How much to exert yourself?

[Rick]

I am a 38 year old man, pre-surgery, moderate severe aortic regurgitation, bicuspid aortic valve, mild tricuspid regurgitation, mild mitral regurgitation, and slightly dilated aorta and left ventricle. Have annual check up in 8 months.

I read at Biscuspid Foundation to do 30 minute walks per day. What level heart rate are we supposed to be trying to get to? Anyone had this question answered. My cardiologist just said "dont worry about that, just go for a walk" but frankly, I wonder whether this does anything. Is this advise for someone older with BAV or any age? What is the mechanism whereby walks help (ie. direct impact on the connective tissue or BP effects) or is it just general fitness? Or BP effects? How do I know if I get something out of these walks? How do I know if too much?

[ChouDoufu]

are there really any standards as to amount of exercise, or is this advice given
by doctors solely based on their experience and/or bias and/or preferences?

for example:

after TTE #1 (poorly done) doctor calls and says do nothing, no exercise, no
excitement. i got the idea he wanted me to sit in a dark room and wait for
someone to come get me, even avoid things like rice krispies, as the snap
crackle pop would be too much excitement.

after TEE doctor says do as much excercise as i like, can even run marathons,
as long as not competitive (tooo much stress) and no discomfort.

after TTE #2 doctor says moderate excercise (moderate is subjective, no),
no more than 30 minutes 2-3 times per week.

[BackDoc]

I was 48 years old when I was diagnosed. I was almost 51 at the time of my surgery. I was a former surf lifeguard in my younger days. I exercised my entire life.

I exercised right up until two days prior to my surgery. Lifted weights--of course once diagnosed I reduced the poundages, as well as intensity, continued to ride my bicycle and go on hikes.

Once I knew my surgical date, I trained for it. I walked daily--not slowly either. I had a severely regurgitant aortic valve, as well as an ascending aortic aneurysm. My symptoms were almost non-existent , and I was told that this was because of the over-all good condition I was in.

I would advise anyone to continue to exercise within the guidelines given by their attending physicians. Your recovery will go much smoother. I was up and walking the night of my surgery, and continued everyday thereafter.

I had a short bout of arrhythmia, but this was shortly brought under control. Other then that, my recovery was picture perfect, and I was back to work on part-time basis at 4 weeks post op. I attribute this to the exercise I did pre-and post surgery.

At the 3 month point I was given the go ahead to resume any and all activity. That included horseback riding.
My surgery was 12/12/07. By the 12 week point I couldn't tell I ever had surgery, all was very well.

At 38 you are young. Don't get hung up on heart rate. Walking isn't likely going to send you into any danger zone.
You will get tremendous benefit from it. As the ad's say; "Just do it".

I am convinced that a great deal of recovery will depend on your physical and mental state going in. Make the most of it.

[SHEEPDOG]

I ride a bicycle for the Atlanta Police Dept. and my surg said to do what I want. I am only slightly symptomatic. (winded pretty quickly when riding hills. recover quickly too) Ill be in for AVR in 12 days. Did 18 week police academy at 41 and made it just fine. Doc said I have been dealing with this for a LONG time. IMPROVISE, ADAPT AND OVERCOME:cool:
So, it seems that if you know your limits and don't push the envelope too much, you should do fine:D
God Luck to all
SHEEPDOG

[Duff Man]

If you're looking for a number/heart rate, I'd say less than 140 would be prudent for somebody with an aneurysm. That's just my personal opinion backed by some advice I've heard from one surgeon. I prefer a nice leisurely < 130. I had a doctor tell me once that he would be "less excited" about weight lifting... which really probably meant "don't lift serious weight".

[BackDoc]

SheepDog, good luck with your surgery. I lived in Atlanta for 4 years and know the hills. I used to run them. Sounds like you'll be up and about in no-time.

[Leeroy996]

Hi Rick - I had chronic severe regurgitation, with a dilated ascending aorta and the left ventricle was 7.5cm.
I never cared about my heart rate. Fitness helps recovery.

I couldn't find a cardiologist that would tell me to stop exercising or even limit my exercise.

[Rick]

Thanks for your replies. I basically go for brisk walks 5 to 6 days per week for 30 minutes. I do not feel too tired during the first 20 minutes or even much immediately after the walks but do feel tired the rest of the day and get out of breath easier the last 3 weeks.

I am thinking my increased shortness of breath may have less to do with my walks or worsening regurgitation and more to do with problems with my wife....we are separated and likely getting divorced and in the time I tried to work this out I subjected myself to a daily argument and/or daily regiment of being yelled at or squeezed for more money (for 4 months). In addition I was called from school saying that she was not taking our 4 year old to classes often and that they wanted to kick him out unless he started attending; she also stopped taking him to therapies etc. This whole separation/divorce thing is very stressful, especially when the other party is hell bent on making things as difficult and stressful as possible for you. Sorry to vent on this... I going through the most difficult moment of my life and am concerned my heart is not gonna hold up. I think the walking may actually just have to be a little easier for now but likely good for me.

[marie]

I'm so sorry you're going through this. I'll keep you in my thoughts. Earline

[mrwjd]

You are probably correct, Rick. Before surgery, my cardiologist told me no sudden draw on blood (run or jump from standstill), no hot tub, and no big meal that could pull too much blood to the digestive system. But the one thing that knocked the breath out of me and scared me was the day I lost it and yelled at my teenager--rather long and loud! I probably should suggest that for his patients who are parents, he add that to the caution list.

[ponygirlmom]

after TTE #1 (poorly done) doctor calls and says do nothing, no exercise, no
excitement. i got the idea he wanted me to sit in a dark room and wait for
someone to come get me, even avoid things like rice krispies, as the snap
crackle pop would be too much excitement.

after TEE doctor says do as much excercise as i like, can even run marathons,
as long as not competitive (tooo much stress) and no discomfort.

I'll bet you thought no one on the forum would know what ChouDoufu is!

I had a similar experience to yours. My general practitioner was the first to find my giant aorta, and he called me on a Friday night to warn me that I could blow any minute and he was sending me to a cardio-thorasic surgeon and ordering a ton of tests.

After the tests, everyone was like, "False alarm!" I was jumping horses the day before surgery. The only limit on my activity was "no straining to lift heavy things."

[Philip B]

I've pursued a pretty active lifestyle without ever falling into the "fitness junkie" catagory. As others have said, going into AVR surgery in fairly decent physical condition seems to help with the recovery process.

It is important to avoid pushing the envelope too fast and hard post-op, but that defining the boundaries of the envelope is a very individual thing. What works well for me may not be good for you. When I entered a cardiac rehab program two weeks post-op my maximum heart rate was capped at 140 bpm. Now, at about a year and a half post-op 140-150 is my average during long periods of exercise. I try to avoid pushing my heart rate over 175. That 175 number was where I hit my max when I tested myself about six months ago.

My cardiologist is pleased with my efforts to pursue the maintenance of a decent level of cardio fitness. Last week, when I saw him he suggested that I have his staff run a formal stress test on me to see if 175 is really my cap or if I can go higher.

In the weeks and months following surgery, it's pretty easy to define where your limits are. Your body tells you if you're pushing too hard. Listen to it. This is really a good topic to converse with your cardiologist about.

I'm a firm believer in the concept that exercise is much easier if individuals look for activities they enjoy and simply engage in those activities on a regular basis. Like others, I started walking a lot following surgery, but I don't enjoy just walking. I moved on to other activities as soon as I was healed-up enough.

-Philip