I too am an ER doctor. Everything in life is about risks and benefits. I would argue that HPDE is NOT racing and you are more likely to be involved in an MVA on the way to/ from the HPDE than at the HPDE itself. Designated passing zones, point by passing and teched cars is certainly safer than any toll road here in Dallas. I would probably not push it with W2W racing, but HPDEs seem like a good compromise to me. Anytime you are on blood thinners, EVERYTHING is a calculated risk. Even walking the dog is risky. But remember, we routinely put 70/80/90 year old people on these medications with HUGE fall risks and we don't tell them to wear padded clothing and never get out of bed....

 

 

Blood thinners were the reason I gave up DE in 2007 and started autocross. A lot. It was not the same as DE and at first not as much enjoyment, but allowed me to play with my GT3 RS. But then I got better and faster and started kicking butt. Got wifey hooked on it too (best damn thing ever) Our peak was 35 events in our season of 7 months. My best season was 2016 where I took the seasons win in my class with all 4 clubs that we ran with. Grand slam.

 

Disclaimer: I am not a physician. I didn't even read through this entire thread. BUT, I do take Coumadin/Warfarin every day - and likely will for the rest of my life.

I was terrified of having to take anticoagulants for the rest of my life. When I need an aortic valve replacement at 22, I opted for a route that guaranteed at least one more open heart surgery in my lifetime specifically because I wanted to avoid taking Coumadin through my twenties and thirties. I didn't want to give up racing bicycles, climbing mountains, driving on the track, muay thai or jiu jitsu. But eight years later, I needed to replace my replacement valve - and I opted for the route I ultimately tried to avoid: anticoagulants for the rest of my life.

After six years on Coumadin, my experience - and again, this is just me - is that doctors are often accustomed to speaking to older patients, or patients with much less active lives. In my case, they didn't understand just how much these seemingly silly pursuits defined who I was. And so I asked lots of questions, read and researched as much as I could to understand the risks. Which I suppose is my suggestion: understand the risks, and make the decision for yourself. Don't let someone else's value system decide how you live your life.

My target INR is rather low (2.2). I ultimately take Coumadin to avoid a less than 1% chance (for someone of my age/health condition) that a blood clot attaches to my valve. For me, this research led me to give up mountaineering - I was in a place where my trips were becoming more and more remote (think bush planes onto Alaskan glaciers), and my risk-calculus suggested that the chance that a simple injury (like a broken bone) in the backcountry could become life threatening. That's not a risk I was willing to take or responsibility I wanted to put on my climbing partners - and so I quite climbing. But I started road racing six months after my second surgery. I have to sign a waiver for each organizations I race with - but knowing that (1) Coumdin can be reversed somewhat quickly, and (2) that there is always emergency medical assistance on site, I figure that I'm safer in an accident on-track than I would be in an accident on the street. I still ride road bicycles, though I don't race anymore. I likely wouldn't race bicycles on Coumadin given how often crashes happen, but I've never crashed outside of a race in more than 50k miles and so I think that's rather safe. I was afraid of training in muay thai or jiu jitsu until the last six months. While my shins had some terrible shades of purple over the first month or so, bruising is pretty limited at this point. I do spar - though I likely wouldn't ever take a fight without headgear.

This is just my experience. I'm sure physicians will disagree with me; my cardiologist certainly does. But I feel like I'm quite aware of the risks and made decisions that I'm comfortable with.