5 weeks...so far so good...questions

[cpj123]

So I have few questions and comments. Thanks in a large part to info on here my recovery has been really predictable….in a good way.

1. My surgeon got inside and said he could not justify fixing my aneurism (3.8). Which brings me to my follow up with the surgeon in which in fact was only with his PA. She gave me the never more than 50 pound routine and that pull ups and pushups should be avoided. My question is if all I had was a valve replacement and a “small “aneurism am I really at any exercise induced risk? I could tell she was being careful and I will grill my cardio who I am seeing in a couple of weeks. Just looking for opinions. I am not hard core but above average in the exercise department….but I love P90X and would love to resume.

1. I took beta blockers for about 6 months before the surgery. I was a very solid 120/70 with HR of 65 during that time. After the surgery I noticed the bottom number is higher (85ish). Is that common? On my follow up they did not seem to notice. Today all the way up to 89. Otherwise I feel good.

1. They waved cardiac rehab since I am up to 4 miles a day. I was a little disappointed…I liked the idea of somebody pushing me a bit…and getting comfortable with how far that might be. My plan is to stick with walking until 12 weeks.

1. Kinda dumb question but it got me thinking. The DRs. So far have been pretty determined to keep me on Beta Blocker. The question is my valve (bovine) going to have a certain amount of pumps? In that case it seems to make sense to stay on a BB and get maximum life out of the valve. The other part of that is I had a BAV…my blood pressure and HR were always very solid until about 50 when it went up for the first time ( I am now 53). I was told there was a good chance the BAV caused the rise as it deteriorated. Is there not a chance it would normalize on its own after the replacement? Lots of BB questions because I could do without them personally.

Thanks,
CPJ

 

[Paleowoman]

Hi CPJ - Glad you're doing well !

I wasn't given any limits on weight lifting or on doing push ups or pull ups - perhaps they thought I wouldn't do those things being a woman ? When I had rehab the rehab nurse, who was a sportsman/ironman, gave me a weight lifting routine as part of the rehab. A pity they waved your rehab as it's really good to have someone push you and give you confidence in your heart, so I understand your disappointment.

Re your blood pressure - mine has gone very similar since surgery. Prior to surgery it was always quite low as in approx 90/65 but I felt really great on that. Since surgery, two years ago, it has been quite high I think. The diastolic pressure, the bottom number that is, is usually in the 80's, sometimes even the 90's. Occasionally it comes down into the 70's. I don't think it's very good that it is so high so I will be curious as to what you find out about this. Every time I see my cardiologist (every six months so far) I give him the readings from the previous four weeks or so and, although he sometimes comments on the high numbers, he then says that others are lower so that's okay. I wouldn't take BP meds but I would like to know why it has gone higher like yours.

I came off the beta blocker around 7 or 8 weeks post surgery. I did not want to stay on it. I've never heard of the valve going to have a certain number of pumps. I have a bovine one too. Well there's not much we can do about that, and to me beta blockers can have adverse effects so not sure what the answer is there.

 

[rakesh1167]

I would like to comment on your first point.
My aorta size is 3.8 and surgeon advised against lifting heavy. It increased between 2007 and 2013 when i had boderline high BP and used to lift heavy.
I think that lifting heavy had contributed to this increase. Giving up weight lifting was one of the hardest decision of my life.They could be suggesting weight restriction so that it doesn't increase further. Lifting heavy and workout contributes to this.
I remember a member posting here where his aorta was increasing and he used to run a lot . He replaced running with brisk walking and his aorta remained stable for next 7 years.
With this size your aorta is unlikely to blow during a workout but it could increase in size.

 

[AZ Don]

1. I think that the risk of exercise to those with an aneurysm is related not only to the intensity of the exercise but to the size of the aneurysm and whether there are any other factors (eg. marfans). I was lucky in that my aneurysm was not discovered until it already met the surgical criteria. After having my aneurysm replaced with a graft I still avoid the most strenuous exercise, and my risk now is probably at least as low as those with the smallest of aneurysms. I don't lift a weight that I can't lift at least 15-20 reps, and when I feel that I have hit my limit, rather than try to push on (as I used to), I just stop. I posted some info relevant to exercising and aortic aneurysm here: http://www.valvereplacement.org/for...2576-exercise-and-stress-with-aortic-aneurysm
2. I had my BAV spared when my aneurysm was repaired, but it started leaking after my surgery, so my bottom number actually went down. From 70-80 prior to surgery to 60-70 after.
3. I skipped cardiac rehab. My Dr's said that I had already surpassed what they did in the earlier phases of cardiac rehab and that I was much younger (52 at the time) than many of the patients they see. Because I was only referred to the latter phase of cardiac rehab it was not covered by my insurance and it would have been almost an hour round trip to go to. I did not see the advantage over going to my local health club 5 minutes away. I have heard cardiac rehab has been very helpful for some.
4. I had an appt just a week or so ago with a surgeon and asked him about tissue valves and the opinion I've seen expressed in this forum that the life span of a tissue valve may be related to activity level. He said that the life span of a tissue valve is clearly related to age. He placed a tissue valve in a patient in their mid 80's; they recently hit 100 and he said the valve was still like new. He said that beyond the relationship to age they just don't know for sure what effects the tissue valve life expectancy. I take metoprolol and as I understand it, this is primarily to lower my risk of a repeat aneurysm. My HR and blood pressure were pretty normal prior to surgery. I tolerate metoprolol very well, as long as I don't take it at night (it interferes with my sleep if I do), so I have continued to take it the last couple years. I know that many people don't tolerate it so well - if I was one of them I would definitely have more of an issue with it, or perhaps look to try a different medicine.