Running worse after surgery

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Tom Walski

Member
Joined
Jun 1, 2008
Messages
17
Location
Nanticoke, PA, USA
My Personal Fact Sheet
Date Of Birth 6 Dec 1950

Suffered from Mitral Valve prolapse
Underwent Mitral Valve repair surgery 27 Dec 2002.

Surgery ?successful?. Some post operative complications ? some pleural effusion

Athletic performance (running/biking) became significantly worse after surgery

Here are my running times from a 5 mile (8K) race I?ve competed in numerous times.

Year Time Age
1990 31:06 39
1991 31:05 40
1992 31:25 41
1993 31:14 42
1994 31:54 43
1997 32:18 46
1998 32:47 47
2000 32:52 49
2001 32:51 50
Surgery
2003 37:02 52
2004 36:24 53
2005 38:10 54
2006 38:34 55
2008 39:05 57

You can?t help but notice that the valve repair surgery seems to have really hurt my running performance.

Had exercise treadmill test and spec imaging before and after surgery

Pre-surgery Post-surgery
(2 months) (8 months)
Ejection fraction 48 49
Diastolic volume 276 176
Systolic volume 144 91
Ejection volume 132 85

Diastolic BP 120 100
Systolic BP 80 70

I had some anemia after surgery

Pre-surgery Post-surgery

Hemoglobin 15-14.5 8.6 increase to 14 after 1 year

Had several blood tests. Tested feces for blood and CT scan of spleen. Condition normal.

Had three instances of pleurisy since surgery.

I realize that I am slowing down with age but the huge drop in performance as a result of surgery really bothers me. I?ve repeatedly heard, ?Just be happy you can still run?, and I am, but doesn?t mean I?m satisfied.

What could have caused this problem and, more importantly, what can be done to correct it?

I?ve heard several theories such as

1. The opening for the Mitral valve is now overly restricted.
2. My heart muscle was overly stretched before surgery and it lost its strength.
3. The heart muscle was damaged by surgery.

Help.
 
Tom I want to welcome you to the zoo....glad you joined us......

I am not a runner so my input most likely means little to you...but we have lots of runners that will chime in with more credible input.....but I noticed a difference in stamina post surgery.....I think many do.....and last but not least, although in my opinion it sucks....you are getting older....and older means slower:mad:....Again, welcome.
 
Tom,

I too want to welcome you to the Forum. There are a good many active runners who will no doubt come along and give you good information and advice. Just wanted to give you my perspective, for whatever it's worth.

I played sports in school days -- baseball and football, then a lot of industrial league softball in working years, and then went through a phase of middle years when I did some distance running, even though I was rather heavy-set to do that.

My thought is this: Sure, surgery no doubt contributed to slowing down your times, but most of us can't do athletically in our 50s what we did in our 40s or 30s. That's why there are "master's" divisions of major road races -- with advance of age, personal bests are age-adjusted. Don't run as fast, but still in good shape and can strive for personal bests within new age levels.

As I say, some current runners may come along and give you much better, more useful answers. I just wanted to chime in with my take on it.
 
Yep, that's pretty much what happens whatever the reason. I got my valve in 1991 at age 43. Year before: 5k = 21 to 22 min., Year after: 5k = 26 to 27.

I didn't know back then that I'd even be able to return to running at all, so I was pleased as punch.
 
Gday Mate,

If I can offer you some hope perhaps - I too had Mitral Valve repair just over 12 months ago - my times were shocking as I recovered. I have found the key is good rest between training and since I have been very systematic with my increase in mileage and rest periods my times have begun to drop again. I consulted a cardioligist here in Australia who indicated that my times should come back and may even be better - I guess I am grateful I can run. Good Luck.
 
So everyone has slower times post-surgery, which probably can be interpreted as lower cardiac performance, but WHY? Is it because the myocardium is starved for oxygen during surgery so much that it is damaged?
 
Tom

I wouldnt jump to conclusions too early , simply based on that set of numbers.

Understand that the numbers at first glance are not what you are looking for, but do you have a benchmark against people (over the same time period, same age group) how they are doing over a 16y + time span?

all the best
ar bee
 
Tom, a couple of things come to mind. First, are you training exactly the same you did before sugery? Training has the most direct impact on race times. I am still slower (18 months post op) than before surgery by a good 1.5 minutes per mile. However, since surgery, I have not trained 5 days/week at the intensity I did before surgery. Over on cardiac athletes, we have mch discussion on this, and it seems it takes one year plus just to recover, and another year plus before you can get back training at a decent level. Also, note that many heart medications adversley effect running performance.
 
