Summer Foods and Warfarin

summer foods that can impact the anticoagulant warfarin

Vitamin K is an essential nutrient for human beings. It helps create various proteins that are needed for blood clotting and the building of bones. Our blood needs vitamin K to help clot wounds. We can’t and shouldn’t eliminate all clotting, but excessive clotting or clotting in unwanted places, such as blood clots in the deep veins of the arms or legs (deep vein thrombosis or DVT) or life-threatening blood clots in the lungs (pulmonary embolism or PE), are a serious problem. Vitamin K is also (surprisingly) in some summer foods and can impact the anticoagulant warfarin.

Vitamin K and Warfarin

If you take the blood thinner warfarin, you probably have a fairly good understanding of how diet and nutrition, particularly vitamin K, can impact your medication. A sudden change in the amount of vitamin K you eat can cause dangerous bleeding (if you consume less) or blood clots (if you consume more).

People who take warfarin have regular blood monitoring to ensure they are taking the right amount of warfarin. A prothrombin time (PT) test measures how long it takes for a clot to form in a blood sample. An INR (international normalized ratio) is a type of calculation based on PT test results. A PT/INR test helps find out if your blood is clotting normally. It also checks to see if Coumadin/warfarin is working the way it should. An INR value that is too low may mean a person is at increased risk for blood clots and an INR value that is too low may mean a person is at increased risk for clotting. Vitamin K can interfere with how warfarin works and cause the INR value to fluctuate. 

The major foods to be aware of are green leafy vegetables like spinach, broccoli, and kale. It can be frustrating to try to eat a healthy and balanced diet if you take warfarin because some of the most nutritious foods also contain high amounts of vitamin K. It’s critical that people who take warfarin find a balance by aiming to consume consistent amounts of vitamin K and avoid sudden and drastic changes to their diets.

Even if you don’t like or choose to avoid vegetables with typically high vitamin K content, what common summer foods contain higher amounts of vitamin K that could potentially impact your dosage of warfarin? The answer surprised me.

Summer Foods and Warfarin

Vitamin K is a staple in my diet, even though I take warfarin, so I eat it as part of my daily diet (usually spinach or peppers). With summer in full swing – and as a new home gardener – I decided to change up my diet to add in more fresh fruits and vegetables. For breakfast, I had a spinach, avocado, and blueberry smoothie, and for lunch was a cucumber salad. I had freshly sautéed carrots with dinner and a handful of fresh cherries for dessert. It was Saturday night, so I also indulged in one glass of delightfully sweet Peach Moscato on the patio where I settled in to search the Internet for a few new recipes. It was a fantastic feeling to be so summery all around.

That was short-lived though. Much to my surprise, I discovered that cucumbers – along with blueberries, avocado, carrots, and cherries – have a higher vitamin K content. I already knew that alcohol can impact anticoagulants, but an occasional glass does typically not interfere with my medication. However, almost everything else I ate that day also had a higher vitamin K content. 

I felt myself sliding into a panic about it, and I immediately deduced that I should never try anything new ever again – or stay off the Internet completely. There was nothing I could do to change what I already. After taking a few deep breaths, I began to calm down and developed an actionable plan to address my situation.

I have a standing (always on file) order for my INR at the hospital near my house, so I went first thing Monday morning to have it checked. It was within my normal range, perhaps because I already consume vitamin K daily. I felt a lot better knowing for sure that my warfarin dose did not need to be adjusted to accommodate my dietary choices. Tuesday I had a regular appointment with my hematologist so we discussed the next time I should get my INR checked.

Summer Foods That Are (Maybe Surprisingly) High in Vitamin K

  • Blueberries 
  • Cherries 
  • Cucumber 
  • Cabbage
  • Green Snap Beans
  • Kiwi
  • Pickles
  • Avocados 
  • Blackberries 
  • Pomegranate 
  • Carrots 
  • Red Bell Peppers
  • Grapes

Vitamin K content listed by food.

Enjoying Summertime Foods

If you want to change your diet to include summer foods and take warfarin, or if you make changes unexpectedly as I did, be aware of your body and check in with your medical providers if you have any concerns. Be prepared to check your INR perhaps more frequently than usual or for the possibility that your warfarin dose might need to change temporally to get you back on track. If you experience any unusual bleeding while taking an anticoagulant, contact your doctor or go to the hospital right away.

You can still eat a healthy diet and enjoy summer while being aware of the foods (and drinks) that can impact your health. 

There is hope for healing from blood clots, and you are not alone.

Reader Writes In: What foods would you add to the list? How do you manage warfarin and summertime eating?

Share your thoughts in the comments!

Menstrual Cycles and Anticoagulants: What’s Normal?

