Limits to exercise

[Chris Green]

Hi all,

I am pre-op (hopefully a number of years), and have always played competitive sport. My cardiologist advised me to stop doing so. I'd been wanting to retire from rugby for a while anyway!

I wonder what people have told with regards pushing themselves when in my condition. The cardiologist advised me to exercise in the cardiovascular range 65% - 75% of max bpm, which I do.

However sometimes I want to run hard, or play football (soccer to you US types), just to get the buzz. I have been advised not to do distance running, but just occasionally I'd like to push it.

Anyone have any thoughts/experiences?

 

[Les]

Hi,
Unclear as to what condition you have that would compel your card to advise against strenuous exercise. He knows best I'm certain. I had bacterial endocarditis that resulted in my aortic valve being replaced in '93 and again in '95. However, my card has always told me to just "go with it" and I have. Myself and a couple others on this site run a lot and have done marathons. Sure, there are rhythm problems and all that but I work with people with NO heart problems at all and they can barely make it into the office from the parking lot! Each of us requires evaluation by the trained professionals and, I would like to hear more from you on what exactly is going on. Feel free to send me a private message. Looking forward to hearing from you. Just remember, life doesn't stop with a valve replacement... Just read all the Personal Stories on this site. Talk about a group of fighters!
___________________
Les AVR '93 / '95

 

[Chris Green]

Thanks for the reply,

I have a regurgitating aortic valve (still classified as 'mild'), that is not noticeable in everyday life. When I exercise (treadmill, stepper, rowing machine) I achieve results that are good for someone without my condition. All in all I am fairly fit.

My previous cardiologist said it was okay to do a 1/2 marathon, which I did, but then the new one advised me against 'competitive' sport and endurance training.

This is due to the extra stress placed on the heart. But why would exercising at 165-170 bpm be any more damaging for my heart than someone without the condition, simply because it takes less exertion on my behalf?

I do not have an enlarged heart (although I did when this was first diagnosed. probably a virus).

 

[epstns]

Hi Chris (you're the second Chris I've met here),

I would ask your cardio specifically why he wants the limits where he describes. I have a different condition (moderate to severe aortic stenosis) and my cardio has advised me to avoid competitive sports, isometrics, weight lifting over 40 lbs. and any "high dynamic" activity like basketball, baseball, etc.

I've been a runner/jogger for over 20 years, and a moderate health/fitness nut for even longer than that. My cardio is OK with my 5 day/week 4-mile jog at 9 min/mile, but he instructed me to slow down from my previous 8 min/mile pace and cut back from 7 days/week training to 5. I have been keeping my max heart rate at or below 150 bpm at this pace. I wouldn't (at my age) feel comfortable at 160-165 bpm, although I have done it and am still here to admit it. I'm still in far better than average shape for my age (55) and still feel good with this level of training. Yes, I can see that as spring turns to summer I may wish for a good hard run, but I will think twice about doing it.

 

[Chris Green]

Hi Steve,

Thanks for the post.

There's nothing that makes you want to do something more than being told you shouldn't!!

It seems your level of exertion is similar to mine. I try to do 3 X 60 min sessions a week at the gym at a constant 147 bpm.

I guess there are 2 issues here: intensity and duration.

I would sometimes like to blast out on the rowing machine for 8 minutes, and get into the 170's, just to feed my sense of wellbeing/manhood/ego, and to know that I can still do it.

Similarly, I would love on a sunny summer evening to put on my running shoes and do an 8 miler (which at my speed is well over an hour).

To know I could do these occasionally without compromising my long-term health would be a boost. I am not foolish enough to try without the blessing of my cardiologist, but I wonder if I am being TOO wrapped in cotton wool.

 

[epstns]

Who Knows?

Who Knows?

Yeah, Chris, I know what you mean. I'm very new to all this (didn't even know of my condition until Dec. 2002), so I think it wise to wait a couple of weeks until my next check-up with cardio and ask him directly then.

Stay in touch -- I'll keep you posted.

 

[John Cochran]

Reality Check

Reality Check

Hi Chris,

I know what you mean about sometimes just wanting to push the limits. Don't...at least, not now. Please make yourself familiar with what SCD (sudden cardiac death) is all about. You can do all the things that will maintain your health that are reasonable, but your cardiologist didn't make these suggestions to you for no reason. This is serious business, and putting exceptionally high stress on your heart at this time can be fatal. Sorry, I'm not trying to scare you, but you really really need to be prudent about this.

