Classtime 

I'm just a Math Teacher but my wife is the Doctor and she suggests that if you haven't yet seen it, watch "Forks Over Knives" and on the genes thing, start here
Basically, if you have a sub-optimal cardiovascular system, it is a good idea to drastically decrease your consumption of animal proteins.

Btw, I have two dogs, I train them with praise and traditional training collars, and my shoes, belts, and most of my Brooks saddles are leather.

Maelochs

Yeah ... if the dogs act up, show them the leather seat and say, "You could be next ... "

jlstrat

My cholesterol levels were not great--190, sometimes higher, but my balance of good to bad was good. Same with my glucose level. My family physician looked at my last four lab results for my annual physical and said she would not have anticipated a heart attack for me.

2metalhips

https://nutritionfacts.org/


Diet, not drugs is the answer.

Gresp15C

Glad you made it!

I had mine at 52, two January's ago. I was extremely lucky... from calling 911 to having a stent in my LAD, couldn't have been much more than an hour.

I had none of the standard risk factors. My weight had crept up a bit, but not to an alarming degree. I exercised -- year round bike commuter. In fact I rode to work and back at -7 degrees F on the day before the event.

But I decided to lose weight, and cut a few things from my diet, including butter and mayo. I'm down to 152, which has held steady for more than a year. Of course, that meant cutting the things that taste good with butter, mostly carbs. And I started riding again when they said I could, which wasn't more than a few weeks after the event.

I think that being in decent overall shape probably helped my recovery. A lot of the people who I saw at Cardiac Rehab were practically immobile due to other health problems, and weren't all that old. I figure that even with a stent in me, I may be healthier than a lot of people my age.

And I got a new bike.

I decided, since I had been given a new life, that I would get a brand spankin new bike with all of the modern goodies such as an aluminum frame, 1x gearing, wide tires, and disc brakes. I've enjoyed riding it a lot, though I have to admit that I still love old steel.

jppe

That’s what I was afraid of. I’m right there with you.

bobwysiwyg

Not quite sure what to make of this. I had a stent implanted in Feb. I never had any symptoms and have not had any since. I was "issued" the standard nitroglycerin which I carry all the time, but I think it's just protocol.

https://www.nytimes.com/2017/11/02/h...ction%2Fhealth

Maelochs

Not going to read the whole thing ... sorry ... but it seems to be saying that nobody gets stents without a least a partially blocked artery and the stent is Not to ease pain but to keep the artery open. Therefore whether or not it eases pain is not that important.

I did note: "Dr. David Maron, a cardiologist at Stanford University, praised the new study as “very well conducted” but said that it left some questions unanswered. The participants had a profound blockage but only in one artery, he noted, and they were assessed after just six weeks.

"'We don’t know if the conclusions apply to people with more severe disease,” Dr. Maron said. “And we don’t know if the conclusions apply for a longer period of observation'."

So ... sort of inconclusive i think. Check back in a year, find out if the people changed their lifestyles, if the blockages worsened ....

As far as I am concerned, when you get a life-saving procedure you are getting free life, a chance to do right what you did wrong the first time (or to make up for the bad genetics you didn't know you had.)

I'd care more about knowing if, after a year, people who got stents were able to live healthier, active lives.

I get heart pain every single time I push too hard on even a tiny hill. You might hear me talk about it, but you won;'t hear me complain, because without surgery I wouldn't even be walking up that hill, let alone riding.

pain after six weeks. Take six months to rehab, clean up your diet, and start an regular exercise regimen.

If you got out of the hospital and ate two fast-food burgers and found that your partially blocked artery was still partially blocked .... Surprise!

jlstrat

I just hope I'm back on a bike in a few weeks, even it it's just for a few miles a day.

Maelochs

It took me five weeks ... but I bet I could have pushed it and started at three ... maybe. Start slow and be really aware of heart rate. Check your blood pressure after every couple miles. Ride so slowly you barley enjoy it. You want to make sure everything is physically healed before you crank up the system to twice normal pressure.

I would suggest returning to a treadmill, elliptical trainer, or exercise bike if you have the option---do the first couple weeks in an controlled environment where you can stop frequently and not be a couple miles from home if you don't feel well. Also, an environment where you can monitor your stats easily.

I found that my body was amply ready to tell me every time I pushed, by making me feel really terrible. I was able to discard the heart monitor eventually, because I could accurately estimate my heart rate by how bad I felt. But I was stupid ... I pushed too hard too soon. Looking back I wonder if my body would have adapted to its new condition more swiftly if I had been a little gentler.

Cycling was a Big part of my recovery---mentally as well as physically.

Stent insertion is pretty much old hat now. it's been around for decades. No reason not to view it as any other surgery---let the wounds heal completely, keep exercising gently to keep the metabolism pumping, , and ease into you regular regimen with a close on on how you body is adapting.

If my wife doesn't kill me I expect to do another 25-30 years of cycling. No reason you wouldn't do the same.

Gresp15C

I read the article with interest when it came out. From what I gather, the study was specifically about the use of the stent for treating chest pain.

The article didn't cover the use of the stent to treat or prevent a heart attack. In my view, the magic of the stent is not so much that it provides a treatment for heart attack. They already had a treatment -- the bypass. But for a fair number of cases, the stent avoids the much more drastic and risky open heart surgery.

