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LLJ

LLJ

VR.org Supporter
Supporting Member
Joined
Jul 19, 2005
Messages
283
Location
NJ USA
Hi everyone: I am returning to VR.org after my intial go round nearly 5 years ago. I 've been discussing the early failure of my medtronic porcine mosaic valve on another forum. I am now resigned to the fact that another surgery is in my very near future and believe I am going mechanical. So-all those mechanical athletes please raise your hand! I am an avid cyclist and have done a few triathlons this year as well as 1/2 marathons . I developed a high pitched " squeaking" (bring on the pig jokes) two days after the last tri about a week ago. An echo revealed mod+ regurg (4months earlier the valve had been "perfect" on echo) Yes I trained all winter and have been very active since my surgery. Leaflet infection ruled out. Cardiologist says he has "never seen this before" It good to be unique;)
ANyway-my question is: have you mechanics noticed any thing about heart rate, recovery INR ANYTHING you can share? I really would be driven nuts if I couldn't return to exercise.
Laura
 
Laura, of COURSE you can exercise with a mechanical valve. Take a tour of the members and you'll see all sorts of athletes with mech valves. You might prefer to try the On-x valve since you may be able to take less coumadin than with a St. Judes or similar mech valve.

My only heart rate issues are because my valve was undiagnosed for so long, and I had horrid a-fib, had to have a maze, and am pacemaker dependent. Even with that, I exercise much more now than I did pre-surgery.

We've got a fair number of serious runners here.
 
Artificial Valves and Pursuit of Exercise

Artificial Valves and Pursuit of Exercise

First, keep in mind that the outcomes of valve replacement surgery can vary despite what kind of valve you have implanted. Now that the disclaimer statement has been made, here's my personal perspective...

The artificial valve I received back in 2007 has not restricted my activity level in any way at all. I'm probably more active now than I was before I got the new valve. Wanting to keep my heart in shape is really a major focus now. I'm not an exercise junkie, but I'm kinda obsessed with cardiovascular fitness. I'm on one of my bicycles every day for at least an hour; often more than an hour.

INR management has never been a big deal and taking coumadin hasn't imposed any restrictions either. You'll sometimes hear advice to opt for an On-X valve because at some point coumadin may not be a requirement for individuals with that particular valve. I think that despite our hopes that this will become a reality for those with On-X, we're not there yet and may not be there for a very long time. My St. Jude works very well, but On-X is a very good product.

As you've undoubtedly noted in the posts we've exchanged previously, I've had some pretty bad crashes while cycling. Yes, I've had bad wrecks while on Coumadin (including being the victim of a hit & run last year). I've also done the endo thing while riding my mtn bike more times than I'd like to remember. Injuries heal when you're on coumadin just like when you're not. Bruising probably looks a tad worse, but it heals. You just pick yourself up and keep yourself moving after something bad happens.

In addition to cycling, I run a couple of times a week. Again, I've never had restrictions because of my artificial valve or coumadin use. Now that I live in an area where sprint tri events are held several times a year, I may try doing one if I can figure-out the swimming thing.

I do home monitor. INR for me is really affected by how much activity stuff I'm doing... it's a metabolic rate thing for me. Frequent checks help me make the minor adjustments to stay in range.

-Philip
 
I got my St Jude valve in December of 2000. Although I was "functional" within three months, it really took me about nine months before I felt 100% again.
After my AVR, my cardiologist advised me to cut back on my heavy weight lifting and do more aerobic exercise. That eventually led to me doing my first sprint triathlon in February 2004. I love all three disciplines in triathlon, and the the cross-training aspect helps reduce the stress on my 57-year-old joints and bones.
At the time of my AVR I had developed enlargement of my left ventricle, my resting HR was in the mid 70's and my blood pressure was in the pre-hypertensive range. Within 18-24 months post-op, the enlargment had reversed itself, my resting HR was in the mid-40's and my BP was down to 122/72.
Coumadin has really been an non-issue for me. The biggest hassle has been having to do a Lovenox bridge a couple of times for colonoscopies (it sounds strange, but in a way I enjoy giving myself the Lovenox injections).
I've crashed my bike at +22 mph with no ill effects other than the standard road rash, a dislocated finger, a cracked helmet and some torn clothing. No, the Coumadin didn't cause me to bleed to death in the middle of the road. I did a triathlon a week later with the dislocated finger taped up.
Both my primary care physician and my cardiologist have been support of my triathlon training, although they did have me go to a lab for lactic threshhold heart rate (LTHR) and VO2 testing to establish baseline data for my training. My doctors haven't given me any restrictions, but prefer to have me limit my time in the upper anaerobic HR ranges.
I was fortunate to link up with a local triathlon coach who is a colleague of Joe Friel, author of The Triathlete's Training Bible
who has also authored a book on HR training. My coach was very helpful when I started to do some serious training, especially with goal-setting.
I still go to the gym a couple of days of week, mostly for circuit training with light weight/high reps and core stuff. I'd like to gradually work off some of the bulk (15-20 lbs) I still have from my weight lifting days.
Good luck getting back to an active lifestyle!

