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I developed a deep vein thrombosis (DVT) in my right leg on Tuesday, January 6, 2009. This is the second DVT I've had in the past 6 months. For those of you that remember, my 2008 season was prematurely ended due to a DVT in July.

Around Friday, January 2, I started to notice a pain in my right calf. It felt like I had strained the calf, although I couldn't remember anytime when I could have injured it. I trained through the weekend, but, by Monday, the calf was sore enough that I had difficulty walking. Also, it was tremendously swollen. My calf was just as thick as my knee, and this swelling extended from my ankle to my knee.

Even though I had the blood clotting history, I still figured that this was a muscle strain, so I went into my chiropractor/sports medicine doctor on Tuesday. The chiro, aware of my DVT history. recommended that I get an ultrasound scan of the leg to check for clots. After a few hours in the ER, the diagnosis was in, blood clot in the right calf.

I developed this clot while on the Warfarin (generic for Coumadin) blood-thinning medication. This is not a good sign, as Warfarin is meant to prevent clotting. Now, I am on Lovenox shots, and I may have to take these shots for a long, long time.

You may notice that the title of this blogpost is somewhat awkward. That's because I am hoping to find other athletes, triathletes, cyclists, runners, etc. who've had DVT's. I've searched google, and I've found a few people talking about being an athlete with a DVT. I am interested in hearing from anyone out there who's an active person and who has had problems with blood clots. As the post below shows, I am a young, healthy dude. Anyone who has any ideas what may be causing this, feel free to leave a post in the comments section, or feel free to shoot me an email.

In regards to my training and racing, I am out of commision for the time being. I am going to have to scrap the Miami Half-Marathon at the end of the month, and I am ending my Maximum Strength Training Program 6 weeks early. I am doing some light biking, and I am heading back to Aquacrest pool to start floating around with the swim team there. Having put in a solid two and a half months of hard lifting on the Maximum Strength program, and having cycled for about 3 months on the powercranks (including a few 200 mile weeks), a few weeks of relative rest will probably only make me stronger, anyway.

82 comments

msacaris said... @ January 12, 2009 at 3:11 PM

Have you been to hematologist to get a complete work-up and find out what the hereditary abnormality is in your blood? I have been in the field of medical education in thrombosis for over 15 years. Actually involved in launching Lovenox in the U.S.back in 1993. Check out website for National Association for Thrombosis and Thrombophilia. Has some good information on there.

Bondi Swimmer said... @ February 23, 2009 at 5:42 AM

Last year I ran 2 marathons and an ultra, and I also do ok on the ocean swimming circuit (win my 25-29 age group, for e.g.).

Had a knee injury, which requires an op, so not been running for a months. Swam instead. Entering the ocean, I twisted my other leg and ended up with an avusion fracture 5th metatarsal.

Two days later, swelling a pain, diagnosed a further week later as a DVT. 3 veins, extending into pop, thankfully below knee.

On 3 months of Clexane injections - just gently hammering up and down the pool (not easy to change the habits of a lifetime). Really want to run though.

How do you find it, still cycling? Or can you not do much?

Really bad you got another one so soon after - dehydration play a part?

TommyB said... @ March 7, 2009 at 12:35 AM

I developed a DVT in November 2008 just before Thanksgiving. We are still trying to figure out why. Still on Coumadin and riding cautiously. Spin class is good as is swimming and Yoga according to me doctors. I do have a gene mutation that makes me more apt to clot, but the hematologists is not blaming it on this gene. I would love to know more about what you know

wannaberando said... @ March 17, 2009 at 6:11 PM

I'm a cyclist with a DVT. Got dysentery in India over the holidays which severely dehydrated me. Thought I was nursing myself back, but had an extraordanarily long flight home (52 hours with connections and missed flights). Soon, my right calf felt sore, like a pulled muscle. Couldn't go down steps but one-at-a-time.

Went to the doc for diahrea (from dysentery), and as an afterthought told him of my calf. Ultrasound found DVT. On Warfarin now (done with Lovenox!), but cycling away. Have a RoadID ankle bracelet when I ride alone.

I think the obvious link is the dehydration and depletion that long events (I'm a budding randonneur) can lead to. I'm a 52 year old male.

I also wonder--as I've seen sugegested elsewhere--whether our low resting heartrates lead to blood pooling?

By all means, any who have pains need to get checked IMMEDIATELY. Since I was diagnosed one aquaintance got a PE (now on Lovenox) and my wife's coworker (39 years old) died of a PE due to clotting AFTER she had seen her doc. She may have had heart arrhythmia, but we do know she had trouble walking two days before being found dead in her apartment.

frey maxim said... @ March 17, 2009 at 7:23 PM
This comment has been removed by the author.
Anonymous said... @ March 24, 2009 at 5:07 PM

I'm 48 and in good shape.Completed two olympic distance tris last season and several weeks later, after back-to-back races (10K and 5K) and a waterski spill, sprained my MCL. Flew NY to Vegas to visit relatives 3 weeks later and had calf pain on return to NY. Did not think DVT, but suspected (wrongly) muscle pull from overstretching (part of physical therapy routine for MCL). Pain went away. 4 weeks later, after a short plane ride, woke up with intense pain and swelling in left calf. Diagnosed with DVT (and Factor V Leiden) (fortunately no pulmonary embolism). Spent 4 days in hospital on Coumadin and Heparin. On Coumadin for 3 months. Now just on just low dose aspirin and plavix? My other numbers (blood pressure, cholesterol, LDL, HDL, etc.) all good. I do have a low resting heart rate. Clotting specialist in NYC thinks combination of reduced mobility from MCL sprain, dehydration, long plane ride and Factor V Leiden all came together to cause the clot. I am back to running (hoping to do a half marathon in May); swimming and biking (hoping to do an Olympic in June and a half ironman in October 2009). Minimal discomfort and minimal swelling thus far in training. When I'm at my desk, or otherwise not moving, I find a below the knee compression stocking very helpful. Hope to get back to 100%. Not pushing myself as much during this "recovery" year.

Anonymous said... @ April 11, 2009 at 4:18 PM

I have just been diagnosed with my second DVT. I have no genetic markers. The first occurred after a 10 hour flight which is understandable. The latest occurred after a 3 hour flight which is odd.
However, every year I train hard for a 2 day 170 mile bike ride. Both DVT's have occurred when I am probably at my fittest during the time that I am training. I have wondered if the fitness leads to an especially low at rest heart rate which causes the clots on these flights.
I am also fairly sure that there is a strong link to dehydration.I was not able to walk around on this latest 3 hour flight and did not bring my normal bottle of water.
It is amazing to read about how many of these DVT's are diagnosed as a result of calf pain( which occured on both of mine).--I am surprised that this symptom is not more commonly known

Neal said... @ May 1, 2009 at 10:56 AM

I have been diagnosed with DVT. It's my second go-round. I had my first clot back in '01. The first symptom this time was shortness of breath. Yes, I had devloped mulitple PE's that were effecting my breathing.

I was training 6 days a week for a long multi-day bicycle trip, and my fitness level (for me) was high.

I was 3 days in the hospital early in March on Heparin; now on coumadin. I'm unable to ride my bicycle because increasing cardio puts strain on my lungs and back-pressure on my heart. My heart then starts going into a elevated rate, and only slowing way down or stopping alleviates the pressure.

Believe me I'm bummed about not be able to ride. I'm told the the PE's will be reabsorbed in time. The question is, how long?

Keith said... @ June 12, 2009 at 11:53 AM

I'm a 50 year old crit racer. Cycle about 150 miles/week, lots of high intensity interval and hill workouts. Diagnosed with DVT last weekend. Was experiencing a sore calf for several weeks then it swelled and my wife dragged me to the ER. I had no long plane or car trips.
From my and my doctors research it appears to be a combination of tight leg muscles, dehydration, and low heart rate. Here is a link to one of the better descriptions that I have found - http://www.tristatevelo.com/node/87
This seems to be way more common in athletes than the ER doctor or my doctor thought.

Anonymous said... @ July 5, 2009 at 7:14 AM

Just diagnosed with DVT and PE. 6 july 09. Transatlantic flight 3 months prior. Misdiagnosed as cellulitiss (spelling?) 3 weeks after flight. Same as others intially I thought it was a strain on a thursday. By Monday was seriously hurting and all the veins in my foot were 'pumped' like a had a tourniquet on the leg. Off to doctor, who did not really listen. NO ULTRASOUND. I believe I would not have the PE if they scaned then.