I don't know that this New York Times article answers your question about the effect of surgery but I thought it was an interesting discussion about slowing down with age, and how some runners defy that to some extent (for a while). The writer says that the reason for slowing down with age is a decline in oxygen consumption.

My personal perspective is that I would be grateful just to still be running after heart surgery and stringing together sub-8-minute-miles over a 5-mile race looks pretty darn good to me. Anyway, here is the link to the article:

http://www.nytimes.com/2008/01/31/health/nutrition/31BEST.html?pagewanted=all
 
Here's a tool for calculating your age graded score. You have slowed but not by as much as it seems. It's less than 1 min per mile and as most of us have indicated we slowed considerably more than that.

http://www.heartbreakhill.org/age_graded.htm

There's another one that takes both age and weight into consideration in case you've put on a few lbs as I did.

http://academic.udayton.edu/PaulVanderburgh/weight_age_grading_calculator.htm



I've posted my thoughts on returning to running a few times here before, but since you've not likely seen it, I'll repeat myself.

Back in the 50s I was told I'd have to lead a sedentary life. In the 60s no H.S. sports allowed, declared 4F for the military, etc. By the 70s they came around and said it was OK to exercise with a valve defect, but NO competitions. I ignored their advice and ran some races anyway. Scores of them in the 80s. By the 90s my valve needed replacement and as far as I knew and my cardiologist knew, no one had returned to hard running after AVR.

In 1991 I thought I was the first when I dared to lace up the old running shoes again. So I restarted with much trepidation and never again (until very recently) even attempted high intensity training or racing. There was no web forum such as this to search or find others with a common background. I did manage to find a few, but very few, perhaps only three or four others and they were equally afraid.

So I don't really know how far I might have come back. It was only a short time ago that I found this forum and CardiacAthletes.org.uk with all these folks having similar backgrounds. And it was just about one year ago I decided to get myself back in decent shape. I lost 42 lbs (so far) and restarted interval training this spring for the first time in almost 20 years.

Being 60 now, I rely on the age graded time calculator to tell me where I am relative to 20-25 years ago.
 
Aaron... I'm not sure it has anything to do with the heart's capacity but more to the effect of what our bodies have gone through and one other very big factor. That factor would be "time off" from running.

My son runs cross country for his high school and has a decent time. He fractured part of his foot last season and had to take the entire winter off. When he started again late winter /early spring, his times were dismal, and it almost got the better part of him. One thing he could have done is said "I can't run as fast anymore because of my foot", or he could have done what he did which was realize that he had to almost start all over again. It is taking him some time, but his times are slowly surpassing what he had before.

I think the thing we all have to remember is that our body has gone through a very traumatic experience, and I know it took my body at least a year to feel back to normal. What you see as a runner doesn't shock me. Just give it time, and with time, you should be back to normal and more than likely be better than you were.
 
Post-surgery Performance

Post-surgery Performance

Interesting post concerning performance loss...the post-surgery exercise and competition subject is an interesting one. It's also very complicated.

Performance below your expectatons could be the result of the issues you noted in your original post; however, it could also be the result of a lot of factors. The ability of the lungs to process oxygen (VO2) has a major impact upon performance. As noted in others' previous posts, issues like age and training also have a huge impact upon performance.

I just posted a thread concerning an cycling event that I participated in on June 1. I thought I had trained well for the event. My ego took something of a hit during the ride when I noticed I was being passed by people who from outward appearances looked to be in worst shape than I ever was. I can't begin to guess how many excessively overweight people passed me like I was standing still. I really had to force myself to remember that the event wasn't a race and I simply needed to focus on the goals I had set for myself.

If you really want to whittle some time off your performance on these runs, you might want to find someone who can coach you. I'd look for someone who has some level of expertise in the activity you are pursuing and understands the mechanics associated with the activity. When I used to coach track it was always pretty neat to watch the kids' performances improve as we progressed through the track season. I could always gauge how effective my coaching was.

-Philip
 
I too have gotten the "be happy you can run at all" attitude that you mention and frankly I find it pretty insulting. You are asking a legitimate question and deserve to get a serious answer.

