Is there a doctor in the room?

During the 2016 race season, my doctor put me on Eliquis (anticoagulant) to address what appears to be a hereditary blood clotting issue. I was told to avoid dangerous activities, which included discontinuing my Spec Miata habit.

Two years on, I’m trying to figure out how to get back to wheel-to-wheel racing. With their emphasis on no contact and avoiding low-risk passes, I’m wondering if vintage racing with an organization like SVRA would be reasonably safe.

Hoping that a doctor and fellow racer can provide an opinion/assessment on the relative risk of wheel-to-wheel racing with a vintage organization while taking Eliquis.  To the uninitiated, all auto racing is dangerous so I don’t fault my doctor for discouraging this behavior.

Please note that I am not seeking a medical diagnosis, a prescription or anything else that would constitute medical treatment. Rather, just hopeful that a qualified medical professional and fellow racer could weigh in with their opinion …

Thanks in advance for any insight you can provide.

I'd talk to my life insurance agent, and base it off that conversation.

Now, define "Dangerous Activity".  Shingling your house, or using a reciprocating saw is far more dangerous for you than motor racing.

But that's only my opinion, I could be wrong.

My life insurance policy has exclusions for scuba diving, sky diving and motor sports.

If you ask your insurance agent about this, you'll probably get the same.

I am an emergency physician, but I have never done any wheel to wheel racing. That said, I would say that even track days or non competitive automotive events are fairly risky if you are on a blood thinner. The issue is that you are at significantly increased risk of brain bleeds or other serious internal bleeding with trauma. If you were to crash, it will almost certainly go worse than if you were not on blood thinners.  My disability insurance policy specifically excludes any motorsports or racing activities as well.  I don't think you will get a physician to endorse any sort of racing while anticoagulated. I also get that people need to make their own decisions and decide what level of risk they are willing to accept.

In reply to tra68 : “If you were to crash”  oh you mean fall in the shower? Trip on the sidewalk? Get into a fender bender driving on the street? 

I Vintage raced for nearly 30 years without a scratch. I never actually saw people injured vintage racing.  I heard of the rare accident but Vintage racing isn’t as risky as most motor sports.  

Cars in vintage racing are highly prized.  Some are worth millions and even the most modest ones are carefully prepared and lovingly restored.  

Contact of any sort is extremely offensive to those who put their prize on the line!  So offensive that most clubs have a 13-13 rule.  Basically one minor trivial bit of contact  has you on suspension for 13 months. A second bit and you are banned.  

13 months means that for two years from the bit of contact you won’t race at that event! 

We are serious about that issue!  

Race, race hard but carefully,   always keep your car under control.   

Now I can’t tell you that all vintage racing is safe.   But if you enjoy Motorsports it’s probably as safe as you’ll get.  

turtl631 said:

I am an emergency physician, but I have never done any wheel to wheel racing. That said, I would say that even track days or non competitive automotive events are fairly risky if you are on a blood thinner. The issue is that you are at significantly increased risk of brain bleeds or other serious internal bleeding with trauma. If you were to crash, it will almost certainly go worse than if you were not on blood thinners.  My disability insurance policy specifically excludes any motorsports or racing activities as well.  I don't think you will get a physician to endorse any sort of racing while anticoagulated. I also get that people need to make their own decisions and decide what level of risk they are willing to accept.

I wish you would look at vintage racing before you make blanket statements like that. 

First accidents happen everywhere! Trip on a sidewalk, fender bender on the road, fall in a shower!  That’s part of life. 

Once you accept the risk that is life you need to look at what events increase those risks.  Auto crossing for example puts you at or below the speed of driving on the street.  Without the risk of collision with a drunk driver, or someone texting.  Or just wandering over into another lane.  

Vintage racing is a strictly no contact event!  Because the cars can be worth millions but even if an extremely modest car it reflex the owners most prized possession, carefully restored and prepared. In 30+ years of vintage racing  I never received a scratch, nor did I ever see anyone injured. 

On rare occasions I heard of it happening. But no contact is strictly enforced.  There is a 13-13 rule to prevent drivers from any such risky behavior.   Finally there is no prize money or or any other inducement 

30,000 people are killed driving on the road every year.  And while the numbers of racers isn’t nearly as high as the number of drivers on the road, racers are specially well protected, helmets, fireproof suits gloves and scarfs, special racing harness is worn and a HANS device provides neck protection.  Fire extinguishers rollcages, fuel cells and cut off switches are just a tiny portion of all the special protection drivers are given.  

All drivers are trained to drive at racing speed. They all are driving in the same direction with the same focus and goal.  Closely monitored for sobriety, attention, and skill. Different speed cars are grouped with cars with similar speed potential . 

