Blood Clots, DVT, and the Future Pussification of My Skiing

Having had intermittent pain in my left leg, I was diagnosed with DVT (blood clot) in my left leg a week ago. I'm 34, healthy, active, have generally clot-free genetics, and have done countless long flights and drives in the past without issue. I suspect the cause was a fall I had while mountain biking in Whistler a couple months ago. I broke my wrist and hit the back of my left leg pretty hard. I also continued to ride for another 1.5 hours but realized I was finito the next day when x-rays revealed that I had fractured my scaphoid. The day after that, I did a depressing 24-hour solo drive back to Tahoe followed by 2 months of broken-wrist induced inactivity.

Given the foregoing, I'm guessing that (1) the hard impact on the back of left leg + (2) long drive back home + (3) several weeks of sedentary lifestyle = blood clot. At least I'm hoping this is the case.

I now have the pleasure of giving myself daily shots of Lovenox into the stomach until the Coumadin gets my blood where it needs to be. While the first few times involved 10-15 minutes periods of literal navel-gazing before I was able administer the shot, I've gotten much better. It's not that it hurts much. It's really just the concept of puncturing myself and then injecting foreign fluids into my body that gets me. (I have a newfound respect for diabetic and heroin attics.)

Today the doc told me that I'd have to take the Coumadin (a blood thinner) for 6 months, which dovetails harshly with the ski season. He said that I should avoid things that might cause bleeding--e.g., shaving, carpentry, machete juggling.

As for skiing, well I can do it . . . kind of. The doc used the word "groomer" waaayyy more than I was comfortable with. But his point was that I should ski in a manner to ensure that I don't cause external or, much worse, internal bleeding. Bad year to get a Squaw Pass, I guess. Anyhow, my plan is to continue skiing, but to just dial it back. No 15'+ hucks; no park; no skiing in exposed areas; no maching through trees. I plan to continue skiing backcountry. But I'm putting my couloir fetish aside. This year, or at least until April, I'm going to be a meadow-skipping seeker of hippy turns, which, in all honesty, doesn't sound half-bad.

So, talk to me folks. What's your blood clot story? How'd you deal with the thin-blood issue? Ever hear of impact/trauma related DVT? Should I find a specialist? Should I be freaked out or just annoyed? (I right now, I'm much more inclined toward the latter.)

Jesus dude, you're having a rough shoulder season.

I don't know man.......compared to mountain biking, the times I've ended up bleeding from skiing are pretty few and far between. I mean as long as you're not an idiot (which you're not), it seems pretty easy to enjoy skiing without risk of lacerations.

I'd be more worried about what goes on in the KT lineup that what goes on beneath your skis.

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Originally Posted by kidwoo

Jesus dude, you're having a rough shoulder season.

I don't know man.......compared to mountain biking, the times I've ended up bleeding from skiing are pretty few and far between. I mean as long as you're not an idiot (which you're not), it seems pretty easy to enjoy skiing without risk of lacerations.

I'd be more worried about what goes on in the KT lineup that what goes on beneath your skis.

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I generally agree about mountain biking. I seem to draw blood on maybe 1 out of 3 rides. Whereas, I've only drawn blood skiing a few times over 25 years. That said, something like a concussion could potentially fuck me up while I'm on Coumadin.

Also, this excuse is the perfect vehicle for me to be the complete pussy I've always aspired to be.:wink:

I hate this place yet I am drawn to it.

ACL surgery 4 years ago. Once I got the Donjoy brace, I went skiing again. Tightened that sucker down to the point it indented my leg, dumb.

Clot formed in calf and had to take the same pills for 4 months.
Bump a wall, large bruise forms.
Stub toe and bleeds.........and continues to bleed.
Blow your nose hard in dry climate.....tissue box emptied.

But I skied. I was careful, very careful. Slowed down, don't fall, don't tighten boots too much so not to bruise,......

Yeah, groomers seem like the common sense answer to keep skiing at least.
Annoyed is probably better than freaked out, BUT if said clot moves to your lungs or heart, you could keel over. That is the part that was rather scary to me.

My story again, not a doc, don't take any advice from me disclaimer.

of course you rarely cut yourself skiing,so that is not the problem(and neither is shaving)

but you could get some fatal internal bleeding from and whack that would not have been a problem without coumadin. and i dont think a helmet would fix it

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Originally Posted by Buzzworthy

I hate this place yet I am drawn to it.

