Exercise - Straight Answers?

[DavePitt]

A few questions while I start this "adventure"!

A few questions while I start this "adventure"!

I'm a 58YOA retired cop on a steady adrenalin rush and having a cardio-cath tomorrow in Pittsburgh to confirm what my cardiologist thinks is a "slam-dunk" for the need to replace BOTH the aorta and mitral valves. Naturally, I've got a "cazillion" questions, but these stand out:

#1 - I ski, mt. bike, and road cycle, will I be able to continue?

#2 - Does a blood thinner for life prohibit an active sex life? Having a couple of beers? Or avoiding any other type of foods or beverages?

#3 - After having the right adjustments to my dosage, do I need to monitor?

#4 - What's the biggest adjustments to enable an active, sporty lifestyle?

 

[Les]

Hi Dave,
Welcome to this site. Your questions are normal ones and have been discussed many times throughout the years. Fully understand your concerns and you are no doubt going to receive different responses to them. Some of us have run marathons, done tris, bike race, everything you seem to like to do. Some on the other hand are fearful of their new life, more than they were their old one. Neurosis exists with a few Coumadin users, but most of us live normal lives and Coumadin is no big deal. It certainly has NO effect on your sex life. However, if on a beta-blocker, that is one possible, but not common, side effect. Hell, lately people on this site have been more concerned with PROPER GRAMMAR than health issues...my point being, life is NORMAL after valve replacement surgery and for most of us, even better. My signature states my belief: "It's better to wear out than rust out." Go back and read the topics discussed in "Active Lifestyles" and "Coumadin." Plenty of good info there for you to get started. Ask any questions you may have of any of us. We'll help alleviate your concerns. Best wishes to you!

 

[BillCobit]

Hey, punctuation is important too, Les!

Hey, punctuation is important too, Les!

Hi Dave,

Hell, lately people on this site have been more concerned with PROPER GRAMMAR than health issues...Go back and read the topics discussed in "Active Lifestyles" and "Coumadin".

That period after "Coumadin" should have been INSIDE of the closing quotation!

(Just kiddin', Les!)

Dave - I second the response from Les. It takes a few months to recover, but after that you'll probably be able to do just about anything.
Les, Mark Wagner, Simon Gee and HosackTom are all post-op marathoners...and there a several of us who aspire to be just like them when we grow up!

Just be prepared for some difficulty during the first month after surgery. The first walk around the block can be pretty tiring and discouraging -- but don't give up. You'll be back to an active life within a few months.

Welcome to the club, and best of luck to you. Stop back and ask questions when you have them. You'll find the people here to be knowledgeable and supportive.

 

[Les]

Oops..."periodic" insanity! Replaced and repaired, no charge...

 

[Harpoon]

#1 - I ski, mt. bike, and road cycle, will I be able to continue?

Yup.

#2 - Does a blood thinner for life prohibit an active sex life?

Hasn't stopped me....

Having a couple of beers?

Some folks here still have a few rounds, some don't. Be aware that alcohol in ANY form can affect how your meds work and that might lead to problems you don't really want to hassle with...

Or avoiding any other type of foods or beverages?

Keep an eye on this stuff called vitamin K which is in dark green leafy veggies and a fe other foods. Eat more of it, take a higher dose of coumadin (they interact with eachother) eat less of it, take a lower dose. All of this of course should be monitored by a doctor or in a anticoagulation clinic. Generally I've found having a veggie lasagna with spinach (VERY high in vitamin k) in it once in a while doesn't affect things too much, however if I started eating more spinach week to week it might mean a different PT/INR score. Always in moderation....

#3 - After having the right adjustments to my dosage, do I need to monitor?

Yup. As you move forward in your recovery they'll check it less. I guess most people settle around once a month give or take. It might get checked more often if the results are out of range for one reason or another. A lot of people here do home testing, just like if you were a diabetic checking your blood sugar levels. Not everyone can do that yet, but that's mostly an insurance issue. The machines cost a few grand a piece.


#4 - What's the biggest adjustments to enable an active, sporty lifestyle?

A higher conciousness of what your body can handle, how it reacts to the way you use it. More exercise is good for your heart, as long as it's not overdone. Aerobic (jogging, cycling, swimming, team sports) activities are better for your heart than anerobic (weight training) activities.

It's best to consult with your cardiologist about the things you want to do and ease into them when you have the Ok to do so.

Certainly, if you were doing it before OHS you'd be fine to do it after once your body has recovered. You might have to modify what you do some, but not stop altogether.

There a few people here that actually started doing things like marathon running AFTER having their valve replacement....

 

[Mb]

Hello everyone!

I hope you don't mind my posting this, but I know there are some here who have excercise limitations, my husband being one of them. Due to chronic a-fib, moderate tricuspid valve leakage, etc. his doctor has recommended that he never "push" it. He should not stretch his abilitities at all, as it will not do his heart any good at all. My husband can walk, but certainly not run, or even walk very fast for any long period of time. He pays if he exerts his upper body at all. Runs SOB, and will retain fluids.

