Excessive Exercise after Open Heart Surgery: "I am interested to hear what other people have experienced and have to say about this."

"...I am not ready to accept this..."  

I was training for my third Los Angeles marathon when in December, 2012 my eye doctor noticed that one pupil was smaller than the other and that my eyelid was drooping, signs of Horner's Syndrome. He sent me to the Jules Styne Eye Institute at UCLA where it was confirmed and I was immediately sent to get MRI's and MRA of my head chest and abdomen. These showed no signs of cancer which can cause Horner's but did show that my ascending aorta was dilated to 5.5mm. My gp had noticed six months previous that my heart murmur was stronger than it had ever been and sent me for an ecocardiogram which showed dilation to 4.2mm. Upon hearing about the additional dilation he sent me to Dr. John Robertson at St. John's Hospital in Santa Monica. 

Due to my travel schedule and his surgery schedule, the appointment did not occur until February 14th. In the meantime I continued to train and ran 12, 14, 15, 16 and 20 miles in Boston in 28 degree weather - all with no chest symptoms of any kind. My goal in the marathon was to run it in the same time as my first one at age 61 - 4:37 which at age 72 would put me in the top 10 in my age group. I believe I could have done it. Dr. Robertson did a CT scan and called me that evening on my way to a Laker game and told me I had a chronic aortic dissection and would need surgery. I wanted a second opinion and went to Dr. Steven Tabak, cardiologist, in Beverly Hills, who set an appointment for me with Dr. Alfredo Trento at Cedars Sinai Hospital. He had an opening the following week on February 26th and I decided to proceed. 

He did a dacron graft and replaced my aortic valve with a bovine valve. With my trained body, my blood returned to normal in 4 days instead of the usual 4 to 6 weeks. After two weeks, Dr.Tabak detected a heart flutter and last week I went back to Cedars for a cardioversion which worked and returned my heartbeat to normal. 

I am doing cardio rehab at UCLA. Last week one of my doctors told me he does not want me doing excessive exercise which would cause elevated blood pressure which means no marathons or half marathons or century bike rides. He said I could play competitive tennis, run 6 miles and bike 30 miles. I am not ready to accept this although at the moment it is a non-issue only eight weeks out from surgery. I am interested to hear what other people have experienced and have to say about this.

-Jerry


7 comments:

FitOldDog said...

Hi Jerry,
Rule #1 is to avoid becoming a prisoner of your condition, which you seem to be tackling just fine.
Rule #2 (in my book) is to study body awareness, then you have a chance of making the right decisions.
I wrote a surgery recovery guide based on my AAA experience 3 years ago (Ironman actually saved my life on this one), and three years later I am finally back in full training. It takes time and patience. If interested you can download my Aortic Surgery Recovery Guide at this link http://goo.gl/gmQeP . Also take a look at the advice I gave to someone recovering from aortic dissection surgery http://goo.gl/KjtgI which I may have pasted into the back of that guide, not quite sure. Benjamin moved on and is doing well, and I hope he has signed up for NYC Marathon 2013, because I missed meeting him in 2012 due to the mess. You will be fine, and run as well as you did before I suspect, as long as you do things sensibly and have some patience. Don't underestimate the recovery time. I am finally getting my wattages back where they should be on the bike, have moved to Hoka One Ones for the run (another story) and we have (my AAA stent and I) a heavy race season this year. I sure would like to run Boston again, and I plan to work on that in the next couple of years, but my sights are really on Kona. If you want any input, let me know, as I like to think about this stuff. The doctor's advice will always be tempered by liability concerns, so it is important to do your own risk-benefit analysis. Have fun, and welcome back from not being dead - you'll find that life is even more precious now. Kind Regards, Kevin aka FitOldDog

Jerry Katell said...

Kevin,

Thanks for your response. I will look at the Recovery Guide. Definitely gives me hope. I have lots of patience but didn't like the idea of giving up marathons and centuries for good.

Jerry

FitOldDog said...

Hi Jerry, no reason you should give it up, in my book, as endurance sports are ideal for this kind of situation, and for aging in general. You may have to work on reducing impact as you run, but that will only extend your running life, so it is all good. Consider Hoka One One's! Just make sure you wait long enough for the repair to be fixed in place and a part of your body. Cheers, Kevin

Anonymous said...

Jerry,

There is a lot on the internet that can answer your question and give you some confidence that it is, indeed, possible to run long distances after surgery.

Before my aortic valve and ascending aorta were replaced at Cedars Sinai a few weeks after your surgery, I was swimming competitively, and actually was pretty fast. That, of course, is on hold for the time being. But I've told both my cardiologist and my surgeon that I intended in the future to once again swim fast, and although they would make no promises that I would get back to my old levels, they didn't say I could not get back into the pool after I recover. My plan is to get back in the pool this summer, to slowly rebuild my endurance and cardiac fitness for the next year, and to not try too hard to compete at a national level until 2015.

I'm doing cardiac rehab at Cedars, and am making steady progress - whereas my swimming workouts would push my pulse to 130 to 160, I'm poking along at a peak of 98, but am feeling stronger by the week. I figure that slow and steady will win this race, and at this point I have the time.

Meanwhile, it would seem that long-distance running would be a lot less stressful than the kind of swimming I do. I prefer 100- and 200-meter races, which last between a minute and up to 3 minutes: it's heavy on the anaerobic energy systems, so the heart rate tends to hit the maximum levels. In contrast, for a longer distance race, the body runs mostly on the aerobic energy system, which means a lower pulse. My point is: what I plan to do is harder on the heart in some ways than what you plan to do.

You should take a look at a web site, cardiac athletes, which is for heart patients who do things like run 10Ks. Also, look at the forum of the "active lifestyles" section of the valvereplacement dot org web site. At the bottom of that forum, re-set the search to 75 days, and you'll find the thread I started, which looks at the prospects of competitive swimming after surgery - the bottom line is that a number of people have positive experiences with serious exercise after surgery.

Hope that helps ... Jim Lucas

Anonymous said...

Hi Jerry,

I was diagnosed with 5.2 cm AAA and was operated January 8th 2013/David's-procedure. After 6 weeks I was running again and a first half a marathon training run after 10 weeks. I feel almost like before the operation now after 4 months. Do not loose your hope!

You should also check out this research paper

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2566917/

Jerry Katell said...

Thanks for the advice and comments. I really appreciate them. I ran a 10k yesterday, Pacific Palisades July 4th, with quite a few hills. Ran 13.5 minute miles putting me at the back of the pack but only 4 months after aortic dissection surgery I can't complain. Will see later this year about whether or not I can get approval to run a marathon.

Jerry Katell said...

Thanks for your comments, I really appreciate them and will follow up. I ran a July 4th 10k with lots of hills but never stopped or walked although I was much slower at a 13.5 mile pace instead of 10:30 to 11. Will evaluate later this year whether I am ready to train for a marathon.

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