After my open-heart surgery to replace my aortic valve and ascending aorta on 11/19/2024 I had a pleural effusion which kept me in the hospital for 9 days and lasted for weeks after I returned home. I was extremely weak. The weakness was more troubling to me than the pain which was pretty well-controlled with opioids.
My cardiologist gave me an order not to exercise until after I had cardiac rehab. The cardiac rehab in my area is backed up for months and never called me back.
I wore a cardiac monitor for 2 weeks that showed normal function. Based on this and my prior experience of post-operative physical conditioning I designed my own cardiac rehab program. I had a stress test a month ago that showed normal function for a woman my age.
My follow-up visit with the cardiologist scheduled for 4/29/25 was canceled yesterday because he will be out of town. They offered a meeting with a nurse practitioner but I declined because I don’t see the point of driving 5 hours to spend 15 minutes telling a nurse I feel OK. I rescheduled for 9/11/25.
Google records a massive amount of data from my Fitbit. It took quite a bit of effort to put these into charts which I mailed to my cardiologist.
Chart 1 shows my steps per minute with the slower walks overlaid on the Zumba classes.
Chart 2 shows heart rate over 24 hours. The Zumba class at 10 AM shows 120-130 beats per minute while the walk at 3 PM shows 100-110 bpm. I generally walk over 5,000 steps per day.
It has been 5 months since my surgery. I am doing 3 Zumba and 2 strength classes per week. I’m feeling more like myself again although my muscle strength still hasn’t recovered completely.
Of my several major surgeries this was by far the worst. I honestly don’t see how an elderly person in sub-optimal physical condition can survive it.
Bottom line: if you need a heart valve replacement get TAVR…unless you also need to replace an aneurysm.
Dietary question, are you getting enough protein? Have been reading articles over the past couple years that was we age we need MORE protein, not less. Around 1-2 grams/kg as opposed to the 0.5-1 for those less than 50. My wife makes herself a protein smoothie to help with intake I tend to graze on almonds.
Weight lifting, might as well consider yourself starting from scratch due to the long layoff. Remember, any progress is better than no progress.
Due to the long (ish) layoff…especially at your age (sorry to bring it up…not sorry!) It’s a sad reality that a good many folk don’t experience because they spend their adult lives in a state of minimal conditioning (so, I guess Sedentarianism does have a redeeming feature) but for the reasonably fit individual, there’s a noticeable decline in conditioning as the late 60s are approached. To the extent that, if a period of enforced idleness happens…injury, surgery etc…the near-precipitous decline can feel like toppling over the edge of a cliff. After such major surgery there’s the added handicap of now having a different body to work with.
After about 9 months of trying to rehab myself…knowing plenty from knowledge, skill , and experience…I bit the bullter and started working with a personal trainer. First once a week and, since the New Year, twice a week with a third day of prescriptive training on my own. A total game changer. Even my feet are thanking me …and, as a consequence, my aerobic conditioning apparatus (cardio vascular/cardio respiratory/musculoskeletal etc) as I have now gotten a return to the stamina that allows for extended Z2/MAF/ASCVD mitigation training. Last September I had all but given up on that.
Of note is that, from the get go, my trainer…whilst accepting that I knrw well enough how to eat…emphasized accountability with my protein intake. Not only do the Chronologically Enriched absorb less dietary protein than the whippersnappers, but there’s a phenom known as Anabolic Resistance whereby there’s less muscle building goes on in response to the normal stimulus of available amino acid availability + resistance training. I too have resorted to protein smoothies to get a top up to my previously almost adequate levels.
I eat protein at breakfast (yogurt), lunch (homemade chicken & quinoa) and dinner (beef, fish, chicken, etc). I also add 2 tablespoons of collagen to build skin, tendons, etc. I add taurine (which is a sulfur-containing amino acid), fish oil and Co Q-10. In addition to the usual multivitamin plus 5,000 I.U. per day of Vitamin D.
Before my surgery I could stand on my hands but I wouldn’t try that now.
@VeeEnn what is your routine with your personal trainer? I do a weight class twice a week which is pretty demanding. But I use 5 lb weights due to injuries with heavier weights.
Wendy
Well, like I said I was really hamstrung last year because of the layoff after my second lapiplasty at the start of Jan. Bedbound for 2 full weeks but for bodily functions…and I didn’t need telling twice. Whenever my foot wasn’t hiked up “toes higher than nose” the throbbing was enough to just about crease me. Then another 6 weeks non weight bearing and so on from there. So much muscle mass lost…particicularly fast twitch fibers…that just bodyweight exercises were a challenge. Fast forward to working with my trainer and first thing she did was get me using machines to establish movement patterns that I just couldn’t find with free weight. Such a simple notion that hadn’t occured to me. Hack squat machine…and leg press if those were occupied. Squats using a safety bar. RDLs using cables/dumbbels/barbell. Single legs RDLs with the Smith machine. Presses with free weights. Assisted pull ups/lat pull downs. All standard stuff really but having eagle eyes on you to offer form corrections …however small…has more than compensated for the loss of power and the change in proprioception (I have totally numb areas in both feet alongside heightened sensitivity…really strange)
Tuesday we focus mainly on lower body, Friday it’s full body. Wednesday, when I pick the granddaughter up from school and she has a pickleball class, I do the upper body routine the trainer sets for me during her class time.
I taught 2 group strength/BodyPump classes a week before we m9ved to Colorado…plus the sessions I did to put the classes together. I absolutely wouldn’t have been able to do these routines on my own last year…even using stale bagels instead of weight plates!!! Srsly!