If you are a woman, one of the first questions you might have after starting blood thinners may be, “Should my menstrual cycle be this heavy while taking anticoagulants?” It was one of the first things I worried about after I was discharged from the hospital on low molecular weight heparin blood thinning injections several years ago. I worried – a lot – and wondered if it would be a major issue for me, especially since I had already struggled with uncomfortable periods for as long as I could remember. My periods were a little heavier, but nothing that made me worry, or think something was wrong. I had more frequent and slightly heavier periods for several months, but eventually my cycle returned to what was normal for me. Once I transitioned successfully to the oral anticoagulant warfarin, my periods stayed the same. A little unpredictable, but mostly manageable. They were occasionally longer or heavier, or I would occasionally have two shorter cycles in a month, but nothing was overly concerning for me or my doctors.

About five years after my blood clot, I had a period that was not normal for me. It arrived at the regular time, but it started out a lot heavier than usual. My first thought was, “Good. I’ll get it all out of the way in a day or two. I began to grow more and more concerned as the third day of my cycle arrived, and the bleeding worsened. By that time, I was going through a 10-hour pad in less than hour, and I was soaking through my clothes. It was a weekend – which is when all of my issues seem to happen, blood clots included – and I thought, “Since it’s my period, I’ll wait until Monday and call my gynecologist.”

It got worse as the weekend went on, so I called my gynecologist’s office. Most gynecologists have an on-call physician for pregnant patients who go into labor and delivery, so I was relieved to hear a messaging service answer where I could leave my number and have an on-call physician call me back. A doctor at from my gynecologist’s office called me back in about 10 minutes and asked me what was going on, so I explained my situation. The doctor was alarmed, even though I was very clear that I was taking the blood thinner warfarin. He instructed me to go immediately to the emergency room, which I did, now completely panicked about my situation.

At the hospital, I saw a number of doctors who ran and performed numerous tests to determine whether I was bleeding internally from my abdomen or from my uterus. After several hours, and a lot of uncomfortable evaluations, it was determined that I had uncontrolled uterine bleeding. In my case, it was a period that wasn’t stopping. The cause was an INR level that was way too high, which I did not know about. I needed a reversal treatment (oral vitamin K in this situation), to help bring my INR back into a safe range. I am very fortunate that I did not need a blood transfusion or need to be admitted. The ER staff told me repeatedly that it was very good I came in when I did, instead of waiting until Monday, because the bleeding may not have stopped on its own.

It took several weeks of medication adjustments, blood draws, and ultimately bridging with injections to stabilize my INR. While it was a very scary experience for me – and one that has also taken me some time to think about sharing here – it is an experience that I take very seriously. I learned a lot about my body and what not to assume. If I ever have bleeding like that again, I will not assume it is my period, because I know now that something could be seriously wrong.

If you have heavy periods on blood thinners, at least have one conversation with your doctor, before ending up in a situation that requires emergency room visits and emergency interventions to resolve.

FAQ: What You Need to Know About Periods and Blood Thinners

Below is a list of frequently asked questions about menstrual cycles and blood thinners. These are questions that I have asked myself, and that I hear a lot. What is the bottom line? If you have a heavy period on blood thinners, please talk to your doctor.

Q: Since I am on blood thinners, I can expect a heavier period, right?

A: Like so many things when dealing with blood clots and blood clot recovery, it depends on the individual situation. Not every woman has a heavy cycle on blood thinners, so if you do, you need to discuss it with your doctor to find out if it is normal or not. A possible side effect of the newer oral anticoagulants are heavier periods, so if you take those medications, talk to your doctor about your concerns and what to expect. It is important to make sure nothing else is wrong, or going on, as well as to find a solution for managing heavy periods.

Q: What kind of doctor should I discuss my heavy periods with?

A: It is probably best to involve two doctors, or specialists, in your care when discussing your menstrual cycle: The doctor who prescribes your anticoagulant (for me it is my hematologist) and your gynecologist. If you do not have a gynecologist, you can find one with this search tool: The American College of Obstetricians and Gynecologists.

Q: My doctor(s) said to expect heavier bleeding on blood thinners, so do I need to worry if I am bleeding a lot?

A: Don’t assume heavy bleeding is normal, especially since it could be dangerous and have dangerous consequences, such as blood loss or anemia. If you have heavy bleeding, you need to go to the emergency room, or hospital, to be evaluated. The U.S. Centers for Disease Control and Prevention (CDC) defines heavy bleeding as: 1) needing to change your pad or tampon after less than two hours, or 2) you pass clots the size of a quarter or larger. Read more about heavy periods, also known as menorrhagia, from the CDC: Heavy Menstrual Bleeding.