Mark
 
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The mechanical valve doesn't slow you down. But the drugs do depending on what you take. Not coumadin though, that has no real effect on HR. I'm 19 years, 200 races and 20,000 miles post-op so maybe I'm not typical.
 
I am sorry to hear that you you will need new valve so soon; I know you were expecting to get a lot more miles on it. As for the mechanical valve and Coumadin; it hasn't been a major impact to my lifestyle. I still run, ride, practice martial arts, ski and generally play hard. I have had some nasty falls and taken some hard hits with no ill effects. The only change for me is that I now wear a helmet when I ski the trees. Our mutual friend kyoung has some very impressive marathon times with his mechanical valve; he once jokingly told me that Coumadin is a performance enhancing drug.

Pam says hello and is counting on you to be her teammate in Harrisburg.

Send me an email or give me a call if you want to talk.

Philip & Pam
 
A good cycling friend of mine is on coumadin because he developed a blood clot in his leg several years ago. Now he always wears a compression sleeve on his leg and will take coumadin the rest of his life. He's 57 and he'll ride about 16,000 miles this year. This guy rides hard all the time and hammers a lot of the local racers. The drug hasn't slowed him a bit.
 
I cycle lots, and go tick-tick

The mechanical valve/warfarin hasn't slowed me one little bit.

Plus I don't wear a helmet, naughty me. It's a generation thing. All the kids nowadays wear 'em, but us kids who grew up in the '70's never used them as kids, and don't now. Having said that I bought one to keep the wife happy, it's just unused.

Ade
 
Laura, sorry to hear the news....those nice hoody sweatshirts you bought us years ago for the Ohio get together mean even more now! (moo, oink, click!). Although you know I have a bovine valve now, I would not be anxious about a mechanical and athletic abilities. Hope this gets resolved before Harrisburg!
 
Dan Tread is another Very Active (On-X) Mechanical Valve Recipient. (Member Name "dtread")

You may want to look over some of his informative posts.
His member profile can be seen at http://www.valvereplacement.org/forums/member.php?3702-dtread

There is a Link to "Find all Posts by Member xxx" and "Find all Threads started by member xxx" in the profiles
(which can be found under "Community" on the Red Line at the Top of the Page. Scroll down to the "Member List".

'AL Capshaw'
 
Tom: No kidding! This has put a serious damper on my racing and social life!! It's amazing how many of my daily activities centered around running, biking or swimming. I was slotted for the Timberman Triathlon at the end of August with several friends,and a few other races,not to mention a much anticipated 90 mile hill climb bike extravaganza and beginning training for NYC Marathon. Hey-as long as I can get back to it;it's just a detour on the road. The only race i really want to be ready for is our Harrisburg Marathon--I will make sure my surgeon gets me in before than ;)
Laura
 
Just I wanted another chest cracking.....

Just I wanted another chest cracking.....

