DVB posted a note for Travis that says:
Hey Travis. Thought I'd check in with you and see how you're doing. Sounds like a mixed bag what with the pain episodes and the Navy deal. Well, they don't know what they're missing out on. Anyone who can face the challenges you had and add to it the physical conditioning regime you are on and then on top of that working through the pain episodes is the elite of the elite. Yeah, elite of the elite of the elite even.
I really hope that it works out getting to the bottom of the pain episodes. Keep pushing them to figure it out. Maybe consult with a place that's done even more thousands and thousands of MV repairs? Hopefully somebody has seen it before. Hey, but I know you are unique!
So, a 6 out of 10. Can I convert that to a 2 out of 4? That's not so bad. The important thing is to keep track of it. Athletes as a matter of course have more regurgitation than average according to the stats. It's partly because athlete hearts are beefier in the muscle, but conditioning does not enlarge the valves along with the muscle. That pulls the bases of the valves apart a bit so they don't meet as well in the middle anymore. You have an annuloplasty ring, right? That's supposed to stabilize the valve circumference and keep the leaflets at the right separation so they meet properly (coapt) on the ventricular beat. That means something else is going on. Here's my (un)educated guess:
You mentioned numbers below that suggest your heart has remodeled significantly post surgery. So, and I'm just free wheeling here without any real expertise - take it with a grain of salt - when your valve was repaired they moved the chords around on the leaflets as part of the repair. Then they check for leakage and coaptation to be sure they've got them in the right place so the leaflets properly meet before finishing up. That all happened when your heart was still enlarged. At that time the chords were just the right length. Now after remodeling, your heart has gotten smaller because it doesn't have to fill 140 ml to pump 60 ml anymore (or whatever the numbers are). It only has to fill 80-90 ml or so now that half the blood isn't going the wrong way. Being smaller means the distance from the papillary muscles where the chords are rooted to the valve leaflets is shorter. But the chords are the same length. So there's some room now for the valve to prolapse. Maybe they compensate for this effect in the surgery, but if so, I imagine it's hard to get just right. Or maybe I'm totally off base, engaging in pure and idle speculation, or just plain wronger than wrong. In any case there should be some details in the surgery report about what was moved, trimmed, and added. Whatever is going on should be apparent in your echo.
In my journal I have a piece about afterload reduction, which has been shown to slow down the progression of MR using common, safe drugs. They basically lower your blood pressure through a variety of means to promote more prograde rather than retrograde flow. You might want to see if this is a viable approach for you. It's my journal entry "An ACE up your sleeve: from October 28, 2012.
As usual since I'm not a medical doctor these are just talking points you might want to use with your cardiologist to stoke a conversation that might end up with some good ideas.
OK buddy, time to book. May your beat be strong and long!
Svetlomir Ivanov posted a note for Travis that says:
Hi,Travis..Very important data,I know the meaning of this numbers.....Thank you very much for it...About Italian method,I think that you didn`t get the idea of the method..It is not especially for elongated chords ...The idea is other : just to prevent leaflet of the valve to bulge back..because your chords may be OK as length,but they are elastic and doesn't prevent leaflet to bulge back in atria...these artificial chords are much more tight and STOP leaflet to bulge back deeply,keeping leaflets in one contact line ...the traditional repair surgery as I can see is based on completely different idea - they cut part of the tissue and make the mitral valve to close completely..but when surgery is done,blood flow put a pressure to leaflets and even not so loose,they again (in some cases) bulge back in small or bigger extent...the Italian method,as I can see,just restrict leaflet from opening further from some level,i.e. more then some length....nevertheless of blood flow and BP..remember the bungy jump - rope prevent the jumper from touching the ground....after some level it is like a break ...this direct counter - force,acting in opposite direction of BP,is much more stable,then the repaired tissue ..I think this is precious in this Italian idea..of course,only animation now,but very smart..more over these artificial cords are stronger they original mitral chords/tissue and will not elongated because of BP as mitral tissue do..ok,may be it is not "tight seal" because of not perfect leaflet's contact line,but MR will be just several drops of blood (as typical for normal valve),but not a "backflow"...keep in mind,that if this Italian method become reality ,no necessity of stopping heart,no such a long recovery period,no opened heart,but only one hole...and the most important - you decide problem forever and forget about second OHS..no artificial valves needs,no risk of new mitral valve loosening because of permanent BP...just technically new approach ...you actually don't have sick heart,but just mechanical problem with mitral "door"....problem is the location of the "door" and difficult surgery access to that "door"...look again video...look and schemes of mitral valve..and you will appreciate the new idea and its defence against blood back flow...But my general idea for the very moment is other : Do not be in hurry for second OHS...just try all these lifestyle changes,we are talking about to postpone OHS as much as possible...you see- new technologies are close...and they probably will solve MVP problem in entirely new way,and this way will be stable and life-long..and if you again will be declined by SEAL Navy will be not because of your heart this time,but only because of your age - you will not be young enough for them:) Even with mitral valve much more tight,than nature give to healthy people...you will agree that artificial cords are stronger than natural ones,right?...your enemy now is BP and everything which stretch in mechanical way your valve (too strenuous exercises,salt,weight, endurance running/swimming, etc.)...your MR/MVP in my opinion is not result of age degeneration or cellular disorder,but mechanical problem in the valve caused by extra physical efforts.I am neither expert,not a prophet,but I think that you have the chance to be one of those men who first in the medical history get STABLE,LIFELONG and SATISFYING decision for MVP.
