Staying the Course -- 05/20/2019

[Superbob]

"It's a beautiful day in the neighborhood..." Mister Rogers.

It is indeed sunny with some big puffy clouds intermittently sailing along in coastal Carolina -- but the humidity is reaching uncomfortable levels. Summer is here, sans solstice. Hurricane season begins June 1 but usually aren't big ones til Aug/Sept/Oct. Enjoy it all as it comes. Nature is wonderful.

Going to dawgwalk at dusk so sun not beating down on us. Close to 90F today. Besides that going to do a little biking in exercise room.

No weights because have decided to delay open-heart surgery while seeking more solid evidence that ascending aortic aneurysm actually is growing dangerously. Thankfully, the surgeons' folks at UNC/Chapel Hill understood perfectly and slotted me in for a repeat chest CTA and echocardiogram in 6 months -- so November, a good time of the year.

So I am at peace with all that. Are there risks in delay? -- sure, but there are risks to every aspect of life. Certainly there are risks in OHS for anyone, but especially those of us who are septuagenarians or octogenarians. (In showing off, hope I spelled those correctly -- oh well, I can edit if needed -- oh the joy of editing!)


Let's hear from you all this week -- whatever you've got going....I feel good; heck, I might even step on scales today and set a new weight goal.

Cheerio,

Superbob

 

[ottagal]

Superbob, glad that you got some sage advice from others and are at peace with your decision. That is the most important thing. You are correct...there are no certainties in life.
Just came back from a nice bike ride...

 

[Paleowoman]

Hi SB - you sound so much relieved and good about your decision, and supported by the medics too - if they didn’t think your decision good they would have certainly said so

I’m having my echocardiogram on Wednesday, basically checking on the valve leaflets. I had the MRI last Thursday. It was a very soporific affair, such that I found it really difficult to keep my eyes open and was dropping off to sleep near the end. The radiographers said I was a “model patient” as I kept so still ! I should get all the results next week when I see my cardiologist.

Weather here in England so-so, not terribly warm for the time of year but that's typical here.

 

[Gordo60]

Sounds like a good strategy Bob.

Besides that going to do a little biking in exercise room.

I get quite bored on my exercise bike so have started alternating 5 sets of 5 mins of cycling with 20 reps of light goblet squats to bench (no rest in between) which is considered the best squatting exercise for back / joint / knee health and maintaining everyday functional squatting ability especially for those getting older. It seems to be working well in that it keeps my heart rate up offering a good aerobic workout but without the boredom of cycling alone.

A bit more on the goblet squat. I like using the bench as being tall it allows me to stay more upright and sit back more like in many real life movements.

GOBLET SQUAT TO BENCH
Grab a dumbbell and stand with a bench behind you. Cup the weight with both hands and hold it in front of your chest, elbows down. Bend your knees and lower your body until your butt lightly touches the bench. Push yourself back up. That’s one rep.

And here’s a great video showing a 70 year old woman doing this exercise:

 

[Duffey]

35 pounds would do me in!

 

[Gordo60]

35 pounds would do me in!

LOL. There’s plenty of ways to make the exercise more challenging without using any weights at all the most obvious being to increase reps. Another is 1 and 1/2 reps. On way back up pause briefly then back down then full rep. Repeat until wheelchair required to get off bench .

 

[Duffey]

LOL. There’s plenty of ways to make the exercise more challenging without using any weights at all the most obvious being to increase reps. Another is 1 and 1/2 reps. On way back up pause briefly then back down then full rep. Repeat until wheelchair required to get off bench .

Yes, send a wheelchair! LOL!

 

[Gordo60]

Yes, send a wheelchair! LOL!

Tell your kids you want a wheelchair as well as a set of resistance bands.

 

[Superman]

It is nice to be able to get back outdoors again with the arrival of spring. We were getting snow well into April here.

I’ve been running while getting paced by my youngest two kids on bikes. 3 1/2 to 4 miles or so.

Got me a new position at work with a healthy raise so I treated myself to a new lawnmower. Nice. No tractor yet, but a 30 inch, two blades walk behind. Toro TimeCutter.

That’s all I have tonight. Suppose I should sleep.

 

[user 16827]

I'm happy that you are happy with the new plan SB

Hopefully we will see no change in the next 6 months

 

[Paleowoman]

There’s plenty of ways to make the exercise more challenging without using any weights at all the most obvious being to increase reps..

