Aaron Boone: Surprised

[cbdheartman]

Is anyone else surprised that Aaron Boone has been cleared to play baseball again and has in fact returned? I imagine he is weightlifting to some degree, at least doing toning to himself in baseball shape. The reason I am surprised is that the genetics lab at Hopkins has told me (I seem to have the run of the mill BAV with aortic aneurysm syndrome) that they would recommend that I not do any situps, pushups, or pullups (ever) because of the increase these cause in blood pressure. Now I believe the surgeon might have a less conservative approach, but the reasoning from the genetics lab, which seems to be on the cutting edge, is that there is the possibility of aortic tissue being weak in other places and there being the possibility of other aneurysms growing and that isometric pressure will stress these potentially weak spots. I am not sure what I will do personally going forward (right now the thought of doing a pull up is very unappealing!), but with Boone I would think that his doctors would have this in mind. Obviously, we don't have his chart in front of us, but his situation sounds almost identical to mine and so I am surprised.

Anyone else surprised?

A few articles about his return:

http://www.chron.com/disp/story.mpl/sports/bb/6599209.html
http://www.usatoday.com/sports/baseball/nl/astros/2009-08-31-boone-return_N.htm
http://mlb.mlb.com/news/article.jsp?ymd=20090831&content_id=6717516&vkey=news_mlb&fext=.jsp&c_id=mlb

 

[scuba_898]

cdheartman, 1st i want to say that i am glad that your surgery was a success and that your feeling better.

now as to aaron boone. I was surprised that they let him play baseball again, but i also imagine it was his decision to make. I was initially told that after surgery i would never play contact sports again and should enjoy them now while i can.

I was also told that after surgery there would be no physical limitations within reason (i won't be benching 400lbs). I had not heard of not doing situps, pushups, pullups ever again. where did you find that, i am curious to do my own researching. I am scheduled to have a AVR done for my BAV and to have my aorta replaced (last week i was told that it is mildly uniformly enlarged, which constituted a aneurysm.

thats all interesting though, thanks for the update.

 

[MarkU]

I think that it is going to vary on a case-to-case basis and that neither Boone's doctors or MLB would let him come back unless the risks were acceptable. I'm sure all the insurance/risk managers had to sign off on it. The last thing they want is a player keeling over on the field on national TV.

I was an avid weightlifter prior to my AVR and gave up lifting post-op at my Cardiologist's request. Ironically he is now suggesting that I add more weightlifting back to my exercise routine to help maintain the upper body muscle mass I acquired over the years. Still have to avoid heavy bench presses and squats.

As I mentioned, every case is different and the best advice is to consult with your own doc.

Mark

 

[Tom F.]

Why be surprised? He had surgery yea, but that did not turn him into an egg that will fracture when you touch it. I returned to judo, there is one guy that went back to the NFL after a Ross procedure, I have read of folks returning to active duty military after heart surgery, so why be surprised? If you are otherwise healthy the fact that you had valve surgery alone should not preclude you from doing things.

 

[briansmom]

This is what he does for a living. He was an elite athlete before the surgery. When docs tell you not to lift heavy weights it is really kind of a sliding scale. For some people heavy weights are 10 lbs, but for someone who was a serious weight lifter before surgery 100 lbs may be appropriate. It is really about keeping the BP down.

A similar story on a small scale - My youngest son broke his collarbone earlier this summer. He really wanted surgery to fix it so that he could immediately go back to riding and racing his motorcycle. While the doc said that ultimately he would do what we wanted, he did not want to do the surgery. His main reason was that my son was not a pro and the fact that he couldn't ride for 6-8 weeks was not going to adversely affect his "career". Pro riders get the surgery because there is a narrow window in most professional athletes lives in which they can earn a living in their sport.

Boone can also afford to have doctors at his beck and call to maximize his ability while minimized the risk as much as possible. I know a lot of professional motorcycle racers and it is a very interesting and different medical world that they live in.

 

[cbdheartman]

My surprise is that given what the geneticists at Hopkins are saying to me -- someone from all appearances with the exact same condition and who underwent the same surgery.

