Mitral valve repair

[masonje]

I had to be readmitted and taken back to surgery as fluid had formed around my heart leading to a life threatening condition called cardiac tamponade. A liter of fluid was drained (the most my surgeon and his assistants had ever seen)and I immediately felt better when I woke up. I am back home now and continuing my recovery. I actually feel preyty good and my sternal soreness is resolving. I am sleeping well and have a great appetite. Today's workout will be riding in the golf cart while my wife plays a few holes.

This continues to be an almost out of body experience-as if all of these strange things are happening to someone else. I am not sure if it's denial or good attitude but I feel very calm, relaxed and just soaking up every bit of my day whether its making my kids breakfast, taking a walk, or watching the Cards play on TV.

I was so excited about this summer's masters racing schedule with the World Masters in the US and Masters Nationals in Seattle where my brother lives but at this point I am content to know that I will be back in a boat at some point. That's enough for now even if I am not sure of the timing of my return. Have a great Saturday.

[LJWagner]

Don't be in a rush. You are recovering, and better one slow rehab to very good status, than two or more failed attempts overdoing it.

I hardly did anything but walking the first month back, and not much of that either. The 2nd month I started doing more, and went back to work at 8 weeks.

When you get serious to retrain, use a heart rate monitor, and pay attention to your breathing. You are doing the right level of workout when you feel better week by week. Continue to pace the recovery.

[masonje]

I wanted to give an update of my progress. I am 8 weeks out from my valve repair as of today. I've been back at work for 2 weeks and walking every morning for 30-40 minutes. In the afternoons, I ride the stationary bike for 20-25 minutes and am doing some very light weightlifting 3 days a week. I feel normal in my daily activities as long as I get plenty of sleep and sneak in an afternoon nap.

Yesterday, I was back on the erg for the first time for 5 minutes times 2 (taking it very easy) and today I did 10 minutes (SR 18-20, pace 2:18-2:20/500m). I kept my HR below 130 or so. It actually felt pretty good and my breathing was easy(one full breath per stroke).

It's going to be a long process but my plan is for a patient, consistent resumption of training while carefully(!) listening to my body. I am still hoping for the CRASH B's in February but I obviously have a ways to go first...

[Bob S.]

I wanted to give an update of my progress. I am 8 weeks out from my valve repair as of today. I've been back at work for 2 weeks and walking every morning for 30-40 minutes. In the afternoons, I ride the stationary bike for 20-25 minutes and am doing some very light weightlifting 3 days a week. I feel normal in my daily activities as long as I get plenty of sleep and sneak in an afternoon nap.

Yesterday, I was back on the erg for the first time for 5 minutes times 2 (taking it very easy) and today I did 10 minutes (SR 18-20, pace 2:18-2:20/500m). I kept my HR below 130 or so. It actually felt pretty good and my breathing was easy(one full breath per stroke).

It's going to be a long process but my plan is for a patient, consistent resumption of training while carefully(!) listening to my body. I am still hoping for the CRASH B's in February but I obviously have a ways to go first...

Good news, John. Keep it up, especially taking it one careful step at a time. I am a little surprised that you are considering competition so soon. I waited 18 months, but I was almost double your age, so I would expect your recovery to be a lot quicker. In any case, good luck at it.

regards,

Bob S.

[masonje]

Bob:
Thanks for your encouragement. I will be taking a wait and see approach but I like to have a goal in mind. I don't plan on rushing my recovery but if all goes well and I feel ready-great. If not, I'll just take whatever time is needed.

I appreciate your experience and find in it just the inspiration and motivation that helps keep my spirits up on those days that I just feel wiped out.

John

[TomR]

John--

Best wishes w/ the recovery. I'll be looking for you at the Crash-Bs.

Tom

[johnlvs2run]

I had two coronary arteries 99% blocked, a 3rd 80% in many locations determined by angiogram. Triple bypass the next day.

It amazes me that with three coronary arteries blocked that neither you nor the medical practitioners had a clue that there was a problem with your diet. Had this been noticed and steps taken there should have been no reason in the world why your coronary arteries would have gotten to that state.