I have also had the same issue post-op and haven't been given a definative anwer for it. I originally thought it had to do with my being on a beta-blocker, but I have since gotten off of it and haven't seen much improvement. When I was on a higher dose of beta-blocker, my legs felt really heavy when I tried to run, which certainly was not pleasant. My other guess is #1 on your list. I know my valve area is smaller than it was before surgery, but is not small enough where it would be considered stenoic. A smaller valve area clearly would translate to lower blood flow, so there is some logic to that answer. From my standpoint, losing some time on my runs is probably worth the smaller valve area - which presumably increases the likelihood that I will not need another surgery for awhile. That said, it can still be frustating. You should be able to ask your Cardiologist what your valve area was before surgery and what it is now. It's pretty easy to read on an echo. I've never heard of #2 or #3 before sited as reasons for this slowdown, so I can't comment.
 
MikeHeim said:
I too have gotten the "be happy you can run at all" attitude that you mention and frankly I find it pretty insulting. You are asking a legitimate question and deserve to get a serious answer.
Click to expand...

These remarks were just people expressing their feeling and out look on life after OHS and AVR, their gratitude?..They were not directed at you so I don?t see any reason for you to take offence?.They were trying to be helpful to Tom. They evidently struck a nerve with you?..When you are older and taking solace in, ?well I?m getting older? please remember this.
 
Just so y'all won't think Cooker is screaming at you, he always uses that large font and odd color. Usually when people format their text that way it's for added emphasis like a visual shout. In his case, it's rather normal.
 
Nothing about Cooker is normal.......grin. Some of us need the large font for ease of legibility.
Tom, welcome to the group. I can't help with the running, dare I say that I am a weakling :)
 
Recovery for running

Recovery for running

Thanks for all the feedback folks. Yes, I may realize that I may be forced to surrender and admit that my case is hopeless and I should be happy I?m not dead. But I?m not ready to do that yet. I don?t want to find out 10 years from now that there was Procedure X that they could have performed that would have corrected my problem. That?s why I posted here. I?d rather solve my problems than live with them.

In response to some of the comments I received, yes, I know I?m getting slower with age and I accept that. But that rate is several seconds per mile per year (both before and after surgery). The drop in performance due tot surgery was a minute per mile all at once. This is a dramatic quantum drop that could only be attributed to the surgery.

In response to ar bee, yes, I have a lot of benchmarks. There are dozens of folks who I used to beat easily before surgery who now beat me regularly. That?s part of my frustration. I used to be able to place high in my age group at virtually every race. Now I?m lucky to scrounge up a third place medal if none of the good guys show up.

It has been over 5 years since my surgery so we can?t say that I will get better as I recover. My performances pretty much plateaued out at about 9 months post ? op.

I?ve been reading everything I could on the subject. The most relevant paper was ?Effect of mitral valve surgery on exercise capacity, ventricular ejection fraction and neurohormonal activation in patients with severe mitral regurgitation,? Le Tourneau et al, J Am Coll Cardiol, 2000, 36, 2263-69. It noted a slight decrease in things like VO2 max and max heart rate after surgery but not to the extent I?ve found. I wish I had read the paper before my surgery. Anyone have any other good references?

When I talked with the doctor the day before my surgery, he asked why I decided to have it done, I told him ?To improve the quality of my life?. So far the surgery has had a significant adverse affect on my quality of life.

I was doing fine with my heart murmur (asymptomatic pre-op) until the doctors talked me into surgery. In fact, my heart murmur probably saved my life. I was all set to be drafted and sent to Vietnam when they pulled me out of the line and told me I couldn?t go because I had a bad heart. My heart murmur was my friend. Now I?m ?cured? and my heart doesn?t work as well.

I?m not ready to give up yet.
 
Someone else mentioned blaming it on beta blockers and I tried that too. For a few years, I would stop taking it a day or two before a race and my performance improved quite a bit but still not up to pre-surgery times.


Tom Walski said:
In fact, my heart murmur probably saved my life. I was all set to be drafted and sent to Vietnam when they pulled me out of the line and told me I couldn?t go because I had a bad heart.
Click to expand...

Maybe you were two years too late. I went in and passed even with a murmur. In '66 they would take anyone who could walk through the room upright. I would have been on the bus in two weeks except that my family doctor happened to be on the draft board. I was among those willing to serve but he pulled my name from the list and sent me a 4F. I spent the Viet Nam years working at an Army Arsenal (as a civilian).
 
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