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Anaerobic heart strain on brand new stents


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Brother Numsie · · AnCapistan · Joined Jan 2006 · Points: 880

So if a guy has a freshly re-plumbed LAD (stents), and the arterial problems that caused that; what are the odds of creating more problems with the anaerobic stresses we put ourselves through when pulling a hard move?
Any tips out there? Personal anecdotes?
Thanks!

wivanoff · · Northeast, USA · Joined Mar 2012 · Points: 553

Having had a Left Anterior Descending stent put in just two weeks ago, I'd be interested in hearing also.

I'm waiting for Doc's clearance (for climbing) but I've started my noon 2 mile walk/jog again just 8 days after surgery. Thing that I'm anxious about is leading (well, actually falling) when on heavy duty anti-coagulants :(

gary ohm · · Paso Robles · Joined Jul 2010 · Points: 0

This is one of those times where it would be ideal to have a doctor who is also a climber. Or at least an outdoorsy person.

Medic741 · · Des Moines, IA (WTF) · Joined Apr 2012 · Points: 265

Talk to your doc. That said if be incredibly cautious if you're on any blood thinners after the surgery.

Haha yes falling on anticoagulants would be well bad. Hope you guys get out there soon!

Brother Numsie · · AnCapistan · Joined Jan 2006 · Points: 880

One does not have a heart procedure like this w/out talking to your doctors, a lot. My dilemma here is trying to explain the anaerobic nature of -in my case- sport climbing. They do tell you they want you back out returning to your activities since part of the endless dialog you have with dozens of inquisitors involves telling them you are athletic and engage in a strenuous sport. My conversation with 1 of 2 cardiologists I have on Saturday was set around telling me no more "100% exertions"; which sounds like grade-pushing projecting.

Anyway, here's a related thread I ironically participated in:

CT heart scan thread

Leo Paik · · Westminster, Colorado · Joined Jan 2001 · Points: 22,890

Part of the initial answer will come from whether or not you had an MI with the event that led to your stents. If you did, you have myocardial tissue that needs to heal so as not be prone to arrhythmias (abnormal rhythms) that could be triggered by high effort peaks and could result in sudden death. The insides of the stents need to reepithelialize (new cells to coat the inside of the metal stents) so as to allow for smooth blood flow without creating new tiny blood clots on the inside of your stents. The stents themselves should not be a problem with regard to anaerobic stress; however, ordinarily folks are on blood thinners in time needed to wait for this to occur. Certainly the issues of being on blood thinners would affect the wisdom of taking any type of falls, perhaps save the basic TR fall. Head injuries would be the top on the list for worry as far as that goes, but chest, abdominal, and pelvic trauma (maybe how we lost Jack) are also concerns. Also, note there are multiple types of blood thinners used these days.

rob.calm · · Loveland, CO · Joined May 2002 · Points: 630

15 years ago I had my aortic valve replaced. Before such an event, a thorough examination is given to see if there is need for a pacemaker or bypass surgery. I didn’t need either of those, but I was impressed by the cardiologist who said if I bouldered he would recommend one kind of pacemaker and a different kind if I was an alpinist. He retired a few years and passed last spring so I can’t refer you to him.

I was given the choice between a plastic valve and a bio-prosthetic valve. The three cardiologists who examined me all recommended the bio-valve since I wouldn’t need to be on blood thinners, and that if I were on blood thinners they would hesitate to recommend my hiking let alone climbing. You know, far away from the hospital when you trip and bang your knee sort of thing. There are some new blood thinners out there that are easier to use than Coumadin, but it seems they have one big disadvantage, viz., they can’t be turned off if you start bleeding. Something to consider for a person with an active life style.

Maybe the way to explain to the cardiologist what you do while climbing is to point out its anaerobic similarity to weight lifting, e.g., doing 20 heavy squats, power cleans or presses.

Hang in there and good wishes for a strong recovery.

Rob.calm

Brother Numsie · · AnCapistan · Joined Jan 2006 · Points: 880

Thanks guys!

Jason Todd · · Cody, WY · Joined Apr 2012 · Points: 1,114

Mike and/or wivanoff,

How'd your recovery's turn out?  

I'm going to have a million questions (not necessarily for you guys), as I recently had a STEMI due to a clot in the LAD.

Thanks.

mountainhick · · Black Hawk, CO · Joined Mar 2009 · Points: 120

I was on Plavix for a year post LAD stent. No problem in terms of cardiac, but bruised ridiculously from any bumps etc. Also started having small vessels in fingers rupture from pressure, often from picking up a heavy object with a handle like a big gear bag. I was also on aspirin and fish oil. Stopping theplavix made a noticable difference, I don't bruise like that now.

