Because of my blog, I have been lucky enough to connect and make friends with lots of valve surgery patients, many of whom are preparing for their valve surgery. Meet Candy, also a teacher, rock climber, cyclist, workout nut… also needed valve surgery. She wanted to stay in shape before her surgery, and documented one of her workouts, less than a week prior to open heart surgery. I’m sure there will be recovery workout videos once you get moving again. For now, like most people recovering from heart surgery, Candy is walking and gently riding the stationary bike. Thanks for the inspiration Candy!
What is each day but a series of conflicts between the right way and the easy way?
Rock Climbing has taken a backseat these days. The spikes in heart rate and blood pressure during climbing are just too huge to feel comfortable with in my condition. This is a bummer because all I want to do is climb. I’ve realized though, that there is strength training that will maintain, if not improve certain elements in my climbing. I’ve been utilizing my hangboard!
I took a simple workout plan from Steph Davis’ climbing blog. I decided on this one because it does not involve any pull-ups, just hanging. In the workout below, a ‘grip’ refers to a ‘hold’ on the hangboard. I use a Metolius Fingerboard, and did a total of 4 grips. If you plan on doing a hangboard workout, don’t forget to warm up and stretch those digits. Read the entire workout descriptions on Steph’s blog and the Metolius fingerboard workout page, linked above.
(Steph’s) Typical workout:
3 sets for each grip
set one = 7 sec hang 3 sec rest x 7 reps
2 min rest
set two = 7 sec hang 3 sec rest x 6 reps
set three = 7 sec hang 3 sec rest x 5 reps
2 min rest between grips
Doing this type of workout will do wonders for my grip strength while I take a sabbatical from actual climbing. The best news is that while doing this workout, I took my blood pressure in between sets, and found that only a mild increase in BP was involved. I can do this type of workout frequently without risk of dissection associated with dynamic strength training.
just keep hanging, just keep hanging…
A couple posts ago, I mentioned an email correspondence I had with Dr. Lawrence Creswell, a cardiac surgeon who blogs about athletes’ hearts, and athletes with heart problems. His recent post, More on Athletes and Bicuspid Aortic Valve (BAV), dives very deep into the various issues that someone like me thinks about and needs to make decisions about. It is a very thorough post. Dr. Creswell’s blogging helps heart patients everywhere, not just the ones that he gets paid to treat. He touches many hearts (beyond the hearts he touches). See what I did there? That was a heart surgeon joke. In all seriousness, this is what the internet is for. Dr. Creswell ends his post with some points that he also made in an email to me:
“Athletes will ask when they can return to their sports….
…Unanswered questions include: Can a bioprosthetic valve wear out more quickly than expected? Does the (unreplaced) aorta enlarge over time? If so, how quickly? Do medications like beta-blockers limit any potential harm? We just don’t know.
Yet I’m personally aware of a good number of athletes who’ve returned to endurance sport after operations of various sorts for BAV, presumably after discussion with their doctors. Athletes should have detailed discussion with their doctors about any prudent limitations to exercise after operation and settle on a mutually agreeable plan.”
I think Dr. Creswell is saying two things here. On one hand, he feels that heart valve replacement patients should not do certain sports, including endurance cycling and rock climbing, and on the other hand, many patients are going to do it any way, as long as their docs give them the proper low down. I think most athletes are willing to take that risk. I understand that there isn’t enough data out there for some doctors to completely release their heart valve patients into the world of extreme and endurance sports. The thing is, and as Dr. Creswell reluctantly acknowledged, some of us are completely willing to be the lab rats. Quality of life includes doing the things one loves to do, not necessarily living to be 105.
Inspired by Dr. Creswell’s post, and after some reflection, I decided to do my first video Blog (Vlog) while slacklining. Thanks for watching! I call it ‘Slackline Confessional’.
Fun little side note, moments after I posted this video, I hopped back on my bike and almost got clobbered, sending me over my handlebars to avoid a collision with a truck backing out of a driveway. Moments of clarity are often quickly replaced with the harsh reality that is life!
If you live in the Redlands, California area, please check out Inner Evolution Yoga.
Phil and I were originally climbing buddies before he opened his own studio. His studio donates to local causes, and has weekly community donation yoga classes, where anyone can come and practice yoga for whatever they can afford. Inner Evolution is about community.
