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  1. #51
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    Also, hippy pow turns are always enjoyable, no matter how extreme or rad one is.
    Exactly.

    Still have to wait for the lab test results until next week. Sucks...uncertainty is the worst. (well, still kicking alive and I'll try to live on a really "from day to day" basis now )
    "Average summit heights are around 1000m to 1200m but on the high glaciers of the main Lyngen Peninsula there are summits over 1400m with Jiehkkevarri being the highest at 1834m above sea level."

  2. #52
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    No problems on the blood coagulation factors. Or any structural problems (needing later surgery).

    Best x-mas present ever. I will back on skis by March (and off the f****ing rat poison )

    Should be careful with the right shoulder from now on but I guess I'll cut off some climbing and that's it (skiing and MTB are more fun anyway!). I'd like to surf but we don't have any decent waves anyway...so, for the trips I guess I need just better preparation (swimming), more rest days, more stretching etc. Anyway, so glad that I can still take normal skiing/mtb etc. falls/beating without being scared of internal bleeding and such.

    Peace and let it snow!
    "Average summit heights are around 1000m to 1200m but on the high glaciers of the main Lyngen Peninsula there are summits over 1400m with Jiehkkevarri being the highest at 1834m above sea level."

  3. #53
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    Congratulations, Jiehkkevarri!

  4. #54
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    Thanks!

    What a relief

    I am going to see a specialist soon and consult him a bit about skiing, possible future restrictions (in sports) and the possible length of the cure etc. (there's still hope that I get back to the action a bit earlier....but 2 months isn't that long after all, so at the moment I am still happy anyway).
    "Average summit heights are around 1000m to 1200m but on the high glaciers of the main Lyngen Peninsula there are summits over 1400m with Jiehkkevarri being the highest at 1834m above sea level."

  5. #55
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    Eugenio Oregón
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    congrats man! looming uncertainty in sports you love with chronic health problems just blows. I spent some time away from BC skiing for fear my left lung would spontaneously explode and leave me with no good means of rescue while my vascular system would gradually shut down! I have much less worry now in the BC (but I'm missing this season for another stupid health reason). Congrats to getting back out there in March, certainly makes you enjoy each minute that much more!
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  6. #56
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    Wow, I feel your pain. Its great to hear you are doing better.

    I had an aneurysm in my subclavian artery that caused clot to form from my collarbone to my fingertips. I had the whole shebang of symptoms pain, weakness, cold sensitivity, with a touch of necrosis. Luckily I formed colaterals too, but still needed surgery to save the arm. They resected my first rib and gave me a heparin infused gore-tex graft to bypass the aneurysm. I had a pretty uncomfortable experience with anticoagulents. When I started the injections, I had just finished a 24 hour race, and didn't have much in the way of fatty tissue around my stomach. I was spotted with bruises like a Dalmatian. In the hospitals they put me on the heavy stuff, TNK and others for days, which even caused me to bleed out once. I was initially discharged on asprin, but after complications, was put on lovanox again followed by a huge dosage of coumain. It was my GP, a skier, who really put the fear of god into me over trying to be active on those anticoagulents. My specialist had given the go ahead for a little skiing and I took full license, until my GP watched me ski and gave me an earful. (I guess I wasn't inspiring confidence). During this time, my bypass clotted out three times, at one point partially restricting bloodflow to my brain. I was very lucky to live through it, and required multiple surgeries including a complete graft replacement using vein harvested from my leg to get through everything. I am almost a year out from my last procedure and still don't have my complete ROM, but am feeling much stronger. My arm will always be a little colder, and still does not feel as strong. I definitely lost a few seasons, had to give up white water kayaking, and haven't been able to rock climb in any respectable way for at least three years. I have been very lucky, and am happy to say that I am skiing again and off of the coumadin. I will be taking a large asprin every morning for the rest of my life, and even paper cuts make me bleed quickly, but it won't make me hemorrhage.

    So much of the process is out of our control. I feel like you had some of that same frustration. Having fought that mental battle of loosing seasons and come so close to dying has given me an enormous opportunity to re-evaluate my life and how I want to live the rest of it.

    I live in a small town in Alaska and I have just turned 23. I work in health care and have been making the most of this incredible snow year. Something like 350 inches have fallen in the pass so far. I'll be taking my health as it comes, and will try not to let staying alive keep me from living.

    Thanks for sharing your story. Get after it! Good luck.

  7. #57
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    Thanks for sharing your story. Get after it! Good luck.
    Same to you. And wow: that was pretty heavy! Gives some sense of proportion for sure.

