Skiing Post Triple Heart Bypass

A snowHead

Hi folks,

Managed to properly muck up my heart, was on the BB skied first to last and had a chest infection this moved to pneumonia, pericarditis and now heart failure.
The infection has weakened my heart and when they did an angiogram they now think bypass surgery will provide the best long term outcome.
Anyone had any experience of getting back to high level piste and off piste skiing after this type of surgery?

Age 49
12 stone, 7lb
Cholesterol 3.2
BP 120/80 on avg
But long term type 2 diabetes control hasn’t been great so will need to go on insulin full time.

Any tips would be appreciated

Alan

A snowHead

@snowscot, I'm afraid I have no useful advice, just wanted to say how sorry I was to read all this. Unlucky and truly horrid, especially at your young age. Crying or Very sad

I'm guessing now that the bypass procedure will not be a problem as such, lots of people ski after multiple bypasses; your outcome will rather depend on how much of the current situation that procedure manages to rectify.

Well, the person's real but it's just a made up name, see?

Hi Alan. I don't know how much use this will be to you, but I've just turned 53 and had a heart attack late last year. They put a stent straight in, so definitely nothing as serious as your bypass.

Since then, I've felt a 100 times better. I think my arteries had been clogging for about 4 years, so now things are flowing much more freely with the addition of Cholestoral tables and blood thinners, I know I'll have a much easier time on the mountains when I go in March than I've had for the fast few years.

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@snowscot, I've been through all the type 2 diabetes drugs with a variety of side effects until my Diabetic specialist suggested Ozempic (semaglutide) which had just been authorised for NHS.

Since then my diabetes has been under good but not perfect control apart from a period last year when Ozempic wasn't available due to shortages. After about 8 weeks off the Ozempic it had cleared from my system and my blood Sugars went crazy, completely out of control no matter what drugs I took or how little food I ate. I virtually starved myself in order to cut down calorie intake, losing 20lbs in three weeks. Eventually my local pharmacist was able to secure a supply of Ozempic which I have now been back on for a few months and my sugar levels are now back at an acceptable level.

Ironically Ozempic is touted as a miracle slimming drug with which I haven't lost any weight, only losing weight when I came off the drug.

My point is push your local health care for specialist diabetic treatment which should delay any move on to insulin.

Anyway, snowHeads is much more fun if you do.

@snowscot, that sounds miserable. My OH skied with long term type 1 diabetes after a triple by pass but his cardio vascular capacity was impaired and he wasn't "high level". Maybe it depends how serious your heart failure is (I have heart failure and as I understand it, that will get worse but hopefully slowly, with the right drugs to help).

Grab any opportunity you get for cardiac rehab.

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Hi Alan, sorry to hear about your situation. A bit of background, I was a fit and active 50 year old, cycling most days. One lovely sunny day back in 2013 I set out on what was to be a 100 mile ride on a new bike and wearing my bib shorts. About 20 miles in I started to feel discomfort between my shoulder blades and a gripping sensation in my throat and jaw, took on some water and put it down to new bike and pressure from the bibs on my shoulders. Did another few miles and decided to shorten the ride, had to get off and sit a few times. Eventually came to a hill and just couldn't get up it. Rolled back into a village and a kindly delivery driver gave me and bike a lift home. By this time I was sweating profusely and could hardly speak.
Changed out of the bibs as I didn't want them cut off then collapsed on the floor while phoning my wife, all I managed to say was "heart".
The ambulance and my wife arrived and hooked me up to the monitor and I responded by having a full blown heart attack. While being stented, as my LAD was 95% blocked, the surgeon mentioned to the trainee that I needed a triple bypass.
At this point the damage had already been done to my heart, the triple being required as I was presenting with chronic heart disease with furred up arteries.
Six weeks later I had the triple using arteries from my forearm, chest and a vein from my leg. Left hospital ten days later and back on my bike two weeks after that. I cycled 25 miles just a month post op and very soon was upto 50 mile rides, and skied 6 months later. Managed to get a big fall out the way off piste, survived it with no problems and went on to ski with renewed energy and confidence.
This is where we may differ, my problems were caused by furred up arteries, I'm not sure about you from your account. All though I was told that I was "fixed" I went on to present with unstable angina, resulting in me having multiple emergency admissions, stents and ballooning, the most recent being 2022. I have continued to ski at a high level although a recent leg realignment [distal femoral osteotomy] has slowed me down a bit. Just had the plate out, so should be back to normal next season.
Just for your info I am 6ft and 13 stone, I was going to be prescribed Ozempic to reduce visceral fat but don't qualify now under current NHS guidelines, I do have a fortnightly Praluent injection along with 80mgs of daily statins which has levelled my cholesterol. I no longer have angina and only a few other meds.
If you want to message me feel free, happy to talk through my experience and how I may help.

