Rowing and Peripheral vascular disease (Now What?)

[rogerdora]

I am 57 yo male, 5’11”, 160 lbf, been erging for about eight years, my best 10K time was 37:27 four years ago. About 2 years ago I begin to observe a significant decrease in my rowing and running performance which I attributed to ageing (can barely manage a 42 min 10K now), I would row 3-4 times a week and run the other days with an occasional day off. About a month ago I was climbing in Yosemite ( I am also an avid rock climber), about half way up a particular climb my left leg began to just feel dead tired, fortunately to the relief of my climbing partner and myself I was able to finish the climb without incident. The next day instead of climbing I decided to go for a run to test my legs, Shortly into my run my left leg began to have that dead feeling shortly after that I begun to experience calf pain, I finished my run and the pain went away shortly after stopping, I have not run of climbed since. I have continued to row, rowing full stroke for about 14 min until the pain in the calf becomes to much, than arms only and ¼ -1/2 stroke for a total of 52 min. I finally went to my primary doctor last week, He suspected Peripheral vascular disease. A leg blood pressure test was Performed (ABI Test), and the results indicate the blood flow to my left leg is indeed greatly reduced. I have an appointment with a vascular surgeon this week, which I assume will order MRI or some other imaging to locate possible blockage.

My question for now is: have any of you experienced this condition? If so what was the outcome, recover time if surgery was involved etc. Any info would be appreciated, Thanks

[gouldilocks]

I had a similar issue to yours, but in my left hand and fingers.
An MRI scan revealed a blood clot 10cm long in my upper arm - I only got discomfort at really high intensity as a route diversion for my blood had built itself around the affected area and was able to deliver sufficient blood for a normal workload.
The big problem I had was that it was suspected that there was another clot feeding this, and it turned out to be the case - I had a clot on the heart wall and I was put on medication for life - Warfarin, Statins, Beta blockers and ACE inhibitors,
The good news is that a year on and I am the healthiest I have been since early adulthood(I am 47) - I have lost over 50lbs and have taken massive chunks out of my PB's, mostly set 5 or 6 years ago.
It does sound like you may have something similar, it's definitely worth checking out - as I mentioned, I didn't need any surgery and having to take a few tablets every day is a small price to pay for a return to good health.
Anyway, best of luck - I'm pretty sure whatever it is, it is easily treatable.

Paul G

[rogerdora]

Thanks for responding. You outcome is what I am hoping for in my case. I have had ABI test And MRA both pointing to severe blockage. The left lower leg is 37 percent of what the blood flow should be. In a few days I will have a angiogram, the Doctor says it will give him more info. But things seems to be pointing to a leg by-pass surgery. Time will tell! Thank god for the C2, I can still get my cardio.

Roger

[gouldilocks]

Best of luck Roger - it seems as if your doctor is on top of the situation and has ordered all the correct tests, and even if surgery is required, it sounds relatively minor.

Paul G

[rogerdora]

UPDATE to my original post : I had a angiogram yesterday. During the procedure my Doctor with another Doctor He brought in for consulting, made a “most likely “diagnoses of popliteal artery entrapment syndrome not Peripheral vascular disease as first suspected. Popliteal artery entrapment syndrome is a rare condition that usually occurs with 20-40 yo athletes, which makes my case even rarer since I am 57yo. The entrapment means that the surrounding muscle pinches of the popliteal artery, which blocks the flow of blood to the lower leg.
The consensus between the two Doctors was to perform a leg by-pass surgery to fix the problem. Another option would be to do nothing, however, this is not a long term option, the doctor said if I did not do anything I would eventlly have to have my lower leg amputated since the blood flow is so severely reduced. He was amazed that I can even walk. He said the only reason I can walk is my body has adapted because of intense exercise which has created other path ways to get the blood done into my lower leg.
I am going to schedule the surgery for sometime in late January. The recovery time is between 4-6 weeks, if I have no complications. Depending how things go I plan on doing one leg rowing workouts to keep fit while my other leg heals.

I will throw this question out , has anyone reading this had any experice with this type of medical condition? If so could you provide some details, recovery, outcomes etc.

Thanks, again Roger

[dustin]

Roger,

Popliteal entrapment syndrome, as you correctly said, is a rare cause of arterial occlusion. Typically, diagnosed in the young (no offense). There are approximately 5 different types, but essentially, it relates to aberrant anatomy that occurs during in-utero development. With that said, some cases are easily corrected by dividing the medial head of the calf muscle (gastrocnemius). This is the most common presentation of the disease. However, I have treated and operated on individuals whose artery is so badly damaged that a bypass is in order.

In terms of a bypass, best results occur when you have adequately sized vein to use as the bypass conduit. Vein holds up much better long-term than prosthetic material. However, you must know that there is no comparison to your own artery (i.e. bypasses aren't necessarily forever). With that said, results for people with your condition generally are better than other individuals undergoing bypasses of the lower extremity. Reasons of course are that you, being a rower, are likely in better health than 99.9% of the patients I see (if you haven't figured it out yet, i am a vascular surgeon). Further, I doubt that you smoke, which is perhaps the number one, two and three reasons bypasses fail.

Recovery is as you have stated; i would give it 4-6 weeks. You are going to be sore. Your leg will be swollen for a little while after surgery. These are expected outcomes. The hospital course, on average is between 3-5 days. I admire your willingness to do one leg rowing, I have never had a patient tell me that one!! However, as you might expect, by the time you are discharged, the expectation is that you can carry on with most normal daily routines. I always tell patients we discharge them when they are safe enough to get out of the house in case of a fire - seems to put it in simple english for most everyone.

I wish you luck - let me know if you have any other questions.

kind regards,

dustin

[cpallenjr]

Hi Roger, how about an update?

Dustin, my wife is a Nurse Practioner in a Vascular Surgery Practice here in Seattle. She loved your characterization of smoking being "the number one, two and three reasons" bypasses fail.

This is a great forum.

Courtney in Seattle