Q: During that time of the month, can I just skip taking my blood thinners?

A: No, not without speaking to your doctor. Heavy periods are usually not a reason to stop taking your blood thinner. Stopping your medication – even for a day or two – could be dangerous and result in a repeat clotting event. Not taking medication as prescribed is the most common cause of blood clot recurrence. Please do not ever stop your blood thinner without consulting with your doctor first. While some women may be given instructions to reduce or stop their blood thinner during the heaviest days of their menstrual cycles, this direction must only be given my the advice of a medical professional.

Q: Birth control helped with my periods, and now I can’t take it because of blood clots. What options do I have?

A: Birth control with estrogen is a risk factor for blood clots, and many women are advised to stop taking birth control with estrogen after a blood clot. However, many women have options without estrogen for birth control that may also help with heavy periods, especially if they are continuing to take an anticoagulant. More information about these options can be found here: Birth Control and Blood Clots. Other options to help manage a heavy period may include: pads or tampons, menstrual underwear or menstrual cups. We’re all different, and what works for one woman may not be an option for the next woman. Some women may, along with their physician, consider various surgical procedures to help address significant menstrual bleeding, such as a endometrial ablation or hysterectomy.

It can be difficult to manage a heavy menstrual cycle on anticoagulants, and for many women, it can be uncomfortable to talk about, but it is really important. Not only can an unusually heavy cycle be dangerous to your health, it can be damaging for your self-esteem. It can even effect work and social commitments. If you are experiencing a heavy period while taking anticoagulants, talk to your doctor about your concerns, and your options.

There is hope for healing and you are not alone,


Reader Writes In: Journal your thoughts, or share in the comments below. Have you experienced heavier periods since starting anticoagulants?


Read More: Women’s Issues and Blood Clots


Why You Need A Medical ID

Disclosure: I was given a credit from American Medical Id® to select and engrave a medical ID product for review. Although this product was a gift, all opinions in this review remain my own, and I was in no way influenced by the company.

As a child, I had a friend who wore a medical ID for a peanut allergy. I asked her about it once, “Do you like wearing a bracelet all the time?” She just stared at me, and then she said it didn’t matter. She said it was important because peanuts could really hurt her, and the bracelet let people know. I remember being afraid of peanuts for a little while, because I didn’t understand, and then I wondered what it was like to wear a big, shiny bracelet all the time, even in the swimming pool and to bed. I’ve never forgotten the image of that giant medical bracelet on her tiny wrist.

I never imagined that I would be in a situation of needing to wear a medical ID. For my childhood and a good part of my young adult life, I didn’t have allergies, health conditions, or medications that were important to know about in an emergency. However, a DVT and PE in 2012 changed all of that and I found myself on long-term treatment with the blood thinner warfarin indefinitely. For the most part, I view warfarin as something that I need to stay safe, if not alive, and I don’t hate it. It’s hard for me to think of it as life-saving, but I do know it helps to prevent another blood clot that I might not survive again.

Blood thinning medications do help save lives, but as with any medication, there are risks that come along with taking blood thinners. One of those risks is unwanted or uncontrolled bleeding, and usually, you can avoid bleeding risks by taking your medication as prescribed and keeping in good communication with your doctor. If you take warfarin like me, have your INR monitored regularly to ensure effectiveness.

Catastrophic bleeding – like from a car accident or injury – can produce life-threatening bleeding that requires emergency medical treatment. I don’t think about being on warfarin all of the time anymore, but it’s never too far from my mind, and one of my worst fears is that I will have an accident while I am on it and be unable to tell anyone that I am taking this medication. When I started thinking about all of the ways I could be injured without someone there to help me, or without someone who knew me, I realized that a medical ID was an essential part of caring for myself after a blood clot.

If you take an anticoagulant, you should consider wearing a medical ID so that emergency responders and medical doctors know how to best treat you in an emergency, or if you can’t share your medical history yourself. It is important that they not only work as quickly as possible to stop any life-threatening bleeding, but also that they understand you are at risk for blood clots.

There are numerous places to purchase a medical ID from, and I don’t believe they are all the same. I’ve had a few medical IDs that were not worth the money I spent on them. When I was given the opportunity to review a medical ID of my choosing from American Medical ID®, I was excited to give them a try. I chose the Sterling Silver Medallion Red Charm Bracelet for my medical ID.

Read more about Medical IDs for blood clots from American Medical ID®.

Front of my American Medical ID®:

What I love: The medical emblem is large, red and easy to identify in an emergency. The charm design is unique and feminine too, but it is still recognizable as a medical ID. The design I chose is sterling silver and it is of high quality.