Plus a full scoop of NOW unflavoured whey isolate protein powder…which has a few more grams of protein (no photo as I emptied the tub yesterday and have yet to go shopping). I’ll look for a link. I add a generous scoop of either Greek yogurt or Skyr. Here’s my current (Strewth/parakalo)
Add a handful of berries and water to chosen consistency. I guesstimate no fewer than about 40-45 gms protein and no more than 350 or so calories (if that’s important) Modest fat content too (if that’s important)
This focus is fairly recent and I’ve found a tremendous difference in the protein content of “Greek yogurts” that I was previously unaware of.
@VeeEnn whey protein is poor in the stiff, cyclic amino acid, proline, which comprises 25% of collagen. My grandmother advised me to eat gelatin (collagen) about 50 years ago for strong fingernails. I eat hydrolyzed collagen because it dissolves more easily.
As we age, the metabolic process that cyclizes glutamate (a common amino acid) into proline (a rare amino acid which is mostly found in tough, elastic body parts such as tendons, bones (40% of bone mass is collagen), skin, nails and hair.
Well, yes…there really isn’t a single one of these supplemental protein sources that has everything in ideal quantities…whey, casein or collagen etc. Using a protein smoothie after my early am home workout session is really in lieu of my former fave breakfast of whole grain muesli breakfast …with I’d wager single digit protein content. Whey is particularly useful in this context for its fairly rapid absorption.
It’s a good point to make, though, when considering just how much of a replacement these supplements might make to a regular diet.
So I got a bit sidetracked from the original thought I had WRT Wendy’s initial post and the comment on choice in aortic valve replacement…TAVR vs open heart surgery. Definitely a no brainer if there’s any choice in the matter. That’s a big IF of course, since there’s a lot of nuance to decision making here that’s not so easy to fathom.
So, my original thought was more along the lines of just how one goes about providing oneself with the best chance of having any degree of choice in such matters. Healthy Lifestyles etc are the trendy recommendations but beyond that, what to do as individuals when it comes to the advice we receive when making elective decisions in combo with healthcare providers. My husband’s surgery was just the opposite of elective and his bio valve replacement was for an otherwise healthy aortic valve that was being stretched to the point of incompetence by a rapidly expanding ascending aorta. However, both Wendy and I were effectively robbed of too much say in our cardiac care by what would be deemed supervised neglect if, say, a dentist had failed to use available tools and tests to make appropriate diagnoses before irreversible disease had become evident.
Things appear to be working out well for both of us but I can’t help but wonder still (for myself, at least) how much more time I actually had before the detritus hit the fan had I not followed up on my own DIY discoveries on lipidology and such like…and at what point primary prevention strategies could have avoided the need for the attention I’m getting now.
Glad to here that you’re recovering. As we get older we don’t bounce back like we used to. I just wanted to give you a heads up on the cardio rehab. I just finished a cardio rehab program last December. There were a couple of things I got out of it. One, they have you wear a heart monitor and check your heart function while exercising. Secondly, they checked my blood pressure both before and after exercise. You just want to get your heart rate up to a specific range. It’s based on age, weight, height and sex. My range happens to be ~115-125 BPM. It looks like you are doing that. Keep up the good work, I know it’s hard.
I know her main protein source is whey protein. Tosses in whatever fruit of the day, usually strawberries and/or blueberries. Can’t remember if adds whole milk or heavy cream.
Our yogurts tend to be greek style yogurts. More protein per ounce.
Ooh…another thought. There’s someone who can speak pretty authoritatively on strength training and, more recently, on this topic, I believe…@dlbuffy.
He was one of the Heavy Lifters, so to speak, on the old Weight Training Fools board back in the day and I recall back when I designated 2012 The Year of the Athlete in my gym classes…because it was jointly the year of the London Olympics and my 60th birthday in the September…he offered quite a few good tips on the two challenges I set for myself (and rashly announced to my classes). Namely deadlifting at least my bodyweight (around 125/128lbs at the time) plus 10 clean, unassisted pull ups.
If you’re keen Greek yogurt eaters, have you ever tried this..
I stumbled across it in our local Natural Grocers. I haven’t seen a higher protein content in any other iteration of a dairy product. I doubt I put quite enough in my smoothie or as stand alone eats to get the full amount that’s boasted there (you’re looking at 170 gm serving size, I believe) but it beats some I’ve seen in the stores.
I didn’t start from a base of zero lifting experience but in working with a couple of the trainers at one of the gyms I taught at (two lads with a powerlifting background) I had to start with minor form corrections. I think I ended up pulling **170/175lbs. The lads both reckoned I could’ve done “better” if I ate more/more protein and cut down on their idea of “too much cardio” …which is what these bro types always say.
The pull ups weren’t so impressive…but I did develop some nice back cleavage in the process, so that was more than enough for me.
You can see why I was so bummed about what I lost with my surgeries and couldn’t seem to recover. I’m now up to 95lb on the deads, so I feel a bit better. I’m 99.9999% certain I couldn’t have managed this on my own…and I’m almost equally certain I won’t manage much more.
P.S …that weight was something I worked up to. I didn’t try to maintain that as the focus and effort was more than I cared for. Strength training for me is a utilitarian endevour. A means to an end that’s as much fun as brushing and flossing.
@VeeEnn same here. I began lifting at age 20 but I was never strong. I lift for greater stamina and as an antidote to depression.
As I age, I have injured myself doing exercises I have done without trouble 1,000 times before. My latest is my left knee. So my caution to you is…be careful. It’s good that you have a personal trainer to correct your form but beware of heavy weights since your tendons may simply give out without warning.
Wow, this is incredible! If I could find it around here, I would use it. For now, my usual choice of greek yogurt is Cabot with 14g of protein in the 170g serving. But 21g would be better! And I also like that it has fewer carbohydrates.
