diving while on blood thinners

[bkmn103]

would like to know thoughts on diving while on blood thinners, I recently had problem with clots and will be on thinners for a while
Is it safe to dive?

 

[Pedro Burrito]

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A ScubaBoard Staff Message...

Moved from Basic to Diving Medicine

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[oldschoolto]

I've been on coumadin and still have 3 clots in my left calf... started with 6.. That was 3 years ago... Dive , Travel , and have no problems... Now, Doctor Mike may have a real medical answer... But, I giving you my personal experience with blood clots and blood thinners.... I Also wear support pantyhose...Jim...

 

[TSandM]

This is actually an area of controversy. I believe Duke's stance is that one should not dive while on anticoagulants. My personal feeling is that, if the diver is aware of the increased risk of bleeding with injury, it is not unreasonable to dive, if the anticoagulation is stable and well managed. Of course, if you get caught in the boat prop, or have a panicked ascent and rupture a lung, you are going to be in worse shape if you are on blood thinners. But routine diving rarely involves significant trauma, and nothing about being anticoagulated affects your ability to breathe, swim, or decompress.

 

[DavidFL]

I've been diving on Xarelto, one of the newer anticoagulants, for about two years after two DVTs (one of which went on to a fairly serious PE; all clots gone now as far as ultrasound and D-dimer indicate; discussed it with my hematologist and GP. It is indeed slightly controversial. DAN has a warning, but doesn't say in their regular medical weblinks that it is contraindicated. There are posts in other SB threads that say something like the clinicians at DAN are in agreement that it is contraindicated. Other medical professionals have posted yeah and nay and maybe. I consider all of the consultants; I cranked up my "personal" conservative setting to the max and mentally evaluate each dive to see if it meets my intent to dive "conservative profiles". I did query DAN at one point and asked if their guidance, which mostly references Coumadin/Warfarin, was any different with the various newer drugs and they basically offerred the same guidance as they have posted for Warfarin. I do my best to avoid hemorrhaging....on dive boats and everywere else. YMMV.

 

[Duke Dive Medicine]

As TSandM said, our general recommendation is that people should not dive while on anticoagulants due to the increased risk of bleeding from injury and the possibility of long distances to advanced medical help. Before making any further recommendations or decisions, it is prudent to explore the reason that the individual is on anticoagulation therapy. For example, if someone is in chronic atrial fibrillation and his cardiac output doesn't support the exercise and immersion involved in diving, then it's prudent not to dive. If the reason for anticoagulation therapy is deep vein thrombosis, what is the etiology of the thrombus? Is it related to an underlying condition that is not conducive to diving? Is it from prolonged immobility? If so, why was the diver immobile, and what is the probability that the activity involved in diving could dislodge any remaining clots? The question is more complicated than simply whether it's safe to dive using anticoagulants.

Best regards,
DDM

 

[TSandM]

Good points, DDM. A patient who has had a pulmonary embolism and ended up with pulmonary hypertension is very different from the patient with an uncomplicated DVT related, for example, to airplane travel. One must always consider the patient's entire medical condition in decision-making.

 

[Dr. Doug Ebersole]

I agree completely. As with most questions about diving on medications, the most important thing is what medical condition do they have that led them to be on that medication in the first place. By the way, the same goes for diving with coronary stents, pacemakers, defibrillators, etc.

 

[oldschoolto]

Well lets see... I have early signs of MS and take anti-convulsant meds to stop the muscle spasms, Have loss of feeling on the left side of my body with blood clots ( DVT ) in the middle calf area... Have paralysis in the left side of my face and left eye focus problems... I need to wear medical support pantyhose to stop my left leg from swelling up to 3 times bigger than the right... I have a blown out back at the L-4/L-5 that causes loss of urine and unable to climax after over exertion, also makes walking and balance difficult... BUT... I still can get and maintain a erection with is a PLUS... Take 6 meds and painkillers at night if I can't sleep because the pain is to bad... And I'm still diving.... Still Trucking and Still living life.... Jim....

PS; I have given up drinking and skydiving....

 

[oldschoolto]

I'm guessing that the doctors feel I'm OK to dive or are just shaking their heads... That's what my VA doctors do, Just shake their heads and smile...

Jim...