I am curious what your non drug total cholesterol levels were prior to that triple bypass surgery. Isn't there is a 10% mortality rate from just having the surgery? I.e. 10% of the patients don't make it through the surgery. Also you should be aware that the surgery only deals with the arteries in question, but not the circulation system throughout the rest of the body. Consider if the rest of the circulation was and is 80 to 99 percent clogged, and you clear out three arteries, that does nothing for the rest of them!

In my opinion the very best remedy is to take your health seriously, and to do whatever you can to take the very best care of yourself. And not being lazy, relying or depending on some operation or drug.

The thing to do is to do whatever you can to take the very best care of yourself and to start doing it now, before it's too late.

[LJWagner]

Why Mr. Rupp,

That is the gentlest forum entry of yours I have ever read. Interested, caring, nothing outlandish suggested. If visiting, I would feel your forehead to see if you were feverish. But seriously, thank you.

I was eating fairly healthy, and exercising. I am slim, look fit, do (and did) exercise, ate my vegies, light on meats (only small servings), though not as much fruit as I ought to. Don't smoke, no drugs, no alcohol. Statistically, the first sign of any heart trouble is not angina, but a heart attack, and usually a fatal one. So, I got off pretty lucky to have multiple warning signs of (possibly the two valve incidents), and the multiple angina attacks on vacation. But the angiogram showed I had developed remarkable collateral circulation that went all over my heart. So its possible that while the arteries were clogging, this collateral circulation was literally picking up the slack. Just once the main arteries were 99% blocked, that was too much to make up for. But I was still ok at rest and doing light walking. I walked into ER pain free, but not knowing when the next bout would occur. I had the first and only bout of angina resting in bed at 9:00 PM the night before the bypass surgery. That bumped my surgery time from 10:00 AM the next day to 7:00 AM. First in line.

I wonder if my two mitral valve incidents might have been caused partly by insufficient blood flow from the clogged arteries. Those, and my broken arm 2 years ago forced a severe drop in any cardio work I could do since 1991 or so. Prior to the first incident, I could walk stairs two at a time (18 floors) with little appreciable rise in heart rate for 20 minutes, twice a day. Then Boom ! One day walking single steps 5 floors, I felt some pain in the chest and a little trouble breathing. That was the first incident, from an infection that lodged in the mitral valve and caused swelling there. Not really diagnosed until I could force an echo-cardioram stress test 4 months later. By that time, I could handle a treadmill and HR of 178 for 15 minutes.

As reported earlier, I think my big dietary faux pax was about 10-15 years of a bowl of ice cream every night, and eating way too many crackers on a daily basis, too. And I've been a bread and bagel fan for years. I lost any interest in ice cream about 5 years ago , and cut he crackers entirely when I learned about transfats at about the same time.

Also, I have one helluva adrenal reaction in action and thriller movies, which might have been the bigger problem. I now refuse to attend/watch any. Life is more mellow. Have to keep the wife and teenage daughter from stressing me. Both are more mellow after my surgery.

I was aware of parental and grandparent heart attacks at age 57, so expected exercise and adequate nutrition to be sufficient. My doctor thought there was no way any angina last December was health related. Well, it went south while on vacation, worsening by the day. You know the rest of the story.

I did make an interesting accidental discovery. I've read that blueberries , grapes, and pomegranates are good for the blood pressure and arterial system. Well, after going through about a gallon of one blend of them over about three weeks, my blood pressure dropped 20 points, and my pulse stays lower, too. Brand: TRUEBLUE, variety Blueberry Pomegranate (it has grape juice, also, and no added sugar).

Jogging sends my HR up to 160 in 2 minutes still, so I can't do that, and rowing below 2:30/500m does too, so I still limit my cardio to 135-145.

An interesting study on exerise at predicted anerobic threshold:
http://www.findarticles.com/p/articles/ ... i_n7638047

Take good care of yourself, too, John. I hope you picked your parents better than I picked mine.

[LJWagner]

Pre-surgery, my cholesterol was 187, ratio of HDL to LDL about 1:3.5, decent.