ACL surgery 4 years ago. Once I got the Donjoy brace, I went skiing again. Tightened that sucker down to the point it indented my leg, dumb.

Clot formed in calf and had to take the same pills for 4 months.
Bump a wall, large bruise forms.
Stub toe and bleeds.........and continues to bleed.
Blow your nose hard in dry climate.....tissue box emptied.

But I skied. I was careful, very careful. Slowed down, don't fall, don't tighten boots too much so not to bruise,......

Yeah, groomers seem like the common sense answer to keep skiing at least.
Annoyed is probably better than freaked out, BUT if said clot moves to your lungs or heart, you could keel over. That is the part that was rather scary to me.

My story again, not a doc, don't take any advice from me disclaimer.

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Thanks man. This was very helpful. I looked up your thread and it was also very helpful.

The bad news is that the Coumadin doesn't seem to be affecting my blood much. So I'm on like my 12th day of giving myself a Lovenox shot to the stomach with probably at least another 5-7 days more. My stomach is now covered in dime-sized purple bruises.

It blows, but I'm still skiing. So, as they say, it could always be worse. Much worse.

Sorry to hear about this AK. I've got the grand history on this one - and I'm nearly that worse case scenario. Don't let this scare you though. 10 years ago I developed a significant DVT in my left leg that landed me in the hospital for 8 days. I thought it was plane travel since I was on 2 flights per week at that time - I was wrong. So during this stay I was strictly bed ridden and dosed up on heparin so they could figure out what caused the DVT in an otherwise healthy 26 year old guy. A CT scan revealed the source was a tumor in my abdomen that had severely restricted the blood flow in my inferior vena cava - causing this massive clot in my left leg. The cancer was advanced but treatable, and I obviously made it out alive (which is a whole other story). Although chemo and surgeries sucked, the single biggest long term issue from cancer was the blood clot in the left leg. I was on coumadin for over a year. And because of my history, I even went back on it when I had my knee surgery last January.

During that year I skied, biked and did a lot of things I had always done - but I kept it mellow. Besides the hemoraging risks, I did not feel my leg was anywhere near as strong as it was before if the blood wasn't flowing through it the same way - so that kept me pretty scaled back as well. I did gash my leg pretty good while skiing at Mt Bachelor while taking coumadin. Surprisingly it did not bleed too much, but the bruising was hideous. I didn't feel that I was overly fragile or anything, I just needed to be a little more cautious. As we all know the random car wreck is more likely to be a problem than a fall skiing, but for 6 months you should play it safe and don't do anything stupid. The doctors told me that if the blood clot released they absolutely could not save me - even if I was on an operating table and they knew it was coming. If it let go and was headed to my heart and lungs, I was done. Remember, mine was huge.

It is amazing how the body compensates. All sorts of veins have 'collaterlized' and made up for the restricted inferior vena cava. I kind of think of it as my blood now takes several fast parkways back to my heart instead of one super freeway. Long term my left leg has never fully recovered to be as strong as the right. It does still swell pretty regularly - I always know when I pull my sock down and there's a a depression ring around my shin / calf where the sock band was. This angers more than anything. Maybe the DVT contributed to my ACL wearing out sooner, maybe not, I don't know. I believe I'm not quite as strong aerobically as I once was because my blood doesn't pump as efficiently - but I still do a lot of aerobic stuff and am fine with where I'm at.

For the last 9 years I have taken two low dose aspirins every day to keep my blood just a tiny bit thinner, but not dangerously thin. I also stay as active as possible - that really helps. If I sit too long or work a long day in the office chair it swells up worse. If I ride my bike and it's swollen when I start, it's not swollen at all when I finish - that feels good. All in all it is great. I do everything I love and never feel restricted by it.

If you have any other specific questions please feel free to PM me. Make sure you come to a solid conclusion about what caused it. Have you had an X-ray or CT scan? It is most likely due to the injury you mentioned, but you should be positive, not just pretty sure. Blood clots are serious shit and do affect people permanently and fatally if not treated correctly and quickly. Coumadin controls the blood flow and allows your body to dissolve or scar over the clot without the same amount of risk....but coumadin doesn't cure what caused it. Something caused it, make sure you know what that is. For me I thought it was plane rides, turned out it was a surprise tumor the size of a grapefruit. And I went from healthy young man to house of cards in a hurry.