What I wish was different: I wish the chain was heavier/chunkier. This is a lot more delicate than I thought it would be, so if you like delicate jewelry, you will definitely love this. I also wish it was easier to get on and off (I don’t sleep in it unless I am traveling away from home), but I think this is pretty standard with any clasp such as this one. I’m not worried about it coming off accidentally, it’s very secure.

Back of my American Medical ID®:

What I engraved:

My Name (first and last)
My Date of Birth (XX/XX/XXXX)
WARFARIN ASPIRIN
PROLONGED PTT W/
INHIBITOR INR
HX VTE

A note about my engraving: I talked to my doctor about my situation, and he suggested I keep this information regarding a prolonged PTT with inhibitor INR readily available in case of an emergency. He also said to let my family members know this information in case I am ever hospitalized or need surgery. I have an interesting and complicated set of circumstances. In short, this information means that a heparin (blood thinner) IV, should I need it, could be inaccurately dosed due to an INR inhibitor that I have. I have this information stored in my phone – and in my relative’s phones – and now on my new medical ID.

What I love: For the size of the charm, I could fit a lot on this ID. The type is large and easy to read.

What I wish was different: I wish the engraving was oxidized, or a little darker (it is still readable).

I consider a medical ID an investment, and it might be something you have with you for a very long time. Since I have been taking a blood thinner, I have had a few medical IDs. Some with different names of the different blood thinners I have been on, updated contact information, necklaces, bracelets, and even a keychain. I am a jewelry person, but I was annoyed and frustrated with always having to think about – let alone wear – a medical ID. I like to change my jewelry around often, and I don’t like to sleep in it. If I am going to wear something all of the time, I have to love it, and let’s be honest, who loves a medical ID?

It may not be something we wish for or want, but I do think American Medical ID® makes it a whole lot nicer to own a medical ID. I love that they offer a wide variety of styles and products – for men and women – with a broad range of prices too. I believe there really is something for everyone from American Medical ID®. I like the way my American Medical ID® stands out among the other bracelets I wear. It looks like a medical ID, but it is also one that I feel good wearing because of the style. This ID is extremely lightweight and comfortable to wear.

American Medical ID® has an easy to use, and very informative, website. The engraving process is also simple – it costs just $7 – and they also have excellent customer service. I got my ID really quickly – within a week of ordering – and it came expertly packaged and included a small carrying or storage pouch. If you’re looking for a medical ID, I recommend you try American Medical ID®. I’m really happy with my bracelet, and I plan on wearing it.

Here are some of my thoughts about how to select and engrave your medical ID.

My Top Tips for Selecting a Medical ID:
  • Pick one that looks like a medical ID (not one that is too “pretty” or that “blends in”)
  • Pick one that is comfortable for you, or that fits in with your lifestyle
  • Pick one that is easy for you to wear, or get on and off

More tips from American Medical ID® about how to select your medical ID.

My Top Tips for Engraving a Medical ID:
  • Talk to your doctor about what to engrave on your medical ID. You may think this sounds silly, but I had no idea what should actually be on mine, until my doctor happened to mention it.
  • Include your full name
  • Include your date of birth (month, day, year)
  • Include the name(s) of your medication (I don’t recommend saying “blood thinner” or “anticoagulant” because it is not specific enough. Some anticoagulants have bleeding reversal agents, and some do not.)
  • Include your medical history, or essential facts about your condition
  • Include an emergency contact number

More Tips from American Medical ID® about how to engrave medical ID.

More Tips:
  • If you think your medication might change frequently, don’t get an expensive medical ID
  • Once you do get a permanent ID, select a material type that will last (I prefer stainless steel or sterling silver)
  • If you can’t fit everything you think you need on your ID, you could engrave “See Wallet Card” or something similar, and then carry additional information on your person
  • If you don’t wear jewelry, consider a keychain, or other accessory that you can carry with you

Read more from American Medical ID® about why a medical ID is critical.

If you’re taking a blood thinners, I strongly suggest wearing a medical ID. Thank you to American Medical ID® for the opportunity to review and wear an ID from you.

There is hope for healing and you are not alone,

 

 


Reader Writes In: Do you wear or carry a medical ID? Share in the comments.


Thank you to American Medical ID® for the opportunity to review and wear one of your medical IDs.


Get more tips about how to engrave your medical ID from BCRN.


Have an iPhone? You can update your iPhone with a portable medical ID (and it is free). Go to your Health App (pink heart) and select Medical ID to fill in your personal info). Also, find other ways to stay safe on the go.

Fix Your Thinning Hair

Sometimes, medications that keep us safe from a dangerous disease or condition, can also cause unwanted side effects. Anticoagulants, or blood thinners, help to protect us from blood clots, they can also cause troubling side effects sometimes. These side effects can range from mild, like a headache, to severe, like uncontrolled bleeding. Side effects can vary from person to person, and are different for different blood thinners. If you have any side effects while taking blood thinners, it’s important to have a conversation with your doctor about what you are experiencing.

