Dr. Mirkin's Fitness and Health Forum: valve restriction

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trailrider
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Topic: valve restriction
Posted: 28 May 2010 at 10:51am

When the aortic valve is restricted and the ejection fraction is 30 percent, is it sensible to continue with physical activity? This is a senior female with no heart pain but a heart rate of 90.

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Jericho
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Posted: 29 May 2010 at 2:31pm

You do not say why your have aortic insufficiency.

An ejection fraction of 30% is not particularly good ( a healthy ejection fraction being somewhere in the region of 58-65%).

The worst it can get without dying is about 13%.

However, there are different reasons for this EF loss.

If your doctor agrees, then there should be no reason why you cannot exercise. BUT you will need to do this exercise differently and do different exercises.

It is important do do something. I expect you have no wish at all to be idle and to sit around waiting to die.

What does your doctor say ?

Jericho
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Long after people have forgotten what you said, they will remember how you made them feel.

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trailrider
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Posted: 30 May 2010 at 10:13am

Doctor said take propranolol - I passed out for a half hour. I`m afraid to take any more. Blood pressure is usually normal, sometimes low, but gets higher going up stairs. Examples yesterday evening 118/70 110/68 119/53 114/66 112/70 and just now 131/70 with a 90 pulse(usual).

Also have fatty liver - mild - and some discomfort there. No more info or help since I won`t take the drugs when I am alone. A year ago a test showed an enlarged atrium and stenosis of the aortic valve. I will take lasix occasionally. Am supposed to take aspirin and not vitamin E, but iItend to bleed easily, so usually take the vitamin E anyway. No more help seems to be available.

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Jericho
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Posted: 30 May 2010 at 2:57pm

Oh dear. I am so sorry you seem to have no support. It must be awful for you.

The beta blocker propanolol does make some people pass out, or feel dizzy. It may very well be an idea to ask the doctor for a different beta blocker, or a reduced dose. That would have the protective effect without the obviously worrying side effects. With drugs, I'm afraid, it is always a bit hit and miss. The first bad experience should not put you off further trialling of different meds. However, I realise that is easy for me to say and very difficult for you to do.

Lasix tends to reduce the volume of blood by acting as a diuretic. This will make you pee more often, sometimes through the night. This can be disturbing and disrupting.

I feel that exercise, in a different way would be good. Perhaps drop out the aerobic stuff and concentrate on the strength-resistance training exercises. This would help with your liver problems and might indeed help with the aspirin issues.

Please reply to this and let me know what you would be interested in.

I might very well be talking complete rubbish. If so, forgive me. But I would be interested in your ideas.

Kind regards,

Jericho
Senior Instructor
United Kingdom
Long after people have forgotten what you said, they will remember how you made them feel.

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trailrider
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Posted: 30 May 2010 at 11:36pm

Well, my exercise consists of feeding and caring for sheep and their lambs, some ducks, and several dogs. I go slowly on the heavy work, and ride an ATV to exercise the dogs and do some of the work. I had IV EDTA for 10 years, and then a dentist put in mercury in 6 teeth, so I am concerned about no more EDTA since it mobilizes the mercury to the brain. I had a consult with a dentist nearby who suggested Sjogrens symdrome, but this is all confusing. I need a plan.

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Jericho
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Posted: 01 Jun 2010 at 5:31am

I can certainly understand some of your concerns.

The plan - though you may not like this at all.

First: - make friends with your doctor and sort out the medication you need. Aortic valve insufficiency is not something you can overcome by willpower, exercise, or just nutrition alone. Like it or not, you need the medication. I would strongly advise you working with your doctor to overcome your reactions to previous medications.

Second: - Find an exercise therapist who is experienced in dealing with people older than 50. Work closely with him/her to dertermine what type of exercise will be best. You not only need to exercise your heart muscles but also your skeletal muscles and bones to prevent osteoporosis, calcification of the tendons, general weakening etc.

Third:- This is obvious - continue with the aspects of your lifestyle that bring you pleasure and fullfillment.

I am sorry there is no magic wand. Your problems are too intertwined for a forum such as this to deal with. It all has to be sorted face to face.

I hope you manage to get help and support with your very difficult issues.

I would be most interested to hear from you in the future and learn what you have decided and how you are getting on.

Kind regards,

Edited by Jericho - 01 Jun 2010 at 5:32am

Jericho
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United Kingdom
Long after people have forgotten what you said, they will remember how you made them feel.