If it's ineffective for chest pain, that's useful medical knowledge. It's always good to avoid an ineffective treatment, though they might have to treat people with the placebo instead.

nmichell

The genetic lottery sucks. I knew a guy that was about 40, did Ironman triathlons, even qualified for Hawaii. Out on a bike ride and had a heart attack -- the good news being he survived. Doc said if he wasn't in such good shape to begin with he probably wouldn't have made it. And he's back doing triathlons, so there's that :-)

While modern medicine is great (and I'm on a statin), I'd like to pass along some advise from a speaker at a recent medical conference: Exercise is more effective than statins; Exercise is more effective than high blood pressure meds; Exercise is more effective than drugs for depression. The list is long. So keep on biking!

2metalhips

I agree that cycling and exercise is the best thing ever, but you cannot out train or out run or out drug a poor diet. You are what you eat. Hero athlete or not.

https://nutritionfacts.org/

brianmcg123

This has probably been one of the more interesting threads on BF that I can remember. Especially for me now that I’m approaching 50.

My father died of a heart attack when he was 58, and I was in junior high. It was pretty shocking to everyone at the time as he was an avid runner and tennis player.

You simply can’t run or bike yourself to health. I’ve read some articles recently stating the difference between health and being fit. And just because you can ride a century in 5 hours doesn’t necessarily mean your healthy.

I would suggest some readings by Mark Sisson as he goes into great detail about this.

Gresp15C

I asked my doctor: Since I belong to none of the risk groups, why did this happen?

He told me: Every patient wants to know the same thing: Why me? The answer is simply that you're old and male, look up the statistics.

JohnDThompson 

Lack of risk factors does not mean no risk, only lower risk.

Gresp15C

That's right. Also, from what I understand, only about half of the total risk can be attributed to known risk factors at this point. There may be risk factors that we don't know about, or there may be a baseline risk that's simply a consequence of being old and male.

nmichell

This! Doctors talk about hazard ratio -- the risk of an event (ie heart attack) compared to a control group. Exercise lowers the hazard ratio, so do statins. But the ratio never goes to zero! Maybe someday we'll have this all figured out, but not today.

Classtime 

So, I guess that some folks will choose not to lower the risk if it requires a change in behavior and rationalize it all by suggesting that since risk will never be zero, why bother.
Taking a pill reduces risk but requires no change in behavior.
Doctors recommend the pills because they are pretty certain that their patients will take the pill and
Most doctors are not about to accept the responsibility (baby-sitting) of monitoring their patients diet or exercise. Pills are easy for the doctor and the patient. I don't want to deal with the pill's side-effects.

AND, with what we are learning about doctors' lack of understanding wrt the dangers associated with prescribing opioids, I would be careful about taking anything prescribed by a doctor as part of a new "lifestyle".

Bustergut

Get well soon anyway, my dad had a massive heart attack at 48, wasn't really down to bad health just stressed out most of the time because of work. I've always said if you're stressed because of work you're in the wrong job. Touch wood even though I have poor circulation my veins/arteries are clear.

jlstrat

I started cardiac rehab yesterday. They have me scheduled out into February. Wonder what experiences others had with that. Eager to ride again.

Maelochs

I'd say get a heart monitor and a blood pressure cuff and take control of your own rehab.

"Riding a bike" is not any more or less risky than walking around the block, assuming you can control your speed. I realized that I might hurt myself but also realized that I was willing to take responsibility for the my health and the risks to it, and I just made very sure to listen to my body.

It was about three weeks before I was ready for physical exercise and I didn't do much for another couple weeks, and I started doing stuff that is easier to control ... exercise bike and elliptical ... because I knew being out on the bike I was more likely to get over-enthusiastic, and because both the exercise bike and the elliptical had heart rate monitors prominently displayed on the machines themselves.

What worked for me might kill you and vice versa ... Step one is realizing it is serious and that you seriously need to exercise and also seriously need to limit your exertion... IMO.

pdlamb

I started with Physical Terrorists three weeks before cardiac rehab. I thought it was a waste of time, but my wife tells me it did wonders for my balance. (I only fell once, and that was pure stupid tripping over my own two feet. OK, maybe she was right.)


I stayed with the rehab program for a couple more weeks before getting on the bike. The rehab gals started me out pretty slow, and only when I felt like I was starting to get a workout did I ask if I could ride my bike outside the lab. They told me it was OK at that point, as long as I stayed in my target zone. Keeping my pulse down was a bit difficult -- show me a bike and my pulse starts racing and I start sweating! Seriously, my HR was 20 beats (or more!) higher on a real bike than it was for what felt like a similar exertion on the stationary recumbent. I found a quiet, dead-end street and did laps there for a while. (Saw lots of cops parked off that road, chatting and eating doughnuts that I couldn't eat, dang it!)


After some three weeks of that I checked in with my cardiologist (the cycling one), and he told me I was good to go as long as I stayed in Z2. That gave me a bit more breathing room for slightly more serious rides. I spent more time riding in granny gear and middle ring than the previous year about the same time, despite riding only a quarter as much time total.


Overall, with three days a week rehab, I was limited to 2-3 days a week riding while ramping up my work hours. Finally, when rehab was over, I could bike commute every day. I only had endurance to ride one way every day for 2-3 weeks. And I had to work my way up for longer distances; I actually got out a spreadsheet and plotted out a 10%/week increase in long rides for three months, and ended up riding pretty close to that until I finished a metric in September.


Just for extra emphasis, this. Listen to the lovely ladies in rehab, unless or until your doctor overrides them.

qcpmsame 

Congrats on moving forward, do what they tell you, and make decisions on what YOU feel is best for YOU personally. I won't ever cut a PT or OT schedule off again, FWIW.

Bill

jlstrat

I got the go ahead for 20 minutes on the bike on the days I don't have rehab. Out today for a short one, no hills. Let's see how it goes.