Skiing and Biking after a Heart Attack

[Monster101]

Hi folks
I'm 40, had a heart attack driving home from mountain biking mid December North of Glasgow. PCI Stent inserted within 2.5 hrs, I'm 13stone, 5'9", pre Mi cholesterol 3.9, post 2.1 Bp. 130/85, Ejection fraction post MI 64%. No hypertension. Apparently family genetics. I'm on the usual gambit of drugs, bp tablets, statin, aspirin, ace inhibitor.

Just had my final sign off meeting with my cardiologist and regrettably, he was non committal on the ability to return to exercise at a reasonable level.
His opinion (and he admitted doesn't know much about cycling) is that cycling as I describe it, is an extreme sport.
I described typical road bike run would be 25-30miles, a couple of decent hills. 2hr duration and burn about 1,800 cals. Typical mountain bike run would be 15-25miles, 2-3hours some big gradients and burning around 2000 calories. This would be typical red/black graded trail in Scotland.
I also ski 7 days in the Alps each year and another 7-10 days in Scotland. Ski reasonably hard and also do a little slackcountry, boot packing mostly. Play 4hrs of competitive badminton a week as well.
Cardiologist is saying that I shouldn't be cycling or skiing at the above level as he cannot say it is safe to do so but at the same time he says he cannot say it is definitely dangerous. He then stated I have a very low risk of having another heart attack but more than a normal person.
Wife is giving me grief, I don't want to give up my sports as I feel fine and with the exercise I am doing, I am coping with ramping up activity levels.

Any advice on skiing or biking after a heart attack? Experiences?

not much online re a 40 year old
Thanks
Alan

[jon gaper]

" He then stated I have a very low risk of having another heart attack'
You believe that?

I would find another cardiologist who is a skier/biker and can give you some good information on what level to start at and how to progress slowly minimizing risk

[Monster101]

I do think my cardiologist is a tool as there is no way, what I am doing is extreme. Maybe for a lardass 65 yr old who smokes and drinks.

Regrettably, in the west of Scotland that is the typical MI patient.

im trying to find a local cardiologist who has interest in sports.

[Mustonen]

I think you should ask a bunch of people on the Internet. Nobody knows your heart health like a TGR dentist.

[Monster101]

Not getting much sense from my cardiologist so why not?

Someone might have had heart issues and could share their experience? Why else have gimp central?

[powtario]

A) Patients are rarely counseled about when it is safe to resume sexual activity after a myocardial infarction, a Circulation study finds. Current U.S. guidelines recommend that patients can resume sexual activity 1 week or more after an uncomplicated acute MI if they don't have cardiac symptoms during mild or moderate physical activity.

B) If your cardiologist doesn't know, find someone who does.

C) Encourage your wife that both exercise and sex are needed for a physical and emotional recovery.....and post up some titties!

[Monster101]

Sex is definitely not a problem. Although she is not talking to me after telling her to f#$k off if she thinks I am not skiing or biking ever again.

[stuckathuntermtn]

Do you have kids?
No?
Fuck it!

[old goat]

Don't know about Scotland but in the US a lot of patients do a supervised cardiac rehab program--try googling cardiac rehab for a start. I would find a doc who is more helpful and will refer you to a program if they exist where you are, although frankly you may find that it won't be relevant for someone who is fit other than the MI. You should be able to resume biking and skiing. Exercise doesn't cause heart attacks. Blood clots cause heart attacks. If you have a badly blocked artery--presumably you don't any more--you will get chest pain if you exercise. However, it's not the badly blocked arteries that cause heart attacks; those have collateral circulation (detours) that route the blood around the blockage. It's the moderately blocked arteries--the ones that don't cause pain with exercise--that have plaques that rupture and form clots that cause heart attacks. And exercise has nothing to do with plaques rupturing--as many heart attacks happen during sleep as any other time. If you do get chest pain with exercise you need to stop--while the exercise isn't causing a heart attack it can cause fatal abnormal heart rhythms. So--get into a rehab program if you can, start exercise/sports slowly and increase gradually, stop if you start getting pain and let your doctor know.