Aleks Zebastian · · Boulder, CO · Joined Jul 2014 · Points: 175
rob.calm wrote: 15 years ago I had my aortic valve replaced. Before such an event, a thorough examination is given to see if there is need for a pacemaker or bypass surgery. I didnÂ’t need either of those, but I was impressed by the cardiologist who said if I bouldered he would recommend one kind of pacemaker and a different kind if I was an alpinist. He retired a few years and passed last spring so I canÂ’t refer you to him. I was given the choice between a plastic valve and a bio-prosthetic valve. The three cardiologists who examined me all recommended the bio-valve since I wouldnÂ’t need to be on blood thinners, and that if I were on blood thinners they would hesitate to recommend my hiking let alone climbing. You know, far away from the hospital when you trip and bang your knee sort of thing. There are some new blood thinners out there that are easier to use than Coumadin, but it seems they have one big disadvantage, viz., they canÂ’t be turned off if you start bleeding. Something to consider for a person with an active life style. Maybe the way to explain to the cardiologist what you do while climbing is to point out its anaerobic similarity to weight lifting, e.g., doing 20 heavy squats, power cleans or presses. Hang in there and good wishes for a strong recovery. Rob.calm

climbing friend,

what is this "aortic valve" of which one on which you would be speaking of it for its mentioning in this posting? 

would you perhaps be meaning left semilunar valve? or left atrioventricular valve? where beginnings of most glorious systemic circulation it is occurring?

mountainhick · · Black Hawk, CO · Joined Mar 2009 · Points: 120
Jason Todd wrote:

Mike and/or wivanoff,

How'd your recovery's turn out?  

I'm going to have a million questions (not necessarily for your guys), as I had a STEMI due to a clot in the LAD.

Thanks.

Subsequent to stent, I had serious muscle wasting after 1.5 years of statin use. I am finally starting to get noticeably better after 3.5 years and a heap of diet, supplement, lifestyle and hormone treatment.

Huge wormhole here, there is a war going on over statins. 

I find the website name unfortunate as it has hippie-ish connotations, but click through the links and you will find it is all linked to NIH studies, This is no BS:  http://www.greenmedinfo.com/guide/health-guide-statin-drugs

Also research "Relative Risk Reduction" (RRR) related to statins. In one study (ASCOT) cited by Lipitor's own drug info from https://www.drugs.com/pro/lipitor.html :

Whereas, Lipitor claimed in the range of 36% better outcomes, this was based on a comparison of 1.9 out of 100 having subsequent events on statins vs 3 out of 100 in the non statin control group... so where does this 36% figure come from? It is clever mathematical manipulation, a ratio of 2 vs 3, whereas, absolute difference is 1.1%.. Also known as marketing BS. 

This is how we and doctors are sold pharmaceuticals folks.

cragmantoo · · Unknown Hometown · Joined Mar 2015 · Points: 175
Aleks Zebastian wrote:

climbing friend,

what is this "aortic valve" of which one on which you would be speaking of it for its mentioning in this posting? 

would you perhaps be meaning left semilunar valve? or left atrioventricular valve? where beginnings of most glorious systemic circulation it is occurring?

https://en.wikipedia.org/wiki/Aortic_valve

Rod Shaftmoore · · Boulder, CO · Joined May 2008 · Points: 100
Aleks Zebastian wrote:

climbing friend,

what is this "aortic valve" of which one on which you would be speaking of it for its mentioning in this posting? 

would you perhaps be meaning left semilunar valve? or left atrioventricular valve? where beginnings of most glorious systemic circulation it is occurring?

No Aleks, the Aortic Valve controls blood flow from the Left Ventricle to the Aorta.  The Aortic Valve is one of two semilunar valves, but we Americans do not commonly refer to the Aortic Valve as the "left semilunar valve".  The other semilunar valve we refer to as the Pulmonary Valve, as it controls blood flow from the Right Ventricle to the Lungs.  The atrioventricular valves are the Mitral and Tricuspid valves, and they control blood flow between the atria (two upper chambers), and the ventricles (two lower chambers).  Easy to get confused, especially with the language barrier and all.  I hope this helps.  Lucky for you those fish heads are loaded with Omega-3's so I'm sure you'll never have to worry about heart health.  You might want to get checked out for sleep apnea though, that neck is looking awfully thick...

Jason Todd · · Cody, WY · Joined Apr 2012 · Points: 1,114
mountainhick wrote:

Huge wormhole here

It's a bit overwhelming for sure.  I'm on the rainbow of meds until my next cardiologist visit in a few weeks.  Hoping to have enough questions to ask, with the goal of reducing the number as much as possible, by that visit.

wivanoff · · Northeast, USA · Joined Mar 2012 · Points: 553
Jason Todd wrote:

Mike and/or wivanoff,

How'd your recovery's turn out?  

