Rehab from ICU to Marathon Finish Line

[jpattillo]

Any serious runners out there? I'm facing aortic valve replacement soon and have this overwhelming desire to set the goal of running another marathon post repair or replacement. My prior marathon training schedules have started with long runs of 10miles or so and progress over 16 weeks. I figure this is no different. Instead of starting with 10 miles I'm staring with 10 steps. And I'll need to take 12 months instead of 16 weeks...

Anyone else here accomplished that? Or at least set out to accomplish?

Jim

 

[escargome]

Hi, and welcome to the VR forum. While I cannot answer you question, you may want to send a private message to one of these two members: SumoRunner or BeanCounter. I believe they both run and are valued veteran members of this forum. Good Luck to you.

 

[SumoRunner]

Never ran a marathon myself, my longest is usually 10-13 miles any given year, but I was back to that level within one year. Go over to <www.cardiacathletes.org.uk> and you'll find many who have. Proceed slowly at first. Progress for the first 6 mos will be disheartening, then suddenly everything will come back into focus and training will normalize. Race times may never come back to previous levels, mostly because of beta blockers if you have to take them. Blood thinners have no effect on running at all. I'm 21 years post-op. You have a lot of running left in you.

PS: I've done more than 250 races since then, a lot of them on the track at 800m and 1 mile.

 

[TheGymGuy]

Jim, the plan is solid. Pending on weird issues post-op, there is no reason to not be able to finish a full out marathon on your surgery anniversary. Maybe even sooner

 

[spartangator]

Yup, you can do it (assuming cardiologist approval and such, of course). I ran my first marathon about 14 months post-surgery, if memory serves, and several people mentioned similar experiences at the time on the Active Lifestyles thread. As SumoRunner points out, you'll have to be patient with yourself and let healing happen, but you'll get where you want to be. We're looking forward to following your progress.

 

[tprice54]

Welcome! 8 marathons before I even knew I had a valve problem, 3 since surgery in 2007 (although one was a DNF, due to heat, not my valve). Most important, find a cardio who undertands you want to run marathons, there is not reason you can't, barring any big post op issues. I ran my frist 26.2 at 8 months, Twin Cities. I also did the Goofy Challenge, half marathon and full marathon in the same weekend, in 2010. You are right, I made a plan, just like my training plan, for my recovery. I was running 3 miles at 6 weeks, and worked up from there. Two things I cannot stress enough: you are recovering from MAJOR surgery here, so there will good days and bad days, you really have to listen to your body. Also, this is not like recovering from a running injury, it takes much longer and is not linear at all; I saw very little progress, then one day a big jump, then no progress for weeks. Feel free to join us over at cardiac athletes for more on running and heart problems.

 

[jordan]

Patience is the worse part. I'm 4 months post-surgery and I want to push a little harder on my running and cycling. I'm not where I want to be fitness-wise, but its only been a month since I had full clearance to do whatever I want in terms of exercise. I ran my first 5k post-surgery a couple of weeks ago and did it 4 minutes faster than my last 5k pre-surgery. It was 4 minutes slower than my PR, but I had to remind myself that I had surgery not that long ago.

I have several triathlon and cycling races scheduled this year, none the length of a marathon. If you take your time and are patient with recovery, you should be able to get back to that distance running.

 

[Bean Counter]

To give a little background....12 stand alone marathons (3 sub 3) and 5 Ironman triathlons...I was an endurance junkie! When I got to the point when my valve got bad enough to the point that my cardiologist was not comfortable with me running any more races...I was in peak shape. I was running 80-100 mile weeks (I was never a gifted runner...I had to work very hard at it). Anyway, after I had my surgery, I was allowed to start running again 2 months post op and was told to really ease into it. It was very frustrating at first.....I ran by HR and I was running so slow. Anyway, overtime I saw improvment (but not linear like mentioned above). At my 6 month echo check up my cardiologist gave me the all clear to resume training for marathons and did not give me any restrictions. I ran 4 half marathons before I got injured and could not run the Chicago marathon last October. I since spent more time lifting and less time running. Now I am healed up and am focusing on running again and am targeting a half marathon in September and am hoping to do a spring marathon next year (that will be 3 years post op).

After all that, I think u have a reasonable goal...they key is to be patient and dont try to force anything. Also, make sure you Cardiologist is on board.

 

[pnarciso]

Never ran a marathon before the surgery, only a half marathon (1h50m) and many 8-15K mostly "off road". I was told not to do any high HR exercise due to valve condition about 18 monhs before my surgery, which happened in June 1st, 2011 (AVR+Dacron tube), so I lost probably most of my conditioning in this interval. I began my recovery like everyone else, first walking the hospital alleys on day 3. Yesterday (10.5 months later) I completed 10k in less than an hour for the first time (59'00"), my long runs are in the 16k range and increasing, and I will run a half marathon in June. My HR was always higher than average before the surgery (I always blamed it on my leaking AV), but surgery actually made no difference or even a little worse (no BB for me) - my average HR was above 180 in 8 of the ten km yesterday. I expected it to go down as I got fitter but it did not happen yet - I am seeing my cardio to see if this is a symptom of anything else or just "my normal".
Oh, and I do plan on running my first marathon in December. So it would be 18 months for me, but depending on your fitness level and training schedule I believe 12 months is feasible.

Good luck!

