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Skiing after Angioplasty / Stent & Diabetes
ROOT CAUSE = HFCS High Fructose SODA.
Bypasses Liver - high lipids = clogged arteries Causes Fatty liver disease
Kidneys get affected by think blood, and Blood so thick causes NSTEMI.
Note: I am not a DOCTOR. Talk to your own DOCTOR. I am in Above Average condition. Your results will vary!
HAVE Access to a FAX to communicate in writing to Doctor. Always get a copy of reports. Most you can read, as in Lab work has a range. The Echo Cardiogram took me 3 hours to research what it was actually trying to tell me.
The HEART part is discussed below. The Diabetic part has its own area. Both go hand in hand. Many of the same meds treat both conditions. Control of diet effect both, along with exercise.
If you have maintained a regular gym visit, or some form of exercise you may recover quickly. ie. faster than 6 to 12 weeks. Depends on the type of surgery, % Muscle Damage, and number of stents, age, lifestyle, Bypass will take longer to recover. Valve issues no guidance ask your doctor.
I am sharing the information for the purpose of helping others. Information was scattered all over the internet, but no real one stop shopping on the topic. Always ask your Cardiologist and GP before making any changes in Medication or Exercise.
You cannot pick your parents, nor your heredity. By 40+ things start showing up. Cancer, Heart issues, Diabetes seem to be the main issues. My heredity dropped by on 12/29/14. Heart attack (angina) and with high glucose. Wow, the pain was a one and was not like go to the ER. Knowing little-regarding recovery, I used my skills to meet one goal. I had 2 stents placed in the RCA and the procedure took 25 mins. Your recovery will be different. Meds and diet will be the changes to be made. The sugar from the diet is making your blood sticky and harder to pump. If your lucky and have been exercising before the issue, your recovery will be easier. I ski 30 days a year, work out with weights and some cardio machines.
Damage to the heart muscle will be assessed with a cardiac ultrasound. In my case a 1% loss, which is minimal.
The prognosis is dictated by heart muscle damage and rehab. In my case minimal damage. Your case will be different.
Goal: Get back skiing and racing. To get to that goal, Keep good records on food, workout, and blood levels. Take meds as required and eat prescribed Diet. Understanding the risks of skiing along with blood thinners, and how to mitigate by bringing proper ID, Medical info, Nitroglycerin.
Cardio Rehab In General
Most people 50 and older are not achieving 30 minutes on a treadmill before 6 weeks. 30% will do much better. 60 to 70 percent will need structured cardio rehab taking 6 to 12 weeks.
The heart takes 6 weeks to reconfigure. Beta Blocker meds will decrease the heart rate by 10 bpm and offer some protection.
Your Heart bpm (beat per minute) will be limited to 60%-70% of the calculated MAX. My max is 168 BPM x 60% / 70% = 100 to 117 bpm.
On a treadmill, keep the pace below 3.3 mph, give it 15 mins the work up to 30 mins. Stay in that range until a stress test is performed.
Light weight lifting can be added after 1 week. Light meaning 25 to 30% of normal lifting lbs.
Wear a heart rate monitor.
MOVING UP / How hard does the Heart Rate go when skiing:
The doctors say sex if fine. Not sure about you, but I would suspect the heart rate gets pretty high.
Wearing a Polar FT4 heart rate monitor I recorded these bpm.
Getting from car to resort, putting on boots, gear – 90-100 bpm
Skiing easy on a green 100-110 bpm
Skiing Medium on a blue 110 bpm
Skiing hard/ racing 136 bpm (data says 80-82% of BPM Max)
Typical Race Day – 15 mins target heart rate zone.
Treadmill range 90-110 20+ mins.
The process of skiing – 1 min or less max bpm 136 then 6 mins resting bpm.
Calories Burned –
GYM Treadmill – 300-500 20-30 mins + weights
Skiing med hard 3 hours – 550
MILESTONE ONE – STRESS TEST
Stress test was performed 23 days after Stent placement. The test is 3 segments of 3 mins each. All raising the elevation and speed. I practiced the protocol one time. The goal is to push the test the longest in time and max out the bpm -80-85%. During the test an EKG and SW are monitoring the heart.
MY Score- 10 mins, Above Average 135 BPM max 81% of 168
At 3 Weeks given the OK to new MAX bpm of 135. Now I can ski hard and race. (Keeping with Concussion, Heart, and Bleeding protocol)
OTHER RISK CONSIDERATIONS:
Bleeding out- Blood Thinners – My prescribed thinner has minimal issues than others. Do you go thinking “I had 4 aspirin today and may bleed internally via stomach or by injury ie. hitting head, or by severed artery? Not”. Assess the risk and make changes to mitigate.
Mitigated by Concussion, Injury protocol. ie. Stop, Ski Patrol assessment, Quit for the day.
