Do most people run slower after surgery?

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J

Janea

Hi fellow runners,
Just a quick question. I always imagined that after I had fully recovered from surgery, with my new valve and my body being oxygenated better, I would be able to run faster. But from some of the threads I have read, I have gotten the impression that most people end of running slower than they did before. Is this true? If so, why?

--Janea
 
I'm interested in seeing what others respond. I am almost five months post-op, and I'm nowhere near as fast as I was at this time last year. Of course, my symptoms all started about July, and they slowed me down pretty quick. I assume that my speed will eventually come back, but certain days I get really discouraged...
 
Recovery

Recovery

MikeHeim said:
I'm interested in seeing what others respond. I am almost five months post-op, and I'm nowhere near as fast as I was at this time last year. Of course, my symptoms all started about July, and they slowed me down pretty quick. I assume that my speed will eventually come back, but certain days I get really discouraged...

Mike - hope your recovery is going well and that you will join us for the marathon relay team next year - see the posts about the 2006 team. Recovery is an incremental process and we don't have any established body of knowledge about whether athletes can match or exceed pre-surgery fitness. There are a lot of variables in the equation. I would be happy to talk further with you - feel free to private message me.
 
Slower after surgery

Slower after surgery

For some, who were only suffering the beginning affects of valvular heart disease, they'll probably be faster after surgery. For others, who waited too long (with significant symptoms), there could be permanent damage to the heart that prevents long-term improvement. But for most of us, we're somewhere in the middle, depending on the type of valve (and age)?

For me, my running times have yet to reach pre-surgery levels. It feels like 'I hit the wall' once my heart rate reaches ~ 150 bpm. This wasn't the case before surgery. Although I've currently taken a break from running to swim more, my running times were still improving 1.5 years after surgery.

With regard to your question, I think the surgery takes a toll on the body; i.e., I've never heard of ONE runner on this website who has run a sub-7 minute mile pace (or faster) after surgery; It appears everyone is stuggling to get back to 'where they used to be'. Also, the type of valve can affect performance. Here's why (from a fluids engineer): Both the mechanical & tissue valves have similar hemodynamic characteristics at resting heart rates, which is probably their nominal design point (with tissue valves being slightly better). However, as heart rate increases, the flow velocity across the valve generates more pressure loss / turbulence (and decreased efficiency). Although the performance difference between a mechanical valve and tissue valve is small at resting heart rates, it becomes much more pronounced at elevated heart rates; i.e., the pressure loss increases by the square of the velocity! In summary, the mechanical valve probably doesn't perform as well at 150 bpm as do tissue valves; it takes more work to push the same amount of blood through the valve.

Yes, age is a factor as well, however, I could always improve my running times (set in the previous 5 years or so) if I increased my mileage. This hasn't worked after surgery.

Maybe someday, we'll get an elite runner on this website that can provide additional information. I personally believe the trauma of open-heart surgery makes it impossible to completely recover to 100.0% (due to scar tissue, etc.). No matter, I'm very happy I've been able to run a sub-8 minute mile pace over a 4 mile course after surgery. In addition, I set my best Colorado 2,500 yard swim time (1.4 miles) just 4 weeks ago; my time was 37 minutes & 50 seconds.

I hope this information is helpful. Good luck!
 
Janea, At just over a week post-op I am in no position to accurately answer your question. I do know that if I had listened to most of what I was told I would have spent the last 2 years on the sofa. I didn't accept that and I don't accept That I will not be able to return to near 100% age adjusted return. When I started having pace reductions the medical community informed me that "guys my age aren't supposed to run that fast anyway" That was untrue; the only difference was that I was willing put forth the effort and time to achieve my goals. That is now my intention with recovery. I have a friend that is a very good masters runner who goes into every race with the intention of winning it all, not just the masters division. He frequently pulls it off because he puts forth the required effort and he believes in himself. I believe this to be the correct approach. I will keep you posted with my return to running. Please do the same.
Philip
 
Never a fast runner prior to surgery, I must still agree with Buzz. It is a struggle to get to where I was prior to surgery. About a year before my surgery I was able to run 9 min miles. As my condition got worse(Little did I know) my time slowed. Now 15 months after surgery I am lucky to get an 11 minute mile pace for greater than 3 miles. It's all relative. Without the surgery my pace would be 6 feet under. I too feel like I hit 150 BPM and I just can't push any further. I think this will improve as my fitness level improves. I really believe it takes areally long time to fully recover from OHS. The trauma to the body is significant. It is important not to give up because we can't achieve a goal quickly. My cycling,on the other hand is coming along ok!
LLJ
 
Post Surgery Performance

Post Surgery Performance

Philip,
I apologize if my words were negative; that most certainly wasn't my intent (and I'm very sorry). My response was based on running data I've recorded post-AVR, as compared to my running times before surgery. Note: I ran 13,000 miles between 1985 and my valve replacement surgery in July 2004. It's not impossible to return to 100% after AVR (bad words on my part), but for me, the watch doesn't lie.

