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 ‘safe exercise’ tab of this blog.
An Inspiring Book by An Inspiring Guy. Benjamin ran the NYC Marathon with his surgeon, one year after open heart surgery for aortic disease. Great read.
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.
FitOldDog and Pauline, with AAA graft and AAA stent graft, before the 2015 Eagleman Half Ironman race. We both aortic disease, and we both completed this Half Ironman race. Don’t give up, but take care.
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. Here is a nice, succinct review of aortic dissection published via PubMed. 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.
For safe exercise, use the FitOldDog Training Wheel, starting at the top and moving clockwise, with red for danger! Safe exercise for better health is my mantra.
- 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.
Vegetable gardening is a great way to relax. It can provide gentle exercise and excellent food. Good nutrition is important for your aorta. Get someone else to do the heavy lifting!
- 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.
Before you know it, you’ll be inspiring others in your situation.
As Pauline’s surgeon advised, “Don’t become a prisoner to your aneurysm [dissection].“
Don’t take any unnecessary risks, but remember, “A life without risk, is no life at all!”
Happy Trails,
Hi, I’m almost 39 yrs old male (39 in aug) :). On 4th of apr 2012 i had an accute MI & rushed to hospital where i underwent through “Primary PTCA” and two stents were deployed to RCA & one stent to LCX. I’m now on 3 weeks bed rest. I live in Bangladesh where the rehab facilities or advices are not available for angioplasty patients. So i have absolutely no clue that what’s next for me. I love playing tennis and squash. Can i ever play these games. What exercises should i do now and for how long etc.
I’ll really appreciate your help as i’m very frustrated from lack of directions from my cardiologist.
Hi Saqib,
Sorry to hear what you are going through, but with the right approach you should be able to get on with your life fine. Remember that you have to make this work for yourself, but there is a lot of advice, information, and others with the same problem out there. You are young, which will help a lot. I would recommend that you go to the Angioplasty.org (http://www.angioplasty.org/) and Cardiac Athlete (http://www.cardiacathletes.com/) sites (under the ‘Useful Links’ tab on this blog), to talk to others about your situation. I would also recommend that you read my blog post that I wrote for a lady who was recovered from aortic dissection (a much more dangerous condition) for a general strategy (http://goo.gl/KjtgI). Then we can talk via this blog, if that would help. The trick is to understand your condition, make a plan, get started, make changes slowly, and NEVER EVER GIVE UP. You have short-term (getting moving safely) and long-term (fixing nutrition, and whatever else caused the problem - exercise helps with genetic liability, as in my case) issues to deal with. Let me know that you received this, and then I’ll put in a little more thinking about it issue.
I have yet to receive much useful advice, apart from the ‘party line,’ from cardiologists. They do save our lives with stents and stuff, but then it is up to us to make it work.
You’ll be fine if you believe in yourself, my friend.
-kevin aka @FitOldDog
This is a tremendous site! I am so amazed at the quality of this information and the incredible miracle survivor that Kevin has become. He is truly an inspirational and motivational person to learn and grow from. I know I personally play competitive tennis still as it was on the tennis court during a match that I had my dissection. And then off to the ER for emergency open heart surgery and I too got a miracle and second chance at life. There is so much to life and there’s nothing stopping Kevin here. Wow… he’s in tremendous shape and a wonderful wealth of information. I hope that you can also swing by http://www.aorticdissection.com and read other stories about this Aortic Dissection disease. Keep up the great work Kevin! It’s super!
Hi Brian,
thanks for the encouragement. I’m looking forward to your invited post, which makes two in the works, and that’s great. Glad to hear that you still play tennis. I need to go read your story, which I guess must be number one on your site.
You are doing a great job of drawing attention to aortic dissection and it’s issues, by the way, so thanks for doing that.