This is what he does for a living, but from what the lab at Hopkins is saying when you have BAV with aortic aneurysm syndrome there is no guarantee that another aneurysm won't develop higher up the aorta. The woman in the lab there admits that they take a conservative approach, so I can see Boone's doctors clearing him and saying, "We are going to do frequent scans to make sure there are no other aneurysms." I just think it is interesting that the Hopkins lab that deals with this and is probably on the forefront of the research into the whole spectrum of connective tissue issues, does not approach aneurysms as discrete, one-time things. Boone had an aneurysm develop and a BAV and he had the aneurysm repaired and his valve spared. But there is no guarantee that his aortic tissue was only weak in that zone and no other. Now again it might be worth the risk, I am just surprised at his clearance.

Of course this might point at the larger issue here that there is a real breadth of opinion and advice when it comes in how to handle BAV and aneurysms. Take all the varied advice I received on when to have surgery. The Genetics lab would have been suggesting surgery in the 4.5-5.0 range I believe. The surgeons were more apt to wait. This stuff is a moving target. Just find it interesting. I wonder if my surgeon will clear me for more stuff than the lab will and then I will have to decide which way to go!

 

[Bigred]

A couple of things to consider here. Boone is 36/37, he only has a few playing yrs left, it's not like he's 21 and beginning his career and is facing 20 yrs possible issues w/playing. And baseball is more focused on conditioning so this aspect would only seem beneficial to someone that underwent surgery.

Granted there is some contact in baseball but it's not like he's facing off against 340lb linemen every play.

But as others have said, every person is given different advice based on their particular condition and the surgeons view point.

 

[netmiff]

these professional sports clubs have more medical equipment and staff available to them than most small towns. You can bet your last dollar that they are keeping a close eye on him. To the club, he is an investment that they are looking after, and no expense will be spared to keep him playing, if they can. On the other hand, if they think anything might happen, they will bench him, fix him up, and get him out there again as soon as possible.

He will be monitored closely during practice, and they will know his BP, oxygen uptake, recovery times, how fast he could throw/hit a baseball, how long it took him to run certain distances, how much and how often he could benchpress etc.

 

[Maryka]

Borderline cases

Borderline cases

You know how I feel, CD. Of course, I came through the Hopkins genetics department and was told my few Marfan symptoms put me in the "be very careful" with weights, exertion and pushups. Avoiding those things worked for me in that MY aneurysm did not grow over the 15 plus years I knew I had it. (Sadly, the bad valve kept getting worse.)

I was shocked this athlete went back into the game, frankly, but his whole livelihood hinges on exertion, it seems. I hope he is getting his aorta studied VERY frequently to ascertain if the aorta is growing.

You know that you have some striking similarities to a Marfan man, so you should proceed with some caution, I think.

 

[gustaf]

I have only had limited restrictions, such as recommendation to only do limited weight lifting, not too deep scuba diving (preferably less than 18 meters) and avoid extreme endurance and performance training.

The recommendations seem to differ, but what my surgeons said was that they had seen very few, if any, disrupting aortic aneuyrisms in patients they had "fixed" once, except for Marphan patients. They were more uncertain about brain aneuyrisms however, which seems to have been picked up generally lately.

In any case, you gotta live! So I do a bit of all this now, the main issue is that the pump mechanics with everything that was changed, including the pacemaker, just is so much less efficient than before. So I passed on the Stockholm half-marathon this Saturday. Maybe next year...

::g

 

[Bill B]

The same surgeon who is doing my AVR with aortic graft surgery next month, D. Craig Miller, did Aaron's surgery. Lifting heavy weights is about all he has cautioned me about at this point. Dr. Miller impressed me as being at the top of his field and not at all cavalier in his approach. I don't plan to see him again until my surgery, but I plan then to ask him a lot more about specific exercise restrictions, of course. I will let you know what he says about baseball - running down fly balls, stealing bases, etc. He did mention they operate on a lot of athletes.

 

[Bill B]

I talked today with one of Dr. Miller's staff. I am scheduled to have an operation similar to Aaron's, perhaps even a bit more serious with the amount of aorta I am going to have grafted. They will replace any questionable Ao tissue with graft, and I was told that will leave me with ZERO restictions on exercise, other than during rehab, as long as I am cleared with a stress test by my cardiologist. Weight lifting, marathon running, whatever, even baseball. Now, this wasn't from Miller himself, so I will wait until after surgery to see how this goes. I was clearly told to do no heavy lifting in the period prior to surgery, but otherwise I should have regular exercise and after recovery from surgery, no limitations at all.