Good luck - 99% chance it is not the same for you.

SC- Wow. Okay, that's scary as hell. I wasn't sure whether I should see a specialist, but this convinced me that I really should. PM coming your way.

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Originally Posted by AKbruin

Thanks man. This was very helpful. I looked up your thread and it was also very helpful.

The bad news is that the Coumadin doesn't seem to be affecting my blood much. So I'm on like my 12th day of giving myself a Lovenox shot to the stomach with probably at least another 5-7 days more. My stomach is now covered in dime-sized purple bruises.

It blows, but I'm still skiing. So, as they say, it could always be worse. Much worse.

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No problem, passing on this info to others helps. I know others have helped me.
It is not fun, but it will get better.

Patience sucks huh.

Going to bump this thread.....

I came down with a leg clot start of October after pulling my calf muscle two weeks in a row. The doc said I should have never ended up with a clot but none of the the tests show any possible causes and we have ruled out hereditary and cancer. No idea what caused it but being a weekend warrior and getting old (late 40's) while letting my fitness and diet go to shit are my guess in what lead up to my clot. Now I'm paying for it with first shots I had to give myself in the stomach and then 4 to 6 months of blood thinner pills that are literally "rat poison".

Last year, I put 8 months on the slopes and snowboarded my ass off. My best year ever for powder despite a drought year in Colorado. Just seem to have the knack of finding powder stashes that most don't know are there. Anyway, this season is on hold. Sure, I could ride if I wanted to without hurting myself but my doctor has talked me out of it for the time being. According to him, a severe cut or internal bleeding can be dealt with but if I get a head injury then brain bleeding is a real risk that they can't deal with that medically. Take that to mean a simple head injury would equate to a major risk of serious brain trauma and/or death.

So I've sidelined myself from snowboarding and mentally that is killing me. But I have a wife and kids to answer to; so, I will not risk it until I get off the blood thinners hopefully by April. In the meantime, I am kicking my ass at my local Crossfit gym. http://www.crossfit.com/

My doctor is very cautious but he is positive about my recovery and supports my trying to get back into shape while off of the slopes. He wants me to scale my workouts to 50% to 75% of my max but in Crossfit, who knows what that means. So, I sport a Polar wristwatch heart monitor and try to keep that at 75% of my max.

Hope this brings back the clot and blood thinner discussion. It sucks having a clot but misery does love company.

Oh by the way, if available, everyone should invest in season pass insurance. You never know when you might need it. I'm holding on to my insurance and if I don't get cleared by the doc before the start of April, then I'll invoke the insurance to get my money back.

My husband got his first DVT when he hit his knee surfing. After a while things cleared out, so he was cleared to stop using coumadin. The second time was also due to an impact, and so eventually he stopped the coumadin. The third was completely out of the blue and since he was too young for 3 DVTs, he was put on coumadin for life. His mom had a pulmonary embolism(blood clot in lungs) a few years ago, and then his sister died 2 years ago from a blood clot that went to her heart. So they figured that there was a family trait.

He still surfs though. He just has to not bleed out into the ocean...:wink:

I think the coumadin just keeps the blood thin, it doesn't really get rid of the clot. The Lovonox is the biggie, but I'm not really sure the entire clot really goes away. He still had circulation problems for a long time, and had to wear compression socks if he had to stand too long, since the block in the knee seemed to keep blood in the leg more.

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Originally Posted by longboardkook

Going to bump this thread.....

I came down with a leg clot start of October after pulling my calf muscle two weeks in a row. The doc said I should have never ended up with a clot but none of the the tests show any possible causes and we have ruled out hereditary and cancer. No idea what caused it but being a weekend warrior and getting old (late 40's) while letting my fitness and diet go to shit are my guess in what lead up to my clot. Now I'm paying for it with first shots I had to give myself in the stomach and then 4 to 6 months of blood thinner pills that are literally "rat poison".

Last year, I put 8 months on the slopes and snowboarded my ass off. My best year ever for powder despite a drought year in Colorado. Just seem to have the knack of finding powder stashes that most don't know are there. Anyway, this season is on hold. Sure, I could ride if I wanted to without hurting myself but my doctor has talked me out of it for the time being. According to him, a severe cut or internal bleeding can be dealt with but if I get a head injury then brain bleeding is a real risk that they can't deal with that medically. Take that to mean a simple head injury would equate to a major risk of serious brain trauma and/or death.