    Power and good vibes to you...it is great to hear that you can still enjoy skiing so fully (and life in general). I really believe what you said about re-evalution etc. (and I am also in the opinion that that's just "unfair" for a young guy like you...but as they say "unexplored are the ways of the Lord"...so maybe in the end you end up just being stronger and more aware of all the good things in this world! And I definitely hope so too).

    What I am afraid of is that the the symptoms (and anticoagulation cures) will come and go again, kind of like you described. No doc has given any reasonable long-time prognosis for me yet. And that's why I am about to see a specialist, a cardiologist soon - the guy is also an avid sportsman...so I guess he'll know some more/can help my case more that the previous docs?

    Good luck to all of you guys...you (and we) will eventually pull out of troubles, and eventually end up appreciating every turn (single track, route, wave etc) more than ever before!
    "Average summit heights are around 1000m to 1200m but on the high glaciers of the main Lyngen Peninsula there are summits over 1400m with Jiehkkevarri being the highest at 1834m above sea level."

  8. #58
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    Merry Christmas. Glad your cardio is a sportsman. I think if he can empathize with you, your care will be that much better.

  9. #59
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    Quote Originally Posted by Flotsam View Post
    Having fought that mental battle of loosing seasons and come so close to dying has given me an enormous opportunity to re-evaluate my life and how I want to live the rest of it.

    I live in a small town in Alaska and I have just turned 23. I work in health care and have been making the most of this incredible snow year. Something like 350 inches have fallen in the pass so far. I'll be taking my health as it comes, and will try not to let staying alive keep me from living.
    Way to keep on keeping on. We should be fearful people, but we should not allow ourselves to be terrorized by our fears ... Because life is a gift and it is a waste to not live it in a way that best fulfills our souls and enriches those around us. A very brave friend of mine, who had leukemia 3 times before she was 30, taught me that. Stay strong, brother.
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  10. #60
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    Jiehkevarri--Classic Paget-Schroetter is thought to be due to compression of the vein by the first rib and abnormal ligaments attached to it (see flotsam's post-although he had an artery problem). There is no good way to identify the abnormal structures, except in the minority of cases where there is an extra rib above the highest rib (cervical rib). Unfortunately there is not good information on the chance of another blood clot if the rib is removed or if it is not. There are exercises which can strengthen the muscles that shrug the shoulders--mostly traps--that may help. In general elevating the arm (as in driving) increases the compression of the vein, so not climbing is a good idea. I'm assuming the blood tests you had to rule out a genetic cause of the blood clot was done after you were off anticoagulants for a while--the tests aren't valid while you're anticoagulated. The question in your case is whether or not to have the first rib removed. The party line, at least among vascular surgeons, who are the doctors most likely to do the surgery, is to have it done. Having done a lot of these operations, though, I'm not convinced that there is enough evidence to recommend it, especially if the clot was cleared completely by the thrombolysis. If you do get another clot you should definitely consider it.

  11. #61
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    Old goat - that's great info! Thank you very much.

    I'm assuming the blood tests you had to rule out a genetic cause of the blood clot was done after you were off anticoagulants for a while--the tests aren't valid while you're anticoagulated
    Yes, they took the blood sample right after the DVT was diagnosed - which was before I started any anticoagulant medicine (right after that I started injecting Klexane, and after the thrombolysis I got the mentioned cure of varfarin (Marevan)

    Having done a lot of these operations, though, I'm not convinced that there is enough evidence to recommend it, especially if the clot was cleared completely by the thrombolysis.
    Yes, the clot is completely cleared. I have had an understanding that here in Euroland (I live in Finland) this operation (removing the first rib) is much rarer...and there isn't a uniform opinion (among the docs) whether the operation is needed or not.

    n general elevating the arm (as in driving) increases the compression of the vein, so not climbing is a good idea.
    Ok, that is in line with the common sense too. But this and all the above mentioned things are why I am going to see the mentioned cardiologist next week.

    I guess I am more than ok to live without climbing but I would really like to be able to surf at least here and there in the future too...(but we'll see...I guess if that is not possible, you just have to adapt!)

    EDIT
    here are exercises which can strengthen the muscles that shrug the shoulders--mostly traps--that may help
    Ok, that is also very good to hear. I think I will do all I can to to rehabilitate the shoulder!
    "Average summit heights are around 1000m to 1200m but on the high glaciers of the main Lyngen Peninsula there are summits over 1400m with Jiehkkevarri being the highest at 1834m above sea level."