Update! Saw Dr RockStar (aka Dr Leonard Girardi Columbia Pres NYC) Wish I had him the first go round.. Great doc,lots of time to discuss and very experienced. His view is the aortic valve is pulling away from it's setting having possibly "popped a stitch" Unusual in someone 5 years out. He will know more whne he goes in and takes an up close and personal look.
Plan: Repair stitch if possible (I asked him flat out to take it out and give me a ON-X-I don't need another surgery-but he felt it better to repair than replace at this time--we might need further discussion about THAT!) Replace the whole aorta as it is enlarged (who knew??)
POST surgery: No more threshold training or Triathlon racing. He said no one knows how threshold training affects a valve(in terms of power of heart contractility and stroke volume pressures)-if they tell you they do--they don't. As we all are painfully aware here :THERE IS NO REAL RESEARCH ON CARDIAC ATHLETES OUR AGE WITH THIS VALVE REPLACEMENT. I wish someone would do some. I can continue to run, bike, swim and generally have fun playing outside with my friends-just no all out efforts. I am A-OK with that.
Surgery Date: Aug 3
In enough time to join my cardiac buddies at the HArrisburg Marathon Relay in Novemeber!!!!:thumbup:
 
Best of luck LL (cool) J with your upcoming re-do. I think if it was me, I'd probably think long and hard about having 'em just repair it 'cause wouldn't that mean a 3rd surgery in a few years? But I know that can be a difficult decision, esp. for you girls that want to leave the option of pregnancy open. On the original reason for this post, I'm probably too new to the game to be of any help, but since when did that stop me from commenting ;) I'm feeling really good so far about being able to do everything I want (incl. basketball this fall), and I'm a mechanical on Coumadin. Heck, I'm already doing more running than I've been able to do in years (I'm 12 weeks post-op). I know this part is controversial, but my surgeon told me, in addition to the On-X, there's also a chance the valve I got (St. Jude Regent - the newer, replacement for their master series) may not require Coumadin some day. He's involved in the research on that kind of thing. But even if I have to be on Coumadin the rest of my life, I'm cool with it. It hasn't been much of an issue for me. Just makes me think twice about things like concussions from collissions in basketball, falling off a motorcycle, etc. And sounds like it might be harder to get a tattoo now. Of course I'm gonna do those things anyway, but will think twice about them now, lol.

Edited to say... I just re-read your last post and see that while you're already planning to give up threshold training, you're still planning on doing marathons. So my basketball plans aren't very impressive, lol. But I'm not gonna delete my post in case it helps others ;)
 
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I have to tell you that my husband popped a stitch around the sewing cuff of his mechanical mitral, and had to have surgery to repair it. He had HeartPort surgery through his side for this one, but the recovery was just the same as any other valve surgery, 6-8 weeks of not feeling so well, etc.

So even just fixing a suture is still an invasive surgery, like any other valve surgery. They are still going to have to get inside your heart to fix it.
 
Hi EVERYONE!!!!!
I wont go into the gory details of surgery(suffice it to say that this time they could not get me off intubation for 6.5 hours and I was awake as they tried to get me breathing on my own-now I have been to hell -the rest of life is a free ride;) )
I am the proud owner of a Carbomedics Top hat valve. Dr Leonard Giradi and his surgical team (which is impressive) treated me with compassion, lazer focus and skill. I was visited prior to surgery by most of Western Civilization including every memeber of every portion of the surgical team taking lots of notes. The nursing and aide staff was there at the touch of the call bell. The CICU did their best to get me through an awful 24 hours.
Here are the details as I know them:
The leaflet tore on the porcine valve. This happens when the original valve was AT LEAST 1 size too small. An active, young person should have never gotten a valve this size. A congenital septal hole/defect SOMEHOW OVERLOOKED in the first surgery was fixed. Good news-the anneurysm repair done in 2005 looked fine. wo-hoo. The aorta was perfect.
I could not get the ONYX as it is a 21mm valve (like my old porcine valve:21mm) I needed a valve about two sizes bigger so Doc chose the Corbomedics. He said my heart otherwise was remarkably healthy and strong. He said we will proceed slowly,but now that we know what the problem was-I may well be able to return to all activities :)
All yee piggy people-it wasn't the valve itself it was just the wrong sized valve -it wasn't the exercise it was the valve was too narrow to not cause a large buildup of pressure across the opening(although Doc siad he would never write me a pass on 170 BPM--but thats just me-I'm a Ram Pick up,not a Mazaradi.)
WHat can I say I am SOOOOOOO HAPPY!!!!!!!!
Laura
 
Very glad to read your post and see you are doing so well. Continued best wishes :)
 
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