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hipaches
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Posted: 14 Jun 2010 at 9:04pm

Hi Newbie:

From another newbie, Canadian, so I might not be up todate. I had 3 by-passes and an aortic valve replacement done last year. Aside from the blood thinners and a statin drug I'm on a beta-blocker, Metropolol, that regulates the heart pressure from getting too high. My cardiologist wants me working out in a gym 2 - 3 times a week for upper body conditioning, but with this beta blocker I can't get my heart rate up and it leaves me gasping for air. In other words, it's not working for me. I'm not breaking into a big sweat, as I normally would. I read in one of the newsletters that Dr Mirklin has listed a number of beta blockers that may cause more heart problems than it should solve. Am I right? Hipaches

Edited by hipaches - 14 Jun 2010 at 9:08pm

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Jericho
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Posted: 15 Jun 2010 at 4:57pm

Actually--- not trying to be smart--- it is working for you. You are alive and safe. Frustrated and slightly confused, impatient, - but safe.

You have had major surgery and your heart needs to recover from the problems it suffered from.

It does need to work more - but at a slow rate of increase. This is what the beta blockers make happen. You should not force your heart against the beta blockers. It would be very dangerous to do so.

Just do the workouts for a while and talk to your doctor/surgeon.

He wants you to be safe. You want to work out more. The pair of you are talking different languages. So talk to him about your hopes and wishes. Be honest with him and listen to what he says. Work out a plan together.

After a while, however long that is, the level of medication can be changed, lowered, or maybe even stopped completely. But, it will not come easily or quickly.

Just do as you are advised, be patient and talk to your medics. They really do know what they are talking about and they will listen to what you have to say.

I would be most interested to learn what you think, and what happens.

Regards,

Jericho
Senior Instructor
United Kingdom
Long after people have forgotten what you said, they will remember how you made them feel.

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Heart Health
Dr. Mirkin's Fitness and Health Forum : Health Issues, Diseases and Conditions : Heart Health

Author	Message
trailrider Newbie Joined: 28 May 2010 Location: Canada Online Status: Offline Posts: 3	Topic: valve restriction Posted: 28 May 2010 at 10:51am
	When the aortic valve is restricted and the ejection fraction is 30 percent, is it sensible to continue with physical activity? This is a senior female with no heart pain but a heart rate of 90.
	IP Logged

Jericho Admin Group Administrator Joined: 02 Sep 2006 Online Status: Offline Posts: 800	Posted: 29 May 2010 at 2:31pm
	You do not say why your have aortic insufficiency. An ejection fraction of 30% is not particularly good ( a healthy ejection fraction being somewhere in the region of 58-65%). The worst it can get without dying is about 13%. However, there are different reasons for this EF loss. If your doctor agrees, then there should be no reason why you cannot exercise. BUT you will need to do this exercise differently and do different exercises. It is important do do something. I expect you have no wish at all to be idle and to sit around waiting to die. What does your doctor say ?
	Jericho Senior Instructor United Kingdom Long after people have forgotten what you said, they will remember how you made them feel.
	IP Logged

trailrider Newbie Joined: 28 May 2010 Location: Canada Online Status: Offline Posts: 3	Posted: 30 May 2010 at 10:13am
	Doctor said take propranolol - I passed out for a half hour. I`m afraid to take any more. Blood pressure is usually normal, sometimes low, but gets higher going up stairs. Examples yesterday evening 118/70 110/68 119/53 114/66 112/70 and just now 131/70 with a 90 pulse(usual). Also have fatty liver - mild - and some discomfort there. No more info or help since I won`t take the drugs when I am alone. A year ago a test showed an enlarged atrium and stenosis of the aortic valve. I will take lasix occasionally. Am supposed to take aspirin and not vitamin E, but iItend to bleed easily, so usually take the vitamin E anyway. No more help seems to be available.
	IP Logged