Now on Clexane shots for 6 days and Warfarin for 6 months. (Heparene and Coumadin by another name)

Do not want to give up riding as it's the only thing that keeps me sane. Not an athlete, but dedicated rider (aprox 85 miles per week and building)

Told it would be 6 weeks till clots reapsorbed. Only in hospital over night.

Chris Menjou said... @ July 9, 2009 at 4:06 PM

Just got released saturday after four days in the hospital with multiple bilateral PEs. No evidence (yet) of a DVT, genetic bloods all coming back negative. I did two Half Ironmans last year and Ironman Arizona in November. Did a half ironman May 4, followed by a long car ride, symptom (shortness of breath) developed end of May. Maybe the source? Misdiagnosed for about 5 weeks until I ended in the ER with excruciating pain on breathing one week ago today. Didn't know how lucky I was until I started googling PEs.

I too am convinced that endurance athletes are at an increased risk of clotting without taking precautions (hydration, compression tights, etc).

On coumadin and worried that I'll not be able to ride my bike again. Hopefully I can come off the coumadin if nothing is found, but they say if I have another one its coumadin for life. I know a couple guys that ride on coumadin, so I guess it's just accpet the risks....

I can be reached at cjmenjou@gmail.com if anyone wants to contact. It's a bit overwhelming, how fast life can take a right turn......

swimmerdan said... @ September 25, 2009 at 9:58 PM

My 17-year-old son, who is very athletic (competitive swimming) and has an excellent lung capacity was just diagnosed with bi-lateral pulmonary embolism. I'm so afraid this may have de-railed his senior year of swimming. So far genetic blood tests have come back negative but we are still waiting for more results. There was no sign at all of a DVT. He woke suddenly in the early a.m. hours of 9/20/09 with a pain in his right front abdomen. Drs first thought it was his appendix so they removed that on 9/21/09. He still had the same pain after that surgery. They eventually did a chest xray and found the clots. I know he doesn't drink enough fluids for all the exercising he does, and reading this board made me wonder if this could possibly be a result of dehydration. He was otherwise healthy and this happened very suddenly. He did have some long car rides back in August, then started training really hard the end of August up until the day before he woke up with sudden sharp pain. He never had any shortness of breath during practices. So far his PE is a complete mystery. Does anyone know if he will be able to swim competitively with being on coumadin? Mainly concerned about the entry into the water. His hematologist is doing research on this for him. Thanks for reading his story.

Keith M said... @ September 28, 2009 at 11:10 AM

I am a 42 yr old cyclist that rides about 150mile/wk.
In Dec '05 I had a minor muscle tear in my right quad after a week of it not getting better my calf started to swell and I was diagnosed with a DVT and mulitple PE's. I have factor V leiden and factor II. I have been on coumadin ever since and up until 2 weeks ago was fine.
While on a 125mi ride I felt a pull in my right calf. It was sore after the ride but no big deal. The bus ride home was 2.5 hrs. I then rode another 125mi the next day with another 2.5hr bus ride home. My calf was sore all day. I went to the doctor a few days later had an ultra sound and found my DVT was back just not as bad as before, I still had some flow.
I had been in the PT/INR range the doctor wanted me to be in for the last year.
In my case it seems when I do damage to my muscles it leads to a DVT. Not sure if the connection is real, but it is my observation.

Keith M said... @ September 28, 2009 at 11:12 AM

Also I have seen more cyclist using compression socks to recover from an effort. I think I will start to use them more often and hopefully that will help recovery but more importantly help prevent DVT's.

Michael Williams said... @ October 8, 2009 at 4:21 PM

I developed a DVT in my right calf two years ago after a fight to Italy. Unfortunately, I was asymptomatic until I got searing pains in the chest and started coughing up blood. The DVT had started breaking up giving me embolisms in both lungs (potentially fatal). After six months on coumadin, I seemed to be alright. I began taking precautions: compression socks, moving around and (best of all) systematically acquiring miles for upgrades to business class. This summer I rode three time trials after almost a decade out of racing. I wasn't in top shape, having lost almost seven weeks to summer travel. But I still managed an age group silver at the State TT, so things were looking OK on the biking front. Then just over a week ago, I flew back Economy from Mexico City. All the usual precautions. But yesterday I woke up with a a pain in my calf. I suspected right away that it was another DVT and the ultrasound confirmed this. I'm thinking that either I will have to be permanently on thinners, or administer injections before flights. I know of other cases where a first DVT was followed by repeat episodes. Sorry Frey, but this just isn't a good thing to happen to anyone.

Renata said... @ October 19, 2009 at 8:45 AM

I am a 27 year old female triathlete just diagnosed with DVT (from above the knee to my heel). I'm glad it was caught in time!
I had had pains in my right calf for about 4 weeks and went to the doctor who told me I had torn the calf muscle. She made me go through blood tests and I am so grateful because they found the DVT there too (no wonder the pain medication was not helping!).
Now I have to wear a compression sock for the next 3 months, absolutely no exercise allowed until the 3 months are over. I also have to give myself shots every day and take anti-coagulation pills for the next 3 months too. I'm sad to not be able to train as I had just joined a local tri club, but I want to get this healed properly so it doesn't happen again.
I have no history of this happening in my family. I am perfectly healthy and was training 6 days a week. I hear that DVT can occur when a calf muscle is torn.
Have a good recovery!

Anonymous said... @ October 26, 2009 at 2:18 PM

Swimmerdan,
My 17 year old son is also a highly competitive swimmer. He was jut diagnosed with his 3rd DVT in 2 years. He has commented that he feels tired on the coumadin but continues to train and compete. He is looking forward to Jr. Nationals in December. I am thinking that the dehydration has a lot to do with it as well as his low resting heart rate. He is a carrier of Factor V Leiden but his Dr. is not convinced that is the sole cause of the recurrence. More tests will be run next week. Good luck to your son!

Mike said... @ November 8, 2009 at 9:47 AM

Add me to the list of athletes with a DVT. I was training for a marathon when a tore some cartilage in the knee requiring surgery. I was back running within 3 weeks. Then after a 4 hour flight, I felt a charley horse in my calf. That was 12 weeks ago. Still have swelling 100% of the time in my calf. I can do the eliptical for 30 minutes, but I can't run around the block.

Jonno said... @ November 24, 2009 at 12:20 PM

(December 2008) I had been for a run a couple of days before I felt a calf strain and "knew" that it wasnt a normal strain from running or biking ( I have competed at a good standard in triathlons and also rowed to National level - I am 44 now but have relatively low resting heart rate of 38, 6ft and 200lbs) ...went to my Dr and told her I thought I had a DVT, she looked at my leg and because there wasn't any extreme swelling told me she didn't think it was a DVT I asked for a second opinion and got a scan completed a couple of days later and was diagnosed with DVT in left calf (2 clots in fact) ....Clexane injections for 5 days then Warfarin for 6 months.
I continued training after a 6 week layoff and was running some good (for me) 10k times. After 6 months I had full Thrombofiliia screening and various exotic blood tests which all came back normal so I stopped the warfarin and continued on with life. Over the last 8 weeks (Oct/Nove 2009) I have had further 5 clots 3 superficial and 2 DVTs and am now back on Warfarin (probably longterm). I have re focussed and am aiming to do a half Marathion in March (Reading (UK) half).

What I have learnt through my experience....1) no one knows your body better than you and if you think you have a DVT get a scan ASAP. 2) Ask for a second opinion - its your life after all 3) Hydrate 4) dont sit still (either in the office or on flights or in cars 5) Wear properly fitted compression stockings (not pretty but effective)

Hope this helps. On the up side my kids are getting a more active Dad as when I am not training I am chasing them round with a rugby ball or taking them swimming.

Frey Maxim said... @ November 24, 2009 at 12:52 PM

Jonno,

That's a hell of a story... man. Good luck with the clotting and the training. It seems with people like you and me, who have a hypercoagulable state, that the more active you stay, the less likely you are to clot. As triathletes, that's great news. Train more, clot less. Works for me. Just don't sit.

Jonno said... @ November 24, 2009 at 2:47 PM

Thanks for your comments and support....I am seeing my consultant haematologist a week today and she is one of the leading lights (or so i am told) in haematology in the uk so I will put my athletic theory (low HR etc) to her and see what she says... Will report back with any interesting/useful comments.

All the best for your training

Mike said... @ November 24, 2009 at 8:37 PM

What are people finding to be the average length of time for the blood clot to dissolve? I am on week 13 and had an ultrasound yesterday with no improvement.

