Ultra runner with questions.

[R&N Brown]

I am looking forward to getting back on my bike. We still have a little too much snow cover, about a month and we will be clear.

One of my objectives in having a mechanical, specifically an On-X valve was so I did not have to go through this exercise again in say 10 - 15 years or so. I'm only 49. What I am finding though with the mechanical implant is that it, on days, seems to have a mind of it's own. Especially if I've pushed it a little.

I can do all the cardio I want. I'm on average doing a hour of interval 3-4 days a week and I have no feedback from the mouthy one in my chest. My avg hr is usually in the 130's and my peak is mid 150's. When I lift in sets and specifically, higher weights that dude gets ugly with me. Hence the question I have with damaging this thing if it's pushed too hard.

I see where you were very conscious of your HR when you approached around 160bpm. I'm easily 25 points higher then that threshold at the conclusion of my third set. This is the range my doc claims could create some wear in the valve I have. Logically it makes sense to me, realistically, I don't really know, and frankly, I don't want to be the test rat! What I can assure you though is that it certainly is a different animal when pushed.

We sound similar in the respect that we both seem to push the envelope in our recoveries. I returned to running my business full time 19 days after getting off the table. within 2 weeks I was walking a 16 minute mile, up to 3 miles a day within a month. The only thing I did not get back last fall was the ability to play golf. Twisting my body worked the day I would play a few holes but man did I pay for it the next day or two! I'm hoping to get back out, again, after the snow leaves.

I hope your recovery continues well.

Rob

 

[tprice54]

This is an interesting thread! Like Chou, I have a "meat" valve, so I did not stude the mechanical for wearing out. I have read numerous times here that they are good for a very, very long time. If you look at it as using up a defined number of cycles (open/close), that would be the same as with your original valve, and saying it had a limited number of beats. Anyway, exercize is food for your heart, anyway you do it....just keep at it!

 

[SumoRunner]

I once got a note from a guy on another runner's forum I used to subscribe to. He was an engineer with a valve manufacturer and used to conduct life cycle tests for them. They would run it at pressures and speeds way beyond what it would ever see in the human body. The also ran it at very high rates, in the thousands of clicks per minute so they could test it for 30 or more years-worth of beats. They are designed so that the mean time between failure is in excess of the normal life span.

That's not to say they never, ever fail. I guess that's possible. There was no guarantee certificate that came with mine, but it's done OK by me so far.

 

[tobagotwo]

Just a thought...

It sounds like the doctor was reacting to the fact that you had an aneurysm. If you show signs of connective tissue disorder, and your physician is concerned that you could develop another aneurysm, then he would advise you not to do things that will create greatly increased pressures within your arteries. There's a lot more aorta left, and of course, all that piping in the brain. The "red-face test" in this case would not be about embarrassment, but about internal pressures.

The concern about these pressures is unfortunately real, if you have aneurystic tendencies. Were it not for that, I would agree that the doctor was being unreasonably restrictive. While I can't know your individual tolerance for these pressures (I think it's something of an educated guessing game even for them), I would generally agree with a more cautioned approach for someone who has had any aorta replaced before 60 or so.

I am absolutely certain that there are people out there who've had aorta replaced at a young age and are pumping heavy iron or doing other things that would be out of line with this, and are experiencing no apparent problems. However, I'd have to think that some of them are sawing at the last raw nerve of luck.

Best wishes,

 

[echoguy]

from all my reading, at least for meat valves, high intensity workouts do
not affect valve longevity. problem with the meat valves, especially for
the younger folk (under 65) is they tend to calcify. that process proceeds
at the same speed regardless of exercise.

WOW. Thank you so much for all of the info so far. This has been an education into valves and into the culture of the forum. You all seem to play very well together!

I am particularly interested in the last sentance of the quote above. Are we aware of any studies that back that up? I have been advised that a "meat" valve (am I catching on the lingo?) can last anywhere from 5 to 20 years before it calcifies and needs to be replaced. That seems like an awfully wide range and could affect my decision. What are the factors that cause a tissue valve to wear out faster in some folks? Is it pure luck?

 

[echoguy]

What I am finding though with the mechanical implant is that it, on days, seems to have a mind of it's own. Especially if I've pushed it a little.

When I lift in sets and specifically, higher weights that dude gets ugly with me.

What I can assure you though is that it certainly is a different animal when pushed.

Thank you so much for all of the info and perspective.

Could you be more specific about what you mean by, "mind of its own", "dude gets ugly with me" and "different animal when pushed"? Chest pain? Fatigue? Palpitations?

 

[bethfit]

WOW. Thank you so much for all of the info so far. This has been an education into valves and into the culture of the forum. You all seem to play very well together!

I am particularly interested in the last sentance of the quote above. Are we aware of any studies that back that up? I have been advised that a "meat" valve (am I catching on the lingo?) can last anywhere from 5 to 20 years before it calcifies and needs to be replaced. That seems like an awfully wide range and could affect my decision. What are the factors that cause a tissue valve to wear out faster in some folks? Is it pure luck?

I am not sure about any specific studies, but it is true that 'meat valves' tend to last a shorter time on younger people. My understanding is that the younger (and fitter?) you are, then the more your body will attack the valve and ultimately lead to its failure. Its not a true auto-immune response in that you don't actually reject the valve as they are de-naturised to make them supposedly invisible to the body, although it is partly this process which restricts their life-span. What seems to happen is that people lay down mineral deposits (described as calcium but that not all there is to it) on the 'foreign' tissue. Valves seem to go one of two ways, either they calcify and go stiff so they don't open properly (stenosis), or they fail to close tightly leading to regurgitation.

