Exercising Post Op

[Alex]

Has anyones cardiologist told them that they can only do light to moderate aerobic exercises?

I am 24 years old (had ross late 90s then a repeat surgery in 2013 on the aortic and pulmonary valves).

He is telling me to do light weights, lots of reps. Also told me he does not want me to run 6 minute miles or anything. Said 165ish is the max heart rate I should aim for but to try to keep my heart rate around 140ish when exercising.

Is this a common restriction?

 

[AZ Don]

My surgeon and cardiologists have all told me to avoid heavy weights, but that light weights with lots of reps were ok. Re. aerobics, they all said to avoid competitive athletics, marathons, etc. but did not give specific targets for heart rate. My current cardiologist specifically said that I could do interval training if I wanted. In addition to a BAV that is now moderately leaking, I had an aortic aneurysm repaired. I think my restrictions may be due to my risk for another aneurysm more than anything associated with the valve, but then if you ask enough Dr's you will hear just about every answer possible. There doesn't seem to be consensus on this.

 

[pellicle]

Hi

Has anyones cardiologist told them that they can only do light to moderate aerobic exercises?

soon after surgery I think that's common, the desire is to get all the stitching healed and sealed before you put pressures on the cardiovascular system. Blood pressure goes up when doing heavy weight, particularly with squats.

I am 24 years old (had ross late 90s then a repeat surgery in 2013 on the aortic and pulmonary valves).

I became much more the cyclist when I got out of my valve operation at 28 ... I typically did 50Km a day

He is telling me to do light weights, lots of reps. Also told me he does not want me to run 6 minute miles or anything. Said 165ish is the max heart rate I should aim for but to try to keep my heart rate around 140ish when exercising.

sounds a reasonable and prudent range during healing ... to pull out a metaphor its like concrete ... you keep it wet for as long as you can when its setting. Then it lasts longer. Same goes for pottery, when its not yet baked and enameled its fragile. I don't know if I was lucky or it was my strategy but in my cohort of age group (I was involved in a study) I got well past the time everyone else got with their homografts.

patience and good strategy pays off

 

[cldlhd]

My surgeon and cardiologists have all told me to avoid heavy weights, but that light weights with lots of reps were ok. Re. aerobics, they all said to avoid competitive athletics, marathons, etc. but did not give specific targets for heart rate. My current cardiologist specifically said that I could do interval training if I wanted. In addition to a BAV that is now moderately leaking, I had an aortic aneurysm repaired. I think my restrictions may be due to my risk for another aneurysm more than anything associated with the valve, but then if you ask enough Dr's you will hear just about every answer possible. There doesn't seem to be consensus on this.

I agree about the different opinions. My cardiologist wanted me to stay on beta blockers because " people with BAV tend to get aneurysms " . I told her my surgeon,who she trained under, said with BAV you only tend to get aneurysms in certain areas of the aorta and he replaced them with a graft so in his opinion my odds of another aneurysm are the roughly the same as the general population. She immediately deferred to his jjudgement .

 

[epstns]

Alex - I have similar restrictions/advice from my cardio. I am taking a beta blocker, so it limits my max heart rate. For me, I usually can hit the low to mid-140's, but rarely any higher. When I complained about that, my cardio said that the mid-140's was about as high as he wanted me to go, so I remain with the beta blocker.

I have also been under the "low-weight, high reps" instruction since several years prior to my valve replacement. IIRC, they are worried, in general, about possible weakness of the aorta among BAV patients, so they tell us to keep the weights (and hence the internal system pressure) down. They also coach us to be sure that we breathe while lifting, not to hold our breath.

I'm a bit older than you are (now 67), but I don't really feel that these instructions hold me back. Of course, at my age, I don't plan to lift heavy and bulk up, I'm just trying to maintain conditioning and muscle definition, so the restrictions are reasonable. You younger guys may have other goals in mind, though.

