Riding on Warfarin

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Shaznchaz

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Hello,

Basically, in the near future I am going to have to undergo an operation to replace the aortic valve in my heart, and have either the option of a tissue valve or a mechanical. The tissue valve will probably need replacing every 10 years or so (so open heart surgery every 10 years - not a fun thought as I'm only 20!) whereas the mechanical valve should last my lifetime. However, I would need to be on warfarin for the rest of my life if I had the mechanical replacement.

I have spoken to my cardiologist, and they said that riding on warfarin is probably not advised, but also that having open heart surgery every 10 years is also not likely to be good for me! So I am basically looking for anyone with experience of riding on warfarin, and if you have fallen off if it has impacted you at all? Also is rider insurance difficult to come by? I should probably mention that, whilst I only ride for fun, I do enjoy riding difficult and young horses, as well as jumping and XC schooling, so I do have a significant risk of falling, and also falling at speed.

Cookies for ll who've got this far!!
 
I rode when I was on Warfarin, but as I was only hacking my own horses I never considered the Insurance implications. My family made me wear a body protector, but that was the only thing I did different. I luckily didnt have a fall while on my meds, but when one of the ponies broke my toe, the bruising was quite impressive.
I hope all goes well for you.
 
I have the most enormous sympathy for you. I've been on Warfarin for 3 months (they found a pulmonary embolus on my right lung after LONG surgery to remove a huge meningioma (benign tumour - but snug to the brain!) The side effects have been a PITA (mainly swollen and VERY sore ankles and lower legs.) But the other day I got a whack in the nose from a just gelded colt - it bled for 15 minutes. EVERY time I give my hands the teensiest bump (like several times a day) I bleed. And I had to go in for blood tests every week to check Warfarin levels.

So yesterday I went into the doctors and jumped up and down a bit - they decided it was relatively 'safe' to take me off the Warfarin as I was on it for something for which the cause was known. I haven't dared get on a horse while I've been on it - a heavy fall could result in heavy internal bleeding and undoubted fatality.

Personally, I'd go for the tissue valve replacement at this stage. That should enable you to enjoy at least 10 years of riding, and then go for another one when needed. If the surgery is SO bad you don't feel you can face it again, THEN go for the mechanical replacement (and cut your riding right back to the quietest horse on the planet!)

It's bloody mean to have to face this so young. I'm 66 and it's bad enough at this age. Best of luck and good wishes!!
 
I have been on warfarin since july and my blood tests are now monthly....my doctor (who rides and hunts) said I can ride but I must wear a medical bracelet saying I am on warfarin so if I do have a fall the paramedics will know there is a chance of internal bleeding. I have been told that they can reverse the effect of warfarin (I think by injection) if I have to have an op or am injured badly. I have cut myself and although it bled more than normal it didn't take long to clot. I just make sure I have a box of plasters with me and just put one on straight away.. sorry you are so young to go through this I am 69 so not quite so bad I suppose.....I know horse riding is a risk sport but if you fell off a push bike you could have internal bleeding or a car accident, also dealing with horses on the ground can be as risky as riding. good luck with your decision...
 
Ask your GP to prescribe the Warfarin antidote and carry this with you, also buy a special trauma bandage [amazon], carry these in a pocket, in your car and on a horse, you can never be sure when something will happen, hopefully never.
 
Bonkers2 said:
Ask your GP to prescribe the Warfarin antidote and carry this with you.
Click to expand...

The immediate antidote cannot be prescribed just in case as it is a human blood product and held in the blood bank. The other reverser, vitamin K, takes around 4 hours to work so would be useless in an emergency. No doctor in their right mind would do this...

OP - warfarin isn't the end of it, but unfortunately with a mechanical valve your therapeutic range will be higher than that of someone on warfarin for a clot or AF. There is no higher a risk of bleeding than for and unmediated person, just an increased time to stop any bleeding that does happen (and increased chance of bruising).

The chances are that if someone had catastrophic injuries on warfarin, the prognosis wouldn't be much different to any one else, providing PCC is administered immediately.

One thing to remember though, if you are going to do dangerous activities against medical advice, you are better on warfarin (or sinthrome) than the new anticoagulants - they don't have an antidote. We frequently manage large bleeds on those with transfusions. It is rare to have to transfuse someone on warfarin.

As for the testing - stick to the dose exactly and time, don't miss any (don't double dose if you do) and most importantly - don't change habits. Crazy fad diets will mess up your INR. As does binge drinking at weekend, though we can dose around regular drinking (2 glasses of wine a night is better than 10 at a weekend). Keeping everything regular will increase your appointment times - we have some patients who go 12 weeks between appointments :)
 
Get your own inr tester that is approved by your nhs trust if you can afford one. They are easily bought online. My husband only goes to the clinic once a year, and phones in his results the rest of the time. He has the St Judes valve.

Buy a chest guard before your operation to protect the scar while it and the bone heal.. OH said it was invaluable.

On warfarin, you need to keep your green vegetable consumption steady. A big plate of sprouts at Christmas and no other time will send your inr haywire. Likewise, exercise regularly or not at all. You'll be advised not to eat cranberry at all (bad news if you use it to control cystitis) and be careful with grapefruit.


So sorry you are facing this so young.
 
I am so pleased to see this thread as I was wondering about warfarin myself I started taking it 5 weeks ago for heart condition AF I need to be on it for life I have a 4 year old who I bought last summer as a lightly backed 3 year old I then turned him away I've ridden him a bit this year but due to my health not as much as I would have liked. I don't want to sell him and was wondering about what things I should be doing to be safer so the replies you have are very interesting to me I hope you get some more responses to help you with your choices and sorry you are going through this at your age
 
Long term reader here, but I've signed up literally just to reply to this because you are exactly where I was a year ago!

I had to have surgery to replace my aortic valve due to aortic stenosis. Also young (I was 24 at the time, now 25) so the consultants wanted to make sure whatever they did was suitable for me long term.

I have a horse so riding was a big one, but I also have a motorbike and do track days so I really wasn't keen on the mechanical valve and warfarin route. One of my consultants also didn't fancy replacing a tissue valve every 10 years, so after much discussion amongst the cardiology teams across a couple of different hospitals, I agreed to have a Ross procedure.

It involves replacing both valves and so risks are twice as high as for single valve replacement. But there's no degrading tissue and no mechanical valve needing warfarin.

I had the surgery early February this year, spent a week in hospital, 5 weeks at home then by the middle of March I was back riding (horse and motorbike!) and haven't looked back since, in fact me and the horse have probably had our best ever summer.

Not going to lie, it was incredibly stressful and probably the worst week of my life. If you want to ask me anything then feel free, happy to help as I know the whole thing is a bit scary. I would highly recommend asking your doctors about a Ross procedure though, personally I think it was worth it.

All the best,
Katie
 
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