Ice Hockey w/ mech valve / warfarin

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Jcrown

Member
Joined
Oct 6, 2012
Messages
8
Location
Abu Dhabi, United Arab Emirates
Hello guys,
I just got my mechanical valve and route replacement about 6 weeks ago after a VERY emergency procedure in Abu Dhabi. I was misdiagnosed for 12 hours having had a major dissection, then through some amazing connections and grace, I was saved with a 10% chance of survival after a hospital transfer.

Anyway.....My QUESTION is....pre-sugery I was VERY active in Ice Hockey, coaching, reffing, and Playing. I know there are major implications in the chance of impact due to the warfarin, but is there anyone out there that plays or has any thoughts on the matter? I know there are a couple pros who have come back, but I don't know if they are on blood thinners.

Thank you VERY much.
JC
 
There are people with a mechanical valve that refuse to take anticoagulants and thus don't have the increased brain hemorrhage risk as those with proper anticoagulation have. But their stroke risk is much increased. I seen a surgery video that a long time valve replacement surgeon,Dr. Cooley, mentions he's had some patients which have done so for thirty years without a stroke. But I doubt anyone would recommend doing so.

But then again maybe your overall risk would be lower if you did and played contact hockey. I think you would have been much better off going the tissue route and reop than going without anticoagulation therapy and a mechanical valve. You might want to discuss with your cardiologist the possibility of a lower than normal INR ratio and accept some increased stroke risk while lowering brain bleed risk.

Its probably something that's more on whatever one's personal levels of risk vs reward are.
 
There are people with a mechanical valve that refuse to take anticoagulants and thus don't have the increased brain hemorrhage risk as those with proper anticoagulation have. But their stroke risk is much increased. I seen a surgery video that a long time valve replacement surgeon,Dr. Cooley, mentions he's had some patients which have done so for thirty years without a stroke. But I doubt anyone would recommend doing so.

But then again maybe your overall risk would be lower if you did and played contact hockey. I think you would have been much better off going the tissue route and reop than going without anticoagulation therapy and a mechanical valve. You might want to discuss with your cardiologist the possibility of a lower than normal INR ratio and accept some increased stroke risk while lowering brain bleed risk.

Its probably something that's more on whatever one's personal levels of risk vs reward are.

Jcrown,

Welcome to this site, but sorry to hear what you had to go through! That is great that you are on the road to recovery. I am thinking that you might want to check the cardiac athletes forum as well. There are a number of members who are very active and are also on anticoagulation.

Fundy, it sounds like Jcrown probably didn't have much choice with his decision of mechanical versus tissue as he said that this was an "emergency" surgery. Jcrown, you may want to correct me if I am wrong.

Wishing you all the very best!
 
This study looks very encouraging to me, for anyone wanting to play hockey as an example.
http://shvd.org/abstracts/2011/C70_71.cgi

It references a study of very low dose anticoagulation therapy over a two year period. Those with AVR were using a range of 1.6-2.1 and experienced annual rate of Grad III complications (bleeding and thromboembolic events) of 1.07% and 1.16% in the two very low dose categories.

That doesn't seem any or much worse than a tissue valve with no ACT.
 
Yeah, it was a big time emergency and I didn't have a choice. I'm still doing great post op, 3 month check showed great healing and no concerns. I'm back to the ice coaching only, and also on the bench coaching. I'm doing off ice officiating as a supervisor of officials in IIHF events, but i'm really chomping at the bit to get back on the ice officiating and playing at a rec level. I can accept the days of competitive hockey being done, but I really do need to play......Hoping for more info and stats to help support a decision that will satisfy all.
 
