What Should I Advise Larry To Do? To Train For An Ironman Or Not?


Hi folks,

You never know what is around the next corner, and here I am wrestling with the problem of giving advice to Larry, whom I have never met and who contacted me recently via the abdominal aortic aneurysm awareness Facebook page, with the following message (Larry said it was OK to talk about this on my blog!):

“Kevin! Hi my name is Larry. I joined the AAA facebook page not too long ago. I too had an AAA incident in 2010 A 40cm tear. In 2007 I ran my first trail marathon, experienced a setback in 2008-2009 which ended up with neck surgery. 2010 was going to be my comeback year at 56 yrs old. I was training for a triathlon with a goal to compete in an Iron Man. Two weeks later I had a stroke, 5 months later the AAA. After my yearly check-up, the chief surgeon advised me that I can run or exercise as long as my heart rate stays below 120 bpm. I have not run since then. I’ve been deathly afraid of doing anything other than walking. What do you think? Do I need to rethink my goals with these limitations? Your stories do inspire me. Thank-you.

This is a challenging question, and at the end of the day only Larry can decide, but he is surprisingly chipper with his situation. I guess that, just like me, he is pleased to actually be alive. My first response was to ask for more information, and here is his reply:

“There was no family history of strokes or heart problems. My father in fact is a 4 time Olympic weightlifter who has minor blood pressure issues and he is 87 yrs young!! My residuals are numbness in both quads and left legs numbness but no loss of functions. My last cat scan revealed no significant increase in size of the aorta and the chief surgeon was happy to tell me that most of his patients that survived can barely walk to the mail box. I on the other hand can walk up to 2 1/2 hours. I am a little winded but can do that. My resting heart rate is about 50 now and my blood pressure with medication is around 110/58.

I immediately found it interesting that he has a blood pressure issue, as do I, and mine was clearly induced by my aortic stent. Here is the question from Larry that I need to answer:

Do I need to rethink my goals with these limitations?”

Should Larry reconsider his desire to complete an Ironman? It is up to Larry, but FitOldDog’s advice is to answer ‘No Way!‘ That said, Larry needs to very carefully consider how to go about the process, and be prepared to reduce his goals if his body cannot cope. I am 10 years older than Larry, but he has more severe health challenges to address, so I guess we are equal on that score. If I were Larry, I would make myself a careful but flexible plan of at least 5 years duration, with my first goal being to maximize my body awareness. For this aspect of my training I employ Feldenkrais and Continuum, which I talk about a lot on this blog, but there are many different approaches. Every other aspect of the process that I can think of is laid out in my blog post to the lady who was recovering from aortic dissection surgery, and I don’t see any reason to change my opinion at this point.

One critical issue that Larry must address is the support of his family, as they are part of his team, they have to put up with his training regimen and they will suffer any consequences of a misstep. Their reward will be to live with a happy Larry. As I said in a previous blog post, it is up to Larry to carry out the risk-benefit analysis for his life.

I sure would like to see him at an Ironman race one day, as long as he and his family are happy with his decision. I personally think that endurance sports are ideal for our kind of health challenge. I would recommend that Larry find a coach who is ‘volume oriented’ as opposed to intensity!

With time Larry’s fear will fade, as did mine through embracing life and saying to myself “I’ll beat this damned thing if it kills me” (just joking!).

-k @FitOldDog

PS Larry knows that I am a veterinarian and not a doctor, and that I love the Ironman race and am therefore probably slightly unbalanced (but happy!).

PPS When it comes to training heart rate, and the comment of Larry’s surgeon to keep his pulse below 120 bpm, I rarely train with my pulse above 120, and then only for speed work that Larry can completely avoid. Ironman for age-groupers isn’t about speed, it is about not stopping.

PPPS If Benjamin Carey can complete a marathon with a Dacron ascending aorta, surely we can hobble through an Ironman with our minor aortic and other issues.



  1. Rory Conolly says

    Kevin, agree with everything you say re Larry. Need to emphasize to him that whatever he does it has to be his decision to do it – no one but him can say what’s right or wrong for him in his situation (except perhaps his surgeon, and am not really sure about even that!), I agree with the idea that it has to feel right. I would emphasize careful and gradual build-up to Ironman-level events. There’s a lot to do on the way to that goal, and Larry should proceed incrementally.

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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.