Exercise post CABG

[runnertom]

I have posted before as a 57 year old long time runner and serious cyclist that had bypass 2 1/2 years ago due to an LAD blockage. I have recovered and resumed my pre surgery exercise regimen within 2 to 3 months. My risk cardiac risk factors all seemed quite benign except I found later that homocysteine was quite high. I am now taking 40 mg Pravachol, 1.6 mg folic acid, B vitamins. Latest lipid profile was LDL 75, HDL 70, Trig 50, CRP <.3, Homocysteine 11.9.

My question: Several cardiologists have advised me that it is OK to resume my jogging but were less thrilled that I would get involved in any racing or otherwise maximal exercise. The thought was that the max exercise might disrupt some vulnerable plaque and result in an MI. I thought that long term statin usage resulted in plaque stabilization and possible reversal. An extension of the question would be should any 50+ male be involved in max exercise for the same reasons? I can live without racing per se, but much of my daily running and cycling involves hills that demand at least short term intense activity resulting in heart rates in excess of 175. Your thoughts?

[Konopka1955]

Hi runnertom,  I have competed in many races and I would be lying if I didn't get out of control on more than one occassion.  I have had numerous catherizations since my MI in 1992 and they have found that even though my MI area has dead tissue - and over the years I have managed to get new blood flow around my infarct area.   I can only reiterate - that do what feeling comfortable has been good for my heart.  Who's to say I wouldn't have the same medical problems if I had sat on the couch all day.  

I have competed in hundreds of races and numerous times I went overboard with my competitive nature..  But on an everyday basis - No I would not do that.  I raced usually to get my best PR -  or beat the guy beside me.  I didn't always get that.  That's not to say I didn't try.  I even recieved 6 shocks from my ICD racing.  Now that's painful.  I know its hard for some doctors to think a person could compete so intensely with our medical conditions.  I didn't find it hard at all - when I was running I wasn't a cardiac patient.  I was just being ME that day.  Having FUN and doing what I enjoyed.  For one brief 5k or half marathon - I was just ME.. and being the best runner I could be.  Looking back over the years.  I wouldn't recommend races to any cardiac patient.    

I have had the misfortune over the years of having come upon a runner in a race who didn't make it to the finish line.  It was very hard to witness.  There was nothing I could do.  But I definently had second thoughts about whether I should be out there at all. Its a call only you can make.  Life has many joys and throughout our life - we decide what it is we want to do.  Whether its racing or bikeing or maybe to be the best writer or teacher or engineer.  Whatever we want to accomplish personally.  I always try to remind myself that I do it for FUN and I don't do it to prove that I can do this and therefore I can't really have a medical condition.  That is the mistake some cardiac patients make.  I knew when I was running that anyday it could be my last run.  

We make choices and we are very lucky that we know about our medical conditon - some don't know and find out when its to late.  

Wishing you many Happy and Safe Runs.  
Marilyn (runner)

[Konopka1955]

Hi,  I think you were asking the doctor if running races anerobically increased the chance for plaque eruption or may cause smaller ones to become less stable..  

I should have told you that over the years of running races myself (competively) it has not caused any eruptions of plaque in my arteries.  I had an MI in my 30's and subsequently caused damage to my heart from it.  My cardiac tests have shown that my heart has since created tiny little arterial pathways around my infarcted area.  I don't know what would happen to you.  I don't know that any doctor would tell you to run competively with a heart condition.  I know I haven't found a doctor to tell me its alright.  I've been told to use 'moderation' - I said: What exactly is moderation?  Does it mean I should go for second place or third place - or should I just 'finish' the race.  I had to make that decision each and every race - and some races were more important for me to get my best PR.  When I was out running races - I was being ME and not a cardiac patient.  I know I got lucky many times.  I don't know if you would.  

I saw a young guy die in a race once and I've also seen hundreds of runners compete in races without a problem.  

Best Wishes
Marilyn

[Konopka1955]

Hi,

quote - I don't generally give too much attention to heart rate specific training and you should do what you feel good doing.  end of quote

The doctor is so right !!!   I have lived by that above statement since my heart attack 13 years ago and it's the best advice anyone can give you.  I don't wear a heart rate monitor wehn I exercise and I do what I feel comfortable doing.  I listen to my body and if I'm not having any problems then I run whatever mountain I can run.  Somedays its only hills - somedays they are just bumps in the road.  But I enjoy myself in whatever I do for exercise and "I feel good" when I do.  :-)  

Enjoy yourself.

Best
Marilyn

[runnertom]

I think the doctors' point was/is that sometimes in racing and in group riding you get way beyond comfortable. I'm not talking angina or anything but seriously anaerobic.

[runnertom]

The thinking seems to be that since I had one blockage there may have been other smaller ones that may or may not have shown on the angiogram. Current theory is that these smaller young lesions are less stable and more likely to infarct. I didn't take this too seriously until I became aware of 4 or 5 people in my aquaintance that died suddenly while running or cycling.

[Cleveland Clinic]

tom,

thanks for the post.

If anything, unless you are having active chest pains or angina, exercise should decrease your overall risk of having a myocardial event. Age shouldnt impact anything. I dont generally give too much attention to heart rate specific training and you should do what you feel good doing.  Im not sure why the cardiologist told you that unless there was something else they were worried about.

good luck