My girlfriend/partner, Deb, has an autistic son, Rory, which can be challenging. Deb always says that Rory has brought many more positive than negative things into her life, especially in the form of wonderful and supportive people. I have always been surprised by such a positive attitude to what seems like such a difficult, and sometimes sad, turn of events. Now that I have experienced a truly life-threatening event in my own life, a whopping great big (7cm diameter) aortic aneurysm, and my life now depends on this tube of metal mesh and plastic sitting in my aorta, I am coming to understand what Deb has been telling me for several years. As a direct result of my stent surgery only a couple of months ago, I have started to encounter the most interesting and kind people, and each day is now much more precious than I ever imagined. I am coming to realize that my greatest challenge was fear of death (and of my triathlon training coming to an end, which it has not!), which I thought I was prepared for, but clearly I was not.
For a start, during my recovery from surgery people came by with food and companionship that I never did expect. I also found that the inspiration that I get from that odd but fascinating book, The Power of Now (by Eckhart Tolle), held me together through my post-surgical depression (brief though it was) leading to my creating this blog (which has also helped me a lot) and consequently finding great web sites and other resources, including people. What seemed like a disaster is turning out to be a blessing. How about them apples.
OK! That is enough emotional stuff, how about metabolism and training, and why I think endurance training is tailor-made for people with stents. Well!
(a) How did many of us end up with stents in our hearts or aortas in the first place – atherosclerosis combined with hypertension (though apparently not in my case, fortunately, except I think that my stent did induce hypertension, but that is another story!)? And how can we reduce our risks of atherosclerosis and hypertension, and even reverse what we have? Diet and exercise!
(b) How are we likely to displace our stents and put our lives at risk? Risky types of exercise, such as power-lifting, full-contact martial arts, and apparently enthusiastic rowing. Though clearly more research is needed, I would like to suggest that if we pursue non-risky sports we are unlikely to have a problem with this issue – if I suddenly go off-line maybe I will have proven myself to be wrong, but I doubt it, so I am now already continuing my Ironman training, preparing for the Kiawah marathon in December, and of course the Lake Placid Ironman, my annual pilgrimage, next July. For those with a coronary stent, I recommend that you take a look at the site angioplasty.org for advice and support on this issue.
For maximum benefit, and minimum risk, therefore, I strongly recommend the benefits of long-distance endurance sports, for which you have to be kind to your body simply in order to finish the race. One word of warning, however, it is critical that you avoid impact stresses and physical shocks, so train wisely, and keep yourself informed. You are your most important physician, remember!
Which brings me to metabolism. An important part of knowing your body is understanding how it stores and uses energy, in the form of the fuels we burn, including glucose, free fatty acids, and ketones, and the fuels we store. All of this is readably described in Harpers Biochemistry , which I strongly recommend, and partly in an interesting recent publication on metabolism and marathons. Basically it comes down to this – you take in fuel as carbohydrates, fats and proteins, and the form in which you take them and the rate at which you take them in, combined with your metabolic state, that can be dramatically modified by training, will determine whether they are converted into liver or muscle glycogen, or storage fat, or protein. You need the right balance of each at different times during a race, and for Ironman distance triathlons and other long-distance endurance sports getting this right is critical, and very personal. So! If you want to know more, or have specific questions, ask and I’ll research an answer for you as best I can.
As an aside, one book that is also changing my life is ‘The Four Hour Work Week ,’ by Tim Ferris, whom it turns out did a lot of work on the glycolytic index of foods. His book and website are worth a look if you want to take control of your life.