Marty Busekrus said... @ November 28, 2009 at 2:04 PM

Mike...I'm not really sure how long the process takes and I'm not convinced they ever fully go away. I had my 2nd DVT about a year ago in October 2008. There was a DVT and then several "clusters" of what I believe are superficial clots. I was 10 days laid up in the hospital, then released on coumadin for the rest of my life since it was my 2nd DVT. (First one was when I was in college about 12 years prior) About 10 days after I was discharged I did a sprint triathlon (hey I already had the entry fee paid, so why not right?). Needless to say, I took it very easy and no real pain. I slowly eased back into the running/cycling world, but those "clusters" seemed to swell up every once in a while and really sideline me. At first my doc and I suspected it was a muscle pull of the soleius muscle (not sure if that's how it's spelled). I massaged it, iced it, compressed it, elevated it, heated it, but nothing seemed to work. Just a little bit of time off made the pain and swelling go down. Then, this morning, the pain is back. A year after my dvt, I was 9 miles out on a 15 mile run (final long tpaer run before a marathon next weekend) and I was forced to walk back. Pain/inflamation in my lower calf. Not the same as the DVT pain we've all felt, but I'm 90% sure it's these darn superficial blood clot clusters. Immediately went to the doc with two possible explanations:
1) It was super cold here today in SE Florida. It was about 45 degrees when I started my run, so could the cold weather have decreased my circulation enough to inflame the clotted area?
2) I've switched recently from coumadin to warfarin and we're still trying to work out the proper INR, so could I have simply had too thick of blood and these clusters are inflamed?
He felt it was probably the warfarin adjustment.
My question to you all though is:
Has anyone else experienced these "clusters" of superficial clots? How do you get rid of them quickly? Extreme elevation? (hang upside down for a while)
Can these come and go over time and it's not that big of a deal?
Anyone's actual doctor been an avid endurance athlete and can relate to any of us or is everyone's GP like mine and never excersized a day in their life and can't relate at all?
If anyone wants to reply direct, I'm at Marty.Busekrus@gmail.com

Julie L said... @ January 14, 2010 at 4:45 AM

Hi. I too had a DVT in my calf, on Warfarin, 4 months later developed another one! Have you heard of 'Sticky Blood syndrome', otherwise known as Hughes syndrome?
Very interesting! Well worth looking up - lots of other symptoms. Makes sense in my case, but unable to get a diagnosis here in UK, as i cannot afford to pay & local GP's very sceptical about it all.

Gumper27 said... @ January 31, 2010 at 3:12 PM

My story is somewhat different from the posts here...my DVT was in my right shoulder area, under the collarbone. Spent 5 days in the hospital in early January getting the clot dissolved via a 48-hour catheter treatment. Now I'm on Coumadin and have started light triathlon training. Did a very light swim on Friday but experienced pain for the remainder of day, almost feels like a seperated shoulder, if anyone has ever dealt with that. Spinning is fine, but still not pushing it, and I'm doing 3 minute walk/2 minute SLOW jog a couple of times a week, along with core and leg workouts. Going to see the doc on Tuesday so hopefully we'll start to look at exactly what caused this thing...possibly an effort-induced thrombosis (Paget-Schretter Syndrome?) Still hoping to do 2 Half Irons this summer along with a Marathon in the fall.

Leigh said... @ April 19, 2010 at 5:12 PM

I want to thank you for posting this blog!

I'm a category 2, competitive cyclist of 15+ yrs. After a couple stents of calf pain, I finally started googling and found your site this past Wednesday. It prompted me to call my teammate (a vascular surgeon) and he said that although "it's probably nothing, I'll squeeze you in to get an ultrasound tomorrow". Luckily, I did, as I would have gone on to race back to back Pro 1/2 races over the weekend and drive 6+ hours on top of that. It could have ultimately been the death of me, as I found out I have two clots in my left calf.

I believe a number of factors were involved, one of which was arthroscopic surgery in Sept. After returning to the weight room in early Nov., I experienced a brief bit of soreness in my calf and backed off focusing on that exercise. The aches went away after a week or so and I continued to train. I put a huge amount of base/weight training in over the winter and began my normal, early season racing regimen. I was just getting into the heaviest intensity to plan a peak when it began again this past week.

The pain felt exactly as you described; sore, as if I had strained it or hit it with a blunt object of sorts, although not as much swelling as you'd described.

I've just finished a series of 6 Lovenox injections and I'm on Warfarin for 6-8 weeks while being monitored. My teammate stated I could readjust my training and continue to ride on my own, but no racing of course, due to risk of head injury.

So, I'm moving ahead and will hopefully get rid of the clots, while improving my functional power at lower HR zones. Can't do much more, I suppose, but move forward.

Again, I want to thank you for titling your blog as you did. I would very well have not taken advantage of that sharing and raced....

Any thoughts or feedback you'd like to share with me, feel free.


Yours Truly,

Leigh

Pam said... @ August 6, 2010 at 6:41 PM

Thanks so much for this blog! Have any other athletes had difficulty getting their INR levels to rise?
I was diagnosed with a DVT 3 weeks ago. I, too, assumed that my calf pain was due to a running injury but I finally went to my ortho who sent me for an ultrasound. I had no swelling, no redness, no history and am avid with running, cycling, swimming. Who would have guessed? However, I had recently been on a 7 hour car ride. The ultrasound showed that I have a Baker's cyst (asymtomatic) and DVT in the popliteal vein (below knee) The cyst was likely a contributing factor (pressing on the vein when I was in driving position). I have been on warfarin for 2 weeks and my INR will not rise (1.3 today). I am now injecting lovenox (no fun) and they bumped my Warfain up to 10ml for the weekend (I weigh less than 120 lbs). It makes me very uncomfortable to take such high doses.
I wonder if there is a relationship between low body fat, high exercise levels and dehydration (as some of you have alluded to) when it comes to INR levels. Any thoughts are appreciated.

Frey Maxim said... @ August 6, 2010 at 7:46 PM

Hey, thanks everyone who has posted comments recently. For those of you who have just recently been diagnosed with a DVT, I wish you the best of luck. It has been over a year since I have had a clot, and I am doing great. I have no symptoms or residual problems from the clotting, and I had clots pretty bad in my legs (One in the left leg stretching from lower leg to common femoral vein, and one in the right leg in the popliteal vein). I take Lovenox everyday, as I contracted my second clot while on coumadin. Pam, when I was on Coumadin, I was taking over 20mg... my Dr. told me that being an athlete, we metabolize the drug more quickly, just like we metabolize food more quickly. My best advice to anyone with a clot is to seek the best medical care you can. See multiple drs, primary care, hematologists, vein doctors, and get several opinions. Get as many opinions as you can.

Pam said... @ August 7, 2010 at 4:34 PM

Frey, I am glad to hear you are doing so well one (+) year later. Your comment about metabolizing the coumadin makes perfect sense. I am reassured (and have been educated) by that comment and by the other information shared here. Continued good luck!

gav said... @ August 28, 2010 at 6:32 PM

I got a DVT in 2006 when I was 29. It started right after a holiday with several long haul flights. I'm 6"3, slim and was relatively fit at the time. I later developed a minor PE which in turn led to multiple infections and some long damage. Warfarin for 1 year. Tested for everything at the time but no answers. It looked like it was all behind me. Did two marathons and a half IM last year. Then last week out of the blue my other leg started to stiffen and swell. Another DVT in the other leg and a confirmed PE - no flight involved this time. So more tests and probably warfarin for life. I've been training for a half ironman in two weeks and a marathon in october. Both ruled out now. The biggest thing for me is that only a couple of weeks ago I got my entry to my first full ironman in July 2011. On its own this was going to be a challenge. With a DVT will it even be possible? How long has it taken people to get back to training? Is endurance training a good or bad thing? Is there any correlation between low resting heart rate (56 dropping to below 50 as I train harder) and dvts? Doctors always play it same and thing sport is something optional and just dismiss it.

Mike said... @ August 29, 2010 at 8:42 AM

Gav,
There must be a connection between height, low resting pulse, and DVT. A year ago I was a sub-3 hour marathoner at 6'7". Then I got my blood clot which I still have. It took three hours before I could run around the block. I'm back running 40 miles a week and training for a marathon. But the clot is still there. I run with a compression sock. The calf swells like a football. But I've gotten to a point where I can live with it. The Ironman will obviously be a challenge.

gav said... @ August 31, 2010 at 12:10 PM

I'll raise this with the specialist when I see him again in a few weeks, though I'm sure he wont have an answer. Like others have said, doctors just rule out how important being able to train and compete and sport can be to someone. If I was an overweight couch potato this would be great.