I just was concerned that all of these wonderful postings by folks who ARE able to do a lot of excercise might encourage some to throw caution to the wind, and push themselves too hard.

I think the words of "listening to your body" are really important. And, of course, pay some attention to your Doctor.

My husbands exertional limitation by the cardiac rehab personnel is what prompted his cardiologists to further look into the condition of his heart post surgery.

I applaud anyone who has the physical strength, and peace of mind, to follow a sound excercise program!! - Marybeth

PS - I thought most interesting the information about the "bearing down" upper torso info. It explains alot of why my husband can walk but not lift or push anything.

 

[tommy]

Marybeth,

Yes, we all need to know our own limitations. Overstepping them can be dangerous and deadly. Thanks for the reminder.

I give great credit to this web forum for showing me that some of my limitations were perceived and not real. Sorry if we get a bit exhuberant. None of us should ever throw caution to the wind. Yes "listening to your body" and taking doctors' advice are "musts" for everyone. Intense exercise is serious business even for the healthiest of people. It is surely not for everyone.

Sorry to hear that your husband has significant limitations and can't "push it" as much as he could before and/or wants to now. Glad is able to walk. That is really among the best exercises. Please give him our best.

 

[Brian]

I've been bad and lazy regarding excercise since I got back into the full swing of things at work. After the surgery I had all kinds of energy, now when I get home from a day at work I am tired and really need a cat nap as soon as I walk in the door, almost like before my surgery. I am sure it is because I haven't been strict with myself and that the excercise/strenuous activity elimination is making me tired..any thoughts?

 

[GregB]

Exercise-Just Do It

Exercise-Just Do It

Brian,
like you I am back into full time, very busy and at times sressful work post AVR. At the same time I have tried to maintain an exercise program based around running, a bit of gym in bad weather and some bike and swimming at weekends.

For it to work for me I have a 45-minute -1 hour exercise session first thing in the morning. I usually get out to run or the gym by about 7o am. I try to maintain 6 solid workouts per week with Monday as a rest day. If the exercise session does not happen in the morning it tends not to happen at all. The day just gets too busy and I get too tired.

To give myself goals I usually target a race or event of some kind.
I also keep an exercise diary and log my runs and gym visits etc . I also note INR, weight and other health and diet notes. The act of keeping a log serves as a bit of a motivator and conscience. I look for patterns of illness and INR swings etc etc to try to keep the routine as regular as possible.

By about 9:00 pm each evening I have just about given my all and have to start to head to bed.
I feel better for the exercise which also helps cope with work stress. My last echo check gave a very positive response so I will try to keep the program up.

I think that provided you have recovered fully and your doc is OK with it it should be possible to maintain an exercise regime of some kind. You just need to find the routine that works for you.

I hope this helps get you up and at it.

Greg

 

[ar bee]

exercide pre- and post surgery

exercide pre- and post surgery

you need to distinguish pre- and post surgery exercise!!

many medical journal articles strongly recomend against any heavy weight lifting BEFORE (because of potential distruptive force) and immedialtely post (because of the sternum that needs to heel), however i have never come across anything/anybody saying that post-recovery you should not work with weights!
However, as Paracelsus said: it's all a question of dosage!!

Same with the heart rate: monitor it (i monitor mine pre-surgery already...) and dont over-do it ! There are people who climb Mount Everest with artificial heart valves!!

well2u

 

[Marge]

<< That period after "Coumadin" should have been INSIDE of the closing quotation! >>

Ah -- that would depend on whether you follow British or American conventions re: punctuation. The Brits usually place the comma outside the closing quotation mark.

Cf. Louis Menand's review of "Eats, Shoots & Leaves," the current bestseller on, of all things, punctuation:

<< As Truss herself notes, some conventions of British usage employed in ?Eats, Shoots & Leaves? are taboo in the United States?for example, the placement of commas and periods outside quotation marks, ?like this?.>>
http://www.newyorker.com/critics/books/?040628crbo_books1

 

[AJBU]

Bowflex after VR?

Bowflex after VR?

Was wondering if a bowflex would produce the same affects as weight lifting? I'm 18 and was operated on 6/7 with Ross procedure and prior to that was just getting ready to test for brown belt in Kempo. Want to get back into shape but was told no weight lifting. Return to surgeon on 28th and will also ask him, but don't know if surgeon or cardiologist know what a bowflex is and how it operates. Can't understand why they say I will be able to return to doing push-ups but no weight lifting. What's the difference if I'm 6' tall and weigh 180 pounds. Also, when will my heart rate go back to it's pre-op level of about 58 bpm? Will that happen after I'm able to start exercising again? Also, what about situps? Wallchairs? Kicks? Legstretch machine? Also, have won several trophies for sparring, local and national, and was wondering if I would ever be able to return to this since prior to the operation this WAS my life and I truly love it. In fact, want to have own studio one day. I thought that once the sternum healed it was actually stronger than before. I know it takes time, but I hope at least I will one day be able to spar again - it's the one thing I am really good at.