Although listed as a rare, or even nonexistent, side effect for most blood thinners, some people experience hair loss, or hair thinning, while taking them. It’s important to let your doctor know if you are losing your hair, just in case something else is going on. Keep in mind that many things can cause hair loss, such as nutrient deficiencies, other diseases, hormonal imbalances, other medications, stress, and genetics. It’s important to remember that not all medications will affect everyone the same way, and not everyone experiences hair loss, or hair loss to the same degree. The bottom line is, if you are experiencing hair loss – or hair thinning – to any extent, it can be devastating to your self-esteem during what is already a difficult recovery from blood clots. No matter what the cause might be, I am going to share my top tips to help fix your thinning hair.

I have naturally thin and straight hair. I noticed about a year after I started taking a blood thinner, that my hair seemed thinner than usual. Due to my recovery and time away from work, I did not get a haircut for a very long time, and my hair was longer than it had ever been. Seeing my hair coming out in clumps on my brush was very upsetting to me. I found a hair stylist and made an appointment as soon as possible to help fix my hair.

I explained to my stylist that I was concerned about my thinning hair, due to the medication I was taking. I told her I was brushing my hair, and it looked like I was brushing it right out of my head. She inspected it closely, and said that while some medications can cause hair thinning or hair loss, my hair looked to be thinning mostly from the length of it. She explained that hair tends to thin the longer it grows, and when we brush it, it looks like more is coming out because it is so long.

I got my hair cut that day, but since I like my hair longer, I cut it to right below my shoulders, which was still significantly shorter than it had been. I noticed an immediate difference in the next few days as I was combing and styling my hair. It looked fuller and less hair came out on my comb and brush. I am not sure if I experienced hair thinning or loss due to my blood thinner, but I do know that I am more conscious of my hair, and I do care for it differently since starting blood thinners.

There are many things you can do to help fix thinning hair, and not everything works for everyone. It is important to make sure you are eating as healthy as you can, and that you are getting the right nutrients in your diet, which is also important for overall health and well-being. I personally don’t choose to take any extra supplements or medications to help fix my thinning hair, because that can cause interactions with my blood thinner.

I have found a few simple ways to help fix my thinning hair, and these things are part of my daily personal care routine. I am not a hair person, and I try to spend as little time on my hair as possible, but I do like for my hair to look presentable, if not nice. If you’re looking for hair styling advice, this is not the post for you. If you’re looking for some simple ways to help fix your thinning hair, here are my top five tips:

Tip #1: Get your hair cut, or trimmed, regularly.

This is my number one tip to help fix your thinning hair. Keep in mind, shorter hair sometimes looks fuller. I get my hair cut about every four months, which is not as regular as some people, but it is regular for me. Keep a close eye on your hair at first to see how fast it grows, and schedule your appointments around your hair growth. You can tailor your appointments to fit your schedule and your budget. Haircuts don’t have to be expensive, and sometimes you can have a friend or family member cut it for you to save money. No matter how you choose to do it, get your hair cut on a regular basis.

Extra: Find a hair stylist that listens to you, and specifically addresses your concerns about your thinning hair.    

Tip #2: Wash your hair with shampoo and water less frequently.

I was hesitant about this at first – because oily hair is not nice – but it really works for me. I only wash my hair with shampoo and water twice a week, sometimes three times if I have done something active or sweaty. The other days, I use dry shampoo to clean my hair without the stress of a full shampoo. Dry shampoo takes care of oil, and also adds body to my hair.

Extra: Not all dry shampoos are the same, and I tried about 167 before I found one I like. I use this dry shampoo. Get it here

Tip #3: Use products to help add body to your hair, like a root lifter.

Root lifter made a difference in my life long before I started taking blood thinners, and it is my favorite styling product. Most days, I spray dry shampoo, or use root lifter, comb my hair, and go. If you’re using multiple products, be careful not to use too many, which can cause your hair to become weighed down, which yes, can make it look thinner. I don’t use dry shampoo and root lifter together because the dry shampoo also adds body to my hair.

Extra: I don’t like wet products that tend to weigh my hair down and make it heavy, or thin. I use this texturizer/root lifter, which comes in a powder form. Get it here.   

Tip #4: Use products to help add texture to your hair, like sea salt spray.

If your hair is thinning, sometimes adding texture can help. You can do this with cut layers, but you can also do it at home, in your own bathroom. During the summer, I like to use sea salt spray on my hair, which adds a little texture, and smells like I just walked onto a tropical island. It’s easy – just spray it in damp or dry hair, and tousle with your hands.