Svetlomir Ivanov posted a note for Travis that says:
Hi,Travis...Of course,I a can promise that this is right,but I think that should be like that...I used to do fitness,but was not able to gain enough kg...I was,with a lot of eating about 86 kg...After that I start really hard workouts,with proteins and supplements...I become 96 kg....and I think this may be the reason for me,because nobody in my family and relatives has MVP ...Just this extra 10 kg. cause the heart to work more,increase BP and stretch the valve..Now I cut meat,I lost weight and my BP is 120-125/75-80 kg...I start to run moderately and to walk much..and my cardiologist said that my left atria - for 6-7 month become smaller...and MR is 24 ml...I do not know if it is truth or just inaccurate diagnostic,but I think that it is logically ....I tried to convince a friend of mine to make the same changes (he is active in fitness and has MVP),but unfortunately he is not willing to lose weight,and have no way to check this theory with him....But if you search internet you will see,that MR is more common among sportsman as average percent (10 %),than among rest people ( 3-4 %)...But the sportsmen are usually healthy people ...That`s why I think that in the very begging strenuous sport could trigger MR..And,after that this MR 'work for itself" and deepen the problem....And my idea is ; if somebody with this condition,make the above mention changes,may be some reversion could happen ...even to the harmless point....because if your heart is so strong for these strenuous exercises,probably MR is not because of natural (cellular) reasons,but self-induced...Filipides - ancient Greek run 42 km.,after Marathon battle,and after that collapse and die....Obviously this healthy man died because of extra efforts - hearth attack...I mean-even perfectly healthy person,could pass away just because of one extreme physical effort... If so,why are not permanent physical efforts able to induce these changes in mitral valve?...Doctors dont know what cause MVP/MR,but in the same time they always look for "pathological" reason on cellular level..OK,but if the reason is not "pathological"? And we are healthy as mitral valve tissue,but just because of increased heart activity cause this ?...Also,see your case - you did surgery - may be not 100 % perfect,but probably good enough to stop the MR..your valve WAS MADE tightened...but something again loosen your valve...and probably this is your own heart,because it used to work with extra force and extra pressure...if the reason was on cellular level,I think 2 years is too small time...Also,you said - possible bad surgery and doesn't hold up...If it was bad surgery,probably it would fail earlier,after some month and weeks...Doctors usually take decisions,based on your present condition...and doesn`t try to find out what cause this condition...Once they see my BP,they says - should take pills..but I didn`t take pills,and try alternatives,and think they work...Could you tell me your left atria numbers and cholesterol levels? My idea is - my ones,was a little bit higher...but it is possible because of sport (athlete hearth) and meat (if somebody do fitness usually eat more meat and this rise cholesterol)...about chest pain episode : I never have it ,before to understand of MR..after that I has almost one year - I was so depressed and scared..not only chest,but and shooting back pains...Stress produces adrenalin and other chemicals,which can destroy your nerve systems and heart rhythm..After I calm down this pains goes away...About your chest pains,it is possible to be result NOT from the heart,but because of injuries of muscle nerves during the OHS...and because you start too early with exercises it is possible to cause them additional irritation..I dont know if you are under stress (you wrote you manage it),but I knew for me,that stress could cause physical pains,not only emotional depression.