Another way to make exercise harder is to actually do it more slowly, I mean really slowly as in the SuperSlow technique where you raise the weight over 10 secs and then lower over 10 secs - try it with a weight you might normally lift, lift it the speed you normally lift and then lift it the SuperSlow way to feel the difference. The method means the muscles do all the work rather than gravity and inertia helping. Also use a wieght that takes you to complete, or almost complete, failure by only three or four reps. With SuperSlow not only are the muscles worked harder but joints are not so likely to get damaged. My current shoulder injury was due to a physio team who got me doing weighted squats, 30 pounds, three sets, six reps each set so 18 reps, and the same with bench press 30 pounds, six reps, three sets. Prior to that I had been lfting heavier with SuperSlow but slooow and one set of three reps to failure. I'm now over a year on from injury, it takes a long time for tendon injuries to recover and, of course, I've lost a lot of muscle. Will regain it all with SuperSlow.

 

[Gordo60]

I have used Superslow quite some time ago but due to the aneurysm I avoid it now. Over time I’ve seen a number of aortic surgeons / cardiologists advise against using Superslow as due to it’s very slow cadence it becomes more isometric in nature, Similar concern applies to those with hypertension.

For example this from prominent aortic surgeon Dr Allen Stewart:

Another safe weight lifting technique for aortic aneurysm: avoid “super slow” or “negative” training. Move loads quickly to minimize time that blood pressure is high.

https://scarysymptoms.com/2014/09/aortic-aneurysm-safe-weight-lifting/

 

[Paleowoman]

You have to remember to breathe quickly, almost panting, when doing SuperSlow so as to avoid raising blood pressure.....even if a person does not have aneurysm.

I have used Superslow quite some time ago but due to the aneurysm I avoid it now. Over time I’ve seen a number of aortic surgeons / cardiologists advise against using Superslow as due to it’s very slow cadence it becomes more isometric in nature, Similar concern applies to those with hypertension.

For example this from prominent aortic surgeon Dr Allen Stewart:

https://scarysymptoms.com/2014/09/aortic-aneurysm-safe-weight-lifting/

 

[Gordo60]

You have to remember to breathe quickly, almost panting, when doing SuperSlow so as to avoid raising blood pressure.....even if a person does not have aneurysm.

Yes interesting thanks. I must look into this more. There’s breathing techniques which I’m familiar with then there’s the issue of mechanical vs metabolism loading. Too much mechanical loading, ie heavy weights, regardless of breathing technique is often touted as being risky for those with an aneurysm. However due to the very slow cadence of Superslow (10 / 10) it generally results in a significant reduction in weight which is not only beneficial for joint health but likely puts less pressure on the aneurysm.

 

[Duffey]

Tell your kids you want a wheelchair as well as a set of resistance bands.

Speaking of my resistance bands . . . supposedly they’ve been bought but are residing at our son’s house 250 miles from here. He says he’ll bring them next visit, but that may be awhile. In the meantime I’m still pedaling the stationary bike.

 

[FredW]

Nice seeing all the activity. SB, you sound in better spirits but based on my experiences in the waiting room, I know living with risk waiting to get fixed is not without worry.

I was 73 when I had my surgery and now, I'm playing Pickel ball, doing my landscaping work and cutting down trees like a 20-year-old. (well not as fast nor as strong, but I think I'm 20.) Those who fear recovery from surgery in later years should know it can be done. The ease may have to do with your general health, but it is possible.

Can you tell what days I play Pickel ball or cut grass and what days it rains and I sit in front of the computer?

As for losing weight, my wife thinks the drugs I'm on that makes it impossible to lose my winter weight. Today, I'm down two pounds. Time will see if that sticks.

 

[Superbob]

Hey Fred -- great to read about your senior fitness activities. I agree! -- we can stay spry in our senior years.

I am just so thrilled by the revival of our site here. We have a place to go to talk about our challenges with others who have dealt with similar ones. Yesterday I made the mistake of posting on Facebook about where I am with my surgical decision. Heard from many heart buddies who were of course supportive and understanding -- and many others too. But also kept getting repeated messages from one person from DC area who's been popping up on my page for 20 years with a know-it-all attitude. This time her message was: OBEY YOUR DOCTORS BOB! Over and over, that assertion.

Well, as I think most of you all know, this isn't a matter of disobedience. (They don't call this elective surgery for nothing.) It is one of communicating with your cardios and surgeons, being sure they understand your history and your body. Neither my surgeon nor my cardio expressed any problem whatsoever with my idea of putting on a hold until we have better data showing an increase in aneurysm size OR basically confirming just the status quo from the past decade or more. In fact, they both offered to schedule the echo and chest CTA in 6 months. My suggestion to my cardio this afternoon is that we do the echo in 3 months to see if it does indicate rapid growth (if if did, I might well go ahead and schedule the surgery) or if it's ambiguous and a more exact C-scan at 6 months would be in order.

