Ca State Cycling Champion Beating Heart Disease to Race (and win) Again.

I met Loren Stephens through this blog and my twitter. It happens that we only live a few miles away. I have only ridden once with Loren, on his recovery day, as I am rarely in good enough shape to even see his wheel. I am thoroughly motivated, and encouraged by what he has accomplished mentally and physically since his open heart surgery and heart attack. He is committed to not let his heart stop him from once again becoming a cycling champion. He wrote his account of hat happened to him below.

My Odyssey to return to the top level of masters bicycle racing after open heart surgery and subsequent heart attack

by Loren Stephens

I am an elite level masters cyclists in the USA. I have earned many podium finishes in masters time trial and criterium and am a past California State Masters Criterium Champion for 65+ men.

I was diagnosed with degenerative mitral valve disease (60% leakage) in April 2010. On July 1, 2010 at UCLA Ronald Reagan Medical Center I had a 7.5 hour open heart surgery to repair my mitral valve and to do an atrium reduction. My heart was removed from my body in order to make the repairs. I spent 5 days in ICU and a total of 7 in the hospital.

After getting out of the hospital I struggled with some A Fib problems. I ended up having to be cardioverted out of it. I have been AF free since.

I was able to start training on the bike in September 2010. In late September I had a ventricular tachycardia event while riding and passed out cold. My Doc said I was lucky to be alive and took me off the bike and put me in cardio rehab.

After cardio rehab I was given the OK to start training on the bike again in preparation for the 2011 racing season. I was making great progress until February 15, 2011 when I had a heart attack on a training ride. After a stent and few days in the hospital I was out and found myself back in cardio rehab.

After completing rehab I was given the OK to start riding the bike again. I have been riding mainly to gain back my old levels of endurance.

In December 2011 I started working with my long time coach again and  started full on training in preparation for racing USA Cycling Masters Nationals in early September 2012. I have no restrictions other than the fact that I’m on Plavix which will limit my racing for the first half of the 2012 season. I have raced a couple of races just to test my fitness. In June I raced the California Senior Games and came in 2nd in the 40K road race which also qualifies me to race at the 2013 National Senior Games in Cleveland. My next races will be USA Cycling Masters Nationals in early September 2012 in Bend Oregon and the Huntsman World Senior Games in early October in St. George Utah.

Not bad for a guy who was told he would never race again. I proved them all wrong.

You can follow Loren’s twitter here and his blog and coaching website here.

Interval Training Helps Cardiac Patients

Found via twitter @icycleoc who RT @ironheartracing via @runnersworld

Article from Runnersworld.com ©Runnersworld.com

By Meghan G. Loftus

In a new study out of McMaster University in Hamilton, Ontario, researchers have found that completing 20-minute sessions of cycling intervals–with one minute at 90 percent maximum heart rate, one minute rest, repeated 10 times–significantly boosts overall health and fitness, even in patients with cardiovascular disease.

The New York Times reports:

It might seem counterintuitive that strenuous exercise would be productive or even wise for cardiac patients. But so far none have experienced heart problems related to the workouts, [lead researcher Dr. Maureen] MacDonald said. “It appears that the heart is insulated from the intensity” of the intervals, she said, “because the effort is so brief.”

Almost as surprising, the cardiac patients have embraced the routine. Although their ratings of perceived exertion, or sense of the discomfort of each individual interval, are high and probably accurate, averaging a 7 or higher on a 10-point scale, they report enjoying the entire sessions more than longer, continuous moderate exercise, Dr. MacDonald said.

“The hard work is short,” she points out, “so it’s tolerable.” Members of a separate, exercise control group at the rehab center, assigned to complete standard 30-minute moderate-intensity workout sessions, have been watching wistfully as the interval trainers leave the lab before them. “They want to switch groups,” she said.

The American Heart Association recommends 30 minutes of continuous, moderate exercise five times a week, but this study indicates that 20 minutes of interval training is as beneficial and possibly more enjoyable. And, obviously, the interval workouts are shorter. The majority of Americans who don’t exercise say it’s because they don’t have time.