Kind regards
Nigel

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Nigel, I would love to pick your brains on your recovery regime, particularly the post surgery drugs as I also cycle but on MTB and initially consultant is saying no to both skiing and MTB due to potential anti coagulants. I will know on Wednesday the exact surgery and when. If you could pm me your mobile and I’ll WhatsApp you later on in the week if that’s ok.

After all it is free

I think people are unnecessarily scared of anti-coagulants. For me, with heart failure and a very impaired left ventricular function a stroke is the thing I'm most scared of. Not scared of a massive stroke, but don't want a small or medium sized one, thanks. I take my anti-coagulants with enthusiastic zeal.

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Hi Snowscot,
So sorry to hear this.
You're not overweight or anything that you should not be doing.
I hope you get this under control and recover.
You have my sympathy.

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@snowscot, @hardbag who was at the BB had a recent double cabbage and we did 600 vertical meters on the first Saturday without too much trouble (for him snowHead

)

Very best wishes to you for a successful outcome

You know it makes sense.

Thanks Shagger!

Otherwise you'll just go on seeing the one name:

@snowscot, I'm still coughing away not had time to see a quack yet. I think it's starting to improve. I know i should have done something about by now. Hope you make a good recovery.

A snowHead

@snowscot, Sorry to hear that. As @Ski Shagger, mentioned I had a double CABG back in 2019 at the age of 49. Started getting angina pain when exercising which tipped me off something was up. Post operation my surgeon announced that I was essentially completely fixed fortunately, and doing 600 vert up the Marmolada with @Ski Shagger, is a pretty good testament to that.

I know quite a few NHS consultants and they all say the heart & vascular system is probably the most researched and well understood part of the anatomy, so these operations often have very successful outcomes. Of course ever case is different depending on age, fitness, even ethnicity, and any other underlying conditions, but so many studies have been conducted for these factors (I believe you have to complete one to even qualify for being a Cardiothoracic surgeon).

I’ll send you my number. Very happy to chat about it if you want.

Cheers

Andrew

A snowHead

As I understand it, coronary artery disease is not cured for ever by stents or by pass surgery. The reasons the arteries furred up in the first place can continue to cause problems. My OH started going downhill again 10 years after his bypass, and a further stent gave him a few more good years. Diabetes tends to contribute to CAD, and my father in law had had a bad heart and a big heart attack in his 40s. You can't do anything about the genetics, but obviously good control of blood sugars, cholesterol and blood pressure, etc will help a lot. And we are lucky to have such good drugs available to us, too.

Well, the person's real but it's just a made up name, see?

In my case, my Cholesterol levels had mysteriously shot up over several years undetected (gene defect??) even though I was regularly exercising and not excessively over weight at all (though a few kg above what I would consider ideal). Over time this furred up my arteries. Post surgery I'm on Statins, Asprin (to thin the blood) and a beta-blocker to regulate heart rhythm. My Cholesterol levels are as about as low as they can be, to the extent that I've recently been discharged from my Lipid clinic, who have been checking my bloods since 2019. So the surgery (hopefully) will have prevented the likely inevitable heart attack/stoke. The drug regime is preventing anything else from deteriorating my cardiovascular system. Most importantly though...lifestyle. A healthier diet, less alcohol and more exercise (it's got to be lots of cardio for heart unsurprisingly) has made a tremendous impact on getting my bad cholesterol levels down. The Statins alone won't quite do it! (and watch that blood pressure)

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I had a long telephone conversation with my local cardiac unit. When I raised the topic of stopping the pills as soon as possible, she went into some detail about why that would be a bad idea.

As you say Hardbag, they're primarily there to suspend the furring of the arteries by reducing cholesterol levels. As explained, they don't remove any of the furring but will stop any more from taking place.

Unfortunately my local cardiac support (in Colchester) isn't great. I've had to chase every step of the way just to get simple things like blood tests. Sounds like you're in a much better part of the country.

Anyway, snowHeads is much more fun if you do.

It does vary round the country - and self-help is the order of the day, very often. We need to be "informed patients" but that doesn't mean people just deciding not to bother taking their pills, which is not a good move. Some statins create problems for some people - but if that happens, there are others that can be tried. The action of some of the heart drugs (like the Sacubitrol/Valsartan which I'm on, maximum dose having been titrated so gradually because my blood pressure was low) are too complex for the likes of me to understand! Taking a package of medications for ever is probably better than being dead. But if the time comes when it isn't...... (and that time can come) then it's time to think of Plan B. Skullie

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@ratkinsonuk, Ah, nothing could be further from the truth! It's a very long story! Short version is local hospital cardio unit at Kingston were useless, even after diagnosing my condition as severe. They thought they could get away with treating it medically (statins etc). Needless to say I was very dissatisfied with that approach and their general attitude to my condition. Eventually had an exercise stress test with an ECG (which kind of felt like a fob off from them). The nurses studying ECG looked most alarmed at the readings but was able to finish the test. Heard nothing back after that which wasn't a