Anyway, the OBEY YOUR DOCTOR taunting really ticked me off. I deleted the whole thread and won't post such thoughts on Facebook again. Right here is our home where we talk about these matters as brothers and sisters of the heart. Sure we have disagreements sometimes but we are family.

So thanks brothers and sisters!

 

[bizinsider]

My ascending aorta at last check was 4.8-4.9. While still in the waiting room, a slight change in my left ventricle (the first enlargement in the 41 years I have been monitoring this) has accelerated my scans to 3 months from 6. Cleveland, where I would have the surgery, recommends surgery at 5.0 even though the guidelines are for 5.5.

In the meantime, while I wait, I've put myself in a form of prehab for core/aerobic strength. I do a mild version of Pilates plus fairly aggressive walking (including hills.) All of that is fine and I'm relatively asymptomatic BUT... I'm wondering if planks are dangerous, even with active breathing. Something tells me they are not, but I'm not sure where to get a good answer. The above links are great and very helpful, but no matter how I search I can't find anything on planks and aneurisms. (I'm about to turn 67 so thrilled to see others of a certain age who have endured with flying colors.)

 

[Superbob]

My ascending aorta at last check was 4.8-4.9. While still in the waiting room, a slight change in my left ventricle (the first enlargement in the 41 years I have been monitoring this) has accelerated my scans to 3 months from 6. Cleveland, where I would have the surgery, recommends surgery at 5.0 even though the guidelines are for 5.5.

In the meantime, while I wait, I've put myself in a form of prehab for core/aerobic strength. I do a mild version of Pilates plus fairly aggressive walking (including hills.) All of that is fine and I'm relatively asymptomatic BUT... I'm wondering if planks are dangerous, even with active breathing. Something tells me they are not, but I'm not sure where to get a good answer. The above links are great and very helpful, but no matter how I search I can't find anything on planks and aneurisms. (I'm about to turn 67 so thrilled to see others of a certain age who have endured with flying colors.)

Planks and aneurysms: something I've been fretting over myself, with no answers yet, while here in the waiting room.

The past three years, I took a seniors' core fitness class (I am 77) that I loved. While I stumbled through some of the balance stuff, I was pretty adept at planking. Even got in the spirit by buying some silly workout t-shirts, with puns like "Planks a Lot!" My aneurysm of the ascending aorta -- measured at 5.1 cm in 2009 and remaining stable with the assumption it's just my normal -- has bumped up now to 5.3 cm.

No medical person tells me this but I wonder if my enthusiasm in planking -- sometimes holding my breath for extra effort (which you should NOT do) -- may have caused this hopefully slight expansion of the AAA. As I await follow-up tests in 3 to 6 months, it makes sense to me that this type of exertion affecting the chest area could have had an effect. I am continuing my walking, exercise biking, and stretching but definitely will not do any more planking. I am hoping I will regain stability and not require surgery.

Thanks for bringing this up, bizinsider! Good luck with your fitness program and your stay in the waiting room. If I run across any studies (or even just informed opinions about planking and aneurysms) I will post them here.

Addendum: Doesn't mention planking specifically, but I just found this -- certainly plausible that a danger flag should fly for planking: http://www.ucaorta.org/can-i-still-...ic-aneurysm-or-chronic-aortic-dissection.html

Thought-provoking article: Beware of isometric exercise. No-no to that which elevates the blood pressure:
http://www.iradonline.org/articles/lifestyle_recs.html

 

[bizinsider]

Bob, thanks for the feedback and link. The one piece of advice – no, make that order – I have consistently received is NO isometric exercises. That's why planks are so confusing, because you breathe during them but you are also pushing on a lot of weight. Until I get clarity, as good as they are, I'm am avoiding. Of course, I'll get a better read next month (MRA, no contrast) on whether the size has shifted. (If you're wondering why MRA and no contrast...I alternate echo and MRA. The docs always want to do a CT scan but that's too much radiation UNTIL surgery. And I started to get contrast until they found issues with MRI contrasting agents. So I pretty much demanded an MRA w/o contrast and here in San Diego at Scripps, there is apparently one MRI machine that can get a great picture of my ascending aorta using no contrast.)