Detailed metrics for a mitral valve repair weekend very semi athlete

[MitralMan]

Thought I'd start a separate thread to focus on one person's hard data as he prepares for a marathon relay with 4 other valvereplacement forum members. The purpose of the thread is to provide as much detail as possible since it doesn't seem like the medical establishment has very much to tell us about measured limits once we've had OHS. Hope this helps people who swing by our forum looking for answers!!

So:

almost 49 year old male

mitral valve repair 13 months ago

194lbs (down from 211 immediately after leaving the hospital)

6'

morning resting heart rate (MRHR) down to 52bpm from 100 immediately after coming leaving the hospital; rises during the work day or as soon as I stand up, but not more than 95, and typically in mid-70's

morning BP typically 105/65, rises during the work day or as soon as I stand up, but not more than 120/80

only meds are 25mg Metoprolol 2x/day and 1 81mg Ecotrin

typically consuming 1800 calories/day, give or take, 55% carbs, 25% fat, 20% protein

Pulsox readings in the morning vary between 94 and 98%.

ALWAYS slow (walked/ran the London marathon in 2001 in 6:20)

Using a Polar 625SX and occasionally an Omron automated wrist BP cuff and even more occasionally a pulsoximeter. Use a TrueFitness HRC treadmill.

Tonight was the second day of a one month acclimation program established through www.polarrunningcoach.com

Program called for 40 minutes at 120bpm, achieving approximately 4.2 miles

I averaged 118bpm over precisely 4.2 miles, but it took me 64 minutes. I ended up mostly walking at 4.0 mph.

No complaints, no windedness, just decided to keep in the zone but do the mileage.

 

[MitralMan]

Polar OwnIndex numbers

Polar OwnIndex numbers

October 16, 2005: 32

January 23, 2006: 42

The Polar OwnIndex "is equivalent to maximal oxygen uptake" (VO2 max).

I've been exercising fairly regularly according to ESCAPE YOUR SHAPE for RULERS. It seems to adhere to low weight/high rep and moderate aerobic exercises, along the lines for OHS rehab and post-rehab.

This has moved me from "fair" for my age group (male 45-49) past "average" to "good" according to Polar's web site.

http://support.polar.fi/PKBSupport.nsf/ALLDOCS/42256C2B001E0F6A4225681F005E304D?OpenDocument

 

[ChristineBP]

You guys keep talking about what your heart rate should be and what is to hard and so on.

So you got me thinking, maybe I push myself way too hard. But the only restriction from my doctors have been so fuzzy.

They told me no marathons and maybe 5miles was far enough. But everyone talks in numbers, like heart rate and blood pressure and other numbers.

Now I know you can't tell me what is right for me but maybe you could guide me on how to bring this up to my doc.

I have ultra sound the first week of Feb and then shortly after I'll have a stress test or maybe I won't who knows, Then In march I'll see my doctor.
The only problem is he does not run and I'm not sure how active he is.

But he does have a degree in medicine so I guess he knows more then me.

I just need some help so I don't end up killing myself

thanks

 

[MikeHeim]

They told me no marathons and maybe 5miles was far enough. But everyone talks in numbers, like heart rate and blood pressure and other numbers.

Why no marathons and why the 5 mile restriction?

 

[MitralMan]

Christine, aren't we all...

Christine, aren't we all...

trying to find the optimal point in our physical exertion where it helps our fitness and doesn't damage us?

Maybe you just want to print out some of these threads for your doc to read? On the other hand, in this age of capitated medicine, s/he may not have the time or patience to go through it.

You might just say you've met a group of really well-informed post-OHS athletes and it has you wondering a couple of things...

Good luck and keep us posted!!

And I'm glad this little thread may help just a little bit!

 

[msiwik]

check BillC's post on Philip's thread

check BillC's post on Philip's thread

You guys keep talking about what your heart rate should be and what is to hard and so on.

So you got me thinking, maybe I push myself way too hard. But the only restriction from my doctors have been so fuzzy.

They told me no marathons and maybe 5miles was far enough. But everyone talks in numbers, like heart rate and blood pressure and other numbers.

Now I know you can't tell me what is right for me but maybe you could guide me on how to bring this up to my doc.

I have ultra sound the first week of Feb and then shortly after I'll have a stress test or maybe I won't who knows, Then In march I'll see my doctor.
The only problem is he does not run and I'm not sure how active he is.

But he does have a degree in medicine so I guess he knows more then me.

I just need some help so I don't end up killing myself

thanks

Christine - you raise a very good question that it's hard to answer quickly and succintly. Hopefully this Vermont relay will happen and we can get a chance to talk in depth. For now, my quick reply is that all we have is the Bethesda report linked in Bill C's post on Philip's thread from yesterday in this section of VR forum. I look forward to talking more about this with you. Mark

 

[tommy]

Christine,

No, we are not doctors, don't have near the training nor experience as they. But no one has deep experience in this type of exercise after valve surgery, yet many prosper, and provide inspiration to others.

What are the factors, and do they have limits/guidelines? To me, those are the questions. Simply saying "no marathons" and "keep it to 5 miles" seems too vague to me.....kinda of like "don't over do it". What about 6 miles? Maybe 4 is the answer. Your mileage may vary.