Best,
--John

 

[sylviayasgur]

hi chris!
my husband joey was told to ease up on his workouts by his cardio (a marathon runner who has always encouraged joey to work out) when he got into the moderate to severe range. more so due to his stenosis than the in sufficiency.
he was always told to keep his hr at a max of 140, but preferably in the 120's (it was never a problem because his meds kept his hr very low. in fact, he would actually try to get it higher by working harder_ no such luck, those meds really do their job!)
in any case, he went to another doc for another opinion. this was back when the "port method" was new and this surgeon was one of the pioneers. he told joey that he should stop working out altogether. we were very surprised, considering joey was only in his 30's at the time and his as and ai were in the mild to moderate range.

i guess my point is that different doctors have different views on these things. joey's cardio did not allow him to do any weight lifting over his head_ nothing that involved "valsalva " (when you exert to the point of holding your breath and pushing it). he did, however, urge joey to continue his workouts. we all feel that his cardiac fitness level helped to prolong the time before joey needed his surgery.

it's funny how things turn out though. i was the one who always aerobicised and ran, etc. joey played tennis, biked, and ran. we also took hiking and mountain and regular biking trips. now all that has changed.... i think we've created a monster!!!
he is still into his running and biking, etc. it's just that now he can lift weights and do the things he couldn't do before.
he loves it and is becoming "buff".... it's so cute to see how excited he gets about all these new, beautiful muscles.

i agree with john in that you should ask your doctor why he feels you should take is easier.
i'm sure he has good reasons.
either way, maybe it's time to start taking things down a notch like steve does.
you will still stay fit and get the benefits of the workouts.

hope this helps. please let us know what you find out.
be well, sylvia

 

[epstns]

I think everyone is trying to say about the same thing -- the cardio's advise us with (generally) good reason, and we should seriously consider taking their advice. We should also be very aware of the consequences of ignoring that advice. In my case, the "notch down" of my work-outs is not enough to negate the good effects of exercise. If and when the doc tells me to wind it down past the point where I feel I can accept it, my next step would be to begin pushing for earlier surgery rather than later. I want to enjoy my life on my own terms, but I am not willing to accept serious risk of sudden death to do so.

By the way, Chris, welcome to "The Waiting Room" where there are a bunch of us who know surgery is in the future, but not necessarily right now.

 

[Simon Gee]

Hooray

Hooray

Hi Chris,

it's great to hear from another Englishman!!

Since I had my AVR in Oct 2000, I have been more active physically than for a long time. I completed the London Marathon in April 2001 (completed, not ran!) and was in training for the same event next month until a virus knocked me off course. I have not been given any specific advice about heart rate, but I tend to self limit to a max of 160 bpm, with an upper range of 140-150 preferable.

I guess my situation is different because I'm post surgery, but I really believe that the benefits of hard, not extreme, exercise more than outweigh any risk to my own heart. One of my GP's is involved with a number of top sports teams (inc. the UK men's hockey team and the awesome London Irish) and he has advised me to continue as I'm doing - his only no-no to me was my threatened return to the rugby pitch because I'm on warfarin), so I'm happy enough with that.

At the end of the day, our medical profession give us advice with the best of intentions and it seems stupid to ignore that advice completely. However, you sound like a fit guy who's keen to continue exercising and, in your position, I would be keen to carry on so long as I felt comfortable and that the exercise was within my capacity.

Keep in touch,

Simon

 

[Chris Green]

Thanks all for your replies,

I'm not about to run myself into the ground. I have 2 beautiful little boys and a beautiful wife that I want to grow old with. Indeed, cardiovascular exercise is in many ways a pleasant relief from the extreme rigours of training and playing rugby. It's like exercise lite!

You're all reminding me of what I already know, it just makes it easier to know that most of us are in the same boat. It's interesting though that post-operatives are allowed to push harder than people with a 'mild' pre-operative condition.

I really should stop whinging now, and be grateful for the many great things I have. I've set myself a body fat ratio of 20% by June, so I'd better keep that date with the rowing machine!

 

[MarkU]

Just a word of caution based on my own experience. I had a bicuspid aortic valve and was asymptomatic until I was about 45. I go to the gym 4-5 times per week, and I always included at least 30 minutes of aerobic work at 130-140 bpm.
When I first started to develop symptoms, I found that I felt "better" if I pushed myself harder in my workouts, maybe due to the endorphins kicking in, who knows.
As a result of overstressing my heart I developed some left ventricular hypertrophy.
Fortunately, this LVH has been reversing since my AVR, but I think I was just plain lucky that I didn't do any permanent damage.
Bottom line is to listen to your doctor.

Mark

 

[Chris Green]

Mark,

Snap! As I too am a congenital bicuspid aortic asymptomatic case, I thank you for your cautionary tale, maybe sometimes we are better off listening to the doctors rather than our bodies. Because I still feel like running for hours sometimes... sometimes that is.