Mike, you said you use compression stockings. The last time I had a dvt a doctor had me use them for a year after. This time he told the nurse not to provide them in the hospital and didn't mention wearing them when I left. Is there any reason why you shouldn't use them?

Has anyone used "skins" compression leggings? Are they actually tight enough to make a difference or is it just marketing BS. Compared to medical stockings they seem pretty loose.

Frey Maxim said... @ August 31, 2010 at 4:07 PM

Hey Gav... If your doctor isn't giving proper attention to your questions/concerns about endurance sport, you should go find a new doctor. I have seen specialists from Upenn, Mayo Clinic, several local hospitals, cleveland clinic, johns hopkins. There's good and bad doctors everywhere, so keep looking until you find someone you like. I saw a cardiologist at JHU who was a triathlete himself. He said for me, there is no problem with endurance training even given my history of clotting. And personally, it's been about 18 months since my last clot, and I am training now more than ever (just rode 300 miles total last week). Finally, if your doctor has prescribed compression stockings, wear them. Get the medical grade, atleast 30mm HG. The zoot-style ones are crap, in my opinion, just a marketing gimmick, and definitely not suitable for medical use.

Mike said... @ September 4, 2010 at 9:06 AM

Gav,

I agree with Frey. The compression socks for runners are of little value. They don't have enough compression. Obviously talk to your doctor. I wear the knee high compression socks about 12 hours a day every day.

JohnH said... @ September 4, 2010 at 11:42 PM

Hi Everyone,

Thanks to Frey for starting this blog, and to everyone who has commented. It is very reassuring to hear people's stories.

I was diagnosed with multiple DVTs just yesterday.I am now on the clexane, warfarin, tests, treadmill now. After reading the posts, maybe I have had DVT for quite a while and have not noticed it, although I did break my pelvis just 4 weeks ago in a cycling accident so I may be a straightforward immobility case.I have been a road racer for almost 20 years doing about 10-15 hours riding a week. I have often wondered about low heart rates and clotting because you do hear those stories of pros dying in their sleep (although, this may be due to other drug issues!)

One issue mentioned in posts that really resonates for me is hydration.I have always cramped really badly in this calf. I have tried everything over the years and read a great deal and nothing seems to consistently work. Some days I cramp on short training rides, some days I can do 5 hours epics with no problems at all.

Anyway, just saying hello. I will post again if my epxeriences turn up anything that might be of interest. It is great to hear that others have endured clotting and continued to ride, but from what I gather DVT not be as easy to deal with as the doctor said.

Cheers,
John

mrconservative said... @ September 7, 2010 at 6:44 PM

Very relieved to have read everyone's comments within this "blog" so thank you for easing my anxiety.
I'm 35 and in great health. Cycling about 150-250 miles per week. About 3 years ago, before I started training for triathlon and cycling, I had my first DVT in my calf after traveling from Vegas to Chicago after a bacehlor party. Very dehydrated and didn't move from my seat the entire flight. So that DVT made sense.

Then in March of this year, out of nowhere a second DVT was found in my leg. I knew it the moment I felt it and the ultrasound confirmed it. Went on Warafin immediately and the clot was gone within 2 weeks. Went off the Warafin. Then about 3 weeks ago, I had a pain under my right lung. Hard to breath unless I was laying on my left side and I had pain in my abdomin. Went to the ER and 2 CT scans came up negative and they still don't know what caused the pain. Pain went away within 48 hours (anyone else experience this?). Then the next day my leg started to bother me. I thought it was a tight aductor muscle. Turns out it was a DVT. Superficial Thombrosis. The doctor isn't convinced that my trip to the ER is related to my current DVT.

I'm back on Warafin and most likely for life. My blood work shows no good reason as to why I've had these 2 clots within the last 6 months. I'm becoming obsessed with what's wrong with me but no body seems to have any answers. I will continue to ride as if nothing is wrong with me. I'm also going to try and figure out the cause of my clotting. As I get tested and meet with specialists I will try and return to this blog to provide any information that may be beneficial.

JohnH said... @ September 8, 2010 at 12:35 AM

Has anyone ever had side effects from the Warfarin? I have been reading about so-called purple toes, anyone experienced it?I have only been on warfarin and clexane for 5 days and it has been very effective. My gastroc is discernible again after being subsumed in a swollen mass for most of last week.I am walking much better and the tenderness in the calf has almost gone. Can DVTs be cleared up so soon? My INR is only 1.4 and I am only taking 9mg of warfarin.But while the calf is much less swollen my foot is still quite fat.What are your thoughts about exercising with a swollen foot. Is it bad for clotting? My doctors said it is pointless to wear the stockings until the swelling subsides.

Cheers,
John

JohnH said... @ September 23, 2010 at 5:54 PM

Hi All,

The results of a new study into the effectiveness of stockings were published in the paper today. I thought you might be interested.

http://www.smh.com.au/lifestyle/wellbeing/stockings-fail-to-stop-blood-clots-20100923-15ovs.html

Cheers,
John

Frey Maxim said... @ September 23, 2010 at 9:12 PM

Hey John, thanks for the heads up. Reading this makes me realize that me hematologist never told me to wear compression stockings because they prevent clots. He told me to wear them to prevent post-thrombotic syndrome AFTER I had gotten clots. However, the idea that the stockings prevent clots was always in my head, but I don't know where it came from.

Tina Portman said... @ September 24, 2010 at 2:42 PM

Hi All,

I'm just recovering from a femoral vein DVT (3rd one--but the last was 18 years ago and was precipitated by hormones in the pill). I'm 43, heterozygous for Factor V Leiden, Protein S deficient.

Like many of you, I was in great shape after a season of triathlon training. My clot developed on my rest day after a 45 mile bike ride/short run the day before. Looks like I'll be on some kind of anti-coagulation therapy for life.

Symptoms: Gradual "tightening" and ache in my lower hamstrings that I attributed to a muscle pull. But, the pain was diffuse and I found it hard to identify exactly where the problem was. Then I got slight swelling behind the knee and pain on bending. I noticed my one leg getting tired at the end of 800 meter repeats. 3 days of ice, elevation, stretching led to no improvement. My leg was slightly redder than the other when I stood for a while. But, my visible calf veins drained when I elevated my leg. I've had 3 femoral DVTs and never had any swelling of the thigh or calf.

I'm curious. If you don't mind, I have four questions for my fellow DVTers:

(1) Were any of you using "The Stick" or a foam roller as a muscle therapy tool?

(2) Ladies, were any of you eating a lot of soy protein products?

(3) Do any of you on long-term warfarin do home INR monitoring?

(4) For those of you who developed new clots while still on warfarin, do you know what your INR was when the clots formed?

Please email me at tina.portman@gmail.com.
Thanks,
Tina

JohnH said... @ October 5, 2010 at 8:40 PM

Hi All,

I had a follow-up ultra-sound after my initial diagnosis five weeks ago. There has been a massive improvement (my perineal is now clot-free) but I still have a clot in my gastroc. I am on 5mg warfarin and my INR is stable at 2.3. I was planning on getting back on the bike next week. I feel fine. My question is, should you start riding again with a clot?I have restricted myself to walking these last few weeks with no swelling or soreness.Obviously, if I did get swelling or soreness I would stop riding, but as a general rule: is it OK train if you have a clot? Anyone had any experience training with clots?I

Thanks
John

Mike said... @ October 31, 2010 at 7:13 PM

John H,

Everyone on this board is a highly motivated person. We've all run marathons, triathlons. We're all used to pushing our bodies to the extreme.

DVT's are a very serious condition. You need to make sure you're listening to a doctor, not us who have shown to push our bodies to extreme.

It I am on my 14th month living with a blood clot. It swells up every time I run. But two weeks ago I completed a half marathon. So yes, you can train. But my clot has hardened. It is extremely unlikely to break lose and go to the lungs.

You're only at 5 weeks. I doubt the medical world has a clue on how soon you can start training. Do yourself and your family a favor and listen to your body. I'm slower than I was before the clot, but I am getting back to where I was. You won't notice the difference 6 months from now if you wait a little longer to get back on the bike.

JohnH said... @ November 21, 2010 at 7:07 PM

Hi Everyone,

Just keeping you posted about my situation in case you find any part of my story illuminating.Thanks for the last comment Mike, I took your advice and have not been on the bike now for 16 weeks.