Everybody's different, and I'm just one 48 year old data point . . .

Phillip, I wish you the best! If you have further questions about my running times, etc., please send me a note.
 
post op performance

post op performance

I had a gradual decline over 4 years from the time I contracted endocarditis to the time I had my mitral valve repaired. I was never fast - maybe a comfortable 8.5 min/mile guy. Now, 4 years after surg, I am about the same as I was immediately prior to surgery - 10+ minute pace for a 10K :( BUT - I should add that I NEVER invested in any interval/speed work after surgery. I was laser focused on a specific endurance event in 2005, and only did long, slow distances in my training. So I didn't "accidentally" get faster as a side effect of junk training.


My EF was estimated to be 45-50% right before surgery, and that's where it is now. Resting HR was high 50's before surgery, it's remained in the high 70's since, plus I now have some PVCs, so my heart has never really gotten over the physical insult of surgery. Good news is that my heart has shrunk to normal size range, I have zero detectable regurg, and function is stable. I'd like to be better, but I'm thankful for what I have.

I do know of a 64YO who had Ross procedure about 10 years ago who did a sub 12 hour Ironman in 2004 (pretty darn impressive, IMO), but I don't know his stand-alone run performance.

Maybe Grant (Stormrev) will chime in. He was a very successful runner/triathlete prior to surgery, and I know he has gotten back into Masters' track competition.
 
Buzz Lanning said:
In addition, I set my best Colorado 2,500 yard swim time (1.4 miles) just 4 weeks ago; my time was 37 minutes & 50 seconds.

Buzz,
Your time is impressive!
That is some pretty fast swimming!
 
I too hope my response was not too adversarial. I was just having one of my moments. My real goal here is not to run "fast" again but to feel good enough to be the dad that I want to be. Running fast would be just a great bonus. I do believe that I will be to run faster than the times of the past two years, if not I intend to dominate the local 50+ age group with mechanical valves. I think that group locally is a little soft.
One of my personality quirks, some would say flaw is that in most things I have never found "cruise" it is either "full throttle" or "off" I hope that in recovery this will be an asset.
I am now off for a walk and yet another attempt to blow the top off the spirometer.
Philip
 
Thanks everyone! I of course haven't started running yet (Doc said to wait 3 months post op.) but it's nice to know that I should be open-minded with my expectations. I was thinking my surgery would turn me into a new-improved runner and I thought I would finally be able to whiz past my brother-in-law at the next race....I can see myself smiling and waving to him behind me...alas...probably won't happen, but don't tell him that! I want him to worry! :)

Off the subject....Phillip, I noticed you are from New Orleans. How are things going down there. I hear the reports on the news, but I always wonder how accurate their reporting is. Our family still thinks and prays for all you down south! My little daughter Kamry (age 4) always includes, "and bless the people in the flood that the water won't get on their house." She says this on every prayer, even over the food at dinner. So cute.
 
New Orleans Up-date

New Orleans Up-date

Please thank Kamry for her prayers there are many in need. Life in the New Orleans area will be forever noted as pre or post Katrina. Everyone has been effected in some way even if they suffered no physical damage.
Life in many areas has returned to near normal with the only noticeable difference being increased traffic,crowded restaurants and retail outlets. In many of the hard hit areas there are major restoration efforts and optimism. In other areas it looks not much different than it did when the water receded. Unfortunately these are some of the less affluent areas and I don't see how these areas will ever recover.
Tourist are slowly returning. The New Orleans Jazz and Heritage Festival is underway and is a success. Katrina did not wash away our ability to throw a party.
My family is among the fortunate who sustained no physical damage. We live just outside Orleans Parish in one of the higher areas. Our biggest loss has been the loss of friends who moved away because of lack of client base or because they have given up. Although we are not from here we are staying, this has become home and we hope to contribute to the re-building process.
Philip
 
Good to see you Buzz

Good to see you Buzz

Buzz Lanning said:
Philip,
I apologize if my words were negative; that most certainly wasn't my intent (and I'm very sorry). My response was based on running data I've recorded post-AVR, as compared to my running times before surgery. Note: I ran 13,000 miles between 1985 and my valve replacement surgery in July 2004. It's not impossible to return to 100% after AVR (bad words on my part), but for me, the watch doesn't lie.

Everybody's different, and I'm just one 48 year old data point . . .

Phillip, I wish you the best! If you have further questions about my running times, etc., please send me a note.

