy (well, hehe, not that I actually lift HEAVY yet, hehe) lifting until I was off the meds.

Before my knee surgery, I was able to leg press 350 lbs for ten reps. Now, a year after surgery, I am able to leg press 410 for ten reps. I am also squatting and deadlifting without pain. In fact, the post surgical knee has less paim tha the “good” knee.

If you have had PE and are on blood thinners, I would talk to your doctor about the risks of lifting. I think if you were to avoid situations that would cause bruising, you will be ok.

Know that exercise increases the INR, as does any number of foods. As frustrating as it is, keeping the coumadin at a therapeutic level has to be the first priority.

Regards,

Linette

Well…I guess I’ll let my situation known. Last week I found out that I have pulmonary embolism only after passing out on the floor and waking up covered in sweat,chest pressure,and high heart rate. Definitely a scary experience…I was in hospital for 4 days. So at some point I actually had DVT in my leg…probably from leg injury from kickboxing. Don’t know for certain…but highly possible.

Anyways,I’m taking 150mg of Lovenox twice a day…and will be taking Coumadin 7.5mg for however many months…hopefully not years. I know that kickboxing(outside of teaching) is out of the question for me for a while…but would like to know how this type of situation/meds affects lifting weights,doing cardio,etc.

My doc has advised that those activities will be fine as long as I ease into them again…but wanted to know how those who have experienced this dealt with their working out,diet,etc. I know everyone’s situation will be a little different. But as someone who’s never dealt with anything of this sort,any advice/info will definitely be appreciated.

[quote]Chrysalis wrote:
Big_Boss wrote:
Just curious if anyone has had to deal with pulmonary embolism and/or deep vein thrombosis. Also curious if anybody that has taken Coumadin(Warfarin) and Lovenox…and how it affected your diet and working out. Any tidbit will definitely be appreciated.

Tomorrow it will be exactly a year since I was rushed to the ER with, as the doctor called it, a ginormous saddle embolus. It was approximately the size of a hand in each lung and straddled both branches of the pulmonary artery. I had been having chest pains and shortess of breath for about twelve hours. I had had knee surgery (ACL/cadaver graft repair and menisectomy) a week before.

I took lovenox the three days I spent in the ICU, but discontinued after I left due to the enormous cost. I did take coumadin for three months after I was discharged. I had to go to a coumadin clinic to check the levels–several times a week initially, then once a week, then every other week. It took awhile of playing with the dosage to stablize things.

Both exercise and diet can affect the INR. The doctor and the pharmacist at the clinical pharmacy gave me lists of foods that would increase or decrease INR. Not to say I could not have certain things, just that I had to know that the INR would be affected if I did.

I had no prohibitions against excercise, but otoh, I had had surgery and my knee was out of commission for a few months. I was doing physical therapy during that time and I did many of the training excercises under supervision. Bruising can be a concern since the meds thin the blood and keep it from clotting. I chose to forego heavy (well, hehe, not that I actually lift HEAVY yet, hehe) lifting until I was off the meds.

Before my knee surgery, I was able to leg press 350 lbs for ten reps. Now, a year after surgery, I am able to leg press 410 for ten reps. I am also squatting and deadlifting without pain. In fact, the post surgical knee has less paim tha the “good” knee.

If you have had PE and are on blood thinners, I would talk to your doctor about the risks of lifting. I think if you were to avoid situations that would cause bruising, you will be ok.

Know that exercise increases the INR, as does any number of foods. As frustrating as it is, keeping the coumadin at a therapeutic level has to be the first priority.

Regards,

Linette

[/quote]

Wow…thanks. I have my first appointment with Coumadin clinic tomorrow…so I will get a real idea of how all this comes together. So how was your energy levels and overall feeling while dealing with this?

[quote]Chrysalis wrote:
Big_Boss wrote:
Just curious if anyone has had to deal with pulmonary embolism and/or deep vein thrombosis. Also curious if anybody that has taken Coumadin(Warfarin) and Lovenox…and how it affected your diet and working out. Any tidbit will definitely be appreciated.

Tomorrow it will be exactly a year since I was rushed to the ER with, as the doctor called it, a ginormous saddle embolus. It was approximately the size of a hand in each lung and straddled both branches of the pulmonary artery. I had been having chest pains and shortess of breath for about twelve hours. I had had knee surgery (ACL/cadaver graft repair and menisectomy) a week before.

I took lovenox the three days I spent in the ICU, but discontinued after I left due to the enormous cost. I did take coumadin for three months after I was discharged. I had to go to a coumadin clinic to check the levels–several times a week initially, then once a week, then every other week. It took awhile of playing with the dosage to stablize things.

Both exercise and diet can affect the INR. The doctor and the pharmacist at the clinical pharmacy gave me lists of foods that would increase or decrease INR. Not to say I could not have certain things, just that I had to know that the INR would be affected if I did.

I had no prohibitions against excercise, but otoh, I had had surgery and my knee was out of commission for a few months. I was doing physical therapy during that time and I did many of the training excercises under supervision. Bruising can be a concern since the meds thin the blood and keep it from clotting. I chose to forego heavy (well, hehe, not that I actually lift HEAVY yet, hehe) lifting until I was off the meds.

Before my knee surgery, I was able to leg press 350 lbs for ten reps. Now, a year after surgery, I am able to leg press 410 for ten reps. I am also squatting and deadlifting without pain. In fact, the post surgical knee has less paim tha the “good” knee.

If you have had PE and are on blood thinners, I would talk to your doctor about the risks of lifting. I think if you were to avoid situations that would cause bruising, you will be ok.

Know that exercise increases the INR, as does any number of foods. As frustrating as it is, keeping the coumadin at a therapeutic level has to be the first priority.

Regards,

Linette

[/quote]

Damn. I’m sure you know this, but you got really lucky there. Thanks for sharing.

It is good you are going to the coumadin clinic. I really preferred the coumadin to the lovenox, even it I could have afforded it.

Your experience sounds a bit similar to mine. In my case, I know what caused the DVT–inactivity post surgery, birth control pills (doubt that was a consideration in your case! haha), surgical trauma to the leg. I actually quit breathing for a short time. I had left the house for the first time in a week, and w hen I got back into the truck I ever-so-gracefully keeled over, insensate. I actually stopped breathing for a short time. Freaked the hell out of my boyfried (now my husband) and luckily we were only a few blocks from the hospital. I also woke up sweaty, weak, and nauseous. I spent three days in the ICU on telemetry.

As far as weakness…I was very weak for awhile. In my case, the clot in my lungs was big enough to impact my lung capacity for a time. THe first day I was out of the hospital I had a lot of errands to run. I was on crutches, had to go to PT, to the coumadin clinic (where I almost lost consciousness again), the store, etc…I finally had to let my boyfriend come rescue me. I am NOT used to depending on others.

Anyway, it did take me awhile to regain my previous energy level. Now the only real long term effect I have is that my lungs are ot quite as pliable as before, so when I bend over to deadlift I can kind of feel it try to compress.

As I said, I was on the coumadin for three months. I was told that if I have another embolism I will have to be on blood thinners for life. NOT fun! I have flown twice since the embolism with no problems, which is something I worried about. I also did a long car trip without problems. We stopped frequently to stretch my legs. Also, heel pumps are your friend if you have to sit still a long time.

Good luck!