I have been a serious roadie for almost 20 years doing about 300ks a week. I broke my pelvis in a bike crash in early August.On September 9 I was diagnosed with three DVTs: in my peroneal vein, gastroc and soleus.I was put on clexane shots until my INR was in range. I stabilised pretty quickly in the low 2s and was on 5mg initially then 6mg a day. After a month I had another ultrasound and this showed a massive improvement -two of the clots were gone and only the gastroc clot remained but it had dissolved considerably down to 44mm.

Last week (just over two months after initial DVT diagnosis) I had another scan and was told I am now DVT free.I saw my doctor this morning. He called a hematologist while I was in the surgery and was told I could come off the warfarin right away.So, it would seem that I had my last warfarin dose this morning.

From what I have read on this blog and other DVT sites, I have been one of the lucky ones. Time will tell I guess.Still at the back of my mind is the question of why did I get a DVT post-fracture when so many other people, much more immobile than me do not get them. My doctor did not suggest a complete blood work out.

Three things about my recovery might be of interest: I was meticulous about my medication. I took exactly what I was supposed to take at roughly the same time (within an hour) everyday.Second,I was strict about my diet. I was careful to avoid leafy greens, brocolli and beetroot, and in the entire ten weeks I had only 4 light beers!This was tough because my team made the rugby league Grand Final (Australian equivalent of the Super Bowl). Lastly,I went for an hour walk every day - avoiding too much exertion. I have put on about 4 kilos since I stopped riding.

Anyway, thanks again to Frey for starting this blog. It was very helpful to me. All the best to you all.

John

Frey Maxim said... @ November 21, 2010 at 8:52 PM

John, congrats on your progress! Thanks for keeping us posted on your recovery. I look forward to hearing more good news.

Jeff A said... @ November 10, 2011 at 10:42 PM

I also am an endurance athlete. 45years old, low resting heart rate, and experienced many pulled or strained calf muscles over the last 3 years that led me to believe I was having circulatory issues. I then had pain in my leg that lasted 3 weeks and I knew was not a strain and suspected a blood clot. I started having pain in my back and sharp pain in my lung after a tough bike ride. I went to the Doc and 2 DVT's in my leg and a PE. No genetic condition, but do have vericose veins. Hydration could easily be a factor for me. Does anyone get numb feet while riding on the saddle for more than an hour? Clearly the blood is restricted and wonder if that had anything to do with the clot. The PE was after the ride. My mother currently is struggling through her second DVT. I may not have a positive for the genetic tests, but it does run in the family.
Jeff

Jeff A said... @ November 10, 2011 at 10:47 PM

I recently had a DVT and PE during training for an endurance event. 45 years old, 49 resting heart rate, vericose veins, 6'2" 185#, good shape, no genetic tests were indicated. I think hydration definitely could be a contributor for me. I also find that my feet go numb on long rides so clearly am restricting blood flow. Anyone else have this issue? I am on warfarin for now. My mother also has had 2 DVT's so I may not test positive, but it runs in the family.

Garrick said... @ January 25, 2012 at 10:22 PM

Add me (male, age 40) to the list of cyclists with a DVT... I raced from 1989-2002 (mostly Cat. 3) and still try to get in at least 2500 fast road miles during the warmer months in Denver. Following a weightlifting workout, my left calf was sore consistent with a slight muscle strain or delayed post-workout soreness. The soreness remained for over 3 weeks (totally abnormal for me) until yesterday, when I noticed the calf was a bit swollen and this morning, the swelling made it difficult to flex my ankle.

I was scheduled to fly to Las Vegas but, thankfully, ditched that plan. My PCP squeezed me in just before noon, and she sent me to the hospital for a Doppler ultrasound. Sure enough, I had a clot from my knee down to my ankle. I'm starting Enoxaparin (self-administered injection, small needle so it's not bad) and Warfarin (pills) tonight. No other meds... Sounds like the approach is basically to prevent the clot from growing and give my body a chance to re-absorb it. It'll be a few days on my back with my leg elevated as much as possible.

Still no idea why I got a DVT, other than perhaps dehydration coupled with a minor muscle tear?

AK said... @ January 26, 2012 at 6:59 AM

Hi folks, adding myself to your list. South African, age 46, good health (blood pressure fine, low-ish heart rate etc) and recreational triathlete (4-6 hours of training/week). Multiple DVTs in lower right leg March 2011, led to 6 months warfarin therapy. Full blood screen showed no inherent genetic risk factors. Multiple bilateral PEs diagnosed & treated last week (Jan 2012) with Clexane (low mol wt Heparin). Did look for DVTs (although history was noted). Restarted warfarin - this time "for life". Returned to hospital today after right leg swelled up. Doppler found multiple lower right leg DVTs again - still unsure whether these are new (since last week) or remnant of what caused the PEs.

Mike Baker said... @ January 26, 2012 at 2:00 PM

AK and Garrick,
It's disheartening that more and more athletes are affected by DVT's without any warning or pre-conditions. And while the internet is filled with multiple solutions, the most important is to listen to your doctor. Stay on your medications. I'm now at 2+ years living with my DVT in my entire leg. The doctors tell me it will never dissolve. It swells up every day. But last year I qualified for the Boston Marathon and I will be at the starting line in 11 weeks. I wear my compression sock as a badge of honor!! Good luck on your road to recovery.

Jeff A said... @ January 26, 2012 at 10:03 PM

I posted a few months ago following a DVT and PE. Been on warfarin. After more research I believe I have struggled with chronic exertional comparmental syndrome which led to numerous lower leg muscle strains that I have learned to manage over the last 5 years. I checked out with no genetic issues and belive the DVT was caused by repeated small muscle tears during training runs. I waited too long to do much and had the PE. My sis in-law is an internal medicine doc with a specialty in anti-coagulation. The med profession does not typically see endurance athletes. Following my PE I asked when I could run again. She said she had never been asked that question before. Most are sedintary overweight people with multiple diseases related to their lifestyle. They don't know what to do with endurance athletes. Glad to still be alive.

Currently on warfarin 10mg/day. Could get off, but am waiting on a study for unrelated concerns for a PFO(hole in heart). 25% of the population has a PFO and can be cause for higher risk for stroke which I believe I had in 2000.

Garrick said... @ February 26, 2012 at 5:23 PM

Following up one month post-diagnosis... I needed 11 days on Lovenox before my INR got up to 2... Now (hopefully) stabilized on my Warfarin dosage (10 mg 5 days/week, 8 mg the other 2). The bad swelling and muscle soreness abated quickly, now I get swelling periodically from standing for too long without moving around. However, overall my symptoms are much milder than I expected them to be.

I've had good luck with exercise so far. Went skiing last weekend, and the main caveat there is to take breaks and loosen your boot on each lift ride. By the end of the first day, I had pretty bad swelling above the cuff of the boot, and where the boot was squeezing my calf, my veins were bulging pretty dramatically! That abated in a couple of hours.

The big question, as others have had, is when to resume strenuous exercise. As a cyclist, I'm extremely anxious about losing fitness. For now, I'm focusing on trying to rebuild a very basic level of cardiovascular fitness. Having said that, I just got back from a 16-mile bike ride on a cold, windy day. My average heart rate for the hour-long ride was 150 BPM, and while the speed was low by my standards, I felt great and feel like the cobwebs have been blown out of my head!

The clot's still there, and I know there's a long way to go. However, my fears that I'd be basically bedridden for 6 months are not coming true!

Garrick said... @ February 26, 2012 at 5:36 PM

Oops, knew I left some stuff out... My bloodwork came back clean, no clotting factor issues, so it's an idiopathic DVT. I'm quite sure a slight muscle tear lifting weights, copious business travel, long inspection days where I just plain forget to stay hydrated, and a low resting heart rate were factors in The Perfect Storm.

I also looked back at the cautionary comments, and fully expect I'll get chided for getting back on the bike. First, I got a RoadID bracelet before doing anything (the last line reads "ON WARFARIN FOR DVT '12"). Second, my first several workouts were heart-rate limited (I always have a HR monitor) to 120 BPM. While symptoms have been manageable, I've gradually upped my HR ceiling to 150 (although biking in the hills, you have to do what it takes to get over!). Finally, I'm treating the entire patient. If I can't move, especially on two wheels, I'll go completely insane.