Hi Buzz - just wanted to drop a note and say hi - nice to hear from you. Keep us posted - I still maintain that we need a 3 year baseline to truly measure performance after OHS. The first year after surgery should be about getting back on the field. The second year should be about getting into gameshape (the big question is how hard/often you can do some speed work) and the third year we should measure whether pre-surgery performance can be matched or exceeded. For me, I am willing to forget returning to sub 7:00 minute pace (especially if it prolongs my tissue valve) but I would like to race again at a 7:00 to 7:30 pace for the 10k. Only time will tell. I am glad we have a fluids engineer in our midst! Best regards, Mark
 
Thanks

Thanks

Hi Mark,

Thanks for the note.

All is well 672 days post-op & 58 million valve cycles later! Although my running times haven't recovered to pre-surgery levels yet, its been a completely different story in the pool. I swam my 10th best time for 2,500 yards last Friday (37:46), which is based on 832 swims over the last 15 years.

Note: In the pool, my peak heart rate is lower than when I run (by 20 bpm), no matter how hard I swim. Maybe this makes a difference?

I'll definitely keep you posted; please do the same . . .
 
Swimming

Swimming

Buzz Lanning said:
Hi Mark,

Thanks for the note.

All is well 672 days post-op & 58 million valve cycles later! Although my running times haven't recovered to pre-surgery levels yet, its been a completely different story in the pool. I swam my 10th best time for 2,500 yards last Friday (37:46), which is based on 832 swims over the last 15 years.

Note: In the pool, my peak heart rate is lower than when I run (by 20 bpm), no matter how hard I swim. Maybe this makes a difference?

I'll definitely keep you posted; please do the same . . .

Buzz: I am happy for you - any theories as to why the swimming results are superior to running? I had an interesting and positive meeting yesterday at my one year checkup with my cardiologist (my one year anniv. is 5/23). He said the surgery was a "complete success/home run" and that I was free to do what I wanted to do from an intensity standpoint (not exceeded 60 to 75 max. heart rate) and that it should not affect the life of my tissue valve (predicted to last 15 to 20 years). As soon as I am completely recovered from my half marathon which may only take a week since I took it very easy in the race, I am eager to reincorporate some tempo runs. I will keep you posted too - great job on the swimming - maybe you will inspire me to get in the pool too! Mark
 
MAsters running and potential recovery of pre-op fitness

MAsters running and potential recovery of pre-op fitness

Hi Buzz, MArk, Philip et al

I've been away from my home PC for nearly six weeks on some long-service leave in New Zealand!

I've been interested to catch up with some of the discussion about whether it is possible to recover pre-op fitness/speed etc.

Here are my thoughts on the issue...

Prior to surgery (probably 2-4 years prior), I was also able to increase speed by upping training intensity and mileage. What I experienced then in terms of capacity was probably more limited by age/fitness factors than my mild/mod regurgitation and involved a gradual slowing and stamina capacity.

Coming out of a background of elite level competition right though until my late 30's/early 40's (I'm 49 now), I was accustomed to push hard and ignore significant stress levels in achieving goals such as 2:40 marathon and Ironman competitions.

My attitude now has changed somewhat as I have come to terms with heart surgery and life post-op. It does seem that there are significant differences in how my body responds to stress and the demands of running etc. Despite my endeavours to get back to my 'old' ways of running and training, It appears that the 're-conditioned' nature of my heart/engine proscribes some limitations, especially noticeable running up hills or at increased pace! I am relaxed about this in one sense - merely being able to run again is a blessing! In another way, like some of my friends on this forum, I am still intruiged as to why this lack of stamina/capacity? Why do I still get so breathless running up hills when previously hill-running was a strength?

I agree that the effect is nowhere near as marked swimming - I suspect the effort required is further below the anaerobic threshold than for running and therefore less demanding?

Now 26 months post-op I should be, according to medical advice, fully recovered and back to full capacity... maybe!

I agree with the comment that someone made about residual effects from the very invasive nature of cardiac surgery and its impact long-term on the body's system. How long this effect continues or whether it is permanent I'm not sure...

The good news is that I feel recovered energy wise and no longer get so tired in my day-to-day living!

This winter (down-under) I intend to increase my mileage and running frequency to see whether that will make a significant difference stamina wise. Then I intend to have a good crack at the Masters Athletics over the summer (November-March)

As an encouragement let me add (boast!) what happened at the Victorian State MAsters Athletics back in early April before I left to come to NZ:

I managed to gain three bronze medals in the 45-50 age group in the long-jump (5.1 m), triple jump (10.2 m) and 200m race. I was stoked (*Kiwi/Aussie for "very pleased")!

I'm going to give one to my heart surgeon, one to my vascular (Fasciotomy) surgeon and keep one to remind me of what a gift life and health can be!!!

Good on yer!