If you’re in the minority–that is, you do have time for prolonged, moderate exercise–you shouldn’t abandon your current regimen. This type of exercise also has proven heath benefits. But on days when you’ve got to squeeze in a workout, intervals may be the way to go.

How Exercise Effects Metabolites and Genes in Your Bloodstream

Great article on how exercise, as little as just 10 min., “Almost immediately, the metabolites, in combination (but not individually) ignited a reaction that resulted in increased expression of a gene involved in cholesterol and blood-sugar regulation. In other words, the metabolites weren’t just marking activity that was happening elsewhere in the body; they also may have been sparking some of that activity directly.”

“…after 10 minutes of treadmill jogging or stationary-bicycle riding, the healthy adults showed enormous changes in the metabolites within their bloodstream”

But more importantly than how little exercise one has to do to effect change -scientists are starting to understand more about how exercise effects the bloodstream and how that relates to heart disease.

Link to complete NY Times Article.

Why I Check my Oxygen Levels When I Ride

I have been trying to get ready for a the Avenue of the Oaks Century on May 1 and my training has been inconsistent at best….insert excuses here. Today I was able to spend 2 hours on a ride and I wanted to push a bit harder that normal.

SInce I no longer go to cardiac rehab. I try to mirror what the “maintenance” program I was on did when it comes to protocol. Each time I went to rehab the workout started with the following:

1. Weigh myself.
2. Relax and sit in a chair (of my own choice I closed my eyes and relaxed my whole body durigng the next steps).
3. They would hook up the blood pressure cuff, and oxygen monitor.
4. Then take the reading for my BP, resting HR & Oxygen level.

I do my best to do  all of the above things before I do any type of workout or riding (I’m in the market for a new blood pressure monitor as the electric one I had been using was not accurate when I brought with me to an appointment with my doctor and compared it with hers). Now during the cardiac rehab sessions they would check my oxygen levels 2-3 times, more if I was trying something new or pushing up a level of intensity. At home I only check it before I workout and occasionally after my cool down and when I push myself (now getting to the point of this entry) like I did today. Since I was heading out to ride twice as long as had I the past weeks I decided to take my Nonin Onyx Fingertip Oximeter with me to check throughout my ride. I want to point out at this point that this is same monitor 1 of my doctors uses, and 2 of my rehabs use so that is how I qualified it’s purchase. (one other point it is a nice way to check the accuracy of my heart rate monitor as well).

Today I used at the first sign of feeling like the ride should have been a bit easier and I didn’t believe my HRM, it was correct the oximeter read 138bpm and 98%O2. The next time was after a moderate climb and I hit 164 bpm (my doc say to stay under 160) Oximeter read 161bpm ( it took a few seconds to stop and put it on my finger) and 96% O2. It is also a good thing to have when I’m sucking wind and I can be sure it’s just from being out of shape vs a true loss of O2. I used it one more time when I started to feel tired and then after my cool down. I probably won’t bring it with me on a ride again until I do the century on May 1.

It is a useful tool to have if you work out on your own. It provides me with 2 things, 1: Ability to let me doctor know more information about my health & 2. Oxygen content of your blood is only a small factor when determining your risk for a cardiac event but it does provide me with a bit of assurance that my heart is doing O.K.

KEEPriding,

Eric

A New way of Life. Readers Story-

Just ran across your site. I really enjoyed reading your posts.

I’m 47 years old, mostly healthy, though out of shape. Saw the doc for a physical 5 months ago. Immediately was put on cholesterol and BP meds. 4 months later my blood pressure and cholesterol numbers were good and I had lost 15 lbs. Then I had my heart attack. I had it during my first visit to a gym while working with a trainer. A clot broke loose and I had an immediate 100% blockage of the circumflex artery.

I’m 4 weeks past that. Just been released for Cardiac Rehab. A strange thing happened during my stress test prior to release to rehab. I realized that I loved the exercise! They got my heart rate up to 150 bpm, and I loved every moment. This was probably because I’d been wondering if I was always going to be physically limited. I want to turn this new feeling into a new way of life.

I’m looking for ways to increase my fitness, especially after I’m done with rehab.