Svetlomir Ivanov posted a note for Travis that says:
You are very strong man:)SEAL Navy shall be sorry you didn`t joint them...Do not be in hurry for second OHS . ...you may be never need it..try changes with lower BP,we have speak about to see if they will work...I think in you case they will..BP and strenuous workouts probably stretch the valve and increase/even cause MR...also new technologies are possible...did you have before surgery symptoms,or something you find strange? How do you feel now - some symptoms, or problem with the heat ? palpitations?
Svetlomir Ivanov posted a note for Travis that says:
Hi again! Yes,after I understood of MVP I made some changes : no to much heavy fitness - just moderate levels - for example: I was around 90 kg. in muscles,187 sm....I used to do bench press with 90-95 kg...after that stop the gym,and do only home workouts - bench press and other exercises around 2/3 of previous weights...I lost weight and I am know around 80 kg....in the matter of fact,may be lost fat -my waistline drop from 93 sm. to 83 sm....biceps from 41 sm. to 38-39 sm...thigh from 65 to 60 sm...but I think the most important is BP - keep know around 125/75...before that 135/80..and my cardiologist said that MR is smaller - 24 ml. regurgitation volume..left atria - around 42 mm (some echo even under 40,some more than 42,I am surprised with different results in different hospitals in the same time)...BP I learned to measure by myself....try TEE -unsuccessfully,it was disgusting..they says MR - II degree..some even III degrees (from total IV worst)..in the same time only 24 ml back flow...I that echo is not precise measurement...Friend of mine also have MVP,but he refuse to goes to echo...active in fitness,his father has MVP,OHS and died during this "routine" OHS in 1995 ..That's why he refuse medical checks...to avoid all this stress...he feel good....I feel good,also....I lost weight because of reduced intensity in lifting and eating /I used to eat a lot of pork,now not,but my Cholesterol is not perfect even with dietary changes - HDL is little bit under the perfect levels - 0,9 mmol/L, LDL is little bit over - 3,27 mmol/L,the total is OK - 4,79 mmol/L, VLDL is ok,triglyceride is OK...Diet reduse LDL,but HDL does not rise....I run 2 km. one day in the week for around 12 min.,i.e. easily...and walk 5-6 km. everyday....if didn't visit the doctor I would never knew that I have MVP...but after visit I was one year under very big stress...now I start to feel emotionally better enough...I hope never to has OHS...and I am fed up with al this echoes,BP,healthy eating,cholesterol,etc...ok,I gained better waistline,but always feel hungry....may be some small good changes in cholesterol....and eating habits...but very boring and non-tasty like food...Follow now very unpleasant healthy eating : not eating pork more than once -two per week....stop chocolate....stop cakes ..nothing left to eat in the matter of fact,and still the cholesterol is not OK..may be has some profits regarding BP because of weight loss and salt cut,but boring ...about health system - all around the world is just profit..not for health exactly..in US health system has a lot of money, but too much people are not covered...but even in US medicine level of hearth surgery is not so far developed in my opinion..I mean,that medicine and surgery is OK for appendicitis ,but in hearth surgery is not satisfying level,yet - neither in US or anywhere ...surgeons says -early surgery,mitral operation is "routine"...but I am not sure if it is better,than to stay and live without this intervention,if you are feeling OK..In the matter of fact they even can not tell precisely how much leak,what is the reason for leak,but are strong that shall operate to stop the leak....very,very poor knowledge...I suppose,that now you are not willing to second surgery,as before the first one..This Italian method (new cord) seems much more good - no open heart,no stop of the heart,no cuts of mitral tissue ...of course,it is just an animation,but look much more better.
