Since November last year I have had to basically sit on my backside and do nothing, couldn't pump sufficient oxygenated blood to fuel the muscles.
In March had a stent implant. Didn't make any difference. Followed in August with a pacemaker implanted. That provides some encouragement. This week I might get a final prognosis, and with luck I am clear to do things.
Hence my question, is anyone out there tramping with a pacemaker. How is it placed where your pack straps are concerned. Do the pack straps pose a problem, if so what did you do to alleviate it. Did it give you any other problems of any sort.
Ant problems experienced with altitude?
Bought a new Aarn pack (effortless rhythm) last December, it has sat in the cupboard since, but the pack straps on it don't seem to be a problem, of course wont really know until I try it for real.
They definitely wont approve me going skydiving and that really bugs me.
Body boarding also poses some problems, mostly in the arm movements and where the wiring is placed.
Curious to hear, or of similar challenges.
Any suggestions on overcoming the challenges are welcome.
ease back into it? then you'll get an idea of how it might or might not be impacted by tramping? just stand with a weighted pack on to start, walk around the room, then around the house, then a bit further at a time watching out for issues.
Thank you waynowski, sound advice for someone who has never eased themselves into anything.
I read a study on stents vs exercise. People were divided into 2 arms for the study. One arm was given stent(s) and the other was prescribed exercise. The exercise group did better than the stented group so take heart...my bro has now occluded stents but has developed collateral circulation through exercise.
the below comment reinforces the gradual approach to recovery from someone who's been there
http://bushwalk.com/forum/viewtopic.php?f=5&t=21904&p=286384#p286379
"I'm not fitted with a pacemaker but I did have a major heart attack about 5 years ago that I survived by the skin of my teeth.
Recovery after a few stents were fitted involved a slow steady process of increasing activity and fitness under the guidance of a great rehab crew and weight loss (about 30kg) through a much better diet.
My real point is that it was step by step, keeping very aware of how I was feeling physically, watching my heart rate with a heart rate monitor and from time to time checking my SpO2% with a pulse oximeter.
I suggest the best way for your friend to find out would be to take a step by step approach. Try some less arduous walks, with less weight, in areas where he is not too far from emergency help and take it from there.
Diving in head first..........maybe not a good idea.
I always carry a mobile phone and a PLB just in case."
@Honora, Thank you for the comment. Interesting to note what the exercise has done for your bro.
@waynowski, thank for the enquiry you put out. At 6' 4" and 100 kg I probably am not classified as having a significant weight problem. The initial problem was the onset of severe breathlessness Nov last year. Thought a 55 year pack a day habit was the cause. Gave it away in 2013. But tests (many) showed all was clear, with only a 5% decrease in lung function. Cardiologist found blocked artery, stent implanted. The breathlessness problem became permanent instead of just a day or two here and there. Heart monitor over 48 hours showed HR @ 25 per minute whilst sleeping with stoppages up to 4 seconds. Pacemaker implanted, that problem now resolved. Still occasional bouts of breathlessness seems that heart at times does not rise high enough for the activity taking place. Meeting with cardiologist tomorrow.
Since pacemaker was fitted have been walking neighbours dog each night for around an hour. It is Staffordshire Mastiff cross, a 45 kg ball of muscle, and a bit of a handful. Not only does the walk benefit the leg muscles but trying to hang on to the animal gives the upper body a good workout also. Fitness level has improved significantly.
I know I wont get clearance to skydive, but maybe to do a little more through tramping and surfing would be good. Find out more tomorrow with luck.
@Honora: Can you explain a bit further your remark that your brother has "developed collateral circulation through exercise"?
This concept of coronary collateral circulation was completely new to me when I saw it referred to in your post, so I Googled for more info.
I found many articles about collateral circulation, and its relation to prescribed exercise regimes, but unfortunately they all seemed to be very academic medical papers, replete with jargon, that are a bit hard to get to grips with.
The gist of these articles seems to be that some people have redundant small blood vessels in the heart muscles that can, under some stress conditions, develop to form parallel arterial pathways to feed the heart muscles, which would otherwise be starved of blood (and oxygen) during heart attacks due to complete blockages (myocardial infarction) or lesser events, such as angina from severe narrowing of the main arteries. Thus, collateral circulation, if it is present to sufficient degree, can somewhat lessen the damage to the heart caused by these events.
Honora, can you please explain your brothers experience in a bit more detail. Has he had scans that show increasing collateral circulation after weeks or months of systematic exercise, and what sort of exercise has he found most beneficial?