I believe that the 'average' lifetime for a tissue valve is around ten years, but as you say I have heard of them lasting over 20 years or as short as six months. My own homograft pulmonary valve has efectively 'failed' after only three years, and I am now looking at another replacement, probably within the next year. My consultant has not indicated that my fitness 'habit' has done anything to precipitate this situation, but rather that it is my good health, younger age (36) and an element of bad luck which led to it. Perhaps others will be able to elaborate further?

 

[R&N Brown]

Hello Echoguy,
When I first had my On-X installed my hr would run away on occasion, they could clock it between 200-300 bpm and then, boom, slow right back down.
Do it unprovoked, no reason.

I'm not sure that the rest of my system has completely accepted the non- human part even now. I guess that's what I mean by it having a mind of it's own. It's not really the valve it's the rest of my heart that is not all that settled with it's new partner.

Alright, here I go again, are you ready Chou?
My surgeon tells me that it's not all that unusual for your body to not want to accept a fake part. (it's not faked out!) In turn it wants to spit it out much like a fish wants to spit out a hook. Feels a little like that too when it acts up. When I asked how successful my heart could be at chucking out the valve, he said, no way, it's there to stay.

It has become progressively less frequent as time goes on so maybe the boys are starting to get along a little better. Then again, when I have a vigorous workout, excuse the term, parts get pissed off! That's what I mean by acting up. I've heard that you are not supposed to be able to feel your valve, Ya right! Put your hand on my chest when it's thumping and your would agree that something wants it out! You can see my chest move.

Even knowing what my limitations will probably be for the rest of my life, I would still take my chances with this valve over a tissue valve. Being that I am going to live to be 100 I did not want to do this at minimum a couple more times.

What valve to choose is really a personal choice. One great thing about this forum is that you can get a hundred opinions from a hundred folks and somewhere along the way you will figure what's right for you.

Good luck with all, we will expect you to keep us posted.

Rob

 

[R&N Brown]

Even after that very long winded post, I guess I really didn't answer your question.

I wouldn't call them palpitations, I?ve had palpitations when it takes off my hr is still consistent, just consistently faster! Not varied.

No pain, my chest can feel a little sore though for a spell after.

No fatigue, no dizziness, no numbness etc...

What I do notice though is the difference in the sound of the valve. After the boys fight it sounds more like it did when I first brought it home. it has a much more defined clicking sound, almost sounds clean. people around me can hear it. When it has been behaving for a while (which really is 98% of the time now) I'm the only one who can hear it.

Rob

 

[echoguy]

Even after that very long winded post, I guess I really didn't answer your question.

I wouldn't call them palpitations, I?ve had palpitations when it takes off my hr is still consistent, just consistently faster! Not varied.

No pain, my chest can feel a little sore though for a spell after.

No fatigue, no dizziness, no numbness etc...

What I do notice though is the difference in the sound of the valve. After the boys fight it sounds more like it did when I first brought it home. it has a much more defined clicking sound, almost sounds clean. people around me can hear it. When it has been behaving for a while (which really is 98% of the time now) I'm the only one who can hear it.

Rob

Thanks for the details Rob. I appreciate all of the info you have provided on this thread.

I will keep you guys updated as I navigate the next few months approaching surgery. I see my cardiologist again on Wednesday and surgeon #2 next Thursday.

Happy trails.

 

[ChouDoufu]

mr. brown,

here be a thread over at the cardioathletes forum that might be useful.

http://www.cardiacathletes.org.uk/forums/showthread.php?t=32&page=3

mr. echoguy,

last year, i was discussing the pro's and con's of various valve types
with my chinese girlfriend. she made her decision by exclaiming,
"get the meat one!"

 

[runninn]

New to site too

New to site too

I had a Ross procedure 1-30-09 (2nd !!! heart valve replacement) and I have a lot to add. I too run a lot (Boston qualifier, etc).

Anyways, I had a pig valve in June 2001, and it broke down in a mere 7 years.
FOR ME, my activity level did contribute to the breakdown (per my doctors). AGAIN, this was for ME ONLY.

Now, at age 48, I went with the Ross procedure, as I DON'T want to consider another operation.

And yes, I am getting faster, unless you were an elite in your 20's & 30's (I wasn't), you can be faster. I am shooting for sub 3 hr marathon times & sub 1:29 half times. I was close already.

The key is REST (& cross-training)...to be cont'd...NEAT SITE! (Just found it!!!!)

 

[ChouDoufu]

Can I expect to return to my previous level of activity?

by previous level, i assume you mean before symptoms, rather than the
day before surgery.

long ago....i ran the berlin marathon in 3:08, 2 miles in 11:30, i mile in 5:30,
could bicycle 100 miles a day, five days a week. the day before i flew to
india for avr, i ran 2 miles in 14:55. i was unable to run further, not
due to breathlessness, but just general no-energy-ness.

now at 11 weeks: yesterday ran 4 miles at an average pace of 9:12, and
a 5k time of 28:43. slower than pre-surgery, but twice the distance. and
note that reduced speed is partially due to watching my hr monitor to
keep my heart rate down. i'm sure i can run faster and farther. also,
last weekend bicycled 100 km, including climbing the same mountain range
twice, both 2000' climbs.