Thanks for giving us a place to compare notes, Frey! As Lance (I think) said, there are good days and there are great days. Best wishes to all in conquering what really seems to be the insidious monster of DVT!

akm said... @ March 12, 2012 at 11:48 AM

Thanks so much Frey for starting this invaluable dialogue and to all for their postings. I am a 58 year old UK runner and cyclist. I was diagnosed with an acute DVT of the femoral and popliteal veins on March 1st following a swelling of the left knee and calf (which was 6 cms bigger than the right.) I had run a slow (av. heart rate 135 BPM) 6km on Feb 29th and noticed that my heart rate maxed at 197 bpm at 3.5 kms coincident with a pain in my left calf. I followed the run with a short high intensity (3 * 20 secs max VO2) session. I had previously had pains in the calf on runs but never cycling over the last two years. I started wearing the heart rate monitor at Christmas and now see that the calf pain and maxing of heart rate at +190 on runs seems to coincide. My doctor (only 3 weeks ago) said that these max heart rate peaks were a sign of my "high fitness" level, but I now think they could be indicators of clotting. I also have a 3cm popliteal fossa bakers cycst behind the left knee which I suspect may be compromising the flow through the popliteal vein. The hospital thinks this unlikely. Very early days, I'm on tinzaparin jabs and 10mg warfarin, my INR hasn't yet reached 2 (hopefully will today). Other than for some reason all the deep vein vein valves in my left leg were previously diagnosed as "blown" with resultant swollen superficial varicose veins in the left leg, I had no previous firm diagnosis of DVT - this included 4 MRIs and ultrasounds at Mass General Hospital in Boston after a post transatlantic flight numbing of my left lower leg back in 2003. The UK hospital says I am quite unlike their other patients -my long haul (always business class) days are well over and I am physically active. Frey's site does indicate that there is far more to this DVT thing than what the medics have previously concluded.

Manish Kumar said... @ July 22, 2012 at 7:23 AM

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Garrick said... @ July 30, 2012 at 11:36 PM

I'm back... Reference my post from January 25, 2012 for the start of my story. Had my 6-month followup ultrasound, and... Deep breath, now... No trace of a clot remains, and I'm going cold-turkey off of the Warfarin. Whew. The leg is still a little heavy at times (ultrasound confirmed a bit of reflux in the vein), and a compression sock will be useful for days spent sitting at the computer, but with any luck I won't go through this chapter of my life again.

I managed to stay active throughout my treatment, and in fact have ridden over 2,300 miles since starting Warfarin. Exercise always made me feel better, and I even got in some climbing (including Vail Pass). Look me up on Strava or Garmin Connect.

Now for the next chapter: The ultrasound picked up a Baker's Cyst in the same leg. Even before that diagnosis, I could feel a "knot" behind my knee that I figured was an after-effect of the clot. I don't remember feeling that sensation pre-DVT, so perhaps it indeed formed just recently and was not a causative factor in the DVT's forming.

So, is the story indeed over? We'll see, but for now I'm glad the clot is gone.

rory graham said... @ August 16, 2012 at 10:44 AM


Thanks Frey for opportunity to share with this 'catch-22' affliction that seems to affect so many people of all ages, all levels of fitness, all types of lifestyle.

I hope you will be patient with this longish comment, as in my research I seem to be getting inconsistent health benefits from long-term use of Coumadin (Warfarin) for one-off diagnosed DVT, unless ofcourse it is essential due to health condition and cannot be avoided. But there are contradictory viewpoints.

I myself was diagnosed with DVT left calf. first time.
I do martial arts, running and cycle around 200 km a week, and I too thought it was just a muscle strain as i had same pain in right calf before, but had lasted few days and went away with massage and some anti-inflammatories.
This time was more painful so went to doc to see if muscle-tear and straight up DVT was suspected, pending scan, got doppler-ultrasound, and DVT was diagnosed so went on thrombolytic treatment -Coumadin/clexane - then just Coumadin now.
Was the radiologist correct? don't know. too late now.

Have ceased exercise, to let current diagnosed thrombus heal
(bit of a strange situation, as Coumadin actually retards greatly the rate at which healing can occur! - thus my 'catch-22' earlier statement - and can cause another clot from occuring, bit of a snakes & ladders game!).
Waiting on upcoming scan, then perhaps off coumadin.

You'd think with our society's
21st century level of sciences we'd be able to have some less imposing and more therapeutic medication and/or treatment, then
this uncertain see-saw method.

If you develop or have existing health issues, coumadin seems to start a roller coaster set of aflictions, if something else occurs.
I guess I am rather conservative when it comes to medications and doctors, the less the better.

I too have difficulty understanding why a fit relatively young athlete, would get a DVT from an innocuous set of circumstances, and for example, let's say a 58yo taxi-driver/truck
driver/courier or other sedentary jobs where all the high-risk factors for DVT exist, these people have never had one?
Or maybe they do but we are not aware of it.

DVT seems to be random, but I guess there must be several combining factors that cause a DVT, or that lead to a diagnosis of a DVT, but also there appears to be an area of possibly misdiagnosis. cellulitis?, cyst?, lymphatic obstruction?, achilles tendon tear, CRPS?, tumor?, thrombophlebitis?.

We take for granted what a doc or a radiologist says, we don't question, we don't get second opinions, we don't have the time to research.
One cannot rule out medical malpractice in all areas of medicine. They endeavour to be accurate/objective but they do suffer from the 'one-size fits all' mentality which exists within our health-systems, and fatal errors therein.
Most of the time they get it right thank god, but this doesn't mean we don't keep on our toes, and use our insight and intelligence to scrutinize, question and seek answers to situations that provoke doubt and that which don't make sense.

rory graham said... @ August 16, 2012 at 10:59 AM

spent 1 hour trying to put together my thesis on the misdiagnosis of 'apparent' DVT. comment wiped away when signed into google. way to go google.

have first dvt left calf, runner,200 km a week, martial arts, cycling, coumadin/clexane started, continued on coumadin, awaiting scan to get off coumadin. bad stuff. too many contradictory views, health benefits diminish, as length of treatment with this drug continue.
Catch-22 situation, you are forced to take it, to stop apparent thrombus, yet it takes triple the time for the thrombus to heal, meanwhile you can develop other complications for the therapeutic treatment you are receiving, exercise ok? some say no, just walk, some dont care. Multi-billions of tax-payer dollars poured into our health-systems.

this is the best we have in the
21st century of sciences.

Frey said... @ August 16, 2012 at 9:25 PM

Hey buddy, thanks for sharing your experience. I just wanted to let you know that both comments got published, so don't stress about thinking the first "thesis" got deleted. Keep us updated on your situation, and good luck!

chicsnowbdr said... @ April 23, 2013 at 2:07 AM

I'm a cat 1 female, 37 year old racer and just got my first clot in my posterior tibial vein. I actually diagnosed it myself last weekend. I've been training hard over the winter. I actually have been feeling the strongest on a bike than I've ever felt before and this is my 9th year racing, I believe. I've had numerous injuries, such as Acl reconstructions and when I felt this calf pain last weekend I just knew it was a clot. It didnt feel like a sports injury and its extremely rare that I get leg cramps. I think mine may also be attributed to the birth control pill, Lo Loestrin. Also, there were several times during the winter I would travel about 4 hours to snowboard. When this occurred, I was training very hard, while being coached. I felt great, but tired. Legs started to feel strange...and then this happened. I'm currently on Lovenox injections twice a day and Warfarin. So far, my levels are only 1.3. It has only been a little over a week. I have also been riding my bike on the indoor trainer this week. I have only had some slight swelling and pain. But seems to be getting better. Have another ultrasound tomorrow. Hoping to be able to race this weekend, but it's not looking good.

Non-sedentary said... @ May 20, 2013 at 11:06 PM

I am 40 y.o. active and otherwise healthy female who developed a DVT after cycling last month. No known hereditary risk factors. Now on coumadin, not cycling, just started walking/jogging.

http://dvtaftercycling.blogspot.com/

Non-sedentary said... @ June 10, 2013 at 5:23 AM

Anyone on Xarelto? I am curious about the drug. It is a promising drug especially for athletes. Essenatially...quick on, quick off, few drug/food interactions. Recently Approved for the treatment of DVTs and PEs in the US. No antidote, but shorter half-life than warfarin. For me, headaches was an issue which I did not find on the side effect profile of the medication. Headache + anticoagulation was not a good combo for me, so I got off xarelto. Any personal experience?

