Question for heartdoc....

[Shobu]

....or others who have a mechanical valve and are active post-op. Although I understand why we should avoid lifting very heavy at the gym even years after post-op, but given the well documented benefits of maintaining muscle mass as we age, as well as the cardiovascular benefits of weight lifting, what is the "right", or safe amount of weight that can be lifted at the gym? Has anyone been told what the % to max per rep they should do, or since we can't really work out what our % to max rep is, since we can't lift heavy, what other guidelines should we use to make sure we are lifting safely?
I don't buy that zero weight lifting is the answer. There has to be some amount of weight for each individual that is safe to lift post-op (assuming you don't have an AA of course) that can allow you to put on a moderate amount of muscle or be part of a fitness lifestyle. I would include push-ups etc or other bodyweight based exercises in this discussion. So everyone, what have you been told, what do you do, and are there any guidelines out there beyond "don't" that exist, or are we left to muddle around on our own in this area? I
Know Arnold/the Governator had heart valve surgery and lifts, even if just to maintain some level of fitness, so people are doing it and surviving. Thoughts?

 

[Shobu]

I've done a search and looked through old threads; lots of good info here already, just wondering if there is anything new that people who've been through this have been told/discovered, and given there's an MD posting here now too, just curious on his thoughts since he appears to be relatively cutting edge. No pun intended for all us post-op folks....

 

[Freddie]

This is interesting and news to me about lifting.

Granted there should be no heavy lifting after surgery, but years after? I was never told such a thing.

I don't do weight lifting, but I can lift and carry 40lbs+ with no problems.

 

[MarkU]

I was an avid weight lifter prior to my surgery and my cardiologist advised me to focus more on aerobic exercise and only lift light weights post-op (which is how I got involved doing triathlons).

In the last couple of years he has reversed course a bit and has been encouraging me to lift more in order to maintain my upper body muscle mass as I get older. I mostly do circuit training using weights where I can do three sets of 12-15 reps.

Mark

 

[Duff Man]

A very well known heart surgeon told me that even after surgery my weight limit will be 50 pounds. Some of the reasoning was that bicuspid valvers tend to develop aneurysms in other spots in the aorta as time goes on.

Try doing 1 set of 100-150 reps of 5 pounds for curls.... let me know how your arm feels the next day

 

[nate_c]

I like to cross train with weights, push-ups, pull-ups, etc., 2 or 3 times / week, so this was something I asked my cardio. and two surgeons about prior to my AVR. Boiled down, here's the gist of the responses I got. (Sorry if this duplicates info already shared on this forum... Haven't checked older posts.)

I was advised that continued weight training would be fine (even beneficial), as long as I adhered to some guidelines. First, I was told not to do sets to failure with fewer than 10 reps (e.g., bench-pressing with a high enough weight that you can only do 6-7 reps or so per set.) Reason for this, I was told, is that these high weight, low rep exercises skyrocket your BP, putting a lot of pressure on that valve... Second, I was told never to hold my breath during sets... This also skyrockets the BP... Lastly, I was advised that higher weight sets to failure are probably fine for smaller, localized muscle groups (e.g., curls, calf-raises, triceps, etc.), but I might not want to try for that last, strained rep on things like pull-ups, squats, bench-press, etc., where multiple muscle groups are involved... In a nut shell, my take aways were: breathe during each exercise, and if I'm straining to the point where I'm flushing or really struggling to finish a rep, I might want to back-off.... So, I guess my dream of becoming an olympic powerlifter is over , but maintaining/improving muscle mass seems very doable.

By the way, not to hijack this post, but if anyone posting also has advise on getting back into weight-training after a sternotomy, I'd love to hear it. I'm 11 weeks out tomorrow, and have starting doing some light weight training, but I've been a cautious about doing pull-ups, dips, or a string of more than a couple push-ups... I guess the key is probably working back in slowly... And what about sit-ups and other ab exercises? Just don't want to overdo it or risk a longer-term injury.

Thanks,
Nate

 

[RobThatsMe]

Hi,

I do not think there is "any" single rule that applies to your question. People have open heart surgery for various reasons, valve replacement, blockages, bi-passes, dissections, and aneurysms to name a few.

