The drug is actually called "warfarin". Where is the clot, and what is presumed to be the cause?
Member
Training while on rat poison
G'day Rip,
I'm about to start working with a young (16y/o) cyclist, he's all of 50kg wringing wet at 180cm tall, so about as lean as you can imagine a boy can be without having an eating disorder or a tapeworm. He's a very good track endurance cyclist for his age group but oddly enough he can's sprint his way out of a wet paper bag ... There's next to no muscle on him at all. He's just recently been diagnosed with a blood clot and his doctor has put him on a 12 week program of warfin, which is a rat poison, it's an anti coagulant, it's the main active ingredient in many rodent poisons.
Anyway ... I've been at him and his dad to get him into the gym to put some muscle onto him and this is the first chance I'm going to get to do it. I hope anyway.
He's never been in a gym and the most I'm going to be able to get him into it will be for, initially, one session a week, and hopefully I'll ramp that up to 2 or 3 after a few weeks, we'll be doing squats initially, teaching him and his dad the techniques etc, then we'll introduce deadlifts and press, bench press and finally power cleans as he learns and gets proficient. There'll be metcon work on a bicycle ergo as well. As the bike is his sport and he is very good at it that's not something I can (or want to!) take away from him, but I can alter the ratios around and make sure he's eating plenty.
My concern is the warfin, as it's an anticoagulant. He's not allowed to ride his bike on the road or track for fear of a crash and thus a bad bleed, but do you know of any reason not to have him in the gym lifting Heavy Stuff and doing Hard Things? Obviously we'll need to be super-careful with handling of weights so nothing gets dropped on him etc, but have you worked with anyone on this stuff before? Anything to keep an extra special eye on, or should he avoid it altogether? I hope not, I want to build him up, and this may be the only chance I get.
TMPHBITEU
The drug is actually called "warfarin". Where is the clot, and what is presumed to be the cause?
Member
I had heart surgery to correct a heart condition and have been on Coumadin, which is the same as Warfarin for 11 months and have to remain on for the rest of my life. Hasn't stopped me from doing shit in or out of the gym.
Member
The clot is somewhere around his collarbone and I don't know what the cause is. They noticed it when one of his hands started changing colour.Originally Posted by Mark Rippetoe
TMPHBITEU
That will be a brachial plexus thing. I am more concerned about the clot than I am the warfarin at this point. Is he still symptomatic?
Member
I don't think so, they gave him some big dose of something else that cleared it, but I'm only going on 3rd hand info at the moment. I'll find out more, anything in particular I should ask his dad? They're coming for their first session on Wednesday (your Tuesday) and we'll be doing squat technique to start with so that'll be my next chance to question them.
DRLVEGAS
A client of mine is the local Zee Medical distributor. He showed me some stuff they carry called Quick Relief: http://zeemedical.com/zeemedical/New...2005/index.jsp. They are only a distributor, so I'll bet you can find it packaged under a different name in your area. They sell a lot of it to people on blood thinners. I have used it twice(I'm not on blood thinners, but I am a bleeder) & it works amazingly well. Stops bleeding within about 5-10 seconds.
TMPHBITEU
Just make sure the kids dad knows the risks. The clot didn't get there by chance, so you should familiarize yourself with the situation. I have seen a couple of subclavian arterial clots that have scarred into a permanent lesion.
Member
I'm not exactly sure of what the risks are, above any from normal living anyway. Presumably the risk of stroke is greater than for someone without a history of a clot, but if that's increased through strength training or not I don't know. I wouldn't have thought so, and would imagine that the heart strengthening from strength work would decrease the risk of stroke, but don't really have anything to base that on.
Would breath holding through a rep have any effect on clot formation or dislodgement etc? The temporary increase in blood pressure due to a breath hold during a heavy squat would increase or decrease the risk of a clot forming or moving etc?
I don't want to kill or maim the kid, and want to know if strength training would increase any risks of that under his circumstances. I don't have any experience working with clients who have a history of clots so I don't know what to ask or what to tell them that they need to accept as risks. If I tell them to go see a doctor to get a medical clearance, they'll get the 'do lots of reps at light weights on a leg extension machine and breathe in and out' bullshit, which won't be very helpful.
This is the text of an email I've just sent to his dad, I'd much appreciate your comments on this for the kid's sake more than anything else :
G'day XXX,
I've been asking around the S&C community for any special information on training with warfarin and with clots.
It seems the main concern is not so much the warfarin itself, but the clot, what caused the clot and if it's still around. As nothing we do will be high impact, there's very low risk of any bleeds so the warfarin isn't going to be an issue, as best I can glean from the S&C people I've asked anyway.
Training, as you know, increases arterial blood pressure, dramatically at high levels of exertion (sprints, high intensity E3's, weight training etc) and I guess my concern is that I don't know what caused the clot and if it's likely to move etc when we do some hard work.
Before we start, can you fill me in a bit more on what you know about the clot, what caused it and what the doctors have recommended he do and not do, while it's clearing up? The last thing any of us want is YYYY to have some sort of long term injury and I don't want to put him into any greater risk category than he is already.
Thanks!
Carl
TMPHBITEU
Looks good. Perhaps Dr. Prewitt has a more informed opinion, if he has time to post.
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