Better, stronger, faster.....

bigW

Well-Known Member
#1
Well 'Groundhog Day' came to a screeching halt last Friday with a completely unexpected pronouncement that I need one of these...

IMG_3471.jpg


Plus a new Dacron aorta and a lifetime supply of anti-clotting drugs. Crap genes appear to have given me a bicuspid valve and a dodgy aorta. Shit-city.

After a week a get my head around that plan ( better, stronger, faster ) it gets turned on its head today when I meet the surgeon and find out the 50mm ultra sound aorta measurement has been changed to 49mm after this weeks more accurate CAT scan.

Major dilemma as 50mm is the threshold for ( bicuspid valve ) requiring the surgery and I am now stuck in a no mans land where the surgery is now discretionary but high heart rate, stress or any heavy lifting can rupture the aorta.

Gonna wait six months and do the CAT scan again but in the meantime I some need a plan of attack for biking/exercise.

Shit
Shit
Shit

Not exactly Better, stronger, faster.

Pondering and making more Dr. appts.

W
 

qclabrat

Well-Known Member
#2
First
My dad had an aortic dissection over 10 years ago, that kills most but he got lucky. Now his life is blood pressure meds and CT scans. Good luck with everything.
 

fidodie

Well-Known Member
Staff member
#3
1 - shit.
2 - shit again, but i'm throwing some positive energy your way.

gl w/the dr stuff - second opinions?
50 vs 49mm? seems like the outside temp could effect that.

by discretionary, you mean the insurance term? (ugh)
 

bigW

Well-Known Member
#4
1 - shit.
2 - shit again, but i'm throwing some positive energy your way.

gl w/the dr stuff - second opinions?
50 vs 49mm? seems like the outside temp could effect that.

by discretionary, you mean the insurance term? (ugh)
Yep, I'll get second (actually third) opinion next week but I expect they will just throw it back to me to decide how to proceed. 49mm vs 50mm is mostly arbitrary but I would guess that 99.9% of their patients would prefer inaction to a heavy duty surgery that does sometimes have fatal outcome ( rupture, dissection etc )

Zero chance I'll wait indefinitely on this.

Waiting four to six months will likely make the decision easier as I expect to see further dialation by that time ( then surgery without second guessing it ) In the meantime as there is no sure advice as to what would provoke a failure I'll have to get creative with biking/workouts to not run massively excessive risk.

Long flat 'base' rides? and mebbe yoga/core strength training over the winter? HRM will be my friend.

Insurance will cover it any time I choose to give the green light to surgery.

This might become the low-HR, low-impact training blog.

W
 
#6
Bummer news. Can't offer any advice but knowing my own hypochondriatic tendencies I would be too paranoid to wait and would probably opt for surgery asap. Best of luck!
 

bigW

Well-Known Member
#7
Tested the waters a bit with a 37 mile road ride.

Watched the HRM to stay below 140BPM but riding SS the HR kicked up on a few steep bits.

Not a real fun ride but it is a start of sorts...

IMG_3473.jpg


Last time I used a HRM on a typical Watchung Wheelman ride six weeks ago...

IMG_3474.PNG


Not gonna do anything like that any time soon.


W
 
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bigW

Well-Known Member
#10
So, you can't go hard, but can you still go long?
This is a discussion I will have with the cardiologist and heart surgeon over the next few weeks. It has become clear to me that they are not going propose anything as 'safe' so I will need to collect some HR data from actual rides and get their feedback as to whether it is a terrible idea or not.

Starting to mentally plan for having the surgery at the end of June, so it should not be hard to mix things up and try some other things until then. Will likely have to set aside the SS for any group activity as HR management did not work well when hills and SS were involved.

Still very crabby about not being able to slam it but perhaps there is an opportunity for growth here.

W
 

bigW

Well-Known Member
#11
I have some flat routes but it would require you driving to ride. If at all interested just reach out.

I wish you the best.
Thanks, I have done many options from my house to Princeton ( Greenbrook, Canal Rd ) or to the shore ( New Brunswick, Union Beach ) so I'm good on routes at the moment.

W
 

rlb

Well-Known Member
#12
No good man, sorry to hear that you're dealing with this. Hoping you'll find a way to stay healthy and happy and on 2 wheels.
 

Juggernaut

Master of the Metaphor
#14
Dude. Harsh sentence. If you don't mind me asking, was this found as part of a normal scan or did something (other than possible family history) necessitate the screenings?

No matter what the ultimate decision is, we're pulling for you.

D-
 

bigW

Well-Known Member
#15
Dude. Harsh sentence. If you don't mind me asking, was this found as part of a normal scan or did something (other than possible family history) necessitate the screenings?

No matter what the ultimate decision is, we're pulling for you.

D-
Standard annual physical last year noted a noisy valve and advised to go to a cardiologist and get an echocardiogram. Last year cardiologist took a listen and said don't bother with echocardiogram.

Same physical this year, same Dr advised me to go back to cardiologist and insist on echocardiogram. New cardiologist agrees and echocardiogram show a healthy valve but bicuspid ( two flaps not three ) apparently that is reasonably common and not too a bad problem despite being noisy. Same echocardiogram detected my ascending aorta ( aorta root ) is stretched way out. Whatever causes bicuspid valves also pre-disposes one to aortic root dilation for reasons unknown.

Lots of articles out there stating the echocardiogram should be done more often as ruptured aorta is a very common killer. Echo is cheap, quick and painless process. Now as per protocol all my siblings need to get scanned as well.

My head is spinning about what next step to take, gonna avoid Dr Google as lots of articles out there from when mortality rate on the surgery was sky-high.

Thanks all for the support.
 

rustynuts

Active Member
#16
I stumbled across this thread. I am sorry to hear about your heart troubles. Coming from a family with heart problems, my one piece of advice is NYU Langone, first hand family experience they have received the best diagnosis, course of tx and after care.

Good Luck.
 

bigW

Well-Known Member
#17
Attempted HR managed spin class today.

Seems workable if 140BPM is approved ( earlier discussion was stay below 120BPM )

IMG_3476.PNG
 

bigW

Well-Known Member
#18
I stumbled across this thread. I am sorry to hear about your heart troubles. Coming from a family with heart problems, my one piece of advice is NYU Langone, first hand family experience they have received the best diagnosis, course of tx and after care.

Good Luck.
Thanks for the tip, I've jumped in with Cornell/NY Presbyterian but I will likely leverage NYU as my second opinion before taking the plunge...
 

bigW

Well-Known Member
#19
Hokay,

Final guidance is in.

Keep HR below 50% ( 90 BPM ), don't do even that for an extended period of time and don't lift/exert anything heavy that would cause pressure on the chest/abdomen.

Sheesh....gonna have to pull the trigger on the sawsall sooner or I'm gonna weigh 300lbs.

Current thinking is Jan 1st after November work crunch and December trip to Cali and the holidays. Perhaps just in time for FoolsClassic and Flèche Baffoon ( with gears )

W
 

pooriggy

Well-Known Member
Team MTBNJ Halter's
#20
Still very crabby about not being able to slam it but perhaps there is an opportunity for growth here.
Maybe explore different hobbies interests. I'd be crabby too, I'm used to doing what I do on a bike. Recently I've gotten into kayaking, which is low hr impact, compared to cycling.
When one door closes, another opens.

Luckily you caught this in time, with advances is heart surgery, you will probably be back to doing your thing again on a bike in a short time. Keep us posted and tell your wife to shovel snow this winter, you have a bad heart.