Jericho Admin Group Administrator Joined: 02 Sep 2006 Online Status: Offline Posts: 800	Posted: 30 May 2010 at 2:57pm
	Oh dear. I am so sorry you seem to have no support. It must be awful for you. The beta blocker propanolol does make some people pass out, or feel dizzy. It may very well be an idea to ask the doctor for a different beta blocker, or a reduced dose. That would have the protective effect without the obviously worrying side effects. With drugs, I'm afraid, it is always a bit hit and miss. The first bad experience should not put you off further trialling of different meds. However, I realise that is easy for me to say and very difficult for you to do. Lasix tends to reduce the volume of blood by acting as a diuretic. This will make you pee more often, sometimes through the night. This can be disturbing and disrupting. I feel that exercise, in a different way would be good. Perhaps drop out the aerobic stuff and concentrate on the strength-resistance training exercises. This would help with your liver problems and might indeed help with the aspirin issues. Please reply to this and let me know what you would be interested in. I might very well be talking complete rubbish. If so, forgive me. But I would be interested in your ideas. Kind regards,
	Jericho Senior Instructor United Kingdom Long after people have forgotten what you said, they will remember how you made them feel.
	IP Logged

trailrider Newbie Joined: 28 May 2010 Location: Canada Online Status: Offline Posts: 3	Posted: 30 May 2010 at 11:36pm
	Well, my exercise consists of feeding and caring for sheep and their lambs, some ducks, and several dogs. I go slowly on the heavy work, and ride an ATV to exercise the dogs and do some of the work. I had IV EDTA for 10 years, and then a dentist put in mercury in 6 teeth, so I am concerned about no more EDTA since it mobilizes the mercury to the brain. I had a consult with a dentist nearby who suggested Sjogrens symdrome, but this is all confusing. I need a plan.
	IP Logged

Jericho Admin Group Administrator Joined: 02 Sep 2006 Online Status: Offline Posts: 800	Posted: 01 Jun 2010 at 5:31am
	I can certainly understand some of your concerns. The plan - though you may not like this at all. First: - make friends with your doctor and sort out the medication you need. Aortic valve insufficiency is not something you can overcome by willpower, exercise, or just nutrition alone. Like it or not, you need the medication. I would strongly advise you working with your doctor to overcome your reactions to previous medications. Second: - Find an exercise therapist who is experienced in dealing with people older than 50. Work closely with him/her to dertermine what type of exercise will be best. You not only need to exercise your heart muscles but also your skeletal muscles and bones to prevent osteoporosis, calcification of the tendons, general weakening etc. Third:- This is obvious - continue with the aspects of your lifestyle that bring you pleasure and fullfillment. I am sorry there is no magic wand. Your problems are too intertwined for a forum such as this to deal with. It all has to be sorted face to face. I hope you manage to get help and support with your very difficult issues. I would be most interested to hear from you in the future and learn what you have decided and how you are getting on. Kind regards, Edited by Jericho - 01 Jun 2010 at 5:32am
	Jericho Senior Instructor United Kingdom Long after people have forgotten what you said, they will remember how you made them feel.
	IP Logged

hipaches Newbie Joined: 14 Jun 2010 Location: Canada Online Status: Offline Posts: 1	Posted: 14 Jun 2010 at 9:04pm
	Hi Newbie: From another newbie, Canadian, so I might not be up todate. I had 3 by-passes and an aortic valve replacement done last year. Aside from the blood thinners and a statin drug I'm on a beta-blocker, Metropolol, that regulates the heart pressure from getting too high. My cardiologist wants me working out in a gym 2 - 3 times a week for upper body conditioning, but with this beta blocker I can't get my heart rate up and it leaves me gasping for air. In other words, it's not working for me. I'm not breaking into a big sweat, as I normally would. I read in one of the newsletters that Dr Mirklin has listed a number of beta blockers that may cause more heart problems than it should solve. Am I right? Hipaches Edited by hipaches - 14 Jun 2010 at 9:08pm
	IP Logged

Jericho Admin Group Administrator Joined: 02 Sep 2006 Online Status: Offline Posts: 800	Posted: 15 Jun 2010 at 4:57pm
	Actually--- not trying to be smart--- it is working for you. You are alive and safe. Frustrated and slightly confused, impatient, - but safe. You have had major surgery and your heart needs to recover from the problems it suffered from. It does need to work more - but at a slow rate of increase. This is what the beta blockers make happen. You should not force your heart against the beta blockers. It would be very dangerous to do so. Just do the workouts for a while and talk to your doctor/surgeon. He wants you to be safe. You want to work out more. The pair of you are talking different languages. So talk to him about your hopes and wishes. Be honest with him and listen to what he says. Work out a plan together. After a while, however long that is, the level of medication can be changed, lowered, or maybe even stopped completely. But, it will not come easily or quickly. Just do as you are advised, be patient and talk to your medics. They really do know what they are talking about and they will listen to what you have to say. I would be most interested to learn what you think, and what happens. Regards,
	Jericho Senior Instructor United Kingdom Long after people have forgotten what you said, they will remember how you made them feel.
	IP Logged