  12. #62
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    I'm not surprised surgery is less common in Finland--in the USA the profit motive is supreme. I am surprised that a Finn surfs--elsewhere I assume. I wouldn't think surfing would be a problem, but listen to your docs, not some stranger on the internet--who knows if I'm really a doc.

  13. #63
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    who knows if I'm really a doc.
    You are right and I thought about that too...

    Good info anyway...and yes I am going to listen my doc for sure.

    As for surfing...yes, you can surf here now and then...crappy onshore windmush (mostly) and often brutally cold:

    http://moralesedwin.wordpress.com/20...on-surfer-mag/

    So, yes I surf mostly elsewhere (trips to France, Spain, Canary Island etc.). It's been really stormy this fall and we've got surprisingly big (storm onshore) waves here at times - but for a family man the surf here is pretty tough to score cause you have to be on the right spot just on the right time, the good conditions usually only last for some hours!

    EDIT: Funny that in the above article Finland is referred as "a socialist country"...that's kind of misconception but we have e.g. a free public health care system (that works pretty well too...although e.g. I am going to use private services from now on. The public system takes cares of the acute cases and does it very well but in many cases there is still need for private docs/clinics too)
    Last edited by Jiehkevarri; 01-07-2012 at 04:28 AM.
    "Average summit heights are around 1000m to 1200m but on the high glaciers of the main Lyngen Peninsula there are summits over 1400m with Jiehkkevarri being the highest at 1834m above sea level."

  14. #64
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    Jan 2020
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    Blood Clotting at High Elevations

    I definitely have new respect for the clot at high elevations. Heard to many stories about boarders ending up in ER because of a DVT. My Stepmom is a doctor a schooled me recently on the threat of not only a clot but a PE which is a like a heart-attack from a leg clot breaking off and going to your lungs. That shit not only ends your season but your life. Apparently the body goes into a protective state to adapt to higher sudden elevation and this increases the chances of blood coagulating. And if you are flying to your location it makes it worse.
    I have been using something that a ski pro at Bear Mountain recommended called Flight Armour. I get mine on amazon. I take it even though I'm not flying, just because of the elevation change. They seem to have lots of clinical studies backing the stuff up. Anyway, give it a try.
    Stay Safe my friends!!!!

  15. #65
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    It is well known that high altitude can produce DVT and pulmonary emboli (see 1953 American K2 expedition). The questions are how high, how long of an exposure, and the contributing factors. The risk to a recreational skier in North America is very, very low (unless you consider the Messner Couloir to be recreational skiing). Dehydration is certainly a major factor and should be easily avoidable except perhaps on long backcountry trips where melting enough snow can be tedious. With prolonged exposure increased red blood cell count is another factor which is unavoidable, short of bleeding.

    The main promising ingredient in Flight Armour is nattokinase--which seems to be a naturally occurring anticoagulant produced by bacteria in fermented soybeans in the Japanese dish natto. (Another traditional Asian food which supposedly increases longevity is wood ears, a tree fungus used in Szechuan cooking, which has well researched antiplatelet properties similar to aspirin.) The other ingedient , pine bark extract--seems to be promoted for a wide variety of health conditions --high blood pressure, Parkinson's disease, erectile dysfunction, migraine, and atheroscelrosis among others. It doesn't seem to have any documented anti thrombotic effect that I can find.

    The nattokinase would seem to be a promising agent for preventing DVT. The problem is that Flight Armour is an unregulated supplement which means there is no way to know if there is enough nattokinase in it to do any good if there is any in it at all. And if in fact there is a significant amount of the drug in Flight Armour I wouldn't want to take it due to the risk of bleeding. It would be nice to see good clinical studies of nattokinase comparing it with currently available anticoagulants for the prevention of DVT. Natural remedies can be ineffective and harmless (most of them), ineffective and harmful, effective and harmless (unlikely) or effective and potentially harmful (like the wood ears, although the risk is low, or foxglove--digitalis, one of the most effective and most risky heart drugs there is.).

    And if you order it on Amazon there is of course the risk of getting spammed.

  16. #66
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    chew up some baby aspirins and pound the water like there's no tomorrow, maybe add some fish oil.

  17. #67
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    In younger folks, they typically occur as a complication from surgery or with genetic predisposition. I think some of the newer (but crazy expensive) thinning medications like rivaroxaban are a bit safer than coumadin. So long as the clot goes away and doesn't pass to a critical area (lungs/brain), you'll likely be fine. It shouldn't affect your skiing once the clot goes away, I'd imagine.

