Hiking while on blood thinners

[gunner76]

I have been on blood thinners ( warfarin ) for about 7 years now ( developed a blood clot in lower leg while section hiking the AT ) and I still hike. Thinking about doing a thru hike of the AT in a year and wanted to know if any one else on blood thinners has thru hiked the AT ( or another long trail ) and how did you handle the testing.

Talked to my doctor about it and she suggested I do some research on the forum as she had no idea other than exploring the possible use of another type of blood thinner that does not require the same amount of testing to figure out required dosages.

[Dogwood]

I've at least 30K N. America trail miles on blood thinners for atrial fibrillation and a mechanical heart valve. However, I holistically achieve it through supplements and a few vitamins, and lifestyle choices. What I do is not inexpensive(supplements add up financially), is rather complex synergistically, and requires monitoring by a open minded non staunchly pro Western medicine integrated health care provider with knowledge of what I'm doing.


There were several important reasons not to go down the Coumadin path. One was monitoring. Now, after 13 successful yrs managing blood thinness this way, there is a portable PT/INR self monitoring device. Various foods and lifestyle choices affect PT/INR levels when on warfarin so consistency in trail diet is important. Some foods and herbs are frowned upon, or to be avoided when on warfarin, which are largely GREAT foods, which is yet another reason I didn't want to be placed on warfarin.

You are in a different situation. You have a leg blood clot. You should ask your physician if you could be switched to a different blood thinner script that doesn't need as much monitoring.

[Alligator]

Pradaxa may be an alternative for you as it does not require testing. I used it for a short period of time when I had afib so I don't know if it is approved for your condition.

[billreillyjr]

I was on aspirin as a blood thinner and twice developed severe nose bleeds due to exertion.be prepared for that.

[rocketsocks]

I was on aspirin as a blood thinner and twice developed severe nose bleeds due to exertion.be prepared for that.

same.......bring some vasiline and q-tips.

[gunner76]

I am also on a daily baby aspirin and that has not been a problem.

[rocketsocks]

I am also on a daily baby aspirin and that has not been a problem.

every nose is different I guess, blood pressure also plays a part I’m told, as always...see a real doctor.

[Venchka]

I am also on a daily baby aspirin and that has not been a problem.

every nose is different I guess, blood pressure also plays a part I’m told, as always...see a real doctor.

Ditto and Ditto!
For sure and for certain, a real doctor I am not.

Wayne

[BillyGr]

How often do they need to check that now?

Seems it might not be terribly hard to work in testing with other types of stopovers one would make during a hike. Perhaps an extra cost to get to wherever one could be done, but even that may not be as hard to find as you'd think - for instance here in a not terribly highly populated county of around 60,000 people the local hospital has a couple sites beside the hospital itself that can draw blood for tests, and that doesn't include any doctors not connected to that hospital that may have other options.

[OCDave]

...Talked to my doctor about it and she suggested I do some research ...

gunner76,

Clearly, with your 7 years experience with Warfarin, you know that the extra activity and change in diet that accompanies your hike will require more frequent INR monitoring than your normal schedule. Your research will also show you that the "New Oral Anti-Coagulant" drugs are roughly 100x more expensive than Warfarin.

Talk with you doctor about getting an INR Self-testing device. With a self testing device you could check you own INR weekly, avoid the need to leave the trail for a 5 minute lab test and avoid moving from a $5/month therapy to a $500/month therapy.

Good Luck

[OCDave]

Here is a link to some products that might work for you.

http://www.coaguchek-usa.com/coaguch...-products.html

[Coffee]

Here is a link to some products that might work for you.http://www.coaguchek-usa.com/coaguch...-products.html

I don't have this issue myself but a family member (non-hiker) has to have her INR tested weekly and it's hard for her to get around... she says that these kits are upward of $2,000? How much have others paid for self test kits for INR?

[Dogwood]

gunner76,

Clearly, with your 7 years experience with Warfarin, you know that the extra activity and change in diet that accompanies your hike will require more frequent INR monitoring than your normal schedule. Your research will also show you that the "New Oral Anti-Coagulant" drugs are roughly 100x more expensive than Warfarin.

Talk with you doctor about getting an INR Self-testing device. With a self testing device you could check you own INR weekly, avoid the need to leave the trail for a 5 minute lab test and avoid moving from a $5/month therapy to a $500/month therapy.

Good Luck

Here is a link to some products that might work for you.

http://www.coaguchek-usa.com/coaguch...-products.html

Two highly applicable posts.

If I was on Coumadin this is the PT/INR self monitoring device I'd be using both off and on trail. I've seen it used by other hikers twice and a few times off trail. It's similar in size to the self testing devices my Dad uses for Type II Diabetes.


Yet another reason why I chose to take the path I did when first starting Coumadin I was self employed. Getting the Coumadin dose right I was required to submit to $65-85 for each blood test analysis with blood tests every 3-4 days right in the middle of the working day. This added up financially where I was footing the entire bill when already managing the surgery and Post Op costs($$$$$). For two months this went on with arms black, blue, green, orange, and purple from just below the armpit down to almost the wrist. I was a pin cushion. Worse to me, the foods, vitamins, and supplements I had incorporated in my diet over 12 yrs with their many benefits had to be avoided... a triple or quadruple whammy. Things have gotten much better/easier, but, as OCDave says perhaps much more expensive, if needing a blood thinner or on Coumadin, especially if it doesn't involve a heart valve or atrial fibrillation.



