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Pulmonary Embolism
June 2002

Q. I suffered a pulmonary embolism (PE) three weeks ago which required emergency hospitalization for five days. The source is still unknown. My pulmonary doctor wants a CT scan in six weeks to see if the clot is still there. In the meantime, my primary care doctor has me on 5 mg Coumadin/daily. The pulmonary doctor advised against any exercise for months, while my primary care doctor wrote out a permission to participate in vigorous activities immediately. I have jogged 6 miles/day for 15 years. Everything I read says exercise is important post PE. What should I do?

A. Your description has several points that deserve attention. First of all is the need to determine the diagnosis which would explain the blood clot (embolism). This may require evaluation by a hematologist. Secondly, the coumadin medication is a "blood thinner" used to prevent clotting, and it may take several weeks to find the exact doseage that will keep you safe from clotting but not make you at risk for internal bleeding. Until that occurs, vigorous exercise seems unwise. Regular exercise such as brisk walking will certainly help the circulation in general and is probably fine, but your 2 doctors need to confer and come up with the right guidelines for you in this matter!

http://www.nlm.nih.gov/medlineplus/ency/article/001124.htm

http://www.familydoctor.org/handouts/244.html

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