 

[cldlhd]

Excuse my ignorance but what is the IIRC? When you mention concerns with the aorta of BAV patients is that all of the aorta? My surgeon,and some of what I read , suggest only certain areas of the aorta are prone to aneurysm. He replaced my root,ascending and hemi arch with a graft and said that ,in his opinion, once I heal completely I'll be restriction free. Don't get me wrong I'm ok with lighter weight and higher reps but at 45 I'd still like to be able to fully exert myself if needed. Like at work or moving furniture around the house,carrying bags if concrete when working on the house etc... I'm not on a beta blocker post surgery as my blood pressure has always been good , even slightly on the low side.

 

[cewilk]

Had my surgery 8 weeks ago.

My surgeon told me I could start lifting again around my 12 week post op mark. He emphasized using a weight where I could do at least 15 reps per set. I argued back and forth with him (while under heavy medication, so he probably was laughing after he left the room) if I could go heavier with fewer reps and he continuously emphasized to remain in the higher rep range.

As far as cardio goes, he gave me absolutely no restrictions (as long as it didn't compromise sternum healing). He actually encouraged cardio exercise and didn't have any concern about me working up to a sustained 80+% max HR.

I also had my aortic anuerysm repaired with a dacron graft. Another reason why my heavy lifting days may be in the past. But hell, you can still get big and lean in the 12-15 rep range. It's all about working hard and diet.

 

[cldlhd]

I'm ok with that range although I'm not sure what my maximum hr is. I guess it's par for the course that there's so many different opinions on the subject . Maybe he's too confident in his work but my surgeon seems to be of the opinion that it's fixed and it's as if I never had the problem.

 

[pellicle]

Hi

I'm ok with that range although I'm not sure what my maximum hr is. I em.

I specifically asked my surgeon this when I had my graft and mechanical installed. His reply was that the important issue was pressure not HR. So no squats no heavy lifting but as for HR he said go your hardest. He encouraged me to walk and when I said I lived in the top of a hill he said walk as fast as you want.

I asked is 180bpm OK and he said as I had zero evidence for congestion 220 won't hurt me.

 

[cldlhd]

Hi

I specifically asked my surgeon this when I had my graft and mechanical installed. His reply was that the important issue was pressure not HR. So no squats no heavy lifting but as for HR he said go your hardest. He encouraged me to walk and when I said I lived in the top of a hill he said walk as fast as you want.

I asked is 180bpm OK and he said as I had zero evidence for congestion 220 won't hurt me.

Thanks that's good to hear, I'm sure if we talked to five different cardiologists we would get five different opinions. If I'm not mistaken doesn't thegymguy have a graft and isn't he powerlifting? Not to make it seem like he's a canary in the coal mine but he seems to be doing fine. I don't plan on doing any heavy duty squats or powerlifting, I'm okay with lighter weight and 15 to 20 reps I would just like to know that it safe for me to lift heavy weight on occasion if I feel the need to. Like I mentioned before, if I have to move furniture I don't want to have to worry about keeling over in the living room, although obviously you can't get any guguarantee. If the risk is the possibility of a gradual aneurysm from powerlifting 4 days a week for years or sudden death from the connection between your graft and aorta blowing out that makes a big difference to me because truth be told I'm more likely to hoist a few pints these days rather than 300 lbs....

 

[cewilk]

I was just about to mention gymguy. After responding in this post yesterday I actually wanted to go do a few things with weights and see how I felt. I looked back at his posts and found what he was doing and where he was at around the mark that I am at now. He does seem to be doing very well and competes in powerlifting competition often if I'm not mistaken, which definitely isn't in the high rep range. From what I understand, making sure you breath during each rep and avoid holding your breath is important to prevent that pressure build up in your chest.

Just my opinion, but I think moving furniture should be fine. Of course it all depends how heavy and how many extra hands you got helping you, and also if you're going up and down stairs which will add to the amount of strain.

Another thing that I find difficult to interpret is what is considered "light weight"? Say someone is able to bench press 225lb for 15 reps. That may be light for them, but it certainly isn't a light amount of weight. I think it is all relative to your strength and conditioning level, since what is light or easy to one person may be difficult to another.