  18. #68
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    This is an interesting thread bump. Here we are, 10 years later, and AKB has been getting after it way more than the average bear. Puts most of us to shame.

  19. #69
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    Jeez, it's been a long time since I've looked at this thread. To be honest, it's not something I'm eager to think about, but I guess I should update my own story.

    2011: I got off the rat poison (coumadin) and everything was normal for a couple years.

    2013: I wanted to get in a dozen or so hot laps at Northstar's bike park on by DH bike. Naturally, I'm near the end of my last run of the day on a jump line I'd done 100's of times before when . . . fade to black . . . I come to consciousness in a heap with a bike patrol and others standing over me. I don't know or remember what happened, but I'm pretty sure I significantly overshot a tabletop by taking the booster jump on the side and hitting it diagonally. Anyhow, I manage to drive myself to the ER, where they call the heli and lifeflight me to Reno, where I learn that I had a lacerated liver and kidney, punctured lung, concussion, and other stuff.

    Six weeks later I get another blood clot in my calf. I go on Xarelto this time. I also see a number of specialists locally and at Stanford, and the consensus is that the second clot, like the first, was probably the result of trauma. After three months, the docs okay me to get off the blood thinners.

    2014: One month after getting of blood thinners, I got a pulmonary embolism. I had been mountain biking the week before and was at the gym doing my normal warmup, but I felt kinda shitty. Not terrible, but not great. Having had the previous clots, I was aware of the a PE's symptoms. So I told my doc about it over the phone and he thought it was highly unlikely, but he ordered the blood work that morning and then called me and told me to immediately go to the ER, where they found clotting in my lungs and calves. It kind of fucked me up psychologically for a while. It's hard to explain, but I didn't want to leave my house or work for a month or so. One of the things that got me out of that rut was going to my daughter's first ski race.

    After this PE and third clotting incident, all my docs basically told me I'd have to be on blood thinners for the rest of my life. Again, I have no hereditary conditions, so the cause is mostly trauma based and the more clots you get the more likely you are to get further clots.

    Present: Being on blood thinners (Xarelto), the big concern is internal injuries--concussions and destroying my internal organs. Honestly, I have not noticed extra bruises or cuts bleeding more at all. In terms of lifestyle, I've never received any clear guidance from doctors. Some are very conservative and think I should take up video games, others have encouraged me to maintain my lifestyle but with added precautions and awareness. I have obviously chosen to adopt the latter advice.

    I've more or less stopped mountain biking. I continued to trail bike for a year or two but I found myself with a Ricky Bobby complex--I wanted to go fast and it was hard to enjoy going slower. I also felt like it was harder to control the injury risk on a bike, where I was always a pedal-strike away from disaster. I still ski a lot--between 60 and 100 days a year. But 85%+ of those days are in the backcountry. I don't huck things much in the resort and don't go into the park that often any more. In the backcountry, I do ski steep, exposed lines. But I figure in fall-you-die terrain it doesn't matter whether you're on blood thinners. But I'm also dialing it back at least a little when skiing and I rarely take beater falls these days.

    Honestly, I don't think about it that much these days, which is the way I prefer it. Once in a while though, something will come up and force me to take stock. For example, a few years ago, NBA star Chris Bosh had a PE, came back, and then got a blood clot in one of his legs. Even though he wanted to continue to play, the Miami Heat and NBA would not let him. I don't have the full medical story here, but the fact that professionals wouldn't let someone on blood thinners play basketball--a sport I never thought was all that dangerous--was certainly alarming.

  20. #70
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    Damn! Thanks for sharing.

  21. #71
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    Man, that's quite the saga.

  22. #72
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    Blood Clots, DVT, and the Future Pussification of My Skiing

    I think you told me about that on Strava because you’re always running and I was surprised you don’t MTB. But that’s a smart call... it’s just way too easy to get hurt on a bike, exponentially more than skiing.

    I’ve had a few occasions where I had to walk my bike back to my place in Truckee just covered in blood. Random shit can happen too easily... the most recent being a soft berm on Prosser Hill aka Animal DH blowing up on me and suddenly I’m tumbling over rocks. Wasn’t riding recklessly, just bad luck.

    I’m curious, when you had that bizarre snow collapse / creek fall last winter, after something like that do you go straight to the ER just to make sure there isn’t any internal damage? (Or maybe you didn’t really feel that banged up, I don’t quite recall)
    I ski 135 degree chutes switch to the road.