Final sign off meeting with your cardiologist? In the US your cardiologist would probably see you every three months for the rest of your life so he can get paid for the visits (in addition to your seeing your regular doc).

[Monster101]

Thanks old goat, public health service in the UK, although I also have medical with my work. I am doing the formal cardiac rehab, 8 sessions into a 16 session at my local hospital. It basically involves group aerobic circuit class with a whole lot of old crustys.

hr not really going above 120 and not really feeling the benefit. I will be signed off from this by the end of the month. Regrettably, my docs attitude was provided when I asked him when I can ramp up my rehab and walking regime to sports that I enjoy.

Been doing sing a couple of the sufferfest cycling videos with the turbo trainer. Hr working around 145 with peaks on hills of 170.

Skied an indoor ski slope green run for an hour last week and my hr averaged 75 and peaked at 106. I can walk faster and have a more strenuous workout. I'm hoping to get back skiing before the end of the season and maybe get some spring gully skiing in.

[jon gaper]

" I'm hoping to get back skiing before the end of the season and maybe get some spring gully skiing in. "
" Hr working around 145 with peaks on hills of 170. "
Admirable attitude or death wish?

[old goat]

" I'm hoping to get back skiing before the end of the season and maybe get some spring gully skiing in. "
" Hr working around 145 with peaks on hills of 170. "
Admirable attitude or death wish?

as long as you're not having chest pain you're probably ok, although it might be best to not try to get you HR up so high. Better yet see if you can get your doc run a stress test for you with your heart rate that high. As long as you have no pain, no ekg changes, and no rhythm disturbances during the test you should be fine.

I get the problem with rehab. I have the same deal with my back--doing the core strengthening exercises I've been prescribed I can do them all day without any effort. These programs are basically for sedentary, (physiologically) elderly people.
44 y/o head of a local XC skiing center was just found dead on one of the trails. Thought that might cheer you up. My brother had heart attack at 35. I think the hardest part for young people with heart attacks is psychological--the sudden feeling of vulnerability. Most of us get to adapt to our increasing vulnerability more gradually. BTW my brother has been fine for over 25 years since the heart attack.

[CarolB]

Wouldn't it stand to reason that your level of Cardio and ability to recover post exercise is what can determine what your aspirations can be? Also, taking the effects of the medications you're on?

The Heart's a muscle and the thing I recall my friends who have gone through issues tell me that allowing proper "re-strengthening" and importantly- recovery between exercise sessions is important which is why those Rehab Clinics in the US/Canada have become so important for getting people back up to safe levels and keeping people fit after. They also touch on the high level of depression that can occur in younger heart patients.

Get a monitor strap and learn how to use it and get set up with a Heart Rehab program/physio?? Make baby goals that lead towards the big goals as you see what you can do?

Good luck and stay positive!

[old goat]

Good point about HR recovery--you can google that if you're not familiar with the idea. Also is your HR going higher or rising faster than pre-heart attack when you do your training? If so that would suggest the need for caution, but I'm assuming that's not the case.

[yeahman]

A friend of mine had a heart attack at 40. Perfect health, not overweight at all. He got a stent. I don't know the details of everything that happened or what they did to him, but I do know that three years later he is mountain biking like crazy, does long endurance races like the York 38 near Helena, which is supposedly a real tough climb. Everybody is different, but he is proof that it's possible to get back to a high level of mountain biking. Odd thing is before the heart attack he never did races or anything, hardly even biked. He's just gotten into it during his recovery.

[powtario]

Know a guy who got 2 stents last week at 27. Total blockage in one 70% in the other. He's had diabetes since he was 3 but super well controlled and works out 6 times a week, hard.

Luckily no major tissue loss but damn.