what would you do??

[Philip]

Wow, this one got some responses! I can speak only from my experiences with regurgitation and a not too bad of an athlete. The other issues are foreign to me. I was given conflicting information about my level of activity as related to heart rate ranging from 120 max to go as hard as I want and the only negative result would be fatigue. After several stress test it was agreed that the latter was true. While still in denial I would push to the point of sit or fall, after choosing fall a few times I decided this was my body's way of telling me "this is not a good idea, stop!!" I now have used the heart rate monitor enough to know where that point occurs and back off prior to that.
As you know the well trained heart of an athlete can safely exceed your theoretical max. I tried to make myself believe for a long time that hitting 220 was because I was just an animal (still in denial) not because of a defective valve. I would like to honestly tell you to "just do it" but that is not the safe approach. Find a cardiologist and perhaps an exercise physiologist that you trust and listen to both your body and them. Don't let a round Dr. send you to the sofa unless absolutely necessary; they don't understand.
It is hard to accept that we will never be as fast, go as far etc, but you can reach a point where that is not is that important anymore...hard to believe, I know. Although I have never been the athlete that you are athletics has been a dominate force for most of my life. I will not go cognitive behavior on you but at your present level and hopefully your post surgery level you will remain among the elite compared to the masses. I know at this point that this may be of little consolation. I have been fortunate to be able to find another athletic outlet that provides more than adequate challenges, they are just different, that coupled with the 2 little boys I kiss on the forehead each AM as I leave for work and a wonderful wife remind me that slowing the pace a bit is not such a big deal. I hope you can find a similar place.
Philip

 

[LLJ]

I will chime in as a patient,physical therapist and athlete. Get an opinion of of doctor you trust. I agree with everyone else. You BAV isn't the worry,it's the enlargement of the ascending aorta and any anneurysm.
I had no aerobic restrictions from my cardio prior to surgery. 210 is not a good heartrate for anyone to be at EVER during exercise. There is something going on fitness wise and I don't know you well enough to give an opinion on that. I have no idea what the hell your coach was talking about with little reving engines,but I never learned that one in ANY physiology class I took. As you become more fit your heart should be able to pump less with more work. That is fitness. The best advice I ever got was from a cardiac rehab nurse who also was an accomplished marathoner and cyclist. She advised me to take it down a notch;work on endurance base for a minimum of 8 weeks trying to keep the HR at 70% Try to increase your power/work output while keeping this heartrate range. Then add intervals always monitoring your heartrate. Always go to a workout with a predesigned HR max and min as well as number of minutes you are to spend there. It is very tough,but it allowed me to compete for 2 years without incidence prior to surgery.
It is uncool to have dizzyness and tunnel vision working out. No matter how much we love to ride/run etc. now we must be much more responsible about HOW we do it. Heartrate training and a workout plan extending for weeks (yawn!) is our best bet. You may know all this stuff already,so I apoligize if I am lecturing. Feel free to kick me off my soapbox.
LLJ

 

[Karlynn]

Jas, I think you'd be surprised what my old man can do. He can whoop my 22 year old nephew (college swimmer on scholarship, trains year round) in the 100 m butterfly. His last marathon, 5 years ago, was 3:48. Not bad for an old fart. He had a stress test at 40 and they finally stopped it after 25 minutes because they couldn't get him anywhere near the max target, no matter how much they increased the incline - so he is also someone who takes a long time to get his HR up and that is due to being a conditioned athlete since his freshman year in high school. I'm not saying this to brag, just to point out that I'm not a "newbie" when it comes to athletically conditioned hearts (Me and my 80 year old in-laws are basically the only non-athletes in our large family) and why I'm a bit suspicious of your 190 rate being "the norm" for you at 22. But I'll concede that I don't know much about cycling.

It's always been my understanding that the goal is to achieve maximum physical output without having to achieve maximum heart rate, which is why I made the comment about your high rate being a sign that your heart has "issues". If you just jumped on a bike for the first time yesterday, then I wouldn't be surprised at the rates, but you obviously are a trained athlete. With left ventricle enlargement (which usually doesn't happen over night) I'm guessing you've been dealing with this for a while and may have come to look upon your rates as "normal" for you. That's part of the incidious nature of valve or aortic issues. It sneaks up on you and each little change is adjusted to without you knowing it.