Svetlomir Ivanov posted a note for Travis that says:
Hi! Of course you right saying that damaged valve cannot repair itself. I mean that MR can slow down when the valve still is not damaged in great extent,but just because of extra pressure start to leak....I mean that you did OHS in close time,probably it was repaired at least good enough (if not perfect),and it start to leak not because of structural changes,but just because extra BP and workload in the heart.And my idea is,that in the very beginning of MR,the valve still is not grown bigger,with extra tissue and elongated chords ...and maybe in this stage changes are reversible,or no changes yet,but only MR as result of extremely strong back flow. About doctors and study - I've read this hypothesis partially and partially it is my own...Of course I am not expert in this matter,but educating myself of MR reach to this...Of course it could be birth defect or some cellular problem,but it is possible to be and direct result of sport - first you start with "athlete hearth" ,but this stretch and loosen mitral valve apparatus,after that MR begin,after that the very MR stretch additionally mitral valve and the entire "process" to be generated and supported by itself...just one of the possible hypothesis..if things are not like that,what cause this ? shall have some reason,right? OK,which is the reason? they shrug shoulders and say: we will wait and see..but I dont to wait,I do want to know how to prevent it....In the begging,I thought that here in Bulgaria are not good enough in diagnostic,but as I can see even in US the things are the same...The truth is that they don't have a idea about the reason or MVP..MVP is found firstly in 1960...approximately...only thing they know in the moment is OHS..but if there are some underlying reason,after OHS it will still exist...same about hair - you can cut it,but will start to grow again..you shall destroy hair follicle to stop the hair grow...I watch here a video of new Italian method -no OHS,no bypass machine...they just sew the leaflet up with one or more shorter threads..and this prevent mitral leaflet to billow back..of course it is not "seal tight",but MR is very insignificant just because of not smooth contact line between leaflets....but not OHS,not cutting tissue,not bypass machine..and maybe as result will be much more video...see the video here in the site...Also,why big hospitals shall lost patients,if this could be treated easily,instead very expensive OHS? things are complicated...I've read that US government will give billions to investigate Mars ....lost money...better to investigate censer or to create long-life tissue mitral valve...tell me please,about so called "pump head" effect - did you meet it?..Also,how they measure degree of MR? What was your regurgitation volume in ml and left atria dimensions? only with echo was the medical check or otherwise?I get the impression that it is not very precise measurement and even quantitative figures vary by the the different hospitals and doctors...
Svetlomir Ivanov posted a note for Travis that says:
Hi again! I think this is right word - the heart is too strong for the valve.The heart as treasure of put to much pressure to valve,and the valve get stretched.In other words,BEATS of the heart are to strong.Also,blood pressure (BP).As higher is BP,as pressure of valve is bigger and permanent.Try to lower BP - just stop to eat salt and salty product,because salt keeps more water and BP goes up.May be in some degree this will lower MR.Let`s presume
a ship's sail - may be its form is OK,but in case of too strong wind,the sail puff up.This wind in your case could be BP and to strenuous heart beats when you exercise heavy.I mean - may be your surgery is not the problem and technically is not bad,but extra BP and to strong heart beats can cause MVR after technically perfect OHS..Why your heart beats are to strong - because of permanent strenuous exercises..your heart just used to beat to strong to supply enough and more than enough blood to the body...just like a sport - when you are doing workouts regularly,body become stronger,bigger with more energy...i.e. you change your hearth's way of work..and this change is permanent....but what if you slow down? May be and you hearth will slow down,and MR will slow down...Everything has reason...shall have some reason why the valve to leak..ok,you says - valve is weak...but if the valve is not so weak,and reason is too strong heart beats? ....you have door in your home - if you kick the door slightly,the door will stay closed..but if you kick the door heavy,the door will open,I think...if the problem is only internal or genetic,I think your kins will have the same..but they don't...That's why I think that the sport and to much energy in you body can cause this in some extent.. what if you decrease the sport intensity? just try..I think that heart is adaptive,and as a result the valve could become stiff,not so big...if you do biceps,it grows,but if not - it stop to grow and become a smaller...valve and heart is muscle,as the biceps...but valve is under permanent workouts,not temporary as the biceps...you can not change that,but you can change the stress over the valve ,and to see what will happen ...if the MR will decrease or not...