I'm going to have a million questions (not necessarily for you guys), as I recently had a STEMI due to a clot in the LAD.

Thanks.

It's been 5 years since my stent. Still taking statins, a calcium channel blocker, aspirin and an ACE inhibitor. Quit taking the Plavix after 1 year.  

I started easy climbing again about 3-4 months after my stent but during the time I was taking the heavy duty blood thinners I was not leading. During the first year after the stent I noticed some reduced energy. Snorkeling in Belize at 2 months was tough. But, the following year I was able to do some significant hiking in Costa Rica. The year after that we hiked up the volcano in Nevis, West Indies. (That hike took longer and more rest stops than when I did it 10 years ago.) The year after Nevis I was back in Costa Rica again and able to hike up the extinct volcano, Cerro Chato, and swim inside the cone.

I'm not sure I've seen the muscle wasting that others have reported with statins but it's hard to tell at 64. During the past 5 years, in addition to climbing (about once a week) I had been trying to get moderate exercise: fast walking 2 miles at lunchtime, hiking on weekends, etc. That slowed with crappy weather and a few months ago I started at the gym doing cardio and some weights. Also, still going to the climbing gym weekly. Got out on the rock a few times on nice days during January/February and looking forward to warmer weather so I can stop pulling plastic.

Not able to climb as hard as before but still having fun and that may be age, stent or a combination.

Aleks Zebastian · · Boulder, CO · Joined Jul 2014 · Points: 175
K. Le Douche wrote:

No Aleks, the Aortic Valve controls blood flow from the Left Ventricle to the Aorta.  The Aortic Valve is one of two semilunar valves, but we Americans do not commonly refer to the Aortic Valve as the "left semilunar valve".  The other semilunar valve we refer to as the Pulmonary Valve, as it controls blood flow from the Right Ventricle to the Lungs.  The atrioventricular valves are the Mitral and Tricuspid valves, and they control blood flow between the atria (two upper chambers), and the ventricles (two lower chambers).  Easy to get confused, especially with the language barrier and all.  I hope this helps.  Lucky for you those fish heads are loaded with Omega-3's so I'm sure you'll never have to worry about heart health.  You might want to get checked out for sleep apnea though, that neck is looking awfully thick...

climbing friend,

ho ho! 

every day it is possible to be learning something new in your country! Such as "aortic valve" is really valve of left semilunar type - and  mass shooting each other month passing is quite acceptable and should not incite any change, and no one shall be allowed healthcare unless rich!



Rod Shaftmoore · · Boulder, CO · Joined May 2008 · Points: 100
Aleks Zebastian wrote:

climbing friend,

ho ho! 

every day it is possible to be learning something new in your country! Such as "aortic valve" is really valve of left semilunar type - and  mass shooting each other month passing is quite acceptable and should not incite any change, and no one shall be allowed healthcare unless rich!



well, you're catching on pretty fast...

Yury · · Unknown Hometown · Joined Oct 2014 · Points: 0
mountainhick wrote:

Whereas, Lipitor claimed in the range of 36% better outcomes, this was based on a comparison of 1.9 out of 100 having subsequent events on statins vs 3 out of 100 in the non statin control group... so where does this 36% figure come from? It is clever mathematical manipulation, a ratio of 2 vs 3, whereas, absolute difference is 1.1%.. Also known as marketing BS. 

Actually 1.9 is 36% lower than 3.0.
It means that the number of heart attacks (I assume that "subsequent events" = "heart attack") is decreased by 36% by the use of statins.

Yes, calculation of percents is a clever mathematical manipulation and requires at least a Middle School degree.
mountainhick · · Black Hawk, CO · Joined Mar 2009 · Points: 120

LOL! I never received a middle school degree per se, but I do understand the deception involved in advertising relative risk reduction vs. actual or "absolute" risk.

Apparently it does take something more than a middle school level of understanding to grasp.

https://www.healthnewsreview.org/toolkit/tips-for-understanding-studies/absolute-vs-relative-risk/

http://ecp.acponline.org/janfeb00/primer.htm

http://www.tandurust.com/health-faq-6/absolute-risk-and-relative-risk.html

And BTW, forgive me for rounding to 2. That was indeed inaccurate by 3% in RRR

mediocre · · Unknown Hometown · Joined Jul 2013 · Points: 0

I never have much to add other than some sarcastic comments on this site, but being a cardiac nurse for the past 3 years, I just want to point out that you guys fucking tear it up for getting after it after an event like this.
Rock on. 

Guideline #1: Don't be a jerk.

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