So I've sidelined myself from snowboarding and mentally that is killing me. But I have a wife and kids to answer to; so, I will not risk it until I get off the blood thinners hopefully by April. In the meantime, I am kicking my ass at my local Crossfit gym. http://www.crossfit.com/

My doctor is very cautious but he is positive about my recovery and supports my trying to get back into shape while off of the slopes. He wants me to scale my workouts to 50% to 75% of my max but in Crossfit, who knows what that means. So, I sport a Polar wristwatch heart monitor and try to keep that at 75% of my max.

Hope this brings back the clot and blood thinner discussion. It sucks having a clot but misery does love company.

Oh by the way, if available, everyone should invest in season pass insurance. You never know when you might need it. I'm holding on to my insurance and if I don't get cleared by the doc before the start of April, then I'll invoke the insurance to get my money back.

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Sorry to hear that man.

The shots get easier. Trust me. For whatever reason, my body is apparently saturated in vitimin K, which meant that I had to take those belly shots for the about 35 days.

As for skiing and living an active lifestyle, it's a hard call. I think it's obvious that most doctors are going to give you very cautious advice. I don't think that advice should be ignored but that it should be factored into your own risk/benefit analysis. My doc indicated that I could ski but that I should be very cautious. I've skied 10-12 days so far, mostly in the backcountry. I'm having to constantly remind myself to ease back. I've never gotten a concussion skiing before . . . nevertheless I'm trying to avoid situations in which that's a reasonable possibility. So I avoid exposed lines, stay away from the park and hucks, and make sure I'm skiing with complete control at all times.

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Originally Posted by AKbruin

Sorry to hear that man.

The shots get easier. Trust me. For whatever reason, my body is apparently saturated in vitimin K, which meant that I had to take those belly shots for the about 35 days.

As for skiing and living an active lifestyle, it's a hard call. I think it's obvious that most doctors are going to give you very cautious advice. I don't think that advice should be ignored but that it should be factored into your own risk/benefit analysis. My doc indicated that I could ski but that I should be very cautious. I've skied 10-12 days so far, mostly in the backcountry. I'm having to constantly remind myself to ease back. I've never gotten a concussion skiing before . . . nevertheless I'm trying to avoid situations in which that's a reasonable possibility. So I avoid exposed lines, stay away from the park and hucks, and make sure I'm skiing with complete control at all times.

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Damn, 35 days of shots. I thought my 14 days was bad. Glad to see you are out on the slope even though you have to take it easy. That alone is inspirational.

I think that a clot is a real physical threat but it is also a mental battle as well. No real cause and effect to pin point. I've broken bones before but you can say, I wrecked bad, broke my _____ and in 6 to 8 weeks, I'll be back. With a blood clot it is who knows what caused and how long it will take to get better.

I also liked the post by the wife about her surfer husband's tenacity. He is stuck with blood thinners for life but carries on despite it. I would probably do the same except I hope that my blood clot is a one time episode....... Funny, I sit here typing in my compression thigh high socks........ at least they are black and don't look too much like stockings..... but they do seem to help with the clot.

Well thanks for the posts and we will beat this clot thing soon enough or at the very least live on despite the drugs to keep the clots away.

LBK

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Originally Posted by Sierra Cement

Coumadin controls the blood flow and allows your body to dissolve or scar over the clot without the same amount of risk....but coumadin doesn't cure what caused it. Something caused it, make sure you know what that is. For me I thought it was plane rides, turned out it was a surprise tumor the size of a grapefruit. And I went from healthy young man to house of cards in a hurry.

Good luck - 99% chance it is not the same for you.

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This is the second time I've heard of this. While my husband was in for the 3rd clot, I had a friend diagnosed with lung cancer, and he said that one of the markers was clotting and to have my husband checked. Unfortunately he didn't survive very long. And my husband's father had colon cancer, so there's a risk factor there for cancer. So to add more hassle to the situation, In order to have a colonoscopy, he has to go to the hospital, since there is a risk of injury/bleeding in the colonoscopy, and be taken off coumadin.