Effient blood thinner information. Physician opinion on EFFIENT (PRASUGREL HYDROCHLORIDE) (PRASUGREL HYDROCHLORIDE) as adverse event culprit: Unlikely
Heart –
Jane Yost (c) Copyright Used with permission
Mitigated by Heart Pain Nitroglycerin on person.
Injury Prevention – Helmet – Body Armor while racing.
Week 4
26 days – racing 2 GS runs Bronze 48% below Olympic Level VS 22% my best….
Glucose – ADA range 70-180
Week 5
32 days – racing 2 long GS runs 126 bpm. Bronze 48% below Olympic Level VS 22%
Glucose – Tight 70-140
WEEK 6 MILESTONE TWO- Point at which heart/body have technically healed.
42 days – racing 8 GS runs 136 bpm. SILVER 31 HC closer to my prime:o)
Glucose – Tight 70-140
WEEK 7
Raced 2 GS Races Afternoon and evening. Gold race 1 MTN DEW , 27 HC Silver in NASTAR
Cold day and night Under 10 degrees. 4 hours of skiing. 1 hr of racing
MAX bpm 133.
WEEK 8 BIFF RACE – 5 Runs
My Glucose is 100% Compliant with ADA Assoc. Recommendations
87% Compliant with Endocrinology Assoc. Recommendations for Tight. 70 – 140
WEEK 9 race 2 days this weekend.
LABS
eGFR Kidney close to good at 58 need 60.
haA1C = 6.6 down from 11.4 Glucose avg fast 100 Good Numbers.
My Lipids were cut in half to Normal.
Racing my best Handicap on Sunday.
MILESTONE TWO – 6 Weeks 2/10/15
Heart reconfiguration complete. More skiing and racing.
MILESTONE THREE – 8 Weeks March 2015 ALL BLOOD WORK LIPIDS, Glucose, A1C in normal ranges
LABS: Lipid Profile, LDL, HDL, TriG, haA1C now 6.6 vs 11.4,
Cardio: Test: Cardiac Ultrasound, Meet with Cardiologist
GP: Glucose numbers, Tuning, Metformin -?
THINGS TO NOTE:
My racing is silver. NOW SILVER 2/20/15
Add a multi-vitamin mineral to the mix
Consider Creatine Monohydrate & Glutamine, l-arginine as a cardioprotective.
DIET:
Glucose – Take Carbohydrates / 15 = Number. You are allowed (NUMBER=4 total each meal)
Heart- Sodium <1,500 mg/day , Fat <13 grams of saturated fats a day
No Soda!
MILESTONE Four – 6 Months June ALL BLOOD WORK LIPIDS, Glucose, A1C in normal ranges
LABS: Lipid Profile, LDL, HDL, TriG, haA1C now 5.8 vs 11.4,
Was able to stop mealtime Bolus Insulin.
Added Metformin 2x 100 mg every 12hr
Effiant bruising on arms ie.3Gun matches.
Lantus switched to Levemir and now 45 units down from 60units.
Eyesight all checked dilated etc passed.
Weight 216. Down 24 lbs. Waist lost 4 inches.
Took care of left leg and back Sciatica.
Milestone 5 will be October
Made milestone. coming off night BASAL Insulin.
labs good.
Milestone 6 Jan 2016.
Labs good. Stress Test Dec 28 should max it out.
Lost 45 lbs in 1 year, Off insulin, no heart issues.
Mentions:
ExpressCare for the EKG and directing me to Northwest ER. Northwest ER/ICU for stabilization, Sinai ICU/PCCU for care and Dr. Ben Dubois Interventional Cardiologist and Cath lab staff.
To my team of Docs. cardiologist Dr. Syed, and my Internist Dr. Desai.
Dr. Loomis Chiro, Dr. Wasloski Eyes, Dr. Fine Dental.
To Michelle and Dr Dan Morheim MD Delegate for helping with red tape.
To Northern Pharmacy – Can help get the paperwork side done Caid/Care.
Sources:
Blood Thinner:
Early exercise after coronary stenting is safe
Journal of the American College of Cardiology Vol. 45, No. 8, 2005 © 2005 by the American College of Cardiology Foundation ISSN 0735-1097/05/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2005.02.002 36th Bethesda Conference Eligibility Recommendations for Competitive Athletes With Cardiovascular Abnormalities
Exercise Prescription and Proscription for Patients With Coronary Artery Disease
Soga Y, Yokoi H, Ando K, Shirai S, Sakai K, Kondo K, Goya M, Iwabuchi M, Nobuyoshi M.
Eur J Cardiovasc Prev Rehabil. 2010 Apr;17(2):230-4. doi: 10.1097/HJR.0b013e3283359c4e.
Seifert J, Kröll J, Müller E.
J Strength Cond Res. 2009 May;23(3):698-704. doi: 10.1519/JSC.0b013e3181a2b55e.
- Related citations Has a note RE Heart Rate skiing of 82% of max quoted
- An international review of head and spinal cord injuries in alpine skiing and snowboarding A Ackery, B E Hagel, C Provvidenza, C H Tator