Cheers,
Kevin aka FitOldDog
I am 25 years old and just underwent emergent corrective surgery for an aortic aneurysm and dissection. Aneurysm had been dilated to just under 5.5cm. I am nearly exactly a month out from surgery. Before surgery I was a climber and training very hard to take on large prizes in alpine style. I am getting stronger and will work as hard as I need to to get back into the shape I was in and excel in climbing. I am wondering if anyone has any experience with these procedures and their affects on climbers or in the realm of training in general, especially heavy weight training, cross fit and regaining aerobic endurance.
Thanks all,
Steve
Hi Steve, before you do anything, study body awareness, then you’ll be able to proceed effectively without killing yourself. Make sure you fully understand your surgery and GIVE IT TIME TO HEAL. You have your whole life ahead of you, and now is the time to be cautious and sensible. You’ll be back climbing safely and well, but not immediately. You may even climb better (I couldn’t do it, would scare me to death). You have to be patient. I hear of people who had dissection surgery years ago and are doing well, even competing in mountain bike races. These are the people you need to find and talk to. I’m off to see my bike guy now, as I prepare for Los Cabos Ironman (finally over the damned flu). I’ll write more soon, and give you the link to our awareness video set, if you are interested. Awareness keeps me safe and training, but I only have an AAA stent graft. Please be patient at this stage. One month is not a lot of time for healing. Get some idea of the fragility of the repair from your surgery team. Pepper them with questions. What is your medical training? Make a careful recovery plan. Don’t do squats or rowing machine at this stage. Will be back in touch this afternoon. Kind Regards, Kevin
A wwek ago I had 2 of 3 walls of my aorta tear when I was life flighted to wospital whitch was top notch for corrective heart care I was told that I had 25% chance of survival. Well I made it and was lifting heavy before the incident. I was wondering what exercises with the weights and how heavy I can do.
Hi Big Dog Sam, if you dissected a week ago, I’m surprised you are writing already. Congrats on your survival. I wouldn’t even think about exercise until everything was stable. You can pose questions about dissection on various forums, including the AAA Awareness page, https://www.facebook.com/groups/2283898552/ . You need to VERY CAREFULLY follow the advice of your health professionals until your aorta is stable. I have discussed all of the general issues about getting one’s life back on track in my recent e-book, which is linked on the main blog page. You can get back into great shape, but if you go too fast you won’t be in any shape at all. Take your time, as frustrating as that might be. You are dealing with a major and dangerous plumbing issue. Wishing you well, stay in touch, and be careful because life is too precious to waste. Kind Regards, Kevin Morgan aka FitOldDog
just,just, found the page….gotta say…ive only read a few comments and I’m excited. 30 days out of an emergency 8 hour op ascending, will be going back for a stent in the lower section asap. still totally new, just starting to look it up and to understand it all.. i was starting to get worried i couldn’t get back to my 200km per week riding/ my fitness. as i always said and believed i would be strong again so i will be spending a great deal of time reading…it gives me a great feeling to a post aortic dissection life
Hi Ben,
If you’re in Australia, they sure know about aortic disease treatments. In fact, my recent stent repair involved an extension built in Australia. Glad to hear you are up beat. There are several great Facebook support sites for aortic aneurysms, where you can talk to people about your situation. If I can help, let me know, and take your time getting back on track.
I’m still training for Ironman, and now 5+ years out from my AAA stent graft placement.
Kind Regards,
Kevin aka FitOldDog
PS Sorry for the delayed reply, I was in Kona watching my son the Hawaii Ironman.
I am so happy to come across this site. I am a 5 year survivor from a traumatic thoracic aneurysm - I had an abdominal stent graft placed. I exercise often but I find when I jog I tend to get sharp sternal pains in the days following. Eventually they subside but I keep wondering if the jogging is causing this. Anyone else experience this?