Surfing is part of his identity, so when the first doctor suggested giving it up, that was not an option. Nowadays doctors are a little more enlightened, because part of this discussion is quality of life, and if it's in your soul to surf, or ski, or whatever else, then giving it up completely is horrible. Even people who have lost limbs to sharks still go surfing, if that's what they need. None of us get younger, and to be able to continue doing it(whatever it may be) in your 90s is our goal. Most likely not at the same level as when we were in our 20s, but living out loud is better than living in bed! I watched my grandma deteriorate in her body, stuck in her room as things fell apart through inactivity, and don't wish to go that way!

Random INR-related complaint: Have those of you have to get weekly INRs related to your Coumadin intake noticed that certain labtechs are great at drawing blood and others are incompetent boobs? There is a certain labtech who manages to make it a painful, long process everytime. One time, she messed up and blood spurted all over my business casual work clothes. (I felt a little like Ed Norton from Fight Club when I returned to the office.)

cloudswinger- Having to take Coumadin for life must blow, but it's great and inspiring that you husband is still surfing. Despite the risk, I'm pretty sure surfing makes your husband healthier (mind and body) than he'd be if he had to give it up.

Apparently when you've been on coumadin long enough, you can feel when the level is off.

I just had a discussion about ways people die, and apparently a lot of people are found in their bathrooms, having had a stroke or heart attack after straining too much. So probably better to die doing something you love than to die half naked in the bathroom. :eek:

It's not really my nature to put all of this personal information out on an internet forum, but if my story allows some other folks to feel a little better about their situation and have some optimism for a healthy active future - then it's definitely worth it.

AK - Josie from LapCorp was amazing with the needle - literally never felt it. Others were like gardeners. That's crazy about the bloody clothes AK.

From a long term persepective I've always felt that a lot of regular aerobic activity can only help those of us with a history of blood clots. Kind of like how a fast flowing river is less likely to dam up than a slow one. Keep the ticker thumping hard and let that river flow!

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Originally Posted by Sierra Cement

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From a long term persepective I've always felt that a lot of regular aerobic activity can only help those of us with a history of blood clots. Kind of like how a fast flowing river is less likely to dam up than a slow one. Keep the ticker thumping hard and let that river flow!

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That is why I'm doing Crossfit. But damn, I tore myself up with last Thursday's Workout of the Day. Pulled a muscle right where my clot is. Thought I did some real damage but it was better by Saturday, so I was back in the gym.

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Originally Posted by cloudswinger

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Surfing is part of his identity, so when the first doctor suggested giving it up, that was not an option. Nowadays doctors are a little more enlightened, because part of this discussion is quality of life, and if it's in your soul to surf, or ski, or whatever else, then giving it up completely is horrible. Even people who have lost limbs to sharks still go surfing, if that's what they need. None of us get younger, and to be able to continue doing it(whatever it may be) in your 90s is our goal. Most likely not at the same level as when we were in our 20s, but living out loud is better than living in bed! I watched my grandma deteriorate in her body, stuck in her room as things fell apart through inactivity, and don't wish to go that way!

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I mentioned to my wife that if my clot happened back in my surfing days, i would have told the doc to pound sand if he thought i needed to stay out of the surf. Then again as my wife reminded me, i did blow my out eardrum hitting the reef solid with the side of my head while surfing.

As I mentioned before, I was advised by my hematologist specialist doctor; it is not a risk of bleeding out due to a cut while on blood thinners or even internal bleeding due to trauma to the body, it is the deadly risk of a head injury and bleeding of the brain that worries him the most.

Cloudswinger, since your husband is on blood thinners for the unforeseen future and if he is surfing some big stuff or over reefs, then he might consider a Gath Helmet. I used to see people using those Gath Helmets on big days when we were surfing shallow reef breaks.

New doctor suggested that I might be able to cut the coumadin after 3 months (former doctor said 6 months). Hello spring couloirs in the Eastern Sierra and early-season mountain biking! :yourock:

Edit: "Gardening." Very apt expression, SC.

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Originally Posted by AKbruin

New doctor suggested that I might be able to cut the coumadin after 3 months (former doctor said 6 months). Hello spring couloirs in the Eastern Sierra and early-season mountain biking! :yourock:

Edit: "Gardening." Very apt expression, SC.

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Good news! Why the new doc? Hematologist?

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Originally Posted by longboardkook

Good news! Why the new doc? Hematologist?

