Better than before?

[hoboacademic]

Hi all:

I'm a 36 year old male who had valve replacement surgery 9 weeks ago. Surgery went well and luckily I recovered well. Before the surgery I was training for a tri and feeling really good.

When my surgeon opened me up, he said he was surprised to see how enlarged my heart was but he saw it immediately shrink (yay!). He said I was overcompensating a lot prior to surgery.

I am currently jogging and walking and biking (swimming is a week away) and have been doing so for the last three weeks--and I am getting better. I get scared, though, to push it and I stop when my heart rate gets anywhere near the 80%. Now my doctor is pretty laid back and does not have any restrictions on me and says to use common sense. So I want to start pushing it a bit and start training for the tri again.

So here's my question: how many runners/swimmers/bikers out there that are better
now than they were before your surgery? Are you able to run/bike/swim better than before?


THanks,
John

 

[JimL]

Take your time. It is easy to overdue it. Nine weeks is still very early. -- However, I am nearly ten years out, and I still cannot stop walking faster than anyone else around me. I still cannot stop taking stairs two at a time. I still enjoy not being short of breath ever. Take your time. Don't rush too much. Set backs are normal, but still depressing.

 

[camgough]

Hey John,

You are really early to be having such good success, and I hope it continues for you. As others say, just be careful not too push it too hard. For me, I am a year past my surgery, and am still not even close to pre-op conditions. I am hoping to keep improving, but I am having a hard time. Did you have replacement or repair, and did you have mechanical or tissue?
Cam

 

[Cooker]

I'm not a runner, biker or swimmer but I agree with everyone else, take it slow ... At nine weeks you are early in the recovery process ... Oh, I am in better health and have more energy that before surgery:thumbup:

 

[hoboacademic]

Hi Cam:

I had Tet of fallot when I was younger and then nine weeks ago I had valve replacement. It was a bovine valve. And yes, I am taking all of your advice and need to keep my exercise in check. What my doctor said was that I caught this pretty early (although I did push it off for about a year) and that is why I have been successful (so far). Good luck with your recovery as well!

 

[RunMartin]

Some are better than before and some are a bit slower. The main thing is to take it easy early on - i.e. increment the training levels slowly (it is not a race to get back to your original levels). Also listen to your body - it tells you when you are overdoing things! I over did things at times as it took a long time to learn what I was capable of again.

 

[njean]

It's wonderful to know that you are feeling so much better now, after your surgery! It can ONLY get better with each passing day!

OHS has given you a new lease on life! Enjoy it to the fullest!

 

[Bean Counter]

I am a little past my 1 year mark of BAV. I think how much better you are compared to pre surgery depends a lot on your fitness level prior. In 2009, I was training for the Chicago marathon and was probably in the best running shape in the 10 years that I was competitive..all workouts were pointing to a 2:50 to 2:55 marathon, but the cardiologist pulled the plug on me when he saw the results of my stress/ echo a few weeks before the race (we always did a checkup before each race). 9 months later I was on the operating room table.

Now, I dont think I will ever be in the shape again..it seems that everything went right that training cycle, plus I was able to rally push the mileage and the intensity (that burning desire I had is kind of missing these days). I do still think I can get up to Boston Qualifier status (3:10 or better), but that will probably be my limit and it probably wont happen until next year.

Now, if I had only run a few marathons prior to surgery, and did not have 10 years of solid training invested, then I would say I would get better after surgery.

 

[tprice54]

At 9 weeks, you have plenty of recovery yet ahead of you. My totally unscientific opinion is the younger the patient, the better chance of recovery to a point you are better than before surgery. Us old guys just don't seem to get back to that level, although some do, many do not. You have a good chance to get back in the race....remember that recovery will not be linear...you will improve in jumps, slide back a little, over and over again. Just keep at it!

 

[JeffM]

I'm in the same camps as Bean and T. As an athlete, you know better than most how to read your body and when to back off. I know where your head is. You want to hit as hard as possible early on so you can limit the deconditioning. From what my cardiologist told me and from my own experience, once I was 9 - 12 weeks out of surgery, I was OK to go 80 - 90%. I'm a former competitive runner and swimmer by the way, but I exclusively am a road cyclist now. Until I was 6 months out, most of my riding was "base" type training with some interval work and some not too grueling hill work. After 6 months, everything got derailed because I had back surgery. The cycle then began again. So, now almost three years out, with my training time limited by my work schedule, I feel like I could be as strong or stronger than I was pre-surgery, if only I could put in the miles and the time. I'm almost 56 and my max HR doesn't go quite as high as it did before surgery, but logic tells me it doesn't need to. I think you'll make improvements on where you were pre-op. One more example: Another VR member who is a Cat 1 cyclist had a Ross Procedure a little over 3 years ago at about your age. After his surgery, within 2 years, he won a race he had been trying to win for years and he competed in the Ironman (Hawaii) for the first time. This guy described his swimming ability as "like a rock". I recvall that while he had an aggressive training program to get back in shape, he also was deliberate about not over doing it in the early stages. I hope those examples and your own experience and common sense guide you to some PRs in the coming years!