The Yogis call it your ‘yoga practice’, because that’s all it is. It’s like life, something that you must practice, and get better at. Some days are better than others. There are many physiological aspects that Yoga is assisting me with, such as breathing and core strength. Yoga also reminds me that it is okay to let some things go. If it is going to injure you, then let it go. Come back to it next time. Patience and persistence. There are many analogies.
And on that note, something completely different (not really). When I watched the following Nike commercial, I became overwhelmed with emotion. I usually don’t pay much attention to commercials, but I get this one. It’s like Dr. Seuss’ “Oh The Places You’ll Go” for extreme & endurance athletes.
“You’re in a fight against an opponent you cant see but oh, you can feel em’ on your heels cant you? Feel em’ breathing down your neck. Know what that is? THAT’S YOU.”
go get em.
The different opinions coming from different patients and doctors about how much exercise is appropriate for someone with BAV can be a little frustrating. There are various camps out there on this matter, and I will attempt to break it down here. Keep in mind that recommendations can vary depending on severity of regurgitation & stenosis, and the presence/ size of an associated thoracic aortic aneurysm. My current status is Bicuspid Aortic Valve with mild-severe regurgitation and 4.6cm ascending aortic aneurysm. Here we go:
1. Doctors and patients who see the potential of dissection and rupture, even though it might be a small risk. If there is a possibility, then why risk a catastrophic event with the stress of exercise? These opinions stem from the recommendations made at the 36th Bethesda Conference in 2005. Walking, bowling and golf are ok.
2. Doctors and patients who take a cautious yet more liberal approach. This is where I’ve been hanging out for the past few months. I continue my normal forms of exercise, yet I do not push myself. Keep BPM under 140, avoid the Valsalva Maneuver while exercising, and listen to your body.
3. Patients who say, “Screw what anyone else says, I’m doing what I want!” I seriously considered this for a while. Not the smartest move, but potentially liberating. Potentially liberating from life as well.
I just recently had a cool email correspondence with Dr. Larry Creswell, from a blog that I’ve been following called athletesheart.blogspot.com. His blog is exactly the resource that I need. He is a Cardiologist who cares enough about people like me to make his knowledge available to the public. He also responded to an email of mine in full detail. I asked Dr. Creswell about what he thought I should be doing in regards to exercise right now, and he definitely falls under category #1. His response was, and I quote:
“…You ask about my thoughts about exercise between now and 11/25. I’d be very cautious. Guidelines developed by an expert panel can be found online in the Proceedings of the 36th Bethesda Conference. Athletes with BAV and aortic diameter >4.5 cm should participate in only low-intensity sports (eg, golf, bowling). I know that’s not what you’d like to hear. On the brighter side, once you’ve recovered from operation you should be good to go. I’m aware of a bunch of young athletes who’ve returned to their sports after operations like yours. You might check out Ironheart Racing online; their founder, Dave Watkins, had your operation and is back at triathlon. Climbing El Capitan would be awesome.”
Dr. Creswell is right. That IS NOT what I wanted to hear, though it is important for me to hear these second opinions. His thoughts will definitely help me shape the next couple of months. Maybe I should scale back a bit. More yoga. Less climbing. Less hills while cycling. More patience.
About a month ago, I posted about how I was using Digifit to continue exercising while keeping my heart rate low. The editors over at Digifit contacted me about doing a little testimonial for their blog. Check it out!: http://blog.digifit.com/2013/08/digifit-helps-anthony/
It is just really incredible (and strange) that, so far, this has been one of the most positive experiences of my life. I know there is a hard road ahead of me, But I can also see some rewards up ahead as well. I have many ideas that I can’t wait to explore and share with you.
I really don’t know when I was happier than now.
I haven’t posted in a while. Work started a few weeks ago, so I’ve been super busy starting the year off right with a new group of 8th grade science students. I’ve been continuing my workout plan, so cycling, climbing, and light weightlifting/ core workouts, all while keeping my heart rate under 140 BPM. In addition to keeping my heart rate under 140, I also make sure that I do not ever strain. With weightlifting, it is easy to be straining under too much weight and still have your BPM low, so I must manage both. BTW, when I say light weightlifting, I really mean light. I have always been more into light weight, high rep anyway.