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No, my local clinic just had this doc take over supervision of my coumadin regimen, which he seems to do for all the DVT patients. He didn't actually say that I could get off in 3 months. But my plan is to tell him that I desperately want to ski fun stuff and that the danger of my concussing myself is far greater than the development of a second clot. For now, I'm in bar exam lock down, so it doesn't matter. But come March . . . .

Crap. I had another ultrasound on my leg and the clot is still there despite 4 months of taking rat poison. My DVT is much smaller than before and considering I had three clots in total in that leg, I guess I'm doing much better. But s*#%, the balance of my snowboard season is in peril. It is hard to keep my spirits up knowing that this might be my first winter in 12+ years that I might miss out on snowboarding. Can't snowboard, can't surf (not living at the beach anymore), and can't skateboard. Thank god I have my family and for now my job..... Could be worse I guess. Oh well, got to look at the bight side of things.

I am glad I found this thread. I was just diagnosed with a DVT in the left thigh and put on Lovenox (glad I have insurance, that shit is expensive) and Coumadin. I have know idea why I got the DVT, we are waiting for the blood tests to see if there is any genetic issues or something else that might have caused it. I don't fit any of the typical profiles for having a DVT. The cancer thing is freaking me out a bit as well as the dying from a pulmonary embolism. I was surprised how easy it was to give myself a shot, not nearly as bad I thought, all though I have bruise all over my abs. I am having a real hard time with the fact that my ski season is probably over for the year. My doctor told me I had to take it easy for awhile but I realized yesterday that my idea and his idea of taking it easy are not the same thing. A lot of doctors do not understand people that are passionate about the outdoors and working out. I am going completely nuts sitting on the couch now but I guess it beats the alternative. I hope I get an OK to start working out again soon. Thanks for a place to vent.

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Originally Posted by longboardkook

Cloudswinger, since your husband is on blood thinners for the unforeseen future and if he is surfing some big stuff or over reefs, then he might consider a Gath Helmet. I used to see people using those Gath Helmets on big days when we were surfing shallow reef breaks.

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We're in Florida, so no reef breaks. But all the injuries that he has had have been on small days where he's just messing around. Broke his board on a small day. Probably more dangerous because the water is shallow...

Anyway, the clot might always be there. It doesn't necessarily have to stop your activities. Personally, I think doing a full stop is not the best thing for recovery. Do some walking.

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Originally Posted by longboardkook

Crap. I had another ultrasound on my leg and the clot is still there despite 4 months of taking rat poison. My DVT is much smaller than before and considering I had three clots in total in that leg, I guess I'm doing much better. But s*#%, the balance of my snowboard season is in peril. It is hard to keep my spirits up knowing that this might be my first winter in 12+ years that I might miss out on snowboarding. Can't snowboard, can't surf (not living at the beach anymore), and can't skateboard. Thank god I have my family and for now my job..... Could be worse I guess. Oh well, got to look at the bight side of things.

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Damn, man. Sorry to hear that. I think skiing is still okay though, so long as it's done relatively safely. At least I hope this is the case as I'm still skiing.

I'm going in for another ultrasound this week. Fingers crossed.

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Originally Posted by Alaska Skier

I am glad I found this thread. I was just diagnosed with a DVT in the left thigh and put on Lovenox (glad I have insurance, that shit is expensive) and Coumadin. I have know idea why I got the DVT, we are waiting for the blood tests to see if there is any genetic issues or something else that might have caused it. I don't fit any of the typical profiles for having a DVT. The cancer thing is freaking me out a bit as well as the dying from a pulmonary embolism. I was surprised how easy it was to give myself a shot, not nearly as bad I thought, all though I have bruise all over my abs. I am having a real hard time with the fact that my ski season is probably over for the year. My doctor told me I had to take it easy for awhile but I realized yesterday that my idea and his idea of taking it easy are not the same thing. A lot of doctors do not understand people that are passionate about the outdoors and working out. I am going completely nuts sitting on the couch now but I guess it beats the alternative. I hope I get an OK to start working out again soon. Thanks for a place to vent.

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Sorry to hear that. It is a bummer, and SierraCement's story is scary. To be honest though, it's not something I think about that often these days, except when I'm skiing (in which case I remind myself to dial it back). Having to do the Lovenox shots for 35 days kind of sucked though.