Svetlomir Ivanov posted a note for Travis that says:
Hi Travis! I knew that no research in this field,but I think,strenuous exercises could accelerate in big amount the process - In the very begging,I try to find something in this aspect,but no medical research done...That is why, I start to read post in Internet,and I very well can remember that one guy told that he has only mild MR,but after several years of heavy running,his MR become almost severe. And again,when he stop to run so heavy, his MR stop to progress. That`s why,when I've read your journal,I said to myself - this boy (i.e. you) may be did mistake,starting so much strenuous fitness immediately after OHS. I've read very carefully your sport results and said to myself - this is to much even for athlete without MVR,but for patient after OHS is not the best way...Do you have kins with MVR and OHS,because of MVR?...Keep Blood pressure in normal level - if it is not
Svetlomir Ivanov posted a note for Travis that says:
Hi Travis...I've read a lot about MVP..and I think that except of birth defect,shall exist something as a reason...I was a fitness maniac (here no pics,but I can send )...friend of mine,also has MVP - he is very active in fitness,too..And my conclusion is,that extra blood pressure in this exercises can cause mitral valve tissue stretching - just like a T-shirt become bigger,if you are getting bigger...Also,may have something common with eating habits- some substances missing or more..how to be explained that man like you,me,and my friend - with different genes,countries have the same.Only common is the sport.Moreover my kins non of them -has MVP. I think your surgery was OK,but just "pumping habits" of your heart restore the MR- sport require more blood,and heart just adjust to this model,which cause MR.At least,my theory is like that.Think about- all docs shrug shoulders when asking what is the reason for MVR.OK,MVR in many cases is progressive -if it is progress,something cause this "progress". Surgery looks like haircut - your hair is cut,but it grow again..because something cause hair to grow...Sorry for bothering you,but I am not glad of doctors answers...they just don`t know nothing about the prevention and reason of MVR/MVP
Svetlomir Ivanov posted a note for Travis that says:
Hi,Travis...I am asking myself-is it possible to tell what is in your opinion the reason for Mitral Regurgitation(MR)? Sport,when is too strenuous?Or Blood Pressure? What are thinking about? I am very disappointed of hearing that you have again MR...I read your journal and always said to myself- OK,here is the case,of complete recovery...I hope,you will be fine,but I am angry and disappointed to hear that - about your MR.
Thanks for the reply, Travis. I guess I was mostly curious about how soon the incision can be exposed to something as harsh as chlorine. I'm actually having a full sternotomy, so I expect I'll be kicking on my back for a while before I can even begin taking actual strokes.
I am far from a serious swimmer, but I really do enjoy being in the water. How long after surgery did you wait before getting back in the pool? Was it up to you or did your doctor give you a time limit?
Hope your pain issue is heading towards resolution. That doesn't sound like much fun.
I get the sweats hours after my workouts but not as bad as the ones you described, I don't work out as much as you, but I do still get discomfort in the incision site after yoga and weight trainning only, daily walks don't cause me any pain just gets me tired and I have to rest for at least a couple of hours before I get going with my day.
I am sure glad to see that this pains are not in my head since I am suffering from cardiac depression still.
Glad that pain is gone. Ouch. Feeling shaken no fun either. I get that sometimes if I'm short on sleep and then have a hard workout. Like yesterday when I only had 4 or 5 hours sleep and then played ultimate over lunch break (extended!) without really warming up. Boom - Big string of PVC's and that shaky feeling. Settled down after a bit, but still. So I try to get my full night's shut-eye.
Even after almost a year things are not quite in factory new condition it seems. Not surprising since they cut through 2 walls of the heart and the healing produces scar tissue, which alters the conduction pathways. I'll go for that scar to normal tissue conversion procedure when its got the kinks worked out!
So after yesterday and a full night's sleep I did a "commute" run today. Daughter came by work and borrowed the car at lunch so I decided to don my toe shoes and run home on the trails and streets. That's 4.8 miles and 950 feet up. Piece of cake and steady as a rock. Gotta love it. A good night's sleep is great protection and I've got to keep reminding myself of that.
Well tomorrow's a day off and another workout. Have 2 days of ultimate tournament the weekend and really looking forward to it. Last year I had to skip it on doctor's orders. That really got me motivated for the surgery!
You asked about my stamina. For sustained effort, like running, it's back and more. For intermittent but extreme effort, not yet back to my top form. So I'm training some with hill repeats, suicides, and such. I hope to get there sometime tin the next few months.
Well, all the best to you. It seems like on the whole you are almost back to peak form. The pain episodes and nerve symptoms will get more and more infrequent and milder and milder as everything stitches itself back together. That can take a while, nerves grow slowly and it takes a while for their signals to settle down and get integrated properly.
I'ts great to read that someone else is still feeling the pain just like me, it's great to read that others recover so quickly but I really needed to read about those who are still pretty much recovering and feeling the pain.
Your aches & pains seem normal considering how hard to you play and work out. PVCs in an athelete is somewhat normal (I was told) until it reaches 5 or 6 per min.
So, get more massages! And, keep up the great work.