Hey JC, glad to hear everything is going good with your recovery. I thought I would chime in about your desire to play ice hockey again. I too was able to play the game for 40 years and know the feeling of wanting to lace up with the boys. I started to play no hit at age 25, so my last 21 years of playing the game was uneventful as far as injuries, the odd bruise from a shot. Nothing better than a bunch of guys getting a good skate and laugh in a couple times a week. Unfortunately I suffered a TIA at age 46, that I believe was calcium from my valve. It did leave a loss of preferal vision in my right eye. So that did steer me away from the game, couldn't get used to that blind spot. I knew surgery may have been close at that time too, my cardio suggested to give the game up at that point, age 46. My valve replacement followed 3 years later. I have two sons that play now 14 & 18, so I get to the rink lots still. I think for a guy that has skated his whole life and acquired good stability on skates, and if the game is low keyed, cause even some no hit hockey teams get very competitive, I can't see a problem playing. But thats just my take on the deal. I will once again go ice skating and a little puck and stick work in the future as we have lots of out door rinks in the winter.i just can't play at the level I was used to in the past. Hope you find a decision for your desire to play the game you love.
 
I got a mechanical valve in September 2011 and I have been testing the effects of warfarin for about six months now . . . . My conclusion: I'm not a fragile flower like I was made to believe. Here's what I've done lately:

Came off my kayak in a surf break and got cracked on the head by the boat when a wave picked it up and hurled it at me. I was seeing stars and the crunch was sickening, but the fastest way to medical care was to get back in the boat and paddle upriver to the cars. It was 1.5 hours before I got to the hospital and they were not in the least bit worried about the warfarin - they were only concerned about a possible head injury.

Very next day I flew over a jump on my new mountain bike and my foot came off the pedal when I landed - I have spiky pedals - there was lots of blood and some very sexy lumps. Not much I could do about it there other than wash off the blood, and I kept riding for another hour. The bleeding stopped and I was fine.

Two weeks ago in a fit of over-confidence I zoomed around a corner on my mountain bike and suddenly found myself on the ground with my bike in the bushes and a VERY sore hip from landing hard on a rock. Again, back on the bike and continued. I developed a massive bruise but I did not bleed to death internally as I had once feared I might! :)

So I don't see why you can't return to competitive hockey. You're really not that delicate (based on my experiences!). It's probably wise to ask people not to slam into you, but realistically if something goes wrong they can get you to hospital fairly quickly. I reckon get back out there and live your life!
 
I got a mechanical valve in September 2011 and I have been testing the effects of warfarin for about six months now . . . . My conclusion: I'm not a fragile flower like I was made to believe. Here's what I've done lately:

Came off my kayak in a surf break and got cracked on the head by the boat when a wave picked it up and hurled it at me. I was seeing stars and the crunch was sickening, but the fastest way to medical care was to get back in the boat and paddle upriver to the cars. It was 1.5 hours before I got to the hospital and they were not in the least bit worried about the warfarin - they were only concerned about a possible head injury.

Very next day I flew over a jump on my new mountain bike and my foot came off the pedal when I landed - I have spiky pedals - there was lots of blood and some very sexy lumps. Not much I could do about it there other than wash off the blood, and I kept riding for another hour. The bleeding stopped and I was fine.

Two weeks ago in a fit of over-confidence I zoomed around a corner on my mountain bike and suddenly found myself on the ground with my bike in the bushes and a VERY sore hip from landing hard on a rock. Again, back on the bike and continued. I developed a massive bruise but I did not bleed to death internally as I had once feared I might! :)

So I don't see why you can't return to competitive hockey. You're really not that delicate (based on my experiences!). It's probably wise to ask people not to slam into you, but realistically if something goes wrong they can get you to hospital fairly quickly. I reckon get back out there and live your life!

What is Your INR.... I swear the doctors want me to live in a bubble
 
Hey pumpkinhead - my INR is between 3.0 and 3.5. I think my cardio would be happier if I was living in a bubble too but it doesn't seem necessary from my experiences!

Is there anyone on here who has had a bleeding episode and required medical attention??? I'd love to hear your story!
 
It has been 3.2-3.7 as of late, I go tomorrow morning for the first time in 2 weeks. It's been stable so they gave me a 2 week window this time, and if it's good again, it'll probably be 2 weeks again, then once a month.
I'd like it closer to 3.0 though.
you?
 
my Inr stays pretty stable at about 2.5, I take 5mg of warfrin a day and if it dips below 2.5 the doc has me take 7.5 for one day mid week. If Ski Girl is 3.0-3.5..then I have nothing to worry about. God when I was in the hospital shaving the nurse gave me the run around that if knicked myself shaving she would have to apply pressure for 30 minutes
 
my Inr stays pretty stable at about 2.5, I take 5mg of warfrin a day and if it dips below 2.5 the doc has me take 7.5 for one day mid week. If Ski Girl is 3.0-3.5..then I have nothing to worry about.