 

[Jas0n]

wow, thats alot of posts and alot of very helpful information, thank you all. it may sound odd, but when i intially realized that valve replacement might be a very real possibility sometime in the near future (i still dont know a timetable, so i will be giving the doctors everyone mentioned a call, thank you again) - after settling down and accepting that although it is a major operation, it is a procedure which is done increasingly often throughout the country and indeed the world - my doctor told me something which was oddly comforting. he said that i should imagine how hard my heart is working right now. if i can ride the way i can with such a limiter place upon my heart, if and when my valve is replaced, i will likely come back even stronger than i was before hand. now, he might have just been trying to calm my fears, but the more i think about it, the more i hope that it might be true. as hard as my heart has to work now just to be like everyone else, with a "normal" repaired valve, i would pressume - barring limitations initially resulting from the surgery - i will be just as strong, if not stronger than i am before the surgery. the way i figure it, why be an pessimist in this situation ... anyone care to chime in with their fitness experiences both pre and post op ??? once again, you guys rock. thanks a million.

edit: someone mentioned my coach's race engine analogy, and the more i think of my own experience, the more i am starting to think i may have to attribute my high heart rate to my condition. and heres why: despite all my riding for the last five years, my resting heart rate has remained pretty much the same. unlike alot of my other friends, i never had a super low resting heart rate. i could ride the legs off of some of them (and others could def spank me, one needs to know when to be humble !!), but my resting heart rate has always been high 60's into the low 70's. you would think my heart would have become more efficient, and i suppose it might have, but it was at once dealing with the increasing difficulty presented by the condition.

karlynn: what your saying is starting to make alot of sense. and oddly, i shared my heart rates with my doc and he didnt seem to concerned. althoug he seems like a fine doctor, it seems like he doesnt believe my situation is all that important/dire. like your husband, i too "finished" the test at 23 minutes; my doc said he had enough data. perhaps your husband will need a training partner in a little while?? my boss is a former european pro, and even though he just turned 42, he humbles me every ride!! and the worst part is, he weighs 210lbs and climbs just as well as i do at 145lbs (i now weight 158lbs thanks to all the rock climbing im doing). either way, thanks!!!

 

[DLH]

Jason,

I can say that I am as strong as I was before surgery on the bike and on my way to being stronger. My HR before surgery was climbing while on rides and not recovering like it should when I would fall into the draft. My BP was also elevated prior to surgery and now after surgery it has dropped considerably. I will have a echo on May 15th to see how things look and to establish a new baseline for future comparisons. There has been some other posts on these issues in this forum. I agree that if your left ventrical is enlarged that should be a major concern. It can only stretch so much before it will not return to normal after surgery. This is what I was talking about when I said some doctors wait too long and other cardiac damage can occur. If the ventrical can not return to normal size after surgery this creates other issues. Talk to a Surgeon as soon as possible so that you can do what needs to be done.

 

[mntbiker]

Hi biker,

I saw in another thread that you are a martial artist. Are you still doing that? I train in Wado Ryu karate, and have this last weekend reached 3rd Kyu. It is my replacement for rugby.

Have you ever discussed restrictions on exercise with your cardiologist? Did they mention any of the risks? I am interested that you say regurg doesn't present the risks during exercise that other conditions do. I guess it just knackers you out quicker (at least that is what it does to me).


Regards
Chris

Hi Chris,
Sorry I just saw this. I am a Nidan in Goshen Budo JiuJitsiiu (second degree black) and taught for about 5 years. I was not given restrictions for martial arts but I did stop by personal choice. I found that the sudden bursts of energy required for different moves and to spar would wipe me out. This was actually several years ago when I didn't have symptoms. In addition to the difficulties I encountered a primary concern would be the injuries that are a requirement for any form of martial art. There were several other forms I had studied over the years as well. I do miss it though. The school that my son attends has been asking me to run seminars occasionally and I may take them up on it after I'm fixed.

Good luck, if you have questions don't hesitate to ask.