Grant
 
good to hear from stormrev!

good to hear from stormrev!

stormrev said:
Hi Buzz, MArk, Philip et al

I've been interested to catch up with some of the discussion about whether it is possible to recover pre-op fitness/speed etc.

Here are my thoughts on the issue...

Prior to surgery (probably 2-4 years prior), I was also able to increase speed by upping training intensity and mileage. What I experienced then in terms of capacity was probably more limited by age/fitness factors than my mild/mod regurgitation and involved a gradual slowing and stamina capacity.

Coming out of a background of elite level competition right though until my late 30's/early 40's (I'm 49 now), I was accustomed to push hard and ignore significant stress levels in achieving goals such as 2:40 marathon and Ironman competitions.

My attitude now has changed somewhat as I have come to terms with heart surgery and life post-op. It does seem that there are significant differences in how my body responds to stress and the demands of running etc. Despite my endeavours to get back to my 'old' ways of running and training, It appears that the 're-conditioned' nature of my heart/engine proscribes some limitations, especially noticeable running up hills or at increased pace! I am relaxed about this in one sense - merely being able to run again is a blessing! In another way, like some of my friends on this forum, I am still intruiged as to why this lack of stamina/capacity? Why do I still get so breathless running up hills when previously hill-running was a strength?

I agree that the effect is nowhere near as marked swimming - I suspect the effort required is further below the anaerobic threshold than for running and therefore less demanding?

Now 26 months post-op I should be, according to medical advice, fully recovered and back to full capacity... maybe!

I agree with the comment that someone made about residual effects from the very invasive nature of cardiac surgery and its impact long-term on the body's system. How long this effect continues or whether it is permanent I'm not sure...

The good news is that I feel recovered energy wise and no longer get so tired in my day-to-day living!

This winter (down-under) I intend to increase my mileage and running frequency to see whether that will make a significant difference stamina wise. Then I intend to have a good crack at the Masters Athletics over the summer (November-March)

/QUOTE]

Grant: Excellent post and congratulations of finding some peace of mind but also continuing to excel in various athletic pursuits.

1. It would be very useful and interesting for you to post your running schedule/results over the next year. From a competitive standpoint, I have to come believe it's a 3 year process. Year one after surgery is about getting back to normal; getting back on to the proverbial playing field. Year two is about getting back into "game shape." Year three is about testing the limits, trying to achieve peak performance. As serious long distance runners, three years might not even be enough to truly evaluate when you consider it takes 7 to 10 years for a long distance runner to peak and OHS is a major hiatus in the life of any runner or endurance athlete.

2. I have come to view life after OHS as an opportunity to set new personal records. I am also very intigued intellectually about what new discoveries await me and the rest of us. My cardiologist has seen some athletes stay the same; some exceed pre-surgery results, and some not match. He believes it's a combination of (i) mental attitude; (ii) the heart itself; and (iii) opportunity - what's going on elsewhere in the body and in life general.

3. I will post a thread in June about training plans for the second year of my recovery - one year anniversary is a week away. I can't tell you good it felt to have the doctor say don't worry about how hard you run or long you run - a concern for those athletes with tissue valves. I have talked with Paul the cyclist from Vermont and we both agree that we feel smarter. The surgery has taught us to not go "all out" in our workouts all the time but take a more disciplined approach. There are silver linings to everything!

Mark
 
I would like to thank all of you for your posts. At five months post-op, I feel like I can work out with as much endurance as I have ever had, except for running! I've gone on 12 mile hikes up mountains, biked 20 miles easily, and had no problem doing virtually anything else I've tried. However, when I run, everything feels "off". I am at nowhere near the speed I was a year ago (I ran a 3:30 marathon exactly one year prior to my surgery), and I feel absolutely miserable after about 3-4 miles. Seeing from you folks that the running side of things might take another couple years is actually comforting. I was already getting discouraged that I might never feel "normal" again...

:)
 
Article Writing

Article Writing

MikeHeim said:
I would like to thank all of you for your posts. At five months post-op, I feel like I can work out with as much endurance as I have ever had, except for running! I've gone on 12 mile hikes up mountains, biked 20 miles easily, and had no problem doing virtually anything else I've tried. However, when I run, everything feels "off". I am at nowhere near the speed I was a year ago (I ran a 3:30 marathon exactly one year prior to my surgery), and I feel absolutely miserable after about 3-4 miles. Seeing from you folks that the running side of things might take another couple years is actually comforting. I was already getting discouraged that I might never feel "normal" again...

:)

Glad to have you apart of this study group Mike! I am contemplating writing about this experience for Marathon and Beyond - a magazine for ultramarathoners and marathoners. The first article may be a story about the marathon relay team for Vermont later this month. I hope you stay involved with the site and will consider joining us for the 2007 marathon relay event - most likely Akron Ohio in October 2007. Mark
 
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