The Great Blood Thinner Activity Debate (“I can’t do that, can I?”)

For those of us on injections, warfarin or other blood thinning medications, whether or not to engage in physical activity, at what time and for how long remains a constant source of personal and, as I have noticed, even medical debate. What forums, articles and websites exist are full of questions about can I do this or that, when can I do it  and for how long can I do it, and they accumulate into what I like to call The Great Blood Thinner Activity Debate (“I can’t do that, can I?”)

I remember quite vividly sitting in my doctor’s office one week after I was discharged from the hospital for my first follow-up appointment when I asked him, “Can I run again?” He assured me I could and would in fact if I so desired. “Can I run again now?” I questioned. He actually said I could run anytime I wanted, but my body would most definitely let me know when I was ready and when enough was enough. I set out that weekend to walk to the mailbox and back (thinking I would leave my oxygen tank inside for about 10 minutes) and I made it about six steps before my body said, “Enough is enough.” I retreated to the air conditioned living room, oxygen and a seat on the couch. I hated being inside, but I wasn’t ready to be outside in the dog days of summer, let alone on my feet for more than a minute or two. Emotionally, it was a setback I wasn’t at that time prepared to deal with; physically it was exactly what my body needed.

As the weeks and months went by, my doctor and I made several attempts to transition from injection thinners to warfarin, but the attempts failed and I remained on injections for about nine months since my diagnosis. It was only recently that I made the transition to warfarin and was able maintain healthy INR levels. It has taken me even longer – about 12 months – to get back to running with any degree of regularity and there are still days when I wonder, “What the heck am I doing?”

Once you are required to take blood thinners, especially if it is a lifelong prescription, you start to view life and the activities of it differently. A side effect of warfarin, combined with increased INR levels, is the potential for internal bleeding that can be dangerous, and even life threatening. The fact is, blood thinners do save lives because they treat or prevent serious blood clots; but they also pose one potentially serious side effect, which is bleeding because they slow the clotting of blood.

I don’t believe you have to stop living your life the way you want to when taking blood thinners. I believe we can still participate in the same activities we did before – or even new and better ones – we just have to be cautious of the potential side effects. It doesn’t mean we have to stop living, after all, many of us feel like we were given a second – third or fourth – chance, why not spend it how we want? You can still run, bike, hike, ride roller coasters, swim, travel, ride horses and learn archery along with a myriad of other activities. While a certain level of caution is necessary, especially if we hit our heads or see unusual bruising, there is nothing on the prescription bottle that says, “People taking this blood thinner should not___________.” I personally was never given a restriction on any activity, just to listen to my body – I would know what I could do, when I could do it and for how long. So far, that has been true.

Most of the time, bleeding caused by blood thinners is not serious or life threatening, although it is worrisome and inconvenient. Some examples of non-life-threatening bleeding are nosebleeds; a small cut while shaving with a razor; or minor cuts or skin tears. All of these types of bleeding may bleed longer than normal, but are not necessarily cause to panic and seek medical attention because they are superficial and can usually be controlled with added pressure apply to the wound for a longer amount of time. It takes me about 20 minutes to stop a nosebleed, which sometimes happen with the slightest wrinkle to my nose. Several products also exist to aid with clotting such as bandages, gels and powders like QuickClot, which aid in blood clotting, but do not disrupt the blood’s natural clotting abilities.

People taking blood thinners do not need to stop the activities they once enjoyed, especially after we are feeling well enough to participate in them again. They just need to take some extra precautions to maintain safety and peace of mind. For example, we do need to be cautious about things like high risk sports that may result in a head injury, but we do not need to stop them. We need to take extra precautions to increase our safety like wearing proper head gear when biking; gloves when gardening or working with tools and taking care with a few extra minutes when trimming hair and nails. Many people taking blood thinners also wear a medical alert bracelet to let others know they are on certain medications – like first responders in an accident – which can really add to peace of mind. You can find a myriad of medical alert bracelets on the internet and even find ones specific to sports and physical activity through RoadID. It could really save your life in an emergency or accident, especially if you are not able to speak for yourself.

No matter what activity we participate in, accidents do and will occur and sometimes these can produce superficial bleeding like from a cut or nosebleed and sometimes it could be serious, like if in a car accident or fall down the stairs. Just because we are taking blood thinners does not mean we need to stop or stop considering participating in activities that are viewed as dangerous. We can still participate in them, or even learn them for the first time, with a few extra safety precautions and common sense awareness. If you see unusual bruising or sustain a serious head or abdomen injury, you should contact medical professionals. There is no reason to stop living – even the life we’ve always imagined – when taking medications that undoubtedly save our lives. After all, it’s why we’re still here.

Share your story. Does taking blood thinners impact your decisions about normal day-to-day activity? What about extreme activities or sports? Have you given something up because you are worried about life-threatening bleeding? Did you start an activity you had always dreamed of participating in because of taking blood thinners?

There is hope for healing and you are not alone,

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