Because of lack of data, many doctors will default to the conservative side. Others are more creative and flexible - is that bad? It would be tragic to go out and kill ourselves with exercise. But wouldn't it be equally as tragic to sit on the sidelines and miss out on life and all it has to offer, if we are able?

I'd ask about the factors. What are the issues? Heart rate, blood pressure, O2 levels, hydration, etc? We can conveniently measure some of these. I believe that this is the point of the thread, to add to the collective data.

Thanks Mitralman. Great idea!

 

[msiwik]

Christine et al. - check this Link

Christine et al. - check this Link

Christine,

No, we are not doctors, don't have near the training nor experience as they. But no one has deep experience in this type of exercise after valve surgery, yet many prosper, and provide inspiration to others.

What are the factors, and do they have limits/guidelines? To me, those are the questions. Simply saying "no marathons" and "keep it to 5 miles" seems too vague to me.....kinda of like "don't over do it". What about 6 miles? Maybe 4 is the answer. Your mileage may vary.

Because of lack of data, many doctors will default to the conservative side. Others are more creative and flexible - is that bad? It would be tragic to go out and kill ourselves with exercise. But wouldn't it be equally as tragic to sit on the sidelines and miss out on life and all it has to offer, if we are able?

I'd ask about the factors. What are the issues? Heart rate, blood pressure, O2 levels, hydration, etc? We can conveniently measure some of these. I believe that this is the point of the thread, to add to the collective data.

Thanks Mitralman. Great idea!

Mitralman - yes thanks for getting this thread going. Christine - I was alerted today to the fact that ACHA got a story to be picked up by the AP Newswire about the need for long-term treatment/care of adult congenital heart disease. I thought of you immediately because you had your surgery at 13 and because you (like many of us) may face surgery again for one reason or another. Check out the link - it confirms to me how far we have come and how far we have yet to go in supporting each other and those like us with this type of medical condition. We won't really succeed in improving the quality of medical advice for the athletically inclined until there is a systemic collection and review of data on people like us. Best to all. Mark

http://www.newsday.com/news/health/...,0,7908372.story?coll=sns-ap-health-headlines

 

[msiwik]

Well Said Tom!

Well Said Tom!

Mitralman - yes thanks for getting this thread going. Christine - I was alerted today to the fact that ACHA got a story to be picked up by the AP Newswire about the need for long-term treatment/care of adult congenital heart disease. I thought of you immediately because you had your surgery at 13 and because you (like many of us) may face surgery again for one reason or another. Check out the link - it confirms to me how far we have come and how far we have yet to go in supporting each other and those like us with this type of medical condition. We won't really succeed in improving the quality of medical advice for the athletically inclined until there is a systemic collection and review of data on people like us. Best to all. Mark

http://www.newsday.com/news/health/...,0,7908372.story?coll=sns-ap-health-headlines

P.S. Tom you said it very well. And I think this merry band can help the cause of getting more information into the hands of the doctors so we can take the study/advice to the next level.

 

[MitralMan]

Mark, Tom, glad to be of service!

Mark, Tom, glad to be of service!

Maybe, if it develops far enough along, we can have a sub-section just on people's metrics.

If either of you care to, please feel free to share your own metrics!

Christine, care to share yours?

I'm fascinated by the Polar testing. I wonder if it's valid for OHS folks like us, too. I'm betting it is, within limits that I don't yet understand.

 

[msiwik]

metrics

metrics

Maybe, if it develops far enough along, we can have a sub-section just on people's metrics.

If either of you care to, please feel free to share your own metrics!

Christine, care to share yours?

I'm fascinated by the Polar testing. I wonder if it's valid for OHS folks like us, too. I'm betting it is, within limits that I don't yet understand.

Mitral Man - see my Indy half marathon thread for where I am at. I agree with HR monitors and I really look forward to getting to know you at the marathon relay! Best regards, Mark

 

[MitralMan]

Mark, I just read the Indy post. GREAT STUFF!!

Mark, I just read the Indy post. GREAT STUFF!!

Mitral Man - see my Indy half marathon thread for where I am at. I agree with HR monitors and I really look forward to getting to know you at the marathon relay! Best regards, Mark

It really is inspiring to read and track your progress. I'm looking forward to meeting you and the rest of the team in VT as well.

To infinity and beyond!

 

[ChristineBP]

You guys are good.

O.k. first - help me out. What is maximal oxygen uptake? Pulsox readings? Metrics.

I know it's bad, I have no idea what you guys are talking about I just go run. Help

My doctors have never asked or voluntered any info that would help in my running or in racing. They just put limits on me. Which of course frustrated me and inspite of what they said I would do different.

Yes thanks for the e-mail, and yes I was told 2 years ago to be ready at any time for the next round of OHS. When I was told that, I really started running more and just taking better care of myself.

Also I'm always told to try and stay in great shape and most of all to stay thin and lean. This comes straight from my doctor-The less I weigh (i'm not sure the spelling is right) the less my heart has to work. And that is very important to him. I'm 5feet 10 and 1/2 inches tall and weigh around 140. Of course the docs tell me to loose 5lbs just to be safe. Of course if the 5lbs come running would be that much easier.

