Paul's Journal

Ole Bore  your case manager in Cardiac Rehab will help you tremendously with that. For me, I was given the following math: 220 - your age. Then subtract your new resting heart rate. Then take the residual times 50% and add your new resting heart rate. That will give you the lower bound for your training. Then take the residual times 80% and add your heart rate. that will give you the upper bound.

At least, that's what I was told to do. So, when I do intervals I run basically until I hit upper bound and then wait until I get back to the lower bound and do it all over again...

Terrie Syvertsen  Sorry Ole but after reading the above instructions to Paul I am going to slap on my sweat pants, put on my bike helmet, tie my tennis shoes, grab my water, turn on my movie Frozen, open the window wide for fresh air, turn on the overhead ceiling fan so I feel like the winds in my hair again, slip onto the recumbent back and lean back and head out on my 5 mile ride again today and be thrilled I don't have to do the math above! Don't mind me as I am amazed daily at the updates where people are biking up and down mountains and cycling great distances so soon after surgery.
I think it is wonderful and will be happy when I can get outside on my bike and just bike the miles on our bike paths! Good luck to you Paul and Ole it is great to see you being so supportive on this site to so many! Take care all.

Clay Rowe  I'm looking forward to even getting close to Paul and Ole. I'm hoping the pesky Afib goes away soon.

Ole Bore  Terrie - That's a fantastic plan! I'm a numbers guy and had to ask my case mgr how she got to my "zones." Scary thing about Frozen as it is set in Arendal. Let's just say there is no snow there - ever, and if it snows the locals call police angry about the snow and not getting to work. The only bad thing about rehab is that it is inside. Much rather do what you intend to, but that time will come as well.

Clay - it will be a great time when it comes. Can't wait to hear all about it.

Paul Fodor  Thanks guys that is consistent with what I was told. That being said I am at the 8 week mark and will beg for leniency :). - I want to get back to my max rides at 155-170 range. Like you Ole I am stuck in doors on my turbo trainer and right now to avoid going too hard I am writing this note. - Clay stick with it - at the 4 week mark I could barely do anything without heart spasms that took my heart rate above 100pct than somehow at week 5 it all stopped and week 6 I was walking 20km and week 7 riding my bike. The covert is truly non-linear it seems to keep in fits and jumps. - Terrie go for it! He best thing I ever did three years ago was go from couch potato to obsessed cyclist. I see the valve repair as a perfomance enhancer :) - I wear my incision with pride! Now if only i could enjoy a painless sneeze every once in a while :)

Kathleen F.  great post, I've been wondering the same thing, as I am at the 5 week mark and attempting to put together my own reconditioning plan. I've been able to walk (really, a stroll) for hours without fatigue, so I was told I could go back to the gym, and start with 30 minutes on a bike or treadmill, and if my heart rate got to 140 or so, to back off. I understand that to be an anaerobic workout, just below lactate threshold. After reading this post and Ole's interval workout, I am considering mixing it up with three types of cardio exercise: 1) a long slow walk outside, or easy biking at the gym (for endurance, anything over an hour): 2) a shorter but slightly faster "tempo" walk, jog or bike (anaerobic, 30 - 45 mins); and 3) intervals: fast walk/slow walk or jog/ walk, run/walk or fast bike/ slow bike (aerobic intervals to increase "max VO2"). I believe this would use the muscles differently and work the cardiovascular and respiratory systems differently as well. I should add stretching and light weights if it doesn't bother my sternum. Does this sound reasonable, or similar to what some of you are doing in rehab? Before my surgery a few liters of blood was taken, just in case, and at the end, it was put back. Is this doping? If so, I expect enhanced performance as well!

Ole Bore  Kathleen this sounds reasonable. However, it's important to measure both HR and BP during workouts. Ask you cardiologist or clinic about your max for both and try to stick to it. In my rehab they are really pushing 1, once mastered you move to 2 and then to 3 (from your comment). Mixing up is a great plan in general to get into and stay in shape. I'm not very fond of lifting weights so I skip that part of my rehab. However, I get that type of exercise with my 2 kids under 2. Stretching is very important in order to stay nimble and recover. I would also add that watching your HR after workout is important in order to check your recovery rate.

However each recovery is different, but it is very important to check with your dr. about your max limits.

Kathleen F.  thanks, good advice. I discussed with my surgeon and he asked if I had a way to check blood pressure (I don't); I just have a heart rate monitor (from marathon training). I'm off all meds now, including beta blockers, so nothing should impede my normal numbers. Will our usual resting heart rate and max be different, after surgery, I wonder? I guess I can also self-assess and use perceived level of exertion, and not go over 6 or 7? I wonder how scientific they are in rehab about all this...

Wiliam Height  Paul, any sternum pain while on bike: on any three bar contact point, reaching for bottle, turning back?

Ole Bore  Kathleen - My resting HR is about 20-30 BPM higher post surgery. Hence my HR zones are different too.

Wiliam Height  Hey Paul, I am a cyclist as well and typically log between 5-6K miles a year, but don't plan on maintain that mileage in the foreseeable future. I want to continue riding my bikes, but pushing it at the Saturday World Championships and going max heart rate is something i may have to let go of. In my case I returned from a training camp in Majorca and after pushing the limits my post echo chamber size and regurgitation became worse leading to my surgery. Everyone says I could return to same level afterwards and that the stress placed on the heart muscle will be fine but common sense tells me it would not be good with a repaired valve remodeled and or supported by a ring. That's me--I am making money as a sponsored cyclist and have a family to tend to. Dr Stewart would be a great person to ask as he has guided patients post-op to run marathons. I would be curious to know what he says about your case--let me know if you don't mind. Are you local to NYC?

