Hi guys,
First-time poster and the search wasn’t quite intuitive so if this has been addressed please point me in the right direction. The main questions are at end of the post. I know this will be long so I’ve separated the medical backstory from the overall question.
Long story short, I am a 37 yr old male. I have an undiagnosed blood clotting disorder and will be on Warfarin for life. Have been on it continuously for the last 3 yrs.
Long story long (Doctor version): I contracted Rocky Mountain Spotted Fever at age 27 from a tick bite in 2009. That led to a massive DVT in my left leg. Started in the popliteal vein behind my knee and extended to my ankle and hip. It happened fast. Multiple PEs in both lungs by the time I arrived at ER. The onset of clotting event to heparin therapy was about 4 hrs but I didn’t realize what was happening right away. I’m pretty sure the last thing the ER doc expected was a healthy 27 yr old male with a leg the size of a basketball and a massive DVT. 6-month warfarin therapy, no big deal. Had thrombolytic procedure above the knee with IVC filter removed 3 months post-procedure. No post-phlebitic syndrome. Only lingering issue is minor calf swelling (more prevalent on warfarin than not) and what I believe is achilles tendonitis, which may be unrelated or possible due to poorer blood flow. Some minor calf discomfort when running. Feels like the lactic acid just doesn’t get removed as fast as it used to.
Fast forward to 2015, age 34, appendix ruptures. No major pain, nothing. Just a mild fever but otherwise ok. At the time I was doing NLP following SS at home and thought I had a cold. After the 3rd day of very light fever, I woke up feeling a lot better, fever broke, etc. Started shaking uncontrollably while walking down the hall a few hours later. Was in OR within 15 minutes of arriving at the hospital. The surgeon was able to complete surgery arthroscopically, thankfully. Appendix had burst about 5 hours earlier and I had no idea. Doctors said that the feeling of my fever going away and generally “feeling better” was likely the time when my appendix burst.
I was on prophylactic Lovenox in the hospital and about a week into my two-week hospital stay, I came off Lovenox for 24 hr to drain an abscess. Developed pain that felt like sore back muscle but mistakenly believed it was from falling back on to CT table for a scan which happened the day before. CT tech just let me fall backward on to the table instead of helping me lay down. My breath capacity also decreased at this time so internist ordered lung check and ultrasound of legs and arms. They discovered two new clots in my left leg and also discovered two old clots in left arm that had gone unknown. The radiologist said they could tell they were older clots.
All known blood clotting disorders come back negative. I have had 3 different hematologists order tests. All OK. Was basically told, there are new tests coming out to determine some other clotting disorders, but there’s no point in having them done because the treatment will be the same.
I have read literature that says RMSF causes hypercoagulation while you’re sick, but nothing regarding long-term platelet changes post-illness and docs really don’t know enough about RMSF to speak about it much.
Vein surgeon that I saw during another clotting event between these events advised me to stay on Warfarin instead of newer meds due to need for lifetime need for anticoagulation treatment.
My family has a history of heart disease, vein abnormalities, stroke. Two women in my family have died of subarachnoid hemorrhage (My mom (53 yr old) and her aunt (late 30s). All of those people were smokers. I don’t smoke.
QUESTION: I want to get strong and get back in decent shape, so I started NLP following SS again two weeks ago and came across your website by accident. I would primarily like to find out if I should make adjustments for recovery time due to warfarin but can’t find any literature about it on Google specifically related to weight training recovery. I’m also concerned about the effects of warfarin on overall vein health and with blood pressure spikes during training. Given my family history, I know an aneurysm is a risk, but I don’t know if the risk is greater due to the medicine or if just the bleed out will be that much quicker. Not trying to be morbid, just realistic. Obviously warfarin or no warfarin the end result is bad, but I don’t want to let the fear of it stop me from improving my strength if the actual risk of an event is no different.
I had a pretty strong CNS reaction after the first two workouts last week. Left me feeling like I suddenly had a cold several hours after working out, developed a light cough, and then the cold/fever feeling was gone by the next day. Happened both workouts. Third workout not so much but recovery took longer than expected. Weights are light. Squatted 135s on the third workout. Previoius NLP I was squatting mid 200s after about 8 weeks before my appendix ruptured.
I’m also wondering what other concerns I may not know about specifically related to lifting heavy weights while on warfarin. I’m well aware of the overall effects and risks of warfarin, but I also have to be on it for life. I don’t want lethargy or fear to prevent me from being active and strong, but I’d like to be safe about it as well. My primary care is an internist but doesn’t have any weightlifting experience and he’s going to give me the “cover your ass” answers for himself and I’m going to be left without any concrete answers. For example, at what point is the blood pressure spike caused by weightlifting a concern? Is capillary or vein damage more likely specifically due to the warfarin, or is my risk of a vein failure the same and I’ll just die a little quicker if something bad were to happen. I can’t find anything specific to serious strength training and warfarin usage, especially for younger people such as myself.
Basically I’m trying to find the balance of actually getting stronger/healthier with reasonable but not overly restrictive safety.
Your thoughts/knowledge would be very helpful. Thanks in advance.
- Eric