 

[enkaynj]

John,
Looks like you did not go through cardiac rehab or anything like that ? I am getting conflicting advice. Some people that had a bypass suggested it is a good thing to go through rehab but others say that a good dose of common sense should do to avoid over exertion. Any advice based on your experience ? I am 3 weeks post-op and got a bovine tissue valve for my AVR.
Thanks in advance.

 

[johnp]

I would vote for cadiac rehab. In my case it was basically like a short term membership to the gym. They pushed me hard while I was hooked up. This gave me a clear picture of how things were progressing. Sometimes you might feel something unusual, but in my case, it was good to confirm via EKG and other vitals that it was nothing to be concerned with.

 

[hoboacademic]

Hey all:

Thanks for the advice! I know the biggest thing is not overdoing it--of course last night I was in the gym jogging on the treadmill and today my hammy is sore--but at least it's my hamstring and not my heart!

enkaynj: I did not do any cardiac rehab. I was in the hospital for four days/nights. The fifth day, just being out in the real world was hard. The sixth day, I walked two blocks with the help of my wife. Seventh day, I walked it myself. Eighth day I was walking a little farther....I asked my doctor about cardio rehab and he told me the "common sense" thing and said I could do it by myself. But if it was actually offered by me, I probably would have done it as well--it certainly wouldn't hurt and it would be nice to get feedback from doctors right away.


Good luck everyone and thanks!

 

[nate_c]

I'll add my two cents. I'm about 11 months out of my AVR. I was in the best running shape of my life right before surgery (no symptoms, luckily). I ran a 10k this last weekend as hard as I could. Left nothing on the course, and was about 3 - 4 minutes off the time I think I could have done last year. This is consistent with my workout paces, which have progressed back to where I'm about 25 - 35 seconds slower per mile than my pre-surgery workouts. I think the remaining time gap has a lot to do with the fact that i haven't trained as hard this year as I did for the first half of last year. The places I notice the most dramatic difference still are upper body strength and marathon distance endurance. I think i can get back to where i was, but the AVR has been a major speed bump and getting back up to full strength and making up the final gap is going to take a long, sustained effort for me, I think.

Good luck with your training. Keep us posted on how things progress for you.

 

[johnp]

I am about 7 months post op and about 1 1/2 minutes per miles slower in running than I was at top condition pre-op. I don't have my legs back yet. 6 or 8 miles is about as much as I can go.

I am about 1-2 mph slower on my bike, which is not too far off.

Not sure about swim but I am not that far off my pre-op swim stamina. Swimming may turn about to be "better than before" for reasons I cannot exactly put my finger on. I used to have very bad palpitations and I think this used to impact my breathing during swimming. Now I have none of that. I did a 2 mile ocean swim race this past weekend, no issues.

All in all, I noticed right now I just don't have the will to push myself like before. That's probably a good thing.

Its also a bit hot and muggy these days. It will be interesting to see how I do when the weather cools a little and I do some runs in the fall.

 

[tprice54]

John, you are so right...the will to push myself....that is probably harder to get back than anything else. 4 years post op and mine seems to some and go.....but, I'm happy to be running!

 

[normofthenorth]

Fascinating discussion, thanks all!
You might be interested in "Cardiac rehabilitation: What works, what doesn't, and why", at
http://www.theheart.org/article/125...medium=email&utm_source=20110728_EN_Heartwire .

I initially thought it might be "What works, what doesn't, and why" from a PATIENT's POV, but it's really about public-health, promotion, funding, policies, etc. The studies they mention all show better outcomes with CV Rehab, though that probably doesn't include any studies on young fit athletes. I've been an old fit athlete, and I've definitely done more walking and jogging and weight-lifting (and LOTS more driving!) with Cardio Rehab than I would have done without. I've also learned a few things -- and heard numerous lectures on a bunch of others that I already knew about. I'm glad I did it, on balance. I could have done my own, but I probably would have spent more time here, in front of the computer.

 

[LeakyUK]

I started Rehab two weeks ago at seven weeks. As far as I can tell my heart is doing fine, my legs less so due to too little excercise in the past, I am though much fitter than before the op.

 

[RunMartin]

I wish this discussion was happening when I was in my early stages of recovery from AVR.

I find it very strange that I can swim at the same rate as before (I am now doing open water swim races) but my running is much slower. I am getting used to running at my new slower pace now. Good luck to all who are trying to get back into training.

Martin

 

[BillCobit]

So here's my question: how many runners/swimmers/bikers out there that are better
now than they were before your surgery? Are you able to run/bike/swim better than before?

John

Hi John

Which valve did you have replaced? I had mitral valve surgery and did not experience a performance gain. But I have managed to complete 3 Ironman events and I'm working on #4. It took me 9 months to feel like I had recovered from surgery. In any event it sounds like you are doing great. I am confident you'll be returning to tri.

Best wishes for continued recovery. Please come join us at cardiacathletes.org.