Hi Michelle,
I apologize for the delayed reply. I’ve been elsewhere. Sometimes, I have too many balls in the air. I would experiment to find the cause of the pain. For instance, try water running to see if the same thing happens. If it’s due to impact stress, and water running doesn’t evoke the pain, you have your answer. I would then work on low impact running style. I’ve only had an AAA, no thoracic involvement, but I’ve had my own issues. There are several great Facebook sites to pose your question, such as the AAA Awareness Group, that I use quite a bit, at:
https://www.facebook.com/groups/2283898552/
Let me know if you need more input, and I’ll try to keep an eye open for your response.
Kind Regards,
Kevin
I am 4 months into healing from a burst Aortic belly valve. Had the AAA operation plus an umbilical hernia operation the next day. The surgeon saved my life, then said, come visit me in 4 months. ????
No post surgery info, no meds, no clue as to what to expect. I know I have two metal pins under my breasts where they cut me open. No clue what kind of repair.. I know it was my right side. My surgeon seems impatient when I try to ask questions. I’ve been in ER 4 times for weird stuff . CT shows everything is alright. Have pain in my right side and can feel a sizzling down there. Both surgeon and primary doc blew me off.. I don’t have a clue to what to expect? Life expectancy.. etc. I’m doing every natural thing I can to stay well. Dr. Schultz heart med, cayenne .. I do Kyolic garlic with the cayenne, plus tons of other natural things. Trying to keep my arteries clean and open. I have a bad reaction to several BP meds and mine has gone up after surgery.(still have cough 4 mos later) I am doing all natural alternatives including L-arginine with L-citrilin to bring more nitric oxide into my blood .. BP will not go down..
My main concern is lack of follow up by my lame docs. yes the surgeon saved my life, then left me with a ton of questions. I am going to Hospital admin to try to get records of the surgery. I have asked to join the FB group. What type of dr. is a good choice for follow up? I have a referral put in for my old internist who did two colonoscopies on me a few years ago.. I’m female and 66 years old.
Any advice would be great!
Hi Addie.
Typical. Not all of them, but many.
The records belong to you. I need to know what your surgery was, to give useful advice. I was so frustrated with this situation that I wrote a book for the medical profession (Aortic Disease From The Patient’s Perspective). Were they interested (or have time)? No! A nurse in Cleveland tried to promote it. No interest.
You have to batter them until they give you your records, and the scans. Threaten a lawsuit, that usually works. Get a second opinion from the Cleveland Clinic, and get them on your side.
This is a battle. Do you know about the other sites where you can talk to people? Just go to Information Links on this site (Just looked at it, horribly out of date - I need to fix that).
You have to talk to people, and get your medical records - they area your property.
You’re on your own, unless you get a support group.
This drives me nuts, it’s just not right.
OK! That said, make a plan to get your records, a second opinion, and then I am happy to talk about how to get your life back on track.
You can contact me at [email protected]
Or tell your story on the AAA Awareness site: https://www.facebook.com/groups/2283898552/
Hang in there, and be careful until you understand exactly what they did.
Cheers,
kevin aka FitOldDog
PS When it comes to blood pressure, mine went from normal to 220/120 after my stent, and every surgeon denied it was due to the stent. Even when I provided supporting data. In the end, I filed an adverse event report with the FDA, which disappeared like the Lost Arc, in Raiders of the Lost Arc: http://athletewithstent.com/aaa-stent-fda-adverse-event-correctable-hypertension-and-the-role-of-high-technology-in-my-life-recently/
PPS Where did you find me?
thanks for the fast response, I had triple A surgery, My artery burst. right side. also had the belly button hernia fixed.. lol.. didn’t even know I had that.. Oh how I wish 66 was a small number , but I guess it’s all in how you look at things..
I just got the go for the internist.. I’ll see if he can recommend a good vascular pa… Thanks so much for your info. Awaiting approval from the FB group.. This is scary, makes me nervous not knowing what to expect.
Anyway, thanks again, I will stay in touch. It’s just so GREAT to have another survivor to talk with.
ADDIE
PPPS You need a good vascular PA (less ego)!
I just signed you in. Oh to be 66 again, young lady!
oh. . just got the approval for the FB group.. thank you..
AD