While Googling “bicycling after a heart attack”, I found your site. It really gave me a lift. It’s great reading about someone who has had cardiac issues, but still loves to ride.

You’ve given me inspiration to stay on track, increase my fitness, and above all, get back on a bike!

Thanks for sharing your experiences.

Tim

Cardiac Surgery Repairs Rescue Swimmer’s Mitral Valve

May 4, 2009
Robotic surgery gets patient back to his active lifestyle

San Diego – As a military rescue swimmer, 36-year-old Ronny German was in the best shape of his life and had no previous health problems. However, shortly after a routine dental cleaning, Ronny began to experience significant swelling in his joints, which his doctors initially diagnosed as rheumatoid arthritis — a condition that runs in his family. As his symptoms worsened, further examinations and testing revealed a heavily leaking mitral valve in Ronny’s heart.

Ronny was told that he would need an operation to repair his mitral valve and chose to have the procedure using minimally invasive robotic surgery. During the robot-assisted surgery, his surgeon discovered that Ronny’s mitral valve was extensively infected.

After surgery Ronny was informed that the infection was the cause of his leaking mitral valve, and it was likely the result of the dental cleaning he received before the onset of his symptoms.

“I was shocked to learn that a routine dental cleaning could have such a serious complication,” said German. “When I was diagnosed with a heart murmur, I was never told that I should be taking antibiotics when I was having even simple dental work done.”

A recent study from the University at Buffalo in New York linked bacteria commonly found in the mouth to an increased risk of coronary heart disease and other cardiac complications.

After a successful robot-assisted mitral valve repair, Ronny recuperated at home, and within two weeks was back at his job with the U.S. Coast Guard. He received medical clearance three months after returning to work and quickly passed his rigorous monthly fitness test. Since his surgery Ronny has taken up paddle surfing and currently participates in five- to nine-mile races, with hopes to complete the Catalina Crossing in the future.

Minimally-invasive surgery offers quicker recovery
“A leaking mitral valve is more common in older adults, but we do see patients with the condition as a result of infection,” said James Hemp, M.D., cardiothoracic surgeon with the Scripps Minimally Invasive Robotic Surgery Program. “Open cardiac surgery requires a significant amount of recovery time, but we were fortunate to be able to offer Ronny an option that would allow him to continue his very active career and lifestyle.”

Minimally invasive robot-assisted surgery provides access to the heart through five small incisions, eliminating the need for surgeons to split the breastbone and spread open the ribcage in order to gain access to the heart. During robot-assisted surgery, tiny instruments and a three-dimensional camera are inserted through the incisions, and the surgeon controls the instruments from a console that provides a magnified view of the surgical field.

This system enhances surgical capabilities by offering even greater precision during surgery. A patient typically stays in the hospital for three to five days after minimally invasive cardiac surgery, compared to five days or more after traditional heart surgery. While the average recovery time after open-heart surgery is six to eight weeks, recovery time with robot-assisted cardiac surgery is between two and four weeks.

About Scripps Health
Founded in 1924 by philanthropist Ellen Browning Scripps, Scripps Health is a $2 billion nonprofit community health system based in San Diego, Calif. Scripps treats a half-million patients annually through the dedication of 2,600 affiliated physicians and 12,300 employees among its five acute-care hospital campuses, home health care services, and an ambulatory care network of clinics, physician offices and outpatient centers.

Recognized as a leader in the prevention, diagnosis and treatment of disease, Scripps is also at the forefront of clinical research and graduate medical education.

Contact: Kristin Reinhardt
Phone: 619-686-3787
E-mail: reinhardt.kristin@scrippshealth.org

Scripps Mercy Hospital, Scripps Clinic, Minimally Invasive Robotic Surgery, Minimally Invasive Robotic Surgery

More Exercise May Provide Greater Gains in Heart Disease

Taken from http://www.clevelandclinicmeded.com/news/Article.aspx?AID=626959&visitfrom=twitter

Overweight patients with heart disease saw better gains compared to standard cardiac rehab.

THURSDAY, May 14 (HealthDay News) — A program featuring greater amounts of exercise and energy expenditure may be preferable to standard cardiac rehabilitation exercise in overweight patients with coronary heart disease, according to research published online May 11 in Circulation.