Unknown said... @ August 21, 2013 at 7:08 PM

The frightening thing to me after reading this thread is that nobody is really talking much about their return to training.

I was diagnosed with a DVT 2 months ago, and put on Xarelto. Latest ultrasound showed no reduction in clot size. Hematologist is saying that I'm now at risk for PTS and its a possibility that the clost may not ever dissipate and my running/cycling career may be over due to vein damage and persistent swelling. I have been swimming with no problems so far.

Does anyone have experience with navigating running and cycling with persistent old clots?

Unknown said... @ September 3, 2013 at 9:08 PM

I have almost the exact same story as the "unknown" above.. I was diagnosed with a DVT in July in my popliteal vein extending into my calf.. Total occlusion. I was I. Th hospital on heparin for 4 days and then sent home on Xarelto. Saw my doctor at 2 weeks, 1 month, and 2 months when she ordered another ultrasound to find there was no change whatsoever. I was also told Im now at risk for PTS and my running career is likely over. A big pill to swallow at 30!

After some research I got a consultation with an interventional radiologist who said I may already have vein damage but might get some long term benefit from an intervention. So, last week I went through a 24-hour lysis procedure using the EKOS ultrasound catheter. The radiologist (and the research I found a little too late) state that this is the best chance for having a good outcome if you are active. Ideally this is done within the first 2 weeks; however no doctor even listed this as a possibility until I asked.

I did my first run/walk today.. 1 minute on, 1 off, for 2 miles. No pain but definitely leg fatigue and swelling. Imjopethis is the beginning of recovery. I will post ask progress.

alde3620 said... @ February 27, 2014 at 7:18 PM

Does anyone have recommendations for a brand/type of compression stockings to wear during exercise? I am a cyclist who has post-thrombotic syndrome after developing a large clot in my left iliofemoral vein. There are several companies making compression hose from different materials. Any suggestions as to which brand/type to buy in the 30-40 mmHg strength that are comfortable/tolerable during prolonged exercise?

Mike Baker said... @ February 28, 2014 at 2:20 PM

After trying several brands, I've settled on the Zensah sleeve. The right amountof compression, the durability is good. I've had a DVT in one leg for about three years now. I like the sleeve better than the sock because I only wear it on the bad leg.

Garrick said... @ March 26, 2014 at 11:11 PM

Back again... I see the traffic is decreasing, but still there, so I'll add more data. As you can see above, I had a DVT in my left calf in 1/2012, rode extensively while on Warfarin, and got a clean ultrasound (and discontinued Warfarin) exactly six months on the drug.

About a year after the DVT, I noticed increased symptoms of post-thrombotic syndrome anytime I wasn't exercising and began searing Sigvaris compression sleeves when not on the bike. Those have worked wonderfully, and I highly recommend them once your doctor says you can wear compression socks (I was told flat-out that compression stockings are NOT indicated for acute DVT).

Fast-forward to October 2013. By now, I have gotten back into bicycle racing after an 11-year hiatus, joined a team, and am having a blast. I did a cyclocross on a whim with no 'cross-specific training, and afterwards - uh oh - my right calf was sore as hell. I rested and elevated the leg, but the soreness remained. The ominous part was when I developed discomfort breathing, as though I had a softball under my lower right rib cage.

Off to the ER I went, and after ultrasound confirmed a "small" clot behind my right knee, a CT scan with contrast dye found multiple clots in my lungs, including some big ones. Yep, the fact that I'm typing this means that I'm a Pulmonary Embolism survivor. 3 days in the hospital on Heparin, and the inflammation of my chest lining due to the infarction was the worst pain I've ever felt. I was maxed out on Oxycodone and still needed oxygen because I could barely inhale.

So, once more with the Lovenox, then the Warfarin... and I will be on Warfarin for life now. I saw a hematologist, and based on my history he agrees my clots were provoked, but the specific provocation (pulling a muscle while exercising) was not at all normal. For me, the risk of recurrence was much greater than the risk of being on Warfarin.

Now, as before, I found that riding made me feel better, and I believe it helped my lung function rebound faster. I coughed up blood for about 2 months, but my lungs now feel normal (except that I get a slight "heavy" sensation where the initial pain was if I get really dehydrated). I've been riding more than I have in 10 years, almost 1400 miles this year so far, and did quite well in a criterium with 100 riders (in Boulder, no less).

In essence, I'm living my life as if nothing ever happened, except that I take Warfarin every day and I don't binge on broccoli and spinach (although I DO eat salads regularly). Is it risky? Sure, but risks can be understood and managed. Before, I only ever rode by myself. Now, I ride with a team and with other racers who know me and my history. If I should wreck, they know (or can read my RoadID bracelet and figure out) that I may need help, and fast. However, I continue to believe that exercise - even the strenuous variety - is only beneficial and improves my long-term outlook.

Mike Baker said... @ March 27, 2014 at 2:57 PM

Garrick, you made several interesting comments. The first was "but the specific provocation (pulling a muscle while exercising) was not at all normal". I assume "normal" meant long flight, surgery, etc. Looking at your original post, it looks like a muscle strain triggered the first blood clot. The second thing that I found interesting was that the original clot was dissolved. Lastly, I found it interesting the the current blood clot was in the other calf. I wonder how often it occurs in same leg. Keep hanging in there!

Unknown said... @ March 27, 2014 at 4:34 PM

I am circling back to post an update on my clotting condition. I originally posted in 2007 when I experienced my first of three clots in my legs. I went to a specialist who couldn't explain why I was clotting so I went to another specialist. He unfortunately said the same thing. Long story short but I finally met a specialist who discovered that I have a rare MTHFR gene mutation (best to Google MTHFR gene mutation or talk to a specialist to learn more rather than me explain it). The treatment is simple. I take Foblee once a day which is a small pill containing vitamin B6, B12 and folic acid. I have been taking that for close to 3 years and I've been clot free. I know this isn't the solution for all but wanted to pass along the information.

Leigh said... @ March 27, 2014 at 10:23 PM

I would highly suggest looking up external iliac vein or arterial compression/blockage. I'm going through similar issues that you've had and am getting an MRI and a venograph of my pelvis soon. It's becoming more prevalent in cyclists like us due to bending over the bars for extended periods of time.

Keith G said... @ May 26, 2014 at 8:22 AM

I am 60 years old, male. I have been a regular runner for 25 years. I live in the UK.

In January 2013 while running a 10 mile road race, I found myself fatiguing and slowing down atypically. In subsequent races I experienced the same problem. I had no swelling or discomfort in my legs. In June 2013, I had pain in my chest which proved to be a pulmonary embolism. I was put on Warfarin, about a month later I started experiencing pain in my knees, which I had never experienced before. In October I had to stop running. My PE was described as unprovoked, and I would need to be on Warfarin indefinitely. About a month ago my knee pain was diagnosed as osteo-arthritis.I have suspected that my knee pain was due to Warfarin and related vit K deficiency.

I have decided to discontinue Warfarin and be vigilant on hydration, sitting down too long and taking foods that encourage anticoagulation.I have now found I can run better.

Keith G said... @ May 26, 2014 at 8:42 AM

I am 60 years old, male. I live in the UK.I have been a regular runner for 25 years.

In January 2013, while running a 10 mile road race, I found myself fatiguing and slowing down atypically. I had no pain or swelling in my legs. On subsequent races I experienced the same problems. In June 2013, I had a sharp pain in my chest, which was found to be a pulmonary embolism. I was started on Warfarin. About a month later, I started to experience pains in my knees, which I had never had before. In November 2013, I had to stop running.

About a month ago I was diagnosed with osteo-arthritis in the knees. My PE was said to be unprovoked, and that I would need to be on Warfarin indefinitely. I have suspected that my knee trouble was related to Warfarin, maybe Vit K deficiency. In the autumn of 2012, I had run 2 Half Marathons,3 10Ks an a 10 miler, with no discomfort. I have recently chosen to stop taking Warfarin, and be very vigilant regarding hydration, changing posture regularly and taking foods that encourage anticoagulation. I am now able to run better.

Frey said... @ May 26, 2014 at 1:22 PM

Hey Keith, sorry to hear about your problems, but it sounds like you're doing well now. Also, make sure you check with your doctor about any changes that you make in your medicine!

Orestes said... @ July 27, 2014 at 11:17 AM

Hi Frey. I would be curious to know what precautions you personally take today (if any) in regards of your past blood clot episodes.

I had some similar problems time ago although I don't practice your same sports, but I like to search and hear ideas from different sources and people as unfortunately the doctors (at least the ones I saw by now) aren't too cooperative with this kind of health problems in relation with the sport.

