Cardiac Rehab

[johnp]

For me presonally, I've skiied for many years. But I've never fallen as hard as I have when snowboarding. There's no graceful way to fall, for me at least. I love it though.

I figured what the heck, I am only on a blood thinner for 6 weeks. I can wait six weeks. If I was on a blood thinner for a longer period of time I suspect I would do the sports anyway.

 

[johnp]

so I had my first follow-up post surg and my cardiologist felt that I would not get much out of rehab. he suggested a stress test instead. We'll see...

 

[tprice54]

Well, you must have impressed your cardio with your history of athleticism!

 

[johnp]

...or I'm too high risk...

 

[Greg a]

so I had my first follow-up post surg and my cardiologist felt that I would not get much out of rehab. he suggested a stress test instead. We'll see...

That is interesting as my rehab started with the stress test to get a new benchmark on me and then another on the last day each day was measured by that

 

[Philip B]

Risks?

Risks?

Gee Norm, I lived and skied in the mountains of Colorado for thirty years. I think I know just a little bit about crashing and snow sports related injuries. Of course, there's inherent risk in pursuing activities that could involve impact injuries. There's risk for anyone who chooses to pursue an active lifestyle.

AVR surgery for me was about getting a problem fixed so I could get on with my life. An artificial valve and coumadin use didn't make me fragile. Sure, I bruise, but I bruised from impact injuries long before I had AVR surgery.

BTW, I retired early and left Colorado for a warmer climate because a hit & run cycling accident in June 2009 left me with a traumatic brain injury which reduced my ability to handle extremely cold temperatures (the seizures weren't much fun).

You obviously like statistics. What are the odds that I would develop a brain bleed after getting bounced off a car and left for dead in a ditch? Yeah, broken ribs, bruises, road rash, whiplash, and loss of any memory of the month of July, 2009, but no brain bleed... I was back on my bicycle six weeks later. I did need a new cycling helmet since mine was smashed totally flat on one side and broken in three pieces.

The problem with scary statistics is that numbers don't factor in how tough people can really be. My posts concerning pursuit of an active lifestyle are intended to encourage people to pursue the activities they enjoy. If you don't agree with my perspective, that's okay... you're entitled to your opinion just as I am mine.

It's good to hear that you bought yourself a new helmet. Head protection while skiing makes sense to me regardless of whether someone is on coumadin or not. Enjoy BC.

-Philip

 

[Lily]

Way off topic -- sorry -- but Philip, your post struck such a chord with me, wrenching up an old maternal terror from the past. Bear with me?

I have read that once a person has suffered a significant traumatic brain injury (TBI), they are something like 300x more likely to suffer a second one, and then something like 3000x more likely to suffer a third one. Those were roughly some statistics I recall reading when my younger son suffered an acquired closed head injury, a severe concurrent TBI, as a young teen. His coma was a 3, the worst. Happily that whole experience is just a bad memory now. I'm glad to read that you're doing so well too and I hope the seizures have passed.

Anyway, not even going into the possible elevated hemorrahagic stroke risks some of us may need to consider, I hope everyone always skis or snowboards or bikerides with a helmet. Best wishes

 

[traveler]

I was very active before mitral valve prolapse symptoms and surgery, doing triathlons etc. I am amost 4 weeks out from robotic MV repair surgery and starting to feel like I could actually do a little exercise, maybe even run a few miles.

Has anyone done the cardiac rehab thing? When do they start you out, and what types of things have they had you do? Did they give you any guidelines, besides the useless generality - "don't overdo it?" thx

I was told to cardiac rehab so that I would to trust my heart and get back in the game. I was a good decision for me. If want to get active quickly do it.

Also hanging out with all the guys and gals who had had heart attacks made me feel like I was really lucky. Many of them had a lot further to go than I did.

 

[normofthenorth]

First, Phillip B, you said "The problem with scary statistics is that numbers don't factor in how tough people can really be. My posts concerning pursuit of an active lifestyle are intended to encourage people to pursue the activities they enjoy. If you don't agree with my perspective, that's okay... you're entitled to your opinion just as I am mine."

I'm sure we all know, or have heard of, people who've smoked 3 packs a day and died in their sleep at 98 years old. People can be tough, and people can also be lucky. We can also be smart or stupid, aware or unaware, and conscious or in denial. I favor tough, lucky, smart, aware, and conscious, and I try to discourage the other five. I think that assuming that statistics drawn from large numbers of people should not be ignored because "I'm tough" or "I'm lucky", is flirting with some of those other characteristics I try to discourage.

I just finished a fun (though cautious) ski week while 8-9 weeks post-opOHS/AVR and while on Warfarin, so I obviously agree with you about encouraging people to pursue the activities they enjoy! But I think there's a difference between accepting risks and denying their existence.

I think cardiac rehab is going to be interesting for me, because I've been doing a fair bit of it on the slopes, before the CR course starts! I wore a heart monitor, and generally rested until my HR was down to ~110. (I'm usually around 85-105 resting, post-op, and just LOOKING at a ski slope gets me up to 110!) When I'd stop, I'd check my heart-rate, and I kept it <~125 the first day, <~135 the second day, saw it hit 140 maybe twice the third day, and seldom saw it break 130 the 4th day, although I was skiing faster, harder, for longer "bursts", and for hours longer overall. (~17,000'+ of vertical the 4th day, roughly 11,000' for each of the first 3 days. My pre-op range was ~20,000'-34,000' per day.)

I'm expecting to be bored for the first few sessions of Cardio Rehab, but I may be surprised.