Extra: A little goes a long way. I bought a travel size container of this sea salt spray, which lasted me all summer. Get it here.

Tip #5: Style with heat as minimally as possible.

I like to vary how I care for my hair from day to day. I mix up washing it in the shower, using dry shampoo, root lifter, and sea salt spray, depending on how my hair looks on any given day. Sometimes, I fully style my hair with a blow dryer, and that adds body and texture too. However, since I started a blood thinner, I try to style minimally with heat, which can further damage hair. Often times, I dry my hair fully at the scalp to add body, and dry the ends to a damp dry, and then let it air dry the rest of the way.

Extra: If you dry your hair on a regular basis, use a lower heat setting on your dryer. If you use a curling or straight iron, use a lower heat seating.   

I hope these tips help you fix your thinning hair. Give them a try, and come back to let me know what you think.

There is hope for healing and you are not alone,

 

 


Reader Writes In: Is your hair thinning since you started blood thinners? What tips can you share to help fix your thinning hair? Have you tried any of my tips? Did they work for you, or not?


NEW: Shop my favorite hair care and beauty products here.


If you’re feeling down in the dumps, here are my 7 Steps to Feel Better about Yourself.


 

How I Eat After a Blood Clot

How I eat after a blood clot

Before I was a VTE blogger, I was a health and fitness blogger. Before I started writing about my blood journey, I wrote about my weight-loss journey. Before I was diagnosed with a DVT and PE, I was diagnosed with insulin resistance as a pre-cursor to diabetes, which motivated me to make changes in my life related to nutrition and fitness. I started running half marathons and eating better – and I eventually reversed the damage being done to my body and came off insulin-sensitivity drugs. In the process, I became enamored with nutrition, fitness and running and continued training – and writing about it – up until that weekend in June of 2012 when un-relenting calf pain turned into a blood clot in my lung and I was out of the fitness game for the next three years.

During my recovery, I gained back all of the forty pounds I had previously worked so hard to lose – and then some. I stopped focusing on making good choices when I ate food and while I didn’t go overboard, my body reached its highest weight ever and I plateaued there. There was nothing I could do – or wanted to do – to change it at the time. My singular focus was on recovery from my blood clot including managing my pain, decreased lung function, leg swelling, a fluctuating INR, multiple doctor visits, physical setbacks, emotional trauma and the numerous lifestyle changes that come with all of the above. Still, in the back of my mind, I knew I had to get the weight off. Once physically recovered from my blood clot, I still felt horrible, lethargic, fatigued and out of control because of my weight. My self-esteem took yet another beating when I already didn’t have much self-esteem left. Eating – and the choices I was making about food – were wrecking havoc on my emotional health.

It’s hard to eat consciously on a regular day, let alone when you are managing an ongoing illness. Now, some of the most common questions I receive at BCRN are, “How do I eat healthy on a blood thinner and how do I lose weight after a blood clot?” While I am not a doctor, nor am I a nutritionist, I am sharing what as worked for me and some tips that I believe can help benefit anyone who is trying to lose weight or make better choices when it comes to food. Studies tend to show that in terms of weight loss, diet plays a much bigger role than exercise – and just because you are taking an anticoagulant does not mean you can’t eat for weight loss and/or optimal health. As a rule, it is important to discuss any dietary changes you want to make with your physician before you make those changes. I talked to three of my doctors – hematologist, endocrinologist and GP – before I made these changes.

Overview: Establish or find a nutrition plan.

Worst first, right? When talking about nutrition for weight loss, it is important to find a diet plan that works for you (here is the only place you will see me use the word “diet” in this context. I refer to the way I eat as a lifestyle, not a diet because it is how I prefer to eat and it is what makes me feel good). The internet, books, magazines, etc. are filled with an overwhelming amount of information about how to eat, when to eat, what to eat and what’s the right way to do things. The thing is, though, finding a plan is just as individual as the blood clot treatment plan you are on. There is no right way because each of us is different.

I have spent many years researching ways to eat and tried a multitude of the plans that are out there – Weight Watchers, Paleo, Whole 30, Low-fat, Autoimmune Protocols, Gluten-Free, Blood Type Diet, Low Calorie, High Calorie – all of them have their pros and their cons. Finding one that works is entirely up to you.

