Endurance Athlete With Positive Attitude To His Aortic Disease

Shaun, ultramarathoner

Shaun, at the end of his recent ultramarathon (100 miles). Now he’s dealing with aortic valve surgery repair, and working out how to get safely back into training. He’s an inspiration for FitOldDog. Photo with permission.

I just received an ‘out of the blue’ communication from an endurance athlete, Shaun, an ultramarathoner who plans to continue his running once he recovers from recent aortic valve surgery.

Shaun kindly permitted me to present his story here, as extracted from our e-mail conversation.

When you are out there on your own on the trails with aortic disease, inspiration from fellow ‘aortic athletes” provides valuable encouragement.

Thanks a million Shaun.

Pauline and Bob, runners

Pauline, with her husband Bob (also a runner), at Night Town, in Cleveland OH. They drove from Toronto to Cleveland to provide much appreciated support for FitOldDog prior to his second aortic surgery, in December, 2013.

I started this blog with the express goal of finding other people in my situation, that being Ironman-distance triathletes who are still competing, in spite of their abdominal aortic aneurysm (AAA).

Four years later, and I haven’t found one yet!

I have, however, found (or been found by), several endurance runners with aortic disease.

For example, Pauline and Benjamin have been truly inspiring. Pauline, who was a co-creator of the Abdominal Aortic Aneurysm Awareness Facebook Page, has moved on with her triathlon-training since having her AAA repaired. You can read Benjamin’s fascinating story on his website, Heartosaurus. Then there’s Luis, the Spanish Cyclist, and others, who I hope won’t be mad or sad if I stop here.

I really appreciate these people for their encouragement, which comes in the form of the courage to get on with their athletic training, in spite of it all.

Then, a few days ago, Shaun popped up out of the blue, the second New Zealand ultramarathoner with aortic disease to contact me. I lost track of the other guy (I hope he’s OK); hopefully he’ll read this and get in touch with Shaun.

Here is Shaun’s story, extracted from our e-mail conversation; photos provided by Shaun:



Good morning Fit Old Dog

I was rapt to come across your website yesterday after weeks of trying to find;

a. relevant info on the web for my condition (AVR)
b. someone who can relate to what I am going through

A quick summary of me is as follows:

Photo of Shaun at the start of his latest ultramarathon

Shaun is on the far right of this photo, at the start of his recent ultramarathon in New Zealand. I don’t know if this is the whole field. Photo used with permission.

I am a 45 YO male based in Napier, New Zealand who has been happily training for ultra marathons over the last three years including a 100 mile race in November 2013 which I completed (and surprisingly won) in 18 hours 17 minutes. I am very much a ‘completitor’ rather than a ‘competitor’ hence my surprise at finishing first.

I was due to race in Ultra Trail du Mont Blanc TDS in August 2014 (which has had to be postponed).

Congenital bicuspid aortic valve which was asymptomatic until a few months ago.

I underwent surgery on 8th July 2014 – Aortic Valve Replacement with a 25mm On-X mechanical valve. Once levels of Warfarin medication are confirmed I will be able to perform INR blood tests at home.

The only concern my surgeon raised which I wish to address prior to returning to ultra marathon training (apart from the mending of my sternum and remodelling/reconditioning of my heart around the new valve) is the potential risk of clotting due to dehydration (and how to manage this risk). This is a question well outside a typical clinical sports physician.  The Warfarin (Marevan) fact sheet states that, although they do not have sufficient data to estimate an actual risk from gastrointestinal disorders, that vomiting or diarrhoea may reduce the effect of warfarin tablets and require the dosage to be increased. I assume that dehydration should be treated in the same manner as vomiting or diarrhoea. There are a lot of opinions out on the web but there seems to be little (or no) studies.

Is clotting an issue with your stent or do you not need to take warfarin?

Shaun Thompson-Gray

[I replied, to inform Shaun that I was only taking aspirin, and to provide a number of links to relevant websites and information. Then Shaun followed up with this interesting message].

Photo of ultramarathoner, Shaun, near the end of his race.

Shaun, near the end of his recent 100-mile ultramarathon – he sure looks happy. Rightly so!

Hi Kevin

As you will know from your ironman events, fitness is about 5% (you can only get so fit) and the rest is mental. During the 100 mile event one guy took off like a rabbit (I have since learnt that he is a very good 100km runner and was probably just sauntering along) and was about 6km ahead after only a couple of hours. At about the 70km mark (around midnight) I came to a 3km long straight and could see his rear red light in the distance. Every couple of minutes it would flash white as he turned to see where I was (his fear was palpable). When I passed him at around 95km he was a broken man. I walked with him for a while as his tale of woe unfolded – his crew had fallen asleep at one stage, their car wouldn’t start (my crew managed to push start it), they had lost his spare shorts so he was running in his underpants … meanwhile I spent the night admiring the stars. He should have beaten me by a country mile but just lost his happy place somewhere along the way. My guess is that he was pushing himself just the wee bit too much. I have spent a miserable 7.5 hours on a mountainous course before realising (I’m a tad slow of mind) that my mitochondria couldn’t replenish at the level I was pushing myself (I was somewhere near the back of the field so no delusions of grandeur to be had), slowed down only a little and completed the last three hours of the race the happiest I have ever been during an event. It was an excellent piece of learning for me.

I am always amazed how people can’t comprehend how we do the endurance events that we do. I am amazed because I am thinking “there’s actually no difference between me and you (I’m not that fit, I only train three times a week) except a belief that these distances are possible”.



I’m looking forward to hearing about Shaun’s recovery, and his progress with returning to running. I consider endurance training, with minimal excursions into intensity (carefully controlled), to be perfect for those with aortic issues.

As an endurance athlete, being fit before he landed on the surgeon’s table almost certainly improves Shaun’s chances of making a full recovery and returning to ultramarathons.



  1. It really IS mind over matter! I like this a lot. Training the mind is most important I think. Best of luck to both of you. And to me, and all the rest of us.

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Disclaimer: As a veterinarian, I do not provide medical advice for human animals. If you undertake or modify an exercise program, consult your medical advisors before doing so. Undertaking activities pursued by the author does not mean that he endorses your undertaking such activities, which is clearly your decision and responsibility. Be careful and sensible, please.