Hello! Firstly, want to say how thankful I am that Barbell Medicine has this forum, its an amazing resource.
Just a short personal history. I suffered a pulmonary embolism last year and was hospitalized for 2 weeks. I was told the cause is unknown, it wasn’t a DVT though, they said quite confidently. I was discharged with a 3 month prescription of Xarelto. I took my meds and took it easy, I could barely walk without being winded and having to stop anyway. I recovered quite quickly and blood work and CT scans were looking great month to month. After I finished up, I went back to life as usual… until 8 months later. I suffered another pulmonary embolism. The second time was the same story, and was told I’m just going to have to be on Xarelto for life. I wasn’t happy about it, but as long as life goes back to normal, okay.
I was then referred to a specialist at the university hospital. He ran a bunch of tests and scans on my lungs and body, and I also performed a CPX test as well. He said my lungs are very healthy despite having had two pulmonary embolisms and my tests showed I was even slightly above average for my age group. Despite this however, in my final consultation with my specialist he said I should continue to live a normal life with light aerobic activity but absolutely should not lift weights anymore due to the risks.
Unfortunately these embolisms happened while living abroad in Japan, so I’ve been dealing with Japanese doctors for all of this, and like a lot of doctors back home, I think it’s possible they have antiquated ideas about training.
The web is also surprisingly unhelpful when it comes to the subject of training while being on anticoagulants for life. Some of the things the doctor said were 'lifting weights causes tearing of the muscles which will cause hemorrhaging because of the Xarelto. I thought this was just microscopic tearing that takes place, and not anything that could lead to serious bleeding. He also said something about carrying too much muscle mass is also a bad idea for someone like me, I don’t really understand what he meant by this either. Is there any connection with muscle mass and increased risk of DVT or pulmonary embolism (without the use of anabolic drugs, which I have never used to be clear.) I am not a big guy by any stretch of the imagination, but nobody needs to ask if I lift. I look generally athletic.
Lifting is such a big part of my life, but of course I have a daughter who is far more important, so I really want to know where I stand and if this really is the end of my lifting days.
To your knowledge, and experience, is there any evidence that being on anticoagulants (rivaroxaban) for life and doing something basic like a 3 day program with sets of 10 reps (fairly light/moderate bodybuilding style training) would be detrimental to the health of someone, or even cause another PE or bleeding complications?
Thank you for your time, and any help or insight that you can give me. I’m not waiting for a green light to go lift again, but really just want to understand the risks and the mechanisms at work here so I can make an educated decision about my situation and what to do from here on out.