Garrick said... @ October 2, 2014 at 10:47 PM

@Mike Baker, I suppose the "normal" provocations for a clot would be trauma beyond a mere muscle pull, or surgery, or a genetic factor.

In any event, just checking back in as I approach 11 months since 2nd DVT (which led to 1st and hopefully only PE!). Warfarin is just another part of my life now, as is weekly DIY monitoring (I was lucky to find a fellow bike racer who had a CoaguChek kit, and test strips are readily available online).

I've survived a full season of road bicycle racing in Colorado and had a blast, logging 5,500 miles so far this year. I still freak out when I get a sore calf, but they've all resolved themselves quickly.

I wear a Sigvaris compression sleeve on my left calf pretty much full time when not exercising due to post-thrombotic syndrome. Without the sleeve, the leg swells and feels tight due to blood pooling, since the first DVT damaged the valves in the affected veins. Thankfully, the sleeve works very well.

Stay strong, everyone, and remember you're not the only one having to deal with clots.

Garrick said... @ October 2, 2014 at 10:52 PM

@Mike Baker, I suppose the "normal" provocations for a clot would be trauma beyond a mere muscle pull, or surgery, or a genetic factor.

In any event, just checking back in as I approach 11 months since 2nd DVT (which led to 1st and hopefully only PE!). Warfarin is just another part of my life now, as is weekly DIY monitoring (I was lucky to find a fellow bike racer who had a CoaguChek kit, and test strips are readily available online).

I've survived a full season of road bicycle racing in Colorado and had a blast, logging 5,500 miles so far this year. I still freak out when I get a sore calf, but they've all resolved themselves quickly.

I wear a Sigvaris compression sleeve on my left calf pretty much full time when not exercising due to post-thrombotic syndrome. Without the sleeve, the leg swells and feels tight due to blood pooling, since the first DVT damaged the valves in the affected veins. Thankfully, the sleeve works very well.

Stay strong, everyone, and remember you're not the only one having to deal with clots.

richardnpyatt said... @ November 8, 2014 at 4:35 PM

Hello all, Another case of a supposedly fit (and in this case 45 year old male) individual having a DVT and multiple PE's. Incidentally I am told that it's pretty much impossible to have a solitary PE. Anyway my first symptom was superficial thrombophlebitis of the long saphenous vien over the left medial maleolus. Some time later my fitness deteriorated with increasing breathlessness and then only at the end did I have a obvious DVT. Another interesting event was being sent home immediately post diagnosis of multiple PE from A&E after a dose of clexane. Suffice to say I now take warfarin.

The worst bit of all has been the post PE investigations. One showed lesions in the liver which they felt might have been mets. This led to further investigations and it seems that the blobs are benign. Ot goes without saying that those days were not good ones. Modern medicine with its sensitive but not specific invistigations does harm.

Anyway am back on the bike but around 15% down on threshold power. But it's good to still be alive!

Unknown said... @ June 8, 2015 at 12:03 PM

I am following up from my post on March 27 of 2014. I have been on Foblee now for 5 years and for 5 years I was clot free. Until about 6 months ago. I did a fairly hard run and spent the next 2 days sitting at my desk at work, sedentary and dehydrated. By the afternoon on the second day I felt a pain in my right calf and immediately new it was a clot which was confirmed with an ultra sound. The clot, like most of the clots I've had, dissolved within a week. 5 days ago, I was cycling on a warm day, didn't have proper hydration leading up to the ride, and as I was at my threshold limit, my right calf severely cramped. The pain and tightness dissipated slightly but I do still feel something in my calf.

Because of my history I most likely will go get an ultrasound but I'm wondering IF ANYONE ELSE HAS CLOTTED AFTER THEY'VE EXPERIENCED A SEVERE CRAMP IN THEIR CALF? Has anyone been told that because you've had clots in your calf, you are more susceptible to cramping in that same calf?

Your response is very much appreciated.

AK said... @ June 8, 2015 at 11:55 PM

My experience may not be relevant to your situation, but for what it is worth...
I seldom used to experience cramps of any sort.
I came to triathlon only in my mid-forties.
Early on in my weekly swim coaching sessions, I started to cramp regularly in my calves. Initially this was only while swimming, later they came on during rest or while at work (usually when sitting for a long period with bad posture, feet folded beneath chair). I did not make a connection to poor hydration (sufficient fluids), but did (and still do) suspect a connection to electrolyte levels (reduced by too much fluid with poor electrolyte concentration). I digress. The point is, my clots were shown to run the length of my upper thighs and into my groin.
Several years later, the residual clots have dissolved, yet I retain the tendency to cramp in both calves.
It is my opinion that the cramping does not occur anywhere near the clotting site. Rather it indicates compromised circulatory function elsewhere - in my case initial difficulty pushing blood that had gone down my legs back up through veins constricted by clots and nowadays through the same veins with damaged valves.

Patrick Cushing said... @ June 28, 2015 at 3:58 AM

Just returned from dvt diagnosis. Like many it all started with an assumed to be benign cramp on Thurs. By last night and some moving around of the location from calf to thigh to calf, walking was very difficult. Readers take note. In my case I had zero swelling. This almost led to misdiagnosis. Fortunately a blood test and subsequent ultrasound revealed it. An hour ago I thought my cycling life could be done. Thanks to Frey and and his forum I now have some much needed optimism. Thanks Frey.

Patrick Cushing said... @ July 27, 2015 at 8:53 AM

Update to my previous post. Bear with the long post here. On July 29th, following the post, I was diagnosed with bilateral pulmonary embolism. This was discovered when I visited my PCP for a scheduled follow up for the DVT. He was concerned with my elevated pulse and bp as possible symptoms of PE. A quick return trip to the hospital and chest CT confirmed his suspicion. I was admitted that night. Fortunately my PE's were small. After one night, more blood tests and an echocardiogram to confirm that heart function was not being compromised by the PE I was released for outpatient care the following day.

After two weeks of Lovenox & Coumadin treatment and recovery I was sent to the hematologist for further consultation. Based on a family history of two siblings with DVT he decided to run blood tests on all of the known genetic causes for hyper coagulation. All were negative except one. This being MTHFR C677T (Methylenetetrahydrofolate reductase)passed along by one of my parents(heterozygous). In short, this mutation reduces your ability to process folic acid by 40% with the heterozygous expression. This sets forth a chemical chain reaction in your blood which increases homocysteine levels. This conversion is important for detoxifying your blood. Folic acid is the synthesized version of folate found beans, green leafy vegis and fruit. Unfortunately folic acid is found in most breakfast cereals and baked goods with enriched wheat flour.

Even with this my PCP thinks the DVT/PE was brought about by multiple factors. These being; genetic disposition, low resting hr, dehydration and a job which has me sitting at cpu for hours. A perfect storm if you will.

Hopefully some dietary changes and alterations to my work habits will have a positive effect.

Fritz 62 said... @ June 3, 2016 at 5:55 AM

Hi...any news on the possibility to swim in (cold?) Water whilst on coumadin ? Had a DVT after a suspect PE (misdiagnosed as Pneumonia ! ..got it soon after half marathon in London...no didimero prescribed ! No PE suspect. ..)...
Now on coumadin after DVT in left calf...want to go swimming or cycling or running...which I did as an amateur before..

Pseudo92 said... @ July 25, 2016 at 2:34 AM

Another instance of DVT from calf muscle tear. 23 year old otherwise healthy male. Received a slight calf strain at Hapkido training, didn't suspect anything untoward but skipped next training session as I was experiencing mild pain and thought I should rest. Over the course of the weekend pain and swelling grew until walking/stairs were very difficult. Visited the doctors on Monday and after ultrasound, diagnosed with multiple clots in the calf as well as old clots in the process of being absorbed. Had no symptoms with the previous clots.

The GP started me on 15mg Xarelto and after a week the swelling and pain dissipated but still mildly painful on occasion. Unable to see specialist for over a month and very worried as I'm struggling without being able to practice martial arts. Is anyone else practicing while on Xarelto? As there is no reversal agent for this I feel it would be a bad idea, as while practice is mostly non contact/light contact, accidents do happen and throwing/falling is a large part of Hapkido.

My younger brother was diagnosed with a DVT years ago at 16 after a soccer injury and was on Clexane and Warfarin for a year. He was identified as having a mutation in the Factor V gene (Factor V Leiden) so I am suspecting I will have the same.

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