I have chosen to incorporate pieces and parts of these plans to make my own plan, with the guidance of my doctor. The basics of my plan include:

  • 1,500 calories a day (or about 500 calories a meal) – drastically cutting calories does not work for anyone.
  • A focus on eating macronutrients each day with a goal of not more than half of my daily intake of nutrients being carbohydrates, about 30 percent of my daily intake of nutrients being fat and about 30 percent of my daily intake of nutrients being protein.
  • I do not eat (or I limit) white grains (rice, pasta, bread), potatoes (all kinds), sugar (and alcohol), dairy (cheese, sour cream, milk, creams, etc.), soy, whey, protein powders.
  • I eat chicken, beef and fish (although I do limit my intake to a few times a week as a personal choice), beans, eggs, nut butters, vegetables (the list is large: peppers, onions, mushrooms, spinach, broccoli, green beans, tomatoes, squash, asparagus, etc.), sweet potatoes, whole grains (limited to once a day and is either whole grain rice or bread), fruit (apples, oranges, bananas, grapes), olive oil, coconut oil, butter (not margarine) and on occasion bacon fat or lard. I cook with almost every spice except rosemary and fennel.
  • I eat three meals a day and an afternoon snack, usually. I eat breakfast every single day (not an easy accomplishment) within one hour of waking up. A typical day for me is brown rice, spinach, and an egg fried in butter for breakfast; more spinach and beans or roast beef on a whole grain tortilla and spinach with mustard for lunch; chicken/steak and vegetables or a sweet potato with almond butter and vegetables for dinner. Snacks might be an apple with almond butter or Greek yogurt.
  • I do allow myself to have treats. I eat out about once a week with no restrictions, have a pinch of sugar and sometimes cream in my tea each morning and consume wine every now and then.
Fill up on good things – what works for you.

Finding out what makes you feel good – and is healthy –  is important. Once you do, eat those things in excess, even in spite of calories goals. I eat spinach every day because it makes me feel healthy, strong, energized and full. Eating protein makes me feel full. Eating nut butters, fruit and on occasion chocolate makes me feel happy. If I am hungry at the end of the day, I eat a sweet potato, popcorn or a even a piece of chicken, even if I am going over on my 1,500 calorie goal.

Cut out the bad things – what doesn’t work for you.

In the beginning, I read It Starts with Food by Dallas and Melissa Hartwig, which gave me a lot of insight into how poor nutrition might be affecting our overall health, including inflammation in the body. I did the Whole 30 Challenge where I eliminated grains, dairy, sugar and alcohol according to the plan for 30 days. At the end of the thirty days, I started adding things back into my diet that I previously loved to eat and was certain I couldn’t continue living without. Certain things made me feel horrible – and still do to this day. I avoid milk and white grains (rice, pasta and bread). On the other hand, I do love white rice – especially from Chinese take-out with a lot of hot sauce. I eat it once in awhile, but I am prepared to face massive joint swelling and pain the next day so my once in awhile is really only that – once in awhile.

I rarely eat anything that is not whole – meaning I eliminate processed foods or things that come out of a box, a bag, a container, etc.

Consistency is key.

When talking about nutrition – especially if you are taking medications that can be affected by food, like warfarin – it is important to talk about consistency. Consistency is more important than elimination, especially when discussing the foods that are healthy for you. I eat about the same amount of spinach everyday. I eat about the same amount of protein in a day. I eat about the same amount of carbs in a day. I eat about the same amount of calories in a day.

I also consistently cook at home, make two or three meals out of one (before it even goes on my plate I divide it up) and shop the perimeter of the grocery store (that’s where you find whole foods like vegetables, fruits, eggs and meat).

Write it down, somewhere, somehow.

In writing down what I eat everyday (as a means to keep track of calories), I realized two things: We as human beings consume entirely way too many calories without realizing it and we eat generally the same things each day without realizing it. Write down what you eat. I think you might find consistency is more present than you realize and you eat more than you realize. I use MyFitnessPal mobile app (or checkout the desktop version) to keep track of my calories and macronutrients. It’s free to download for iOS and Android. You can also use a paper or electronic journal.

Drink water.

I exclusively drink water – and black tea in the morning with sugar and sometimes cream. If you feel thirsty, you need to drink more water. I don’t really pay attention to cups or ounces, but I do drink to not be thirsty. If I go out, I order water. I don’t drink soda, juice or coffee very often, if at all. If I want flavor in my water, which I rarely do, I put my own sliced lemon or lime in it.

Treat yourself.

You cannot eat according to plan 100 percent of the time. It’s not healthy, either. What I refer to as treat (not cheat) meals are important to your mental attitude. I do this about once – maybe even twice – a week. I do not take a treat day, but I take a treat meal where I eat what I want (usually from a restaurant) and do not worry about calories, nutrients or goals. I may or may not write my treat meal down. I eat what tastes good and looks good to me (insert Chipotle here). Over time, I have found my desire to do this is less and less and I tend to have treats that are not really meals – a chocolate bar, a glass or two of wine, or French fries with my salad at dinner.