Wow Travis, you are doing great. I'm glad the pain episodes seem to be a thing of the past. I know they bummed you out some since otherwise everything was going so fantastic. Your stamina will slowly return. Mine is back completely now at 10 months out, at least to better than pre-surgery. I can do my 8 mile runs easily now, but still not to my younger self in ultimate frisbee, when I could play all day it seemed. I'm still working on it, and it does get better all the time. Your swimming is awesome, and I can't wait for it to get warmer so I can start my mile swims back up. I guess I could use a wetsuit. In the meantime I was challenged to see how many pushups I could do in a day and now its up to 300. Think 500 is possible? 1000? I'm limited by some sternum pain that starts up after the first 200. But it used to start up after 15, so I know I can push through. Keep the beat buddy, you are an inspiration. -- DVB
Hey Travis, thanks for posting again. I am three weeks post op. Was very active physically pre op (though probably not as much as you). Today I walked 1.5 miles in the AM, and did a mile at 20 minute pace in the PM. I am so hoping I can get back to what I was doing pre-op. Reading your journal is great for me to see the possibilites. Keep up the hard work and thanks again for posting.
Travis, thanks for sharing. I'm not young like you or in shape like you but I still find inspiration in your posts. You keep running and swimming and I'll get back to hiking/walking and slow river kayaking. I wish you continued good health. I know you will be 100% very soon!! Janis Kielbasa
How are you getting on? Have you had any more chest and shoulder pain. I am nearly at the end of week 1 of a 6 week steroid course. The cardiologist said he cant promise that the flare ups wont come back, but there is a good chance this treatment will break the cycle. I'm hoping to resume my rehab now and add swimming to my routine. The steroids have some potential side effects- weight gain being one of them!
I was re-reading your post, and I wanted to add that I feel your frustration at being so young and fit, and ready to heal and recover to your former fitness level.
I went into rehab asking to rehab my upper body strength, day 1. They looked at me like a overachiever whippersnapper, and said, "Well, we take it slow, we don't want you to hurt yourself." I hurt myself at home yanking out summer plants prepping my decently large fall garden. My older buddies at rehab weren't doing this. I felt sore, but I expected to, and thought this was because I was becoming active again after 3 months of relatively no upper body exercise. I exercised with interval training with a trainer 2x/wk up until my surgery. I was pretty fit before, and hated to see my atrophied arms and abs (legs were still strong!)
I read how much you exercised post surgery, and how soon, and you are 18 years younger than me, which is HUGE, but my doctors and rehab nurses keep reiterating to impatient and depressed me that this surgery takes 6 months to one year to fully recover to the state your body was in before surgery. I am at month 4. You are closer, at month 5. I get bummed when they keep telling me this, but I am grateful for the well functioning valve.
I'd find a muscle guru to check out muscle damage. I had a chest crack, and you had minimally invasive surgery, so we had different injury, but still, they wreak havoc on a lot of ligaments and muscles to splay those ribs, and ???
Funny you should contact me, I just had a second 7 day episode of shoulder and back muscle spasms. I agree with the pain is worse than the surgery itself! I was cursing a blue streak over the pain. It felt as bad as no drug labor to me. I took Advil and Flexeril, and went to my primary care (as my cardiologist refuses to deal with this, and told me this was a primary care problem, sending me to tears before him...,) and I asked her to send me to physical therapy to rehab my muscles and affected upper body parts.
Nobody mentioned any other possibility but muscle spasm. I talked about this at cardio rehab, and to my rehab massage therapist (I pay privately), and both the cardiologist (!) and my primary care doctors (even squeezed in a call to the Mayo clinic surgeons, though I was 2 weeks past my ending date of care for my surgery,) all doctors and therapists felt this was a back spasm around my trapezius muscle, and involving ligaments to my sternum, and cascading to the muscles between the shoulder blades. I can point to overextension "events" that damaged the trapezius, so this wasn't a sudden onset, but rather a ramp up of pain after doing too much on 2 occasions (latest helping son catch heavy pot that was heading for his face.)
It is scary to think there could be more to this.
I am going to hopefully start PT next week (evaluation?). I'll keep you posted.
My episode is abating, but I still am tender, and afraid to use my muscles (not good for a busy mom during Thanksgiving!) I did have trouble breathing, but my massage therapist says the muscles I would have used to catch the heavy pot connect to my diaphragm, and even continue down my legs. He sees the logic in my symptoms and muscle pain as a cascading spasm of connected groups of muscles and ligaments.
Almost the same thing happened to me. Only I experienced a stabbing pain at the end of taking a deep breath on Rt. side under rib/breast area. This lasted 4 days. I was checked out and vital signs were normal. I was told it was "possibly" scar-tissue or scarring from where chest tubes were. It didn't hurt on regular movement....it was just scarry to me that it was something worse.
I'm happy to hear you are ok and that others are having the same symptoms.
Oops.....Sorry I didn't leave my info.....(from the prior message from Saturday 9/10) but my name is Pete Johannsen.....I JUST created an account here so I will be one of the newer journals......