 

[jpattillo]

Great feedback guys! This is very encouraging but gives me a dose of reality too. I think I'm going with the on-x mechanical. Did your sport influence valve choice at all?

 

[TheGymGuy]

My sport is non-contact and given that I wanted to try to avoid future surgeries, mechanical valve was a no brainer for me. On-X or STJ Regent, or any other mechanical would have all worked.

 

[RunMartin]

Any serious runners out there? I'm facing aortic valve replacement soon and have this overwhelming desire to set the goal of running another marathon post repair or replacement. My prior marathon training schedules have started with long runs of 10miles or so and progress over 16 weeks. I figure this is no different. Instead of starting with 10 miles I'm staring with 10 steps. And I'll need to take 12 months instead of 16 weeks...

Anyone else here accomplished that? Or at least set out to accomplish?

Jim

Hi Jim,

I am a keen distance runner and swimmer. It took me a while to feel really comfortable with distance running post surgery. I had problems with running for the first 16 month with a lactic acid feeling but it turned out to be slight anaemia (it has been two years since my AVR). I feel great since I started taking iron tablets!!!!!!! I am sure I would have been much much better if it had been found out sooner. Note I take Warfarin, beta blockers (Bisoprolol) and Ace inhibitors (Ramipril).

I have done quite a few long distance hill races (20 miles +) post AVR. For the last six months I have been training for a 24 mile hill race with 3 mountains (Three Peaks Fell Race in Yorkshire). I did this race 16 times pre AVR and my aim is to do 21. After surgery I thought I would never be able to do this race again as there are strict cut off times along the route. To train for this I have been doing other long distance runs of about 20 to 25 miles in distance. I feel the same as before surgery whilst running but my times are a little slower.

This race is this weekend and I am really looking forward to it (though a little nervous).

What I have found is that it takes time to heal. For myself it took a lot longer than I thought it would as I had very high expectations. I think I did push a little too hard early on which I regret as I believe impeded my over all progress (it is not just the sternum that takes time to recover!). We need to exercise to recover but it needs to be at the correct pace. My problem was that I regularly competed in races and trained hard for 30 years prior to my surgery. My idea of taking it easy was a lot harder than the nurses and doctors meant!!. It is only with hindsight that a realise what they meant.

A lot of my early races were 5K and I have slowly improved my time 21:36.

The best thing I did to help my recovery was to ignore all my previous personal bests (pb) and start a fresh. My pb of 21:36 is slower than my pre AVR pb but it genuinely does feel like a pb. This enabled me to enjoy my training and see my performance gradually improve week by week.

When I am running and swimming now it does not feel like I have had major heart surgery, i.e. I push as hard as I like and enjoy it.

Good luck and remember to keep a check on expectations. You will get to where you want to if you give your body time to recover and it will not take as long as you think. Try not to think of recovery from heart surgery is a race, i.e. "after 4 weeks I want to be doing.....". Listen to your body and exercise accordingly. Some people recover quickly and for some it may take a little longer.

 

[neil]

good luck and hope you get your marathon run,

 

[tprice54]

Martin, I could not agree more with your post....I only consider POPR, Post Op PR now, what I did before surgery is ancient history.

 

[SumoRunner]

Groan... not only that but now I only consider post-op-post-60 stats. Next year I'll probably start a new set of post-65 numbers. It's been so long, post-op really has no meaning to me any longer.

 

[jpattillo]

I was a baseball player in college and played baseball, football and basketball in HS. Since then I really havent trained hard at anything since and was only an occasional runner (5-8 miles a week). About a yer ago I got serious about training and worked up to 35 miles a week. If it wasn't for surgery I think I would have a lot more PBS gains to make in the next 3-4 years. I'm still going to keep an eye on my current PBs but the advice in this thread is compelling and overwhelming: temper your expectations. I will definitely hit reset on all my time and distance records. I'll also remember the lack of linear progress that several of you have mentioned. That will keep me from getting discouraged.

 

[tprice54]

Sounds like you get it....you know what's funny? I always tell people, running is the only true sport, everything else is just a game! You only play games for short time, but you can run your entire life.

 

[johnp]

I set some goals for myself, but then revised them. I feel (at least in my case) is that other variables can play into your "recovery" that make having a rigid set of goals hard to get to. Here's my own situation as of now-

-I was really only getting into endurance in a big way as I was starting to feel the impacts of a leaky valve. By the time I was worked up, the cardiologist was amazed I said I could easily run 10 miles, bike 100, swim, etc. I told him yes, it was getting harder, but I just attributed it to getting older.
-I'm almost 1.5 yrs from mitral valve surgery, but I am still seeing improvements. One year is commonly used as a benchmark for full recovery, but I clearly have seen additional improvements in strength and endurance within the 12-15 month window. According to the cardiologsists, my heart is still showing signs of remodeling.
-Medications can alter your climb back to PR-levels of endurance. In my case I am on an anti arrythmic and a beta blocker. These two drugs conspire to keep my HR very low, which means (for me at least for now) those 7 min miles may be gone forever.

But its ok. I did a 13 mile "half mary" training run last weekend. I went slow but felt great. I had those blocks of time when I was enjoying the course and forgot I was even running. I'll do a half mary in two weeks and an Olympic Tri in a month. I figure as long as I don't get too caught up with my times, I'll be fine, especially for a guy pushing 50.

 

[jpattillo]

John, I love the quote from your cardiologist in your signature!