Don’t do weight loss alone.

Apps like MyFitnessPal have a community component where you can “Like” and “Comment,” just like Facebook. Find a group, an app, an online forum, a book, etc. – anything to make connections with other people who are on the same journey as you. Not only is it motivating, it also helps hold you accountable to your own goals.

Tips for eating well 3

To sum it up, this is what works for me – and might not work for you too. This is what I discussed with my doctor – your doctor might make different recommendations. All of that is okay.

Weight loss takes time, dedication and hard work. Changes can be slow – they should be slow, as should weight loss. With small changes, comes lasting progress. I take one day at a time. My today is not my yesterday or my tomorrow. By eating to feel good and fueling my body well, I have noticed I feel much better – and while I am losing weight slowly, the emotional benefits far outweigh the physical ones. I feel more confident, happy and secure in my decisions to take care of myself. For me, self-care extends far beyond my initial recovery to caring for my body and my mind from this point forward.

Reader Writes In: Are you trying to lose weight or eat healthy after a blood clot? What works for you? What is your favorite treat?

There is hope for healing and you are not alone,

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BCRN Awareness Matters
More information to share:

How long will I have to take blood thinners?

how long will i have to take blood thinners

It can be very overwhelming in the days, weeks and even months following initial diagnosis of a blood clot in the leg, thigh or pelvis (DVT) or lung (PE). Initial treatment generally involves extensive hospitalization; a battery of tests including blood draws, scans and X-rays; perhaps thrombolytic therapy or clot-busting drugs to break up clots inside your blood vessels; or even surgery to place a filter in the groin area or to address an underlying and more critical issue at hand. Most, if not all, patients are put on anticoagulants – or blood thinners – for some amount of time ranging from a few weeks to a lifetime. Blood thinners decrease your blood’s ability to clot. They’re used to stop blood clots from getting larger and prevent clots from forming. Blood thinners do not break up blood clots that have already formed (the body dissolves most clots with time). As time goes by, the question soon becomes just how long will I have to take blood thinners?

It was one of the first questions on my mind once I could think clearly and for me, it did not come until after I was discharged from the hospital and was sitting in my hematologist’s office for my first follow-up appointment. I was more than hesitant when I asked then and just yesterday at my 16 month follow-up appointment, how long will I have to take blood thinners?

The answer was the same then as it was yesterday – I will have to take blood thinners for the rest of my life, due Antiphospholipid Syndrome. APS is an autoimmune disorder in which the body recognizes certain normal components of blood and/or cell membranes as foreign substances and produces antibodies against them, particularly in the blood, which causes clotting. I had slim hope that something would have changed in the last year, but it did not; while APS antibodies do come and go, the risk of them developing and producing another PE are too great to ever stop taking blood thinners.

Still, others will be on blood thinners for much less time or may go on and off blood thinners at different times in their lives. In fact, there are as many variables affecting how long a patient will have to take blood thinners as there are patients with blood clots. It all depends on the individual and most importantly, the reason for the blood clots to begin with. If you don’t know why you developed a blood clot, request a panel of tests to determine if there are any genetic or autoimmune factors that may have contributed to the clot as this can be critical in determining how long you need to take blood thinners.

In patients with an easily identified and reversible cause of a deep vein thrombosis (such as a recent surgery, strictly birth control pills, etc.) 4 to 6 weeks of therapy may be sufficient. Many patients who experience a DVT or PE with no identifiable cause (unprovoked) or strictly as a result of birth control may only be on blood thinners until initial concerns with the clot are resolved or birth control is stopped. This may be a few weeks at most.

For cases in which the risk of developing new blood clots remains high (such as in patients with certain cancers or even genetic factors, pregnancy, etc.), anticoagulant therapy may need to be continued for months to years.

In the case of someone with recurring clots (genetic or autoimmune disorders or additional medical complications that may contribute to clotting), he or she may need to take blood thinners lifelong (http://preventdvt.org).

Doctors may recheck the leg and/or lungs with a Doppler imaging scan (or ultrasound) between 3 and 6 months after the initial clot. There would not be enough change to require a scan any sooner than that and keep in mind; your clots may never completely dissolve, resulting in residual scar tissue that may always be visible through medical scanning.

Most patients who have suffered from a PE and/or DVT are placed on blood thinning medications for 3-6 months as a general guideline. Again, it is of vital importance to discuss reasons for clotting with your doctor as well as your individual risk for a recurrence. Both will help to determine what your appropriate length of treatment should be.

Share your story. How long do you have to take blood thinners and for what reason? Did you expect to take blood thinners for as long as you are/did? What have you heard about length of treatment pertaining to blood thinners?

There is hope for healing and you are not alone,

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