Hi Travis. I don't know how long its safe to go @max HR. At my cardiac therapy (finished last week!) they had me slow down when I got above 170-175. I'd ask my doctor. But if you are going 2 minutes at a time up there you can try increasing it a little (little!) at a time. Your max HR is your max. It just can't beat any faster on account of the fixed latency at various steps of the cycle. The max isn't set by the strength of the cardiac muscle (though there is more force on it the faster it beats). I googled the question, "can you do damage when at maximum heart rate for an extended period?" and got some hits, you might want to read what's there, although of course with an appropriate grain of salt (low-sodium variety, of course). Most people, heart surgery or not, can't hit max HR without calling it quits, let alone sit there for 2 minutes! -- DVB
I am shooting you a message as you are the only one person I can find who is yonger who has a similar issue as I do...
I am 41 and no where NEAR as in good shape as you are (though with this new valve you never know...) but I had a few questions for you I didn't see in your postings...I guess only one REAL question....
#1- What valve did you go with (Tissue or Mechanical) and why?
Feel free to ready "my story" to get some info.....
And THANK YOU for any advice you could give me....
Hi Travis. Good to hear from you on your journal. I don't know if you should still feel uncomfortable when pushing hard. That doesn't happen to me - I get out of breath and my muscles ache from O2 starvation/lactic buildup. That's what my wall feels like. Can you get the same conditioning benefit a notch lower, without the chest pain? Maybe you could try that for a week and see how it goes. It may be you are setting too high a pace for reconditioning. Any muscle you are trying to develop at a high rate will always be sore, right? There is an intensity where there's no longer a benefit. If you've found it the good news is you don't have to work so hard! Take care bro -- DVB
Hello My name is Marina I have a hole plus valve problems. I am waiting to hear more from my cardiologist next week, I was told that I will need open heart surgery. I am waiting to get more exams. please send an
e-mail I have a few questions.
Not completely normal. It takes me longer to warm up and get past that "blah" beginning of a run that used to just be 2 minutes. And then I'm not all the way back to my best on pace x time. But progress every week. My treadmill sessions are now topping out at 9 mph, and no doubt soon 10 mph. But I can't go sustained at that pace yet. Trail runs I can do 5 miles and should try longer distances now. I did go for a fantastic 3-4 mile trail run in the rain the other day with my daughter - she runs 6-10 miles regularly. And my ultimate frisbee is coming back. I played a couple of games to 7 back to back for the past few weeks and I used to only jump in for a few points (about 3 minutes a point) at a time. So that is also getting better week to week. I haven't done sustained weight work in a long time and I'm probably past where I was any time in the last while except for when I was running college track.
I don't feel it in my lungs/heart too much. Usually the first thing that happens is my large leg muscles start to go anerobic and I feel the lactic acid buildup. I'll pay attention to my breathing to get more volume or slow down. Doing weights I can feel my chest muscles complain when I'm on my last reps. So I just make sure they really are my last reps. Week to week I can push up the weight/reps though, so it seems to be working.
I've noticed the 'push' thing too. And a day off every week seems to help too.
Hi Travis. Don't have a heart blog. Came late to the party so now just make guestbook entries. I started running for real at 4 weeks in rehab on the first day there. Before that lots of walking/hiking and a few unplanned running dog chases when the new mutt busted out the front door. The first at week at rehab they did have a few other restrictions, like don't do over level 8 on this machine etc. But on week 2 I was OK'd to find my own levels advance at my own pace. Most of the patients in rehab are not athletic at all, so the staff doesn't have much experience. The protocol lets them customize after an initial "break-in" period. I was mostly OK with starting slow but did push right up to the boundary all the time. It paid to have an early conversation with the staff about my goals.
One thing that happens at rehab is pretty funny. Since I pound harder on the treadmill etc than the rest of the patients I'm the one that breaks the machines. So far I've done in 2 or 3. They were probably ready to break given the chance, and I pushed them over the edge. The rest of the time they get light use compared to a regular gym. I'm getting a little bit (in)famous. Glad they don't charge me extra!
