Safe Exercise With Aortic Dissection Is A Challenge
I’m an abdominal aortic aneurysm survivor, veterinarian and endurance athlete in my 70s
I’m writing this brief post in response to direct requests for advice on exercise following corrective surgery for aortic dissection
If you want to hear my aorta story, watch this video
But if you don’t live with your doctor, you are going to have to make some judgements yourself. It’s unavoidable. The better you understand your condition the safer you will be.
I’ve published my general principles for safe exercise with a health challenge
under the ‘aortic aneurysm’ tab of this blog.
Developing an exercise plan includes advice from your doctor.
But only you know:
- How you feel when you exercise
- How much you want to workout
- Which activities you prefer
- The nature of your dependents
- Other relevant factors in your life
So you will need to take charge of the process, checking back with your doctor once you’ve decided what to do. As needed.
I strongly recommend that you develop a safe exercise plan. An active body is a strong body. That includes your aorta, diseased or not.
Sport benefit-risk analysis: As you prepare to return to an active life. Especially if you want to return to a sport. I recommend that you carry out a sport benefit-risk analysis, at this link.
Having undergone stent placement for a large abdominal aortic aneurysm (AAA), I have become involved in the aortic aneurysm and dissection community.
It turns out that there are quite a lot of us, some of whom can be found at the AAA Awareness Facebook site.
Locating the appropriate support group is critical when dealing with life-threatening medical situations. It is not always easy to find them. As I have been blogging on the issue of safe exercise for better health for several years, with special reference to on my own experience, people write to me from time to time to request advice.
I was asked for guidance by someone who is two-years post-surgery, for correction of an aortic dissection. Here are my initial thoughts.
- Study your condition and understand it in as much detail as possible. Including all potential effects of treatment and the risks associated with such treatment. If you don’t have a medical background you may be overwhelmed by the available data and opinion. You might even be ‘taken in’ by misinformation. If so, you should find someone who does have some medical training, having the time and motivation to devote to your case.
- Write down everything that happened. Include all symptoms and other observations concerning your health, as it might relate to your aortic condition. I kept such records on this blog, which resulted in a valuable online data set concerning my stent-induced hypertension (FDA adverse event report filed). My blood pressure was finally corrected by exercise combined with an ACE inhibitor.
- Explore the literature for the probable outcome (prognosis) for your condition, including any medical or surgical corrections undertaken. Try especially hard to discover any risk factors. For instance, in my case the risk factors for potentially lethal displacement of my AAA-stent graft included intense rowing, use of a lap belt in a car wreck, or a Heimlich maneuver (can’t avoid that one, for obvious reasons, so I eat carefully!).
- Obtain the guidance of your surgeon, as he/she is the only one who really knows what went on as your aorta was repaired. This is the person who really has the best insight (not certain knowledge) into what might and might not breakdown under stress.
- That said, remember that you are the master of your body and you get to decide which advice to follow and which to ignore. Do so intelligently, using both reason and emotional intelligence.
- When it comes to communicating effectively with your doctor or surgeon, I recommend that you read ‘Your Medical Mind,’ which I reviewed previously. The real trick is to avoid stressing your surgical site unduly, especially early on. I was very careful for the first six months. I didn’t want to displace my stent. One year after my surgery, I completed the Lake Placid Ironman. I did it carefully and relatively slowly, but without incident.
- You have to know what you are doing when you start to train. If you decide to undertake serious exercise, such as marathons, find a coach who understands your condition. I did in the form of Eric Bean, who trained me for my first season post-surgery. Eric is an MD with a background in Biomechanics. He put my mind at rest about the risks of metal fatigue in my stent graft during high cadence endurance cycling – it worried me a lot before talking to Eric. My thoughts on this issue, and the critical nature of body awareness, balance, flexibility and core strength are laid out throughout this blog. I have attempted to encapsulate my experience in The FitOldDog Training Wheel and in the safe exercise page.
- Find out what other people have done in your situation, and talk to them. In the case of an aortic ‘prosthesis’ (Dacron insert), just read the story of Benjamin Carey in his book, ‘Barefoot in November,’ and contact him directly via his blog.
- I recommend that you start with simple body awareness exercises, including meditation, so that you can ‘hear’ the warning signs, then explore balance, core strength and flexibility. Gradually progress to long walks, elliptical trainers, guided weight training (but choose your exercises wisely) and swimming, as they are essentially non-impact sports. Remember that if you bike or run you risk a fall (not a good idea), which is why balance, core strength and appropriate skills are so important for such activities. The repeated impact of running might be a risk factor, though Benjamin (and his surgeon) did fine at the New York Marathon one year after the surgery (see video clip below)
- I strongly recommend that you combine your exercise with the study of techniques designed to improve body-awareness, such as Feldenkrais. It worked for me.
- Find people to talk to and tell your story on appropriate websites, such as Brian Tinsley’s Aortic Dissection Blog and the Aortic Dissection Facebook Page. You might be surprised by the number of people out there in Cyberspace who will give you support and useful input.
- Don’t give up, don’t hesitate to ask for more information. Use the inspiration of others to keep you going on difficult days, as in the movie clip below. You can see that Benjamin is delighted to be back out there, running.