Indeed, discuss this with a real doctor. The three health care providers I've all had advise me over the yrs about managing my blood this way are all M.D.'s specializing in Integrated Medicine with some experience in Asia and/or Europe. They were hard to find though that would be open and knowledgeable about such an alternative.

[Kaptainkriz]

I'm not famililiar with all the different drugs available, but one of my parents (70s) has been on Coumadin for years. One consideration with some of the other thinners is they are not easily reversible. If you suffer a laceration on the trail and/or need a surgical procedure because of a trail accident the complications are a little higher. Although the risk from changing food habits and body changes over time impacting INR may be the bigger risk. Best to have the conversation with your doctor.

[gunner76]

Rat poison ( warfarin ) is easily reversible:

To reverse the effects of warfarin, vitamin K1 can be given. Immediate reversal is achieved with a prothrombin complex concentrate (PCC) and fresh frozen plasma (FFP). Vitamin K1 is essential for sustaining the reversal achieved by PCC and FFP.

I know that this is an issue with some of the other thinners out there.

The Terminator ( my wife ) says she has given up her plans to try and poison me as she figures I have built up immunity . Told her I enough insurance on me to take care of her but not enough to make it worth her while....

Right now I get tested one a month unless there is an issue ( test results are too high or too low ). Fortunately I have good insurance so I do not have to pay for the testing.

I think I will ask my doctor about getting the test kit and doing the tests on the trail and calling or texting the results to the doctor.

[Dogwood]

Curious why 7 long yrs on Warfarin for a blood clot in the leg? Can't the clot be safely surgicaly removed and/or dissloved. What I was always told is there are blood thinners and blood clot buster pharmaceuticals with them both not always having the same action. I experienced a few small blood clots in the heart that had to be treated by I think Hesperin to dissolve them while also on Coumadin. This 9 day serious hospitalization had to be closely monitored It occurred because I don't take those supplements two wk's

[OCDave]

Curious why 7 long yrs on Warfarin for a blood clot in the leg?...s

I don't want to speak for OP but, for first unprovoked clot, therapy might be 3-6 months. Second unprovoked clot, elevated risk of stroke or other coagulation disorder; anti-coagulation for life is indicated.

[Analog_Kidd]

My dad has been on Coumadin for as long as I can remember. This year, at age 52, I got my first leg clot. It was superficial, but it got me worried that I inherited it from my dad. The doc wanted me On xarelto, but I didn't want to pay for it. $200 a month with insurance, yikes. So, I talked to the doc and he agreed that a daily aspirin would be ok for now.

We also talked about me wearing support socks, which I now do. I read that people who are sedentary (I am at my job) should wear them. My question is should I wear them when hiking? I've not been able to find any info on whether or not to wear them when active.

[wordstew]

Hey Buddy

I'll second that if you have had a history of DVT you should speak with your personal doc.

1. About the use of compression stockings.
2. Carry with you extra gauze (ABD pads) and wound packing incase you get a deep cut or have a nose bleed.
3. Instant ice pack to help slow/stop severe bruising from an injury and to help slow a bleeding wound or bleeding nose.
4. A communication system to contact help in case of emergency
5. If at all possible a hiking partner with some medical knowledge

Finally, with a little planning you could probably arrange in nearby towns along the trail a local visiting nurse to meet or you could stop by a local MD office or lab to get a blood draw or instant PT/INR test.

[gunner76]

Curious why 7 long yrs on Warfarin for a blood clot in the leg? Can't the clot be safely surgically removed and/or dissolved.

Blood clot dissolved with all the meds they gave me, besides the warfarin, I also did twice daily injections of Enoxaparin (Lovenox®) for 6 weeks. Stung a little and left some nice bruises at the injection sites. A person I worked with suffered same thing ( blood clot in leg ) and was hospitalized for a couple of weeks as he refused to to the injections himself .

I had genetic testing done and I have a gene that makes me more likely to have blood clots than the rest of the population. When I found out, I called up my parents and thanked them for my inheritance. .
I let my sisters know that they should be tested...one did and does not have the gene, the other sister does not want to get tested.

1. About the use of compression stockings.

Tried them but the rubbed my skin raw.

2. Carry with you extra gauze (ABD pads) and wound packing incase you get a deep cut or have a nose bleed.

Have never had a nose bleed but I do carry a small first aid kit ( have never used it )

3. Instant ice pack to help slow/stop severe bruising from an injury and to help slow a bleeding wound or bleeding nose.

Too much weight

4. A communication system to contact help in case of emergency

I keep a list of all my meds and dosages on my phone along with my doctors info/contact numbers

5. If at all possible a hiking partner with some medical knowledge

The one person who will hike with me is too slow ( and I am not that fast anymore ) plus I take off to go hiking on short notice depending on work schedule and weather. I have a fair amount of basic first aid training, CPR, military, Water Safety Instructor, Dive Master.

These days my hiking partner is my 18 month old Lab mix Sam. My youngest son use to hike with me before he moved. Said the only reason he went hiking with me was so he could tell mom where my body was

Testing can be a pain. My doctor has a testing device ( about the size of a computer mouse ) that only requires a finger prick for a drop of blood and one gets the results in under a minute. The local hospital does not have this device so you have to get a tube of blood drawn and wait a couple of days for the results. Crazy.