From what I've always read, your max HR is 220 minus your age. So for me it's 194. On my last couple of runs I've been hovering between the 160-180 bpm range which has felt fine. I use a FitBit HR for my monitor choice since I don't want to have to wear a chest strap like most of them require. It seems to be accurate when I stop and compare it a self test radial or carotid check.

 

[cldlhd]

I was using a fit it but upgraded to a surge for the great monitor. Well that would out my max hr at 185, I hit 170 the other day which is high for me but as I'm only a little over a month out if surgery I expect it to drop. My resting rate used to hover between 55-70 but just post surgery it was closer to 100. Now it's down to around 80.

 

[SumoRunner]

I used to run 6 minute miles before AVR, but I was 43 when I had it done, so age plus beta blockers prevented me from ever getting back there. I did run a mile around 7 minutes the next couple years though. I did not shy away from high intensity intervals through. Nobody ever told me to "take it easy".

 

[pellicle]

Thanks that's good to hear, I'm sure if we talked to five different cardiologists we would get five different opinions.

and equally I'm sure if we put those together in a room where they were talking to each other (not making assumptions about how the general public will interpret their words) with someone senior in there those opinions would start to become pretty darn close. Not sure who it was but someone mentioned their cardiologist backed down immediately when their old "Sensei" was mentioned as a reference for a "fact".

If I'm not mistaken doesn't thegymguy have a graft and isn't he powerlifting? .

I was referring only to during the healing time ... after that's done (max 6 months to epitheliase) and with no bad news in the subsequent scans and ultrasounds you're good to throw anything at it ... (avoid 180grains doing >800fps)

PS: interesting reading:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC539473/

 

[pellicle]

Hi

I was just about to mention gymguy. After responding in this post yesterday I actually wanted to go do a few things with weights and see how I felt.

too slack to wander through the details, but are you 8 weeks after surgery?

If so the bone's healed and so that's an IMPORTANT point ...

I looked back at his posts and found what he was doing and where he was at around the mark that I am at now.

without an answer to the above question I'd make sure you're where he was in timeline ... not earlier. Err on the side of caution I always say (well unless nailing it into a corner on my bike)

Just my opinion, but I think moving furniture should be fine. Of course it all depends how heavy and how many extra hands you got helping you, and also if you're going up and down stairs which will add to the amount of strain.

I was moving my dad and his furniture and boxes out of his apartment 3 months after surgery ... I reckon its doable.

Another thing that I find difficult to interpret is what is considered "light weight"? Say someone is able to bench press 225lb for 15 reps.

exactly ... its the reason so much debate needs to go on as to "terms" meanings and why in (say) the medical world words have specific meanings not general ones.

 

[Paleowoman]

I'm sure if we talked to five different cardiologists we would get five different opinions..

Problem with the cardiologists is that unless they do powerlifting, or weight training, or interval training or some other such training, they really don't really know exactly what the exercise means or what effect it might have so you certainly will get five different opinions. Do they restrict sex because that puts the heart rate up ?

 

[pellicle]

Problem with the cardiologists is that ...Do they restrict sex because that puts the heart rate up ?

I could get into so much trouble answering this ...

 

[cldlhd]

Ha, well a friend advised I only have sex with my own wife in order to keep the hr in an acceptable range......

 

[cldlhd]

and equally I'm sure if we put those together in a room where they were talking to each other (not making assumptions about how the general public will interpret their words) with someone senior in there those opinions would start to become pretty darn close. Not sure who it was but someone mentioned their cardiologist backed down immediately when their old "Sensei" was mentioned as a reference for a "fact".



I was referring only to during the healing time ... after that's done (max 6 months to epitheliase) and with no bad news in the subsequent scans and ultrasounds you're good to throw anything at it ... (avoid 180grains doing >800fps)

PS: interesting reading:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC539473/

I was the one who had that experience with my cardiologist adjusting her opinion after I told her what the surgeon said regarding odds of future aneurysm and need/ no need for beta blockers.

 

[epstns]

Excuse my ignorance but what is the IIRC?

IIRC is the text message abbreviation for the phrase "If I Remember Correctly. . . "