The racetracks are specially prepared for safety in the event cars get off the road.  Doctor and staff attend each event. Along with EMTs and an ambulance. Each corner is monitored by trained safety people with safety equipment right at hand. Everyone on the racetrack is closely monitored and supervised.  

The protection of modern cars and equipment allow drivers to crash, flip, be run into, at speeds over 200 mph and get out of the car waving to to the crowd.   Yes they are taken directly to a doctor to be carefully checked out but that is less than a few minutes away.  (unlike the road where it might be a long time before they are finally able to get to a doctor) 

Man, you need to calm down.  So you think there's never any crashing in Vintage Racing because of the 13-13 rule?  That people never get red mist?  That the track never gets oiled down?  Get real!  Spec Boxster has 13-13, and there's contact there all the time.  Single car accidents happen on track all the time.

Comparing tripping on a curb to a car crash at speed is ludicrous.  Very serious injury can happen when you're on a blood thinner.  Something you or I would basically shrug off with a "Damn, that kinda sucked." 

End of the day, tra68, you need to make a decision, knowing that the blood thinner puts you in a category where if something happens, its going to be more complicated and could result in serious consequences.  Are you ok with that?

Not a doctor and don't play one on TV, but it sounds like the issue is with anything that involves bleeding.  That doesn't just mean a cut, but internal bleeding too.  You could get that from a spirited drive in a race car all by yourself on track with lap belts, seats, etc. just banging away on your body. Might not even be bruises that you would see, but could still be bad.

Sure, you can do the same in the shower or in your front yard, but the g-forces you're body is exposed to on a track are much different and much more frequent.  I'd almost wager that being on track will guarantee some bruising (especially if it's your first time back in a car in a while) whereas mowing the lawn has the potential, but not likely.

I don't think anyone's bashing racing as dangerous, just that the forces you're body is exposed to make you much more susceptible to bleeding injury.

-Rob

I’m not a doctor but have several very close family members on blood thinners due to a genetic clotting condition and lost one to a brain bleed due to his blood thinners. I hate to say it but they’re very dangerous. Frenchys claims of the safety of vintage racing have nothing to do with it. Just racing with no contact may be enough to cause brain bleeding. The fact is our modern daily life doesn’t put us through the scrambling that racing does. The issue to me isn’t a bruise or a broken bone - though that would be bad on thinners - but the danger to your brain. I don’t know about you but I feel pretty beat up after a couple hours in the race car with vibration and bumps and thumps taking their toll.

I have been on blood thinners ,aspirin, for years, also meds for blood pressure.

I ran track days and ice raced for those years.  

 Due to a recent episode I was switched to Eliquis.

No warning from the doctor.

Normal cuts and scapes heal without problem.

In case of surgery, you may be told to stay off the thinner for a time before.

Not to go totally off the rails, but what about a badass simulator setup and iRacing?

If I recall there is even a GRM sim racing league.

Tell your doctor that you're going racing, and to adjust your medication if he thinks it necessary.  We need to remember who is serving whom.

dculberson said:

I’m not a doctor but have several very close family members on blood thinners due to a genetic clotting condition and lost one to a brain bleed due to his blood thinners. I hate to say it but they’re very dangerous. Frenchys claims of the safety of vintage racing have nothing to do with it. Just racing with no contact may be enough to cause brain bleeding. The fact is our modern daily life doesn’t put us through the scrambling that racing does. The issue to me isn’t a bruise or a broken bone - though that would be bad on thinners - but the danger to your brain. I don’t know about you but I feel pretty beat up after a couple hours in the race car with vibration and bumps and thumps taking their toll.

If they give the same warning about riding roller coasters, horseback riding,  or riding a bicycle, I may agree with you.  

1988RedT2 said:

Tell your doctor that you're going racing, and to adjust your medication if he thinks it necessary.  We need to remember who is serving whom.

That strikes me as an unnecessarily adversarial approach. In lieu of other information, the doctor probably starts with the presumption that your first priority is to stay alive, and that the most effective medication is the approach to take, and that if you need to change behaviors to accommodate that, that may be fine.

Along those lines, perhaps it's worth inquiring whether there's another approach that's more motorsport-friendly but better than just going off anticoagulants?

docwyte said:

Man, you need to calm down.  So you think there's never any crashing in Vintage Racing because of the 13-13 rule?  That people never get red mist?  That the track never gets oiled down?  Get real!  Spec Boxster has 13-13, and there's contact there all the time.  Single car accidents happen on track all the time.

Comparing tripping on a curb to a car crash at speed is ludicrous.  Very serious injury can happen when you're on a blood thinner.  Something you or I would basically shrug off with a "Damn, that kinda sucked." 