Your question is best directed to your own doctor. He is the expert with your personal case. If you had, or are prone to aneurysms or dissections, then for sure you do not want to be placing maximum stress load on your circulartory system. But on the other hand, for some of the other open heart surgeries, they were probably performed as a one time corrective meaure, without an on-going condition that needs to be monitored.

I have been a weight lifter for many years, had my first open heart surgery 10 yrs ago, and for the last 10 years, I have been using lighter weights with higher reps.
I had one doctor tell me, never lift anything over 50 lbs, yet, I had another doctor, one I really respect, tell me; "You have been lifting for years, and you certainly know when you are pushing yourself, so just don't go there and overdue it". That about it. I am not competing at this stage of my life but prior to my latest open heart surgery 6 weeks ago, I still looked pretty good, had low body fat and great muscle tone. All without lifting more than 75 lbs in my workouts, performing high reps, and doing cardio each day for 30 min. I would do a combo walk and jog and get 2 miles done in that 30 min. I workout 5 days a week.

I'll be getting back to that kind of schedule soon, but, I will have to ease into it, as my body has lost over 20 lbs of muscle. It cannablized the muscles I had to obtain the protein it needed to survive my recent surgery just 6 weeks ago. I had some major work done, and was on the table for 13.5 hours, plus another 3 a few days later. I do have a major ascending aortic dissection, and also had an aneurysm over the aortic arch.

Not sure if this answers your question, but it is my personal story.

Rob

 

[Shobu]

@ MarkU , interesting, and this seems to be something I've heard from a number of people in conversation where 12-15 reps (or more) with a weight you can manage comfortably being used a rule of thumb
@Duff Man: I've heard something similar too, in the context of having Marfan's or a variant of it. One doc I spoke with once, even went so far as to claim that all BAV's has some limited expression of Marfan like-syndrome, which sounded a little extreme, but maybe that's some of where the "don't lift heavy if at all" thought process comes in from some heart docs?
@ Nate_c: interesting comments about the number of reps and breathing; I was told something similar, as in "don't hold your breath", but not too much other advice than than that. As I get back into weights in the gym, I have been making sure not to go to the point where I'm straining to lift on the final rep at all, but that sounds like very good advice for the future, esp. considering I had a BAV (risk of other types of aneurysms etc) Thanks for the summary of all the info you've received; seems like some docs are aware and concerned about issues that face some of their more active patient population more than others.
As for the sternotomy, I am about 4 and a half months out, and started lifting light at about 4 months out. The sternum is fine; it's more the muscles that are weak than anything else. Case in point; tried doing a pushup a couple of weeks ago and practically fell flat on my face. Have been doing light squats, light dumbbell rows and light incline bench presses.
Thanks for the information. I know there have to be others that lift to at least maintain their upper body muscle mass post-op. I've seen the profile pics. Any other advice out there?

--Dan

 

[Shobu]

@ RobThat'sMe: true as to there being "a single rule" as to post-op activity. I totally agree. At the same time, I am pretty interested in people with similar conditions and issues and their approaches to rehab and am curious if there is any consistent approaches to rehab that seem to be successful for multiple people. Especially for the more active/younger, or just more active patients, it seems like there is a dearth of information to go on. As for following doctors advice, I typically agree, although it seems like when I have asked them questions about active lifestyles I've gotten responses from my surgeon, cardiologist, pacemaker doctor, and general practitioner that are all over the map, which makes it harder to suss out what the best approach to returning to an active lifestyle is while simultaneously doing so in such a way that minimizes any health risks. (more OHS? No thanks.)
Glad to hear you survived your recent surgery. I had a similar experience in June, where I was on the table for over 12 hours, and didn't wake up in recovery till about 18 hours after first going under. I lost over 20 pounds, (not all of it muscle though and am slowly looking to rebuild some of the muscle that was lost. I'm in no danger of looking like one of the guys from "Spartacus", but would like to at least get some of my atrophied chest and arms back, which rather than being "2 tickets to the gun show" were more along the lines of "2 discount coupons to the gun show" to begin with. Pre-op with the tissue valve I used to have, I was more into being toned and maintaining a functional amount of muscle rather than what I was doing over a decade ago and lifting heavy for mass. Looking to get back to a more toned version of my pre-op self.
Thanks for your detailed reply on your pre-op fitness routine, and good luck with your post-op recovery.