I am interested in this as I have some minor heart problems (occasional AF and angina) and a blood pressure problem (currently managed by Metoprolol), which may become major problems if I just carry on regardless.
the more physically active you are the better your circulatory system develops. your body expands the blood vessel network crating more capilaries and larger arteries, blood vessels arent just static, they arent determined by genetics alone, they are determined in the end more by activity, thats part of the reason someone who has been exercising extensively for years finds exercise a lot easier than someone who hasnt, their blood vessel network is far more extensively developed. more bood can be transported all around the body delivering nutrients and removing waste products. its like a city with an extensive effective transport network versus one with a poor network...
its one of the reasons why people with heart problems are generally encouraged to exercise because it keeps developing the blood vessels and help them overcome blockages...
Is it a pacemaker or ICD you have (these are often confused). Either way, I'd strongly encourage you talk to your cardiologist/GP about getting back in to it. The pack etc. shouldn't impact the device as it the wires should now be imbedded in your heart securely. The type of tramping you are wanting to do is going to impact whether you can do it safely. As exercise duration increases, the risk of an adverse event increases (albeit slightly in the grand scheme). I'd start of with several easy 1-2 hour walks and get these under your bout before trying anything that involves big climbs. A heart rate monitor could be useful to ensure you aren't pushing yourself too hard.
On the topic of collateral circulation, this generally takes months of regular exercise to occur, not something that happens overnight. Aerobic exercise is best - there are a number of physiological mechanisms responsible, but over time you'll find you can work harder, before the angina comes on, or if you are lucky, may not come on at all.
@antico: Hi, my brother got back to me. The short story is that despite having a heart attack and 3 stents, his heart heart was functioning at a level 28% higher than expected for someone of his age (59) with no past history of heart issues. .
"I had my original heart attack in 2006 and the right coronary artery was reopened with three stents. Since then, I had what I thought were some episodes of angina until 2009, when I became unwell again with very slightly raised markers of some heart disturbance, but definitely not another heart attack, and was admitted again to have another angiogram. This showed that the original stents had been blocked completely and I was told by the cardiologist that my heart had developed some good collaterals to the right coronary artery.
About a year earlier, I had an episode of sudden breathlessness, as if I could not get enough oxygen, so I went to after hours clinic where I had an ecg which showed normal heart function. In hindsight, I wonder whether this was when the right artery finally blocked completely? If the artery had been gradually blocking, the collaterals were probably developing at a similar rate to the gradual blocking, enabling a similar level of blood to be pumped. I understand that when the artery finally blocks, that these vessels or small arteries can expand rapidly in the first few hours after this happens. Bit of speculation on my part here, as no doctor can actually advise me when and how the collaterals actually expanded. I have had chest xrays in the past and have been told that my lungs are longer than normal (as the xray cuts off the bottom of them), and my lung capacity is higher than average. In 2011, I had an echocardiogram- nothing prompted this, I think I was part of a medical study at the time as I enrol in anything going. This showed that my left ventricle was normal sized with normal systolic function and no evidence of any narrowing.
I have a stress test (Bruce Protocol) annually followed immediately by discussion with and examination by a cardiologist (Tim Hull)- as much for reassurance as anything else. My last visit in May showed that my heart was functioning at a level 28% higher than expected for someone of my age (59) with no past history of heart issues. The cardiologist says that the collaterals will continue to develop through exercise and natural growth. Despite having no history of high blood pressure, I am on two blood pressure drugs- Metoprolol 95mg and Candesartan 8 mg once daily and a statin once a day 80 mg. When they were prescribed in 2006, I asked the cardiologist why I had to take the blood pressure drugs when my blood pressure was fine, and he said “because you have had a heart attack”. My current cardiologist also prescribes a high dose of nicotinic acid (1500 mg twice daily) which I understand artificially raises your “good” cholesterol. My resting heart rate is about 60 and my cholesterol is quite low, no doubt both due to the medication. My only side effect is from the statin with some muscle soreness in the morning which wears off pretty quickly. I was taking coenzyme Q10 as a daily supplement but stopped taking it a few years ago. I am reasonably fit for my age, and can walk up Rapaki Track from the road end to Summit Road in under 40 minutes without stopping and I bike to work sometimes- about 9 kms return. On Rapaki Track I often pass much younger people and can keep up with some mountain bikers when they are on the steep bits. I never get any angina and I have long concluded that any chest discomfort I get is more a panic attack which usually lasts less than 30 seconds until I tell it to go away- more psychological than physical I think. This might happen two or three times a year. The panic attacks used to be more frequent up until 2009 and go on longer, because I always thought I was having another heart attack.
I’ve been a wary of doing any overnight trips, but a couple of years ago I went up Avalanche Peak (Scotts Track) on a day trip pretty quickly with Honora, Frank and an older brother".