  23. #73
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    Quote Originally Posted by TahoeJ View Post
    I’m curious, when you had that bizarre snow collapse / creek fall last winter, after something like that do you go straight to the ER just to make sure there isn’t any internal damage? (Or maybe you didn’t really feel that banged up, I don’t quite recall)
    Nah. I broke a ski, but I didn't really take a hard beater in that one. I felt fine immediately afterward and continued to feel fine for the long, slow hike out. If I had felt woozy or like I had my bell rung, I would have certainly considered talking to a doctor. (Thankfully, my two main ski partners are ER doctors. )

  24. #74
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    Quote Originally Posted by AKbruin View Post
    Jeez, it's been a long time since I've looked at this thread. To be honest, it's not something I'm eager to think about, but I guess I should update my own story.

    2011: I got off the rat poison (coumadin) and everything was normal for a couple years.

    2013: I wanted to get in a dozen or so hot laps at Northstar's bike park on by DH bike. Naturally, I'm near the end of my last run of the day on a jump line I'd done 100's of times before when . . . fade to black . . . I come to consciousness in a heap with a bike patrol and others standing over me. I don't know or remember what happened, but I'm pretty sure I significantly overshot a tabletop by taking the booster jump on the side and hitting it diagonally. Anyhow, I manage to drive myself to the ER, where they call the heli and lifeflight me to Reno, where I learn that I had a lacerated liver and kidney, punctured lung, concussion, and other stuff.

    Six weeks later I get another blood clot in my calf. I go on Xarelto this time. I also see a number of specialists locally and at Stanford, and the consensus is that the second clot, like the first, was probably the result of trauma. After three months, the docs okay me to get off the blood thinners.

    2014: One month after getting of blood thinners, I got a pulmonary embolism. I had been mountain biking the week before and was at the gym doing my normal warmup, but I felt kinda shitty. Not terrible, but not great. Having had the previous clots, I was aware of the a PE's symptoms. So I told my doc about it over the phone and he thought it was highly unlikely, but he ordered the blood work that morning and then called me and told me to immediately go to the ER, where they found clotting in my lungs and calves. It kind of fucked me up psychologically for a while. It's hard to explain, but I didn't want to leave my house or work for a month or so. One of the things that got me out of that rut was going to my daughter's first ski race.

    After this PE and third clotting incident, all my docs basically told me I'd have to be on blood thinners for the rest of my life. Again, I have no hereditary conditions, so the cause is mostly trauma based and the more clots you get the more likely you are to get further clots.

    Present: Being on blood thinners (Xarelto), the big concern is internal injuries--concussions and destroying my internal organs. Honestly, I have not noticed extra bruises or cuts bleeding more at all. In terms of lifestyle, I've never received any clear guidance from doctors. Some are very conservative and think I should take up video games, others have encouraged me to maintain my lifestyle but with added precautions and awareness. I have obviously chosen to adopt the latter advice.

    I've more or less stopped mountain biking. I continued to trail bike for a year or two but I found myself with a Ricky Bobby complex--I wanted to go fast and it was hard to enjoy going slower. I also felt like it was harder to control the injury risk on a bike, where I was always a pedal-strike away from disaster. I still ski a lot--between 60 and 100 days a year. But 85%+ of those days are in the backcountry. I don't huck things much in the resort and don't go into the park that often any more. In the backcountry, I do ski steep, exposed lines. But I figure in fall-you-die terrain it doesn't matter whether you're on blood thinners. But I'm also dialing it back at least a little when skiing and I rarely take beater falls these days.

    Honestly, I don't think about it that much these days, which is the way I prefer it. Once in a while though, something will come up and force me to take stock. For example, a few years ago, NBA star Chris Bosh had a PE, came back, and then got a blood clot in one of his legs. Even though he wanted to continue to play, the Miami Heat and NBA would not let him. I don't have the full medical story here, but the fact that professionals wouldn't let someone on blood thinners play basketball--a sport I never thought was all that dangerous--was certainly alarming.
    Bumping this old thread because I just stumbled on it.

    AKBruin was very helpful when I went through a nearly identical saga after him (unspecified clotting disorder, followup clot, lifer on the AC's). The dude made me feel a lot less crazy and generally less alone, whether he knew it at the time or not.

    Funny, I still mountain bike but not as hard as I used to and our trails are carpet compared to Tahoe.

    Anyhow, big ups to AKB for helping a mag, even if he didn't know it at the time. That shit is hard to digest psychologically.

  25. #75
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    Thanks, dude. That's really kind of you. I'm glad to hear you're still getting after it on a mountain bike.

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