Pretty much. Its all a bit of a case of the troubles of a few lead to the warnings for all.

But if you were more likely to have a brain bleed (from concussion), well you will be more likely now.
 
Jesus Ski Girl...you take a beating!

I too am starting to notice that I don't bleed or bruise as much as I was told I was. My INR is between 2.5-3.0.

I know we've talked before Jcrown about our situation..I think as time goes on..your body heals and is working the way it should..we should just go for it. Anyone who's played the game knows its not something you can ever quit, you'll die doing it.

That being said, i like to ask around and get opinions.i hope to return to the ice next fall. However I wonder about the cold air, I know it constricts vessels? I was told this in my cardiac rehab. That I should ever mow the lawn again in the heat or shovel snow in the cold. Wonder how that plays out on the ice?
 
Ovie why can't you mow the lawn or shovel snow? I don't have any restrictions at all, my surgeon considers me 'fixed', as do I. Some doctors/nurses seem to have a one-prescription-for-all approach though and very few understand athletes and treat everyone like old crumblies . . . .
 
Ovie - I'll agree with ski girl. Once healing is complete, barring other complications, you should be able to do all the "normal" activities for a man your age. For me, at age 65, that even includes shovelling snow, yard work, jogging, biking, weights, you name it. If it feels good, do it. I would ask your doc whether the caution of the rehab tech applies to you. I remember when I was in rehab. They taught to the worst conditions in the group. In other words, they told us how to take care of ourselves as if we were elderly heart attack/bypass patients, not younger, healthy valve patients.
 
Couldn't agree more with Ski Girl and Steve -- that happened to me too. Cardiac rehab is full of people with ALL kinds of different issues. My understanding is that I had a heart DEFECT - I don't have heart DISEASE.

Always just so important to listen to your own doctor about your own limitations!

Rachel
 
I've been on Coumadin for the past 12 years. In that time I have lived my life without restrictions. I train for triathlons, volunteer at construction sites for Habitat for Humanity, use sharp hobby knives to build model ships and routinely bust my knuckles working on my cars.

I'm fortunate that I've never been a 'bruiser', either now or prior to going on Coumadin. My only bleeding incident was due to a botched polypectomy during a colonoscopy that put me in the hospital for four days.

I still run into supposedly intellegent people who think that folks on Coumadin run the risk of having spontaneous fatal brain bleeds and suddenly dropping dead in the street. They think I'm crazy for doing the things I do.

Probably the riskiest thing I do is ride my triathlon bike on public roads. Does Coumadin marginally increase my risk? Sure. But I'm a defensive rider and always wear my helmet. If I ever get run down by some soccer mom texting in her SUV, being on Coumadin is probably not going to make any difference.

I didn't go through my AVR with the intention of living my life cowering in the dark, fearing something that 'might' happen. I had an AVR so I could live something approximating a 'normal' life.

Mark
 
Three cheers for MarkU! You put it very well. We went through this surgery to have a chance to lead the lives we've dreamed about - not the dreams in our nightmares. Barring other complications, we are NOT invalids, and most of us plan to live our lives to the fullest. Join us, Ovie, just don't do anything "stupid."
 
Yeah, as time goes on, like with Hockey..I'm told not to play, but I'm going to next fall, I think it's wise I didn't in my first year of recovery. I'm starting to shell out a bit, still not to a year yet though. But I'm getting better at not cowering down.

I'd like to skydive at some point, I know the doc will say no, but I'm too young and have way too many things I'd like to do in my life.

Also, in my cardiac rehab is where I was told I shouldn't shovel or mow ever again, however I was the youngest by about 50 years so maybe it was aimed towards the 70 and up crew.

But yes, I'd rather die living my life then hiding in the shadows for the rest of it. Love the motivation guys, and good job on doing what you want. It's inspiring.
 

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