My heart rate does get high, but I've done many stress tests and I've been given no guide lines.

So yes I'm planning on showing him some of these posts and asking Questions. I think there is some one on this site Happystar something- anyway I saw he had some really intresting info. If I start asking the right questions My doctors will be amazed.

Thanks guys-I need all the help I can get.

At one point I used to tell people the only way I would get Up at 6am and run-was If my house was on fire and I had to run out of it. LOOK AT ME NOW. Funny

 

[MitralMan]

Here you go, Christine

Here you go, Christine

from the Polar web site (http://www.polar.fi/polar/channels/eng/glossary/Maximal_oxygen_uptake.html):

Maximal oxygen uptake (VO2max)
The maximum capacity for oxygen consumption by the body during maximum exertion. Also known as aerobic power or maximal oxygen intake/consumption. VO2max is a commonly used determinant of aerobic (cardiovascular) fitness. Aerobic fitness relates to how well your cardiovascular system works to transport and utilize oxygen in your body. The better your aerobic fitness the higher your VO2max. The most accurate way to measure your VO2max is to perform a maximal exercise stress test in a laboratory. VO2max is usually expressed in ml*kg-1*min-1, sometimes in ml*min-1.


(from http://www.nda.ox.ac.uk/wfsa/html/u05/u05_003.htm)
Pulsox (Pulse Oximetry)
Pulse oximetry is a simple non-invasive method of monitoring the percentage of haemoglobin (Hb) which is saturated with oxygen. The pulse oximeter consists of a probe attached to the patient's finger or ear lobe which is linked to a computerised unit. The unit displays the percentage of Hb saturated with oxygen together with an audible signal for each pulse beat, a calculated heart rate and in some models, a graphical display of the blood flow past the probe. Audible alarms which can be programmed by the user are provided. An oximeter detects hypoxia before the patient becomes clinically cyanosed

See especially http://www.wmems.org/pulseox.htm

metrics simply means systematic measurement!

Hope this helps. Some of us are just numbers freaks. I, for one, should probably just get better at listening to my body -- become more intuitive. Oh well.

 

[ChristineBP]

Thanks mitralman


I should pay a little more attention to the numbers. I'll see what my doctors have to say about all my new knowledge. I'm really glad you guys are so willing to help out. It's nice to know that there are other people trying to get to the finish line

 

[MitralMan]

Update: 35 minutes on treadmill...

Update: 35 minutes on treadmill...

avg HR 113
max HR 135
dist: 2.31 mi
max speed: 5.0mph (up a notch since last time)

Roughly:

10:00 warm-up walking at 3.0mph
20:00 alternating between slow jog at 5.0mph and walking at 4.0mph (to keep HR between 120 and 130)
5:00 cool down walking at 3.0mph

Very easy, just following the guidelines. First time I've taken my HR up to the 80% level, and it was just fine.

Sitting at the kitchen table right now, my pulse ox is 97.

 

[msiwik]

Good Workout

Good Workout

avg HR 113
max HR 135
dist: 2.31 mi
max speed: 5.0mph (up a notch since last time)

Roughly:

10:00 warm-up walking at 3.0mph
20:00 alternating between slow jog at 5.0mph and walking at 4.0mph (to keep HR between 120 and 130)
5:00 cool down walking at 3.0mph

Very easy, just following the guidelines. First time I've taken my HR up to the 80% level, and it was just fine.

Sitting at the kitchen table right now, my pulse ox is 97.

Textbook effort - good job! Mark

 

[MitralMan]

Thanks, Mark. A little faster today, a little easier...

Thanks, Mark. A little faster today, a little easier...

Approximately:

10:00 warmup @ 3.0mph
25:00 alternating between 4.0mph and 6.0mph (settled into a routine of 1:00 @ 4.0mph, 0:30 @ 6.0mph, trying to keep HR below 120)
5:00 cooldown @ 3.0mph

went 2.73 miles

avg HR 110
max HR 128

Felt good.

 

[msiwik]

looking forward to May

looking forward to May

Approximately:

10:00 warmup @ 3.0mph
25:00 alternating between 4.0mph and 6.0mph (settled into a routine of 1:00 @ 4.0mph, 0:30 @ 6.0mph, trying to keep HR below 120)
5:00 cooldown @ 3.0mph

went 2.73 miles

avg HR 110
max HR 128

Felt good.

Mitralman: We will know in a few days about the Vermont race. If we get in, it will give us an opportunity to compare notes about the best way to approach training. I like your approach so far. Mark

 

[MitralMan]

Thanks for the encouragement, Mark.

Thanks for the encouragement, Mark.

Mitralman: We will know in a few days about the Vermont race. If we get in, it will give us an opportunity to compare notes about the best way to approach training. I like your approach so far. Mark

I'm a numbers kinda guy.

Last night, I repeated the 10:20:5 gig, but this time a fast walk was all it took to get my HR to 120. So...never above 4.5mph.

Might be interesting for people to see the variability, too.