Paul Fodor  Hi Wiliam - no I am from Hungary but originally grew up in Canada. Yes I am meeting with Dr. Stewart on Tuesday and hope to get some clarity and hope to hear this is all part of the recovery process and while it has to be treated it is hopefully a temporary problem. I feel for you - I raced at 90-95pct of max pulse and was known to ride at 90pct for sustained periods of 3hrs and I am a passionate climber - e.g. I do trips to the dolomites and Alps regularly to see how hard I can push it. In theory I have a ride in the dolomites in June 134km with 4000meters of ascent - I am not looking to break records but just the satisfaction of being to accomplish it and to end it with a great meal (I am a foodie as well). - let's keep in touch for sure when is your procedure and who is doing it. I am in the city for another week before going home (unless something comes up or I hear concern from the Dr. Stewart). Take care of yourself - oh as they say HTFU!

Wiliam Height  Haha--yeah the Rules! Dr Adams Mt Sinai 1/30. I signed up for a Fondo on 6/28, and hope that chest wires will not affect my position/setup on the bike. Take it easy--when ready take the bike for a walk! Ex Duris Gloria!

David Augustus  Paul, I experienced similiar set backs in my recovery. I first experienced afib less than a week out of the hospital. I was cardo converted two times and with medication the afib finally went away. I also started to get puffness in my legs and started getting short of breath approx. 5 weeks post op. My wife is a nurse and made see the doctor again. I developed fluid on my heart and I had to get "tapped" where the doctor removed 1.5 liters of fluid from my heart sack. Since that time my recovery has gone great. (I logged the medications and procedures in my journal) So I know what it is like to have setbacks in the recovery process. Dave

Nitin Natarajan  Paul - I had a similar issue. The first three weeks were going great, I was walking a good distance and recovery felt perfect. I was looking forward to getting back to work in a week and then I had some episodes of a-tach which caused my to pass out a few times. They were able to treat it but I've been in a-fib for a few weeks now. My resting rate is around 80, but even slight activity causes it to go to 100. All of my doctors feel it will pass in the next week or two and it's been feeling better the last few days. They all seem to believe this is just due to the irritability. I've heard of some folks having it for as long as 3 months, but 4-8 weeks seems to be the average. I'm hoping it passes soon so I can start cardiac rehab.

Paul Fodor  Nitin - I think mine have started tapering off - yesterday I had one attack and day before that none. A week ago it was an hourly event sometimes 4-5 times and I could not even climb stairs now - I am beginning to feel a bit more like my old self... I also noted that once I was told it was a normal part of the recovery it subsided so I think it was also anxiety induced. How is it going for you now?

Paul Fodor  William - I did a short ride on Saturday and it felt great though I need to get my rear end used to the saddle again! I now have committed to getting myself a new bike - aka as the recovery bike. What do you ride?

Wiliam Height  Wow Paul you an inspiration--5 weeks out? The weather in NY not good--it's a good winter to have hear surgery :). I just set up my Ti Merlin bike on the trainer for some recovery spins. My main ride is a carbon CYFAC Absolu, which I really like its about 4 years old. I am also somewhat of a retro rider and love to ride for the simple pleasure my steel Della Santa SLX and Zullo Columbus Max bikes--these are not climbing bikes.

Bob M  Great recovery! I feel sensitivity around my incision, but I assume that is normal because of what they did to my sternum, ribs, muscles, nerves, etc.

Paul Rose  Hi Paul,

After 4 weeks your 8 miles a day is amazing, that said you might be pushing a little too hard too quickly! From your Story I see that you were very competitive, I can empathise. I made the mistake of pushing too hard too quickly and competing with myself. It is easy for me to say in hindsight. The Cardio rehab unit were continually throwing anchors out behind me to slow me down, and it took a long time for me to adhere to their advice. I had not understood was it takes time for your heart to remodel. It has undergone severe trauma and you will need to be patient to allow it to recover fully - my hardest lesson learned. You are probably already pushing yourself harder than you would have pushed had you torn a muscle cycling! remember what happened with your overtraining😁

I thought after 6-12 months that I was fully recovered, to be honest it was longer than that and even now 30 months post surgery I get twinges from my chest wires. Formal cardio Rehab is worth every minute and has experts that can help plan your training. You should not be lifting anything over 10lb at 4 weeks! Indeed it took 12-16 weeks before I could add small amounts of weight. the discomfort does go with time and appropriate excercise. You can hardly see my zipper line now! I still feel the cold, but that is getting better. I now only really get out of breath after running a few miles, and if I manage the pace comfortable running 8-10 without after effects😀

Good luck with your recovery and above all try to ease back on the competetive edge for a while, it will make your recovery so much easier and faster.

Cheers

Paul R (ex regurgitator zipper and zapper club member)

Paul Fodor  Paul - I think you are right today has been one of my worst days since I left the hospital. I just could not walk more than ten steps before my heart and breathing went nuts so I came home early and decided that I will make it a really early night to maximize rest time. I just have trouble with limits.... My cycling buddies often make a point of telling me that I tend to over do things and here in lies my problem. I guess this should teach me patience (something I really lack).