Thanks,
Aaron

 

[Tom F.]

Aaron - we can follow this up in private E mail if you like, I am the one your parents E mailed before your surgery. However, in answer to your surgery assuming that all went well during the surgery you should be able to return to all of your activities in time. There was one fellow who returned to professional football after he had Ross procedure done, so returning to martial arts should be possible, including a reasonable degree of weight training, ju-kumite, the works. But right now you need to sit back and relax, to allow both the chest to fully heal, and to allow the surgical work done inside of you to heal as well. That means no sit ups or push ups or weights for a full 6 weeks, I would think. After that you can build up gradually. I know one guy in our dojo that had a bow flex, and my sense was that he got pretty good results from it, but perhaps not as good as free weights.

Now I will be curious if your doc tells you to never use free weights again. Both my cardio said that free weights were fine, after I healed, but warned me against any true single rep power lifting moves, as they would almost anyone.

As for now maybe put on your Gi and practice VERY slowly, you will learn from doing that. E mail me at home if your want to chat more.

 

[perimeno]

I am posting this question for my brother Peter who had a AVR March 21st this year. He lives in England and is blind. He uses the computer, but cannot get around sites like this. Needs to be in letter format for his mechanical reader (voice) to read the screen so I post for him and mail it to him in a letter. I have copied a few of your comments above and will send them to him but I wonder if any of you could write a specific response to him. He is just walking now a few times a day and he has started a second round of an exercise programme at the hospital. Here is his question:
____

To those with mechanical valve replacements, I'd be grateful to learn what
you've experienced or been told about higher intensity physical activity,
for instance, hiking or long distance walking as well as the carrying of
loads. As people with such valve replacements are necessarily on Warfarin,
what are the limits on their activities and when and how did they begin
again to carry loads (from shopping to holidays) and to what degree?

Cheers,

Peter

 

[Gemma]

perimeno

perimeno

Hi Peter,
My boyfriend Jim, who had his AVR in December, carried half a motorbike engine about 500m across a field to the car at a motorbike show last weekend - I think you'd agree that could be classed as carrying a load! In early April (4 months post-op), we went on holiday to Snowdonia and walked up a 300m mountain, then mountain biked down it. About 2 hours in total. I'm guessing you didn't get much in the way of advice regarding milestones from your cardio or rehab people, because Jim certainly didn't. As for the "specially trained" gym instructor - ha! He was scared to let Jim walk faster than 3 miles an hour on the treadmill when he joined the gym in May (this was after completing the 12-week rehab course). Let's just say we agreed to disagree.
I think in America they tend to be given much better guidelines - e.g. no weight restrictions after 6 months post-op (I think from what I've read here). Jim was never told that. His cardio did, however, say that he could do whatever he wanted and that the worst thing to do would be NOT get out there and exercise, as that would lead to further health complications that you'd associate with inactivity. (Try telling that to the gym guy!!!).
Hope this helps,
Gemma.

 

[Robt Z]

Just getting old? or not?

Just getting old? or not?

The exercise thing is really great. I think it is all in moderation. I have hit the gym frequently and felt great but then I think I tired out from overdoing it. Took a week off and am back at it...though less frequently...sometimes I wonder if I am just getting old...48...or maybe the mechanical aortic valve or the heart is not right...echo is fine and doc said friday heart sounds good. I love to feel fit and firm and enjoy the exercise high...am thinking I just gotta get it sychronized just right....

Robt Z

 

[tommy]

Robt,

I love to feel fit and firm and enjoy the exercise high...am thinking I just gotta get it synchronized just right....

Sounds like you have the exercise bug! That is a great thing. Here are a couple of key strategies that have helped keep me going. Hope these help you with the "synchronization" that you seek.

1. Small increments. Increment effort no more than 10% - whether you measure "longest" in time or distance. Likewise for weekly effort. This strategy helps increase endurance while avoiding injury and avoiding burnout. It also speeds recovery. The few times that I violated the 10% rule, I regretted it with aches and pains. On the positive side, at least a couple of times per month, I would achieve something that I had never done before. That has been a huge mental lift.

2. Alternating days. Starting from scratch at age 49, I decided to run only every other day. That means 3 days per week. Again, this helps speed recovery and avoid injury/burnout. The few times that I violated this rule, I got tired and run down. Now, after a year of jogging behind me, I'm adding a fourth day and doing more cross training on other non-run days. But I take it easy on those extra days, or skip them if I feel run down. Time off is part of the process. Hard exercise tears the muscles down. Rest helps them stronger than they were.