I've never skied in a helmet before this week, and it was remarkably fuss-free, so I will probably keep using it, even if I come off Warfarin before my late-March return to Whistler (as I hope).

 

[epstns]

Norm - I can only think of a one-word reply - THANKS! Your common sense manner of verbalizing all this does me wonders as I ponder how life will be for me post AVR/bypass. (Still dealing with the shock of learning that in addition to the valve, I will need a bypass. I'm not that old!)

 

[MarkU]

so I had my first follow-up post surg and my cardiologist felt that I would not get much out of rehab. he suggested a stress test instead. We'll see...

My cardiologist also told me that rehab would be a waste of time for me. He just told me to go home and walk everyday. That's what I did and was back at the gym working out in about twelve weeks and haven't looked back since.

Interestingly even though my biscupid valve was first diagnosed at age five, I've never had a stress test, ever.
A couple of caths and that was it prior to my surgery. Now I just get an annual EKG and an echo every two years. Guess I've been lucky & blessed.

Mark

 

[MarkU]

Gee Norm, I lived and skied in the mountains of Colorado for thirty years. I think I know just a little bit about crashing and snow sports related injuries. Of course, there's inherent risk in pursuing activities that could involve impact injuries. There's risk for anyone who chooses to pursue an active lifestyle.

AVR surgery for me was about getting a problem fixed so I could get on with my life. An artificial valve and coumadin use didn't make me fragile. Sure, I bruise, but I bruised from impact injuries long before I had AVR surgery.

BTW, I retired early and left Colorado for a warmer climate because a hit & run cycling accident in June 2009 left me with a traumatic brain injury which reduced my ability to handle extremely cold temperatures (the seizures weren't much fun).

You obviously like statistics. What are the odds that I would develop a brain bleed after getting bounced off a car and left for dead in a ditch? Yeah, broken ribs, bruises, road rash, whiplash, and loss of any memory of the month of July, 2009, but no brain bleed... I was back on my bicycle six weeks later. I did need a new cycling helmet since mine was smashed totally flat on one side and broken in three pieces.

The problem with scary statistics is that numbers don't factor in how tough people can really be. My posts concerning pursuit of an active lifestyle are intended to encourage people to pursue the activities they enjoy. If you don't agree with my perspective, that's okay... you're entitled to your opinion just as I am mine.

It's good to hear that you bought yourself a new helmet. Head protection while skiing makes sense to me regardless of whether someone is on coumadin or not. Enjoy BC.

-Philip

x2

In my view it's all about individual choice, balancing risk against lifestyle. As long as someone is making an informed decision, I would never second guess them.

My cardiologist just jokingly told me not to skydive, bungee jump or race cars.

I haven't done any of them, but if I ever have the funds, I may try racing cars...but I'll be sure to wear a helmet.

Mark

 

[epstns]

Mark -- All of us here are lucky and blessed.

Oh, and for racing cars, I gave that up a while ago but would love to get back into it. (Of course, I do occasionally "get into it" on the road -- making the kids in the 5.0 Mustangs wonder how the heck the old grey-haired geek in the big sedan ever got it going that fast.)

 

[johnp]

Well now its seems I may go to cardiac rehab after all. One school of thought says that I would get bored, but another school of thought says this is the best way to ease back into some exercise - and I would probably go too hard if I didn't have someone yelling at me. But I also understand that they can alter your program to your abilities (per results of the stress test). 3 days per week for one month. Insurance may even pick up the tab. This may work after all.

 

[Greg a]

I for one am glad to hear this as you will be given an exercise pgm bechmarked to you and then use those benchmarks beyond the program....congrats

 

[epstns]

I plan to push for rehab after my surgery. I think the supervision will help me to regain self confidence after surgery, and it may help me to locate a trainer to help me establish a well-balanced routine after I'm released from rehab. I'm lucky in that my insurance will cover it.

 

[traveler]

Well now its seems I may go to cardiac rehab after all. One school of thought says that I would get bored, but another school of thought says this is the best way to ease back into some exercise - and I would probably go too hard if I didn't have someone yelling at me. But I also understand that they can alter your program to your abilities (per results of the stress test). 3 days per week for one month. Insurance may even pick up the tab. This may work after all.

Going too hard was not the problem for me. They let me go as hard as I wanted. My surgeon said no restrictions. It was the opportunity to go as hard as I wanted and be monitored --- I was learning that I didn't have any limits.

 

[epstns]

Well, at age 63, with 30+ years of running on my knees, and planning to go through both valve replacement and bypass, I will possibly feel some limitations at first. I think, however, that rehab will be my best path back to the life I've put on hold.

 

[neil]

personally i found re hab brill,both mentally and physically it was a great help,to mix with people in the same boat was very good,cant praise it enough,

 

[normofthenorth]

Interestingly even though my biscupid valve was first diagnosed at age five, I've never had a stress test, ever.
A couple of caths and that was it prior to my surgery. Now I just get an annual EKG and an echo every two years. Guess I've been lucky & blessed.

Mark, I've had a bunch of stress-echo-EKGs, and I've had one cath/angio. If I could "trade in" a cath/angio on MULTIPLE stress-echo-EKGs, I'd make the trade! Mind you, I was asymptomatic for my stress tests, so it was just a walk-jog on a treadmill with a bunch of electrodes and attention. My cath went smoothly, but the multiple discomforts and nuisances were way worse than anything I ever had from a stress test. Once I wiped off all the conducting gel from my chest, the stress test was a memory, but my groin remembered my cath/angio for maybe 2 weeks -- not to mention waiting for all the itchy hair to grow back and lie down!