I had a test a few months after surgery, and cholesterol was 142, ratio of 1:1.6, outstanding.

After returning to work, I eat

more salads at lunch
no stir-fry at lunch, even though they use olice oil and canola oil.
far less peanut butter
more water, less juice to drink (except now the blueberry pomegranate)
less nuts.

I already did most of the right stuff. There was not much to change. The two meds bring muscle weakness and fatigue into the picture. Four days off if I get involved with other stuff, and I feel like crap. So I need to keep the exercise up very regular, no breaks. No more taking a day or two off and having the energy level shoot up, now it does the opposite.



Not sure the mortality rate. Hospital I was at does 1500 angiograms a year, about 1% complication rate they say. They do about 300 bypasses a year. Doctors in Nicaragua wanted to operate there, but the wife said, "No, thank you." They did recommend that on going home, not to mess around seeing my doctor and go to ER.

[orcadian1]

Like John Mason I was asymptomatic when mitral valve prolapse was detected, in my case it was a life insurance medical 3 years ago. I was 44. At that time my cardiologist thought I could watch and wait, avoid caffeine and continue working out. Unlike John's doctor he did not advise against heavy weightlifting; I wonder if that would have made any difference. My total cholesterol was only 4 mmol/l. He said in some cases MVP is something you have a predisposition to from birth but stays mild, which sounded not too worrying.

All seemed OK until 10 days ago when my heart rate hit 210 while cycling back from the gym. The cardiologist did an immediate repeat 24 hour ECG which found bigeminy (coupled beats) and was amazed I had no symptoms. He will start me on atenolol tomorrow to convert me back into sinus rhythm. I expect I'll take it for life.

I found the 2006 ACC/AHA Practice Guidelines for management of patients with valvular heart disease on the internet at http://content.onlinejacc.org/cgi/reprint/48/3/598.pdf
After reading the executive summary page 630 I reckoned I should start low dose aspirin. Page 630 also advises in certain cases against competitive sports; since the last 10 days my cardiologist allows only "moderate exercise" which I take to be the mild (UT2) limit on my Polar monitor. He hasn't raised the prospect of an operation... I hope I can manage with drug therapy but I wonder if I will need a repair in the long term. (The ACC guidelines are complex and treatment options are best discussed with a cardiologist, which I'm not).

Is anyone else taking beta blockers and has it greatly diminished your exercise tolerance or limited the time you can row? My best 2000m was 7:39:3 on August 31. I used regularly to row 40 mins. I wonder if I'll manage that again.

John Bremner

[LJWagner]

Interesting. Prolapse very different from strain. Re-reading a prior entry of mine in this sequence, I note I typed 1991 rather than 2001 for the year I last was really fit prior to any cardio events.

Do you feel short of breath exercising, when you don't think you should ? With an MV strain, that is the main symptom. I backed off my cardio way down to where my breathing was unaffected, and slowly built up the capacity at the low hr rate, starting at 104, over that with the strain, my respirations went up too much.

I also wear a heart monitor while working with weights, and limit the set, ending it when my hr hits 140 with an audio alarm.

I just had some bouts of moderate angina. Angiogram and stent last Thursday and Saturday (twice). I now wonder if J Rupp may be right that I may have clogs all over my miles of arteries. Does make sense.

Interesting though, one of the stents went to a section of artery that the doctors say did not exist back in January. It connects the lower ends of the right and left coronary arteries, which usually have no crossfeed.

My cardiologists think I just got a bad draw on the genes, as far as the blockage goes. But a good draw on the capacity to add new circulation.

[LJWagner]

My cholesterol is now 57 LDL, 37 HDL. Seems to be a 3rd value I can't recall for the total.

Added Renaxa for minor angina relief, and I rarely have any angina now, or only very minor. Not even worth a nitorglycerin tab. Pain free exercise if I warm up like a good lad, which I always do.

I am doing a very low fat diet. Almost no oils, no nuts, meatless meals over 60% of the time.

A 2:04 500m has my HR go from 104-154 in 2 minutes. I usually keep it down to about 2:30-2:50 pace, HR about 125-130, and row 30 minutes or so.