Bike BBQ/ Inland Empire Bicycling Alliance Margarita Throw-down Victory! Redlands is graced with a pretty cool cycling scene. Behind Augie’s Coffee Shop (where I write most of my posts) is Bike BBQ, a place where people can use tools and seek expertise from volunteers on how to fix and maintain their bikes. They even sell bikes/ parts for a very good price. These two cycling organizations threw a contest where cyclist teamed up with bartenders and used stationary bike-powered blenders to make margaritas. I am proud to say that my bartender friend Bryan Bruce (From Caprice Cafe in Redlands) and I won with a very interesting jalapeño/black sea salt/pineapple foam Margarita concoction. Check out the video at the bottom of the post to see how it went down. The quality isn’t too good, but you’ll get the idea.
Inner Evolution Yoga: My friend Phil owns Inner Evolution Yoga in Redlands, CA. We used to climb a bit together. When he opened his studio a few years ago I helped him paint the ceiling. I even worked there for 2 weeks as the front desk guy while he was away on a retreat. When Phil read my blog and saw what was up with my life right now, he gave me 10 passes to his studio. Yoga is a fantastic form of exercise that will also aid me in breathing and relaxation techniques that will be very useful leading up to my surgery. Thanks Phil, and if any of my readers live near Redlands, check out his studio.
False Alarm: The other day I had a little false alarm. I had a sudden onset of a sore throat thursday afternoon, and being the researcher/ hypochondriac that I am, I googled it and found this article, and this one too. In my head I understood that the chances of an aortic dissection with only a sore throat as a symptom is possible, yet extremely rare. I also knew that if it was a dissection, and I ignored it, I would die. As I was freaking out, some people said, relax it’s nothing, others said that I should go to the ER just in case, and I just didn’t know what to do. I realized that If I didn’t go to the ER, I wouldn’t be able to sleep, so I just drove myself to the ER thinking that I’d be home by midnight if everything was okay, and that’s exactly what happened. It is a little embarrassing that I freaked out so much. I did learn about how Aortic Dissection can be diagnosed with a blood test called D-Dimer. Really interesting actually. This is what they did for me. The other option is a CT scan, which subjects the body to a large amount of radiation. I’m calling this experience ‘My Dry Run’.
I had a little bit of inspiration today. My buddy Mark (at around 3:30am) adapted the lyrics of C.R.E.A.M. by Wu Tang Clan for me. It was both hilarious and touching to wake up to the message. The message from Mark got me out on my feet and on my bike. I rode my bike up the Redlands, CA classic route ‘Sunset Loop’. It’s just about 12.5 miles, but lots of hills. I usually hit it as hard as I can, so I’ve been avoiding it lately because I was unsure if I could keep my BPM under 150. I did it, with the exception of one big spike, which I hope was a glitch because it came out of nowhere. I’m getting much better at focusing on my breathing. I usually average 15-17 mph on this ride, but today did it in 12.5 mph. It’s all about getting on the bike and riding right now, not how fast it is done. Thanks Mark, and Thanks to everyone else in my life who have been so supportive and inspiring.
Adapted C.R.E.A.M. lyrics by Mark:
Cash rules everything around me
C.R.E.A.M get the money
Dollar, dollar bill y’all
It’s been thirty some long hard years of still struggling
Survival got Tony bugging, but he’s alive on arrival
Tony grew up with a coronary crime side
The aint got much time side and you aint heard half of it yet
Tonys got bulging arteries, and crunked up valves
Stayin alive was no jive
Times for Tony was ruff and tough like leather
Doc figured out Tony’s blood went the wrong route
So Tony went callin up this one, meeting with that one
So then Tony hooked up with sick ass plan and went all out
Under the knife to install a kick ass robo-valve
They say that writing blogs can help you maintain to overcome all the heartaches and pain
Leave it up to Tony to be living proof
To kick the truth to the hip blogisphere
And stay awake to the ways of the world cause shit is deep
But shorty’s running wild,learning science, drinking juice
And ain’t trying to hear what Tonys kicking in their ear
Neglected for now but yo, it gots to be accepted
That what, that life is hectic
I just wanted to let you all know that I added two new pages (clickable at the top bar on this page, below my picture).
1. DIAGNOSIS. This page explains my heart condition in a nutshell, and the surgery techniques that will be used to fix it.
2. WORKOUTS. This page is to document my workouts in chronological order using the Digifit app.