End of the day, tra68, you need to make a decision, knowing that the blood thinner puts you in a category where if something happens, its going to be more complicated and could result in serious consequences.  Are you ok with that?

We agree, in the end it’s his decision.  However the forces in Vintage racing with their hard bias ply tires are much easier than hot sticky slicks.  Plus the age of the typical Vintage driver puts a much different perspective to racing than other racing.  Real gentlemanly conduct, the right crowd and no crowding.  

I suppose it really depends on the degree his of condition.  If his doctor tells him to never ride a roller coaster, a horse, or do anything vigorous then certainly racing is over for him.  Including playing golf because he may get hit with an errant ball.  

 When I was in my 30’s a doctor didn’t want to give me a racing physical because she felt she should limit my risky behavior.  

Could it be a matter of perspective?  Is it possible the doctor believes all racing to be a foolish risk?  I know that before dental work or any surgery  they want you off thinners for a little while.  Is that possible in the OP’s case?  

My NOT ADVICE (damn lawyers) would be exactly as turtl631 wrote above.  And I seriously doubt that in today's society you will find any physician that would recommend dangerous activities for people on anti-coagulants.  Having seen many, brain bleeds are not a whole lot of phun.  Not at all.  Suck for the patient too.  Really bad.  Some things can't be avoided, like walking to the mailbox.  Some things can be avoided, like boxing or racing. 

Dr. Hess said:

My NOT ADVICE (damn lawyers) would be exactly as turtl631 wrote above.  And I seriously doubt that in today's society you will find any physician that would recommend dangerous activities for people on anti-coagulants.  Having seen many, brain bleeds are not a whole lot of phun.  Not at all.  Suck for the patient too.  Really bad.  Some things can't be avoided, like walking to the mailbox.  Some things can be avoided, like boxing or racing. 

Would you tell them the same thing about Roller coasters? Horseback riding? Volley ball?  If so I understand. 

In reply to frenchyd :

I think the signs posted at roller coasters pretty well covers it, with "OR ANY PHYSICAL CONDITIONS THAT MAY BE AGGRAVATED BY THIS RIDE"

Seriously, man, how belligerent are you? 

In reply to mguar:

Everybody here has read what you posted, every time you repeated it. Please understand your point is as made as it is going to get, and let the conversion continue.

So what event triggered the doctor prescribing the eliquis other than family history ?

We need the rest of the story.

Mine was a TIA mini stroke and discovery of partial blockage of the carotid arteries.

That was 18 years ago with 325g aspirin. 

I never gave it a thought and just did what I always do.  Cuts and scapes included.

I got switched to eliquis because of a minor Afib attack.

First off, disregard pretty much everything in this thread, except the stuff that is posted by the doctors.

Aspirin and Eliquis or Lovenox are a totally different ball game.  Aspirin will make you prone to bruising and what not.  The consequences of an event when on the latter are much more likelyto require a religious consult.  It is like walking on a beam laying on the floor vs a beam stretched between two buildings.  Chance of falling may be low for both of them, but one would be tough for you to survive.  Those signs they put on the entrance to roller coasters and such that say keep out if you have a heart problem are not there on accident.  

Maybe autocrossing would be an adequate outlet for your passion, much lower chance of contact, though I know a guy who rolled a Cortina in a sea of cones.

frenchyd said:

Would you tell them the same thing about Roller coasters? Horseback riding? Volley ball?  If so I understand. 

If asked, I would strongly suggest avoiding unnecessary activities that could lead to injury.  Horseback riding, yeah, that's one dangerous sport.  You could get Superman's Disease with that one.  Volley ball?  Dunno.  Roller coasters?  Dunno, do you get hit upside the head on a roller coaster?  And don't forget there's a reason people take those drugs, and it ain't because "everything is GREAT."

Thanks to all that have replied to my post, especially the physicians as their comments were particularly insightful.

My physicians, primarily the hematologist, spent a little time explaining that the real risk while on an anticoagulant like Eliquis was the potential for bleeding on/of the brain as well as the internal bleeding that can be hard to detect until it is too late / getting too late.

What I didn't know was just how much impact or force would be required to cause a problem. Per the responses above, it appears that it might not take all that much to be in a bad way.

Thanks again for your comments, this has helped.  Unfortunately, I think I know what the right answer is.

In reply to slefain :

Thanks slefain, that is a good idea.  My fiance made the same suggestion but I was holding out for the real thing.  Now that VR is available, maybe this would scratch my itch.

In reply to iceracer :

I had a pulmonary embolism.  My father has been prone to DVT.  I got lucky because my PE caused enough pain for me to go to the hospital and I received prompt treatment before it really went bad.