Heart Problems – It’s Not Only For Couch Potatoes

imageI have always been fit whether through running, cycling, mountaineering, skiing, kayaking whatever and for years I was under the impression that my life style made me immune from any possibility of heart problems. After all I was regularly Mountainbiking at a high level and holding my own with youngsters half my age. Our usual testing ground, Innerleithen a well known centre in the Scottish Borders, begins with an unrelenting hour long climb, for many a lot longer, to high on the Minch Moor before the downhill fun starts. This climb is unavoidable and for years I had relished it because my light build and cardiovascular system were suited to that kind of effort. However, for some months I had been enjoying it less and less, often trying to get a head start on the climb so I could take things easier. At 59 years of age the obvious answer was I was getting older and, disappointing as it was, I should expect this drop off in performanceOn 3rd April this year I started up the climb having managed to sneak away while the rest of the
group were still in the carpark and pretty soon I felt things even harder than was becoming usual, so much so that I stopped and sat down at the side of the track. My hands and forearms had started to feel a bit numb and my breathing had become laboured but by the time the others caught up I was recovered enough to continue. I did note how surprised they were to see that I had stopped to sit down. I was soon forced to have another stop which I attempted to disguise as a requirement to remove a rain jacket as I was too warm but by this time my pals were beginning to suggest that I call it a day.To cut along story short I stubbornly persisted in going to the top and continued for another 2 hours doing the normal descents. However in response to the concerns of the rest of the group, I agreed to visit my Doctor the following day.I made an appointment and was delighted to be seen by someone who has been involved in hill running for many years and who might be more open to the idea of someone of my age performing at these levels. I was expecting to be told that I might have to get used to reduced performance as I aged and was surprised when the Dr told me she could detect a heart murmmer. This resulted in a same day admission to the Chest Pain Clinic at the Edinburgh Royal Infirmary quickly followed by the news that I was suffering from Aortic Stenosis and would require Open Heart Surgery to replace the much narrowed valve. I was also informed I may well require a bypass graft.

Stunned I think is the only way to describe how I felt and then sorry for myself and then angry, a whole gamut of emotions as I begun the journey of coming to terms with my new reality.

Being driven home that day immediately following diagnosis, I had been told to stop driving until after the op, my hands were full of information leaflets and my head was full of negatives. The first thing I did on returning home was hit Google, my main focus being not,Am I going to survive this? but How does it affect cardiovascular performance in sports people.Googling occupied me constantly over the next few days I was reading all I could find, desparately looking for positives.Modern technology had,much to my wife’s horror,allowed me to view the whole operation in all it’s intricacies,in full technicolor on You Tube! As my knowledge expanded I focused in on one specific area,that of the Pros and Cons of the ‘Mechanical Valve’ versus a ‘Tissue Valveimage‘ The main difference between the two apart from the former being made of titanium and carbon (very attractive option to a cyclist!) the latter from porcine tissue, was the longevity issue. Mechanical lasting a lifetime while the tissue option would mean me facing a second replacement in my lifetime. A ‘No Brainer’you might think but then we come to the major draw back of the mechanical valve, the fact that it would require that I take anti-coagulent medication for the rest of my life.

The next stage of the proceedings was an appointment for an Angiogram. This was a relatively painless procedure involving a tube being inserted into my wrist and a dye injected which would show on screen any problems with the arteries serving the heart. It was at this point where,from my point of view the game changed dramatically. I had just begun to come to terms with the valve being replaced using the analogy of a valve replacement in a car engine. Nothing inherently wrong with the engine – replace the worn part and off we go good as new But to be told I had a major blockage in one of my arteries blew this out of the water,introducing as it did,the label Chronic Heart Disease.
70kg,Fit,Competetive Mountainbiker,Runner,Good diet Non Smoker,Non Drinker,everything they tell you to do to avoid heart disease and then some. I was angry and phrases like ‘You’ve been given a second chance’ didn’t register only annoyed me.

An appointment with my surgeon Mr Walker answered most of my questions and he laid out the pros and cons of tissue versus mechanical valve and left the decision to me. Our discussion was mainly around the dangers of continuing with sports like Mountainbiking when on anti coagulent medication.He clearly couldn’t say to me it was Ok but made it clear that there were serious risks involved and that the question I had to answer was whether or not it was important enough to me to make these risks acceptable. it was. Interestingly he also said to me at this point that it may be that the dimension of the aperture left after removing the faulty valve may be small enough to preclude the use of the Mechanical option in which case he would fit the tissue valve.His final statement on this was a very matter of fact “I’ll make the final decision when I have your heart in my hand”!

Some 16 weeks after diagnosis, much angst and a lot of support from family and friends brought me to the operating table and thanks to the wonders of You Tube, I had a good idea of what to expect

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