If you are worried about overdoing it, just expand your envelope slowly enough that your body gives you accurate and small amplitude feedback day-to-day. For example you could shuffle a 15-minute mile one day and take a week or two to get to 10-minutes. Another couple of weeks to get it down to 8 and so on. That was my rate, your mileage may vary. Or do low contrast intervals over the course of a mile. Assuming you can easily do a 10-minute pace, go for a few minutes at 10 mile pace, then a minute at 8, etc, slowly making it more challenging from one day to the next. I do that too to mix it up and work on speed specifically. For stamina, you can even just increase the distance but not the pace by adding distance day to day until you top out at your goal - for example a 5% daily increase would double your distance in two weeks of daily workouts. I haven't done that at rehab because I only have an hour there, but on off days I do follow this pattern, either with running or playing ultimate frisbee for longer and longer times before subbing out. Just be sure you start with something that's not challenging to guarantee safety and then "listening to your body" as you progress so you can throttle back if it is too much. Sure, you'll spend a few days doing easy stuff but it won't take long before you are working at it and receiving full goodness. I'd mull it over with my cardiologist over the phone to get blessing and a heads up on what to watch out for. I'm sure he/she will be happy to discuss it. Probably even be pretty curious about what you can do at various times as you recover.
Most insurance pays for cardiac rehab, so if you see any advantage to being monitored you might want to look into it. Your cardiologist can help you choose. For bypass patients rehab is known to reduce long term mortality rates by about 30%, so there is a measured benefit for those folks. Patients like you and me who have a repaired valve after asymptomatic MV regurgitation might also see some long term benefit but I don't think its been measured yet. Probably not as big a benefit since we are restored to normal life expectancy on repair. The statistics may leave room for real benefit though, so why not do it?
One thing finishing a formal rehab program does is it gives you a definite "characteristic" (ie did cardiac rehab) so at some point in the future it will help you determine what cohort you are in for various risk factors / long term outcomes as they become known. In itself that might be helpful to you since you are probably going to put the time in doing workouts anyway. Maybe a somewhat odd reason, but I found going into the surgery knowing about risk factors, risk stratification, and being able to assign myself to a cohort was very helpful in choosing the best strategy. Being able to do that going forward will probably also be beneficial, especially for you since you are younger - or much better preserved - and likely to reap the longevity benefits of advancing medical technologies, more than I am (because they will advance further over your lifetime than mine). The reason it is important is because reaping maximum benefit from the technologies will depend on knowing your cohort accurately so why not have that edge?
Hi Travis. I am 56. But feeling closer to 29 these days! Didn't have much in the way of symptoms except I was throwing PVCs and I reached exhaustion a bit quicker than before. I've always had those PVCs - but not as frequent - and I thought: I'm just getting older. Then came my checkup where my physician let me listen to my heart. Instead of lub-dub it was lub-whoosh. OK, that sounded bad. I did a lot of research and followed pretty much the path you did.
Now I feel a lot more solid. Still don't have the stamina I used to, but it's getting there. I can see progress week by week in my workouts. I haven't really felt my heart bounce around or anything since the surgery. It seems to be in pretty tight and mostly un-noticed. When I rail of course, it pounds (but not as much as before), and then settles nicely. I worked on my breathing pretty religiously in the ICU and haven't had any lung problems. It's easy to catch my breath after going all out. I figure I still have a few months until I'm back to where I was and after that it is blue skies.
I still have about 6 weeks of cardiac rehab (3 1 hr workouts each week) where they hook me up to the telemetry and keep me in safe bounds. They let me get to my age-indicated max heart rate now when I'm doing intervals on the elliptical (they have me slow down when I reach 165, but my absolute limit is probably 185). I use my rehab experience to set my limits on the field and trail and not push beyond. Since they monitor for arrythmia I check at the end of each rehab session to see if I had any PVCs during the workout. They are pretty rare now.
I think your experience with muscle loss matches mine. I don't have the upper body muscle mass you do, but still lost 5+ pounds. Since then its been coming back as I make demands. Feels good.
Hi Travis. You are doing great! Being in good physical condition before hand, getting the surgery before symptoms, and moving out quickly on cardiac rehab are all the right things. Lucky man. Of course, you made a bunch of your own luck yourself. I'm now 10 weeks or so post-op for MV regurgitation via the full open heart treatment. Was able to do 3 miles walking the ward in the hospital pre-discharge (they threw me out after 4 days) and am now doing 6-mile mountain hikes, 3 mile runs, and am back into field sports (ultimate frisbee). I was also symptom free until a check-up and somewhat in disbelief considering all my exercise. But in retrospect, the wall seemed closer than before.
Keep up your physical rehab and you will be back in even greater shape faster than anyone will believe. I have to say you are an inspiration even to us monsters!