Philip A. Ades, M.D., of the University of Vermont College of Medicine in Burlington, and colleagues analyzed data from 74 overweight individuals — mean age of 64 years and mean body mass index of 32 — with coronary heart disease. Patients were randomized to high-calorie-expenditure exercise (3,000 to 3,500 calories weekly) or standard cardiac rehabilitation exercise (700 to 800 calories weekly).

At five months, the researchers found that those in the high-expenditure group had twice the weight loss (8.2 versus 3.7 kilograms) and fat mass loss (5.9 versus 2.8 kilograms). This group also had larger decreases in insulin resistance, total to high-density lipoprotein cholesterol ratio, and elements of the metabolic syndrome. No exercise-related cardiac events were noted, and adherence to the interventions was good, the authors write.

“Considering the negative consequences and increasing prevalence of obesity and metabolic syndrome, high-calorie-expenditure exercise training, combined with a hypocaloric diet, should be considered the exercise approach of choice for overweight patients with coronary heart disease,” the authors conclude. “Some individuals with no exercise experience whatsoever may initially benefit from a standard cardiac rehabilitation exercise protocol and then gradually evolve to four to six sessions per week as they improve their fitness.”

Last Updated: May 14, 2009

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Riding Ave of The Oaks Century after Heart Attack

This Saturday is the Ave of the Oaks metric century ride. I choose this one because while riding 63 miles is not that hard for me at this point, doing it and 6000′ plus of climbing is. I’d say that’s a pretty decent climb for someone without a heart attack so it would be a good goal for me. I try just to be happy that I can ride at all but it’s hard not to compare myself with someone who has no heart problems and I love riding up hills, always have, even though I’m not good at it I’m just persistent that way. Below is the elevation chart.

Ave of the Oaks Century elevation chart.

I’ll be riding it with my PT from my old cardiac rehab program and one of my cardiologist. Which makes my wife extremely happy, even though she wishes I didn’t do it at all. I think I’m ready. While I haven’t ridden that distance in a while I have been riding lots of hills and doing 3,000′ climbs in 28-30 miles rides and some hill repeats so I feel ready and the best riding shape since my heart attack.

I’ll do my best to keep track of my ride and bring you a crank by crank report.

Eric

Please Tell Your Cardiac Story.

I’d (and I assume many others) would love to hear how you have dealt with, conquered or beaten heart disease. Do you still ride a bike, surf, mountain bike, bmx, skateboard, ski or snowboard since your heart attack or heart disease started? Any little story you have can go a long way in providing motivation for others who struggle with wanting to ride.

After you write your story here I’ll make a special page for it so other can communicate about it.

Thanks,

Eric

Prevention: Gains From Exercise After Heart Attack Are Lost if Exercise Stops

I found this on the New York Times website via their twitter page.

Prevention: Gains From Exercise After Heart Attack Are Lost if Exercise Stops

By NICHOLAS BAKALAR

Published: March 20, 2009

Some important benefits of exercising after a heart attack can vanish in weeks if the exercise is stopped, a new study has found.

The researchers tested F.M.D. — flow-mediated dilation, a measure of the flexibility of an artery as blood flows through it — in 228 heart attack survivors. Their arteries averaged about 4.2 percent expansion, compared with the 10 percent considered normal in healthy people.

Then the scientists divided patients into four groups to undergo resistance training, aerobic exercise, both together, or no exercise program at all.

Finally, the exercisers “detrained,” remaining idle for four weeks.

The study, published in the March 16 issue of the journal Circulation, found that the dilation had increased to 5.3 percent in the people who had not exercised, but to an average of more than 10 percent in the training groups. After four weeks of detraining, dilation returned to almost exactly the initial levels in all three exercise groups.

“Cardiac rehabilitation is cheap,” said Dr. Margherita Vona, the lead author and director of cardiac rehabilitation at a clinic in Glion-sur-Montreux, Switzerland, “but the price of losing its benefits is high. It’s important to educate patients about exercise, and essential that they continue for the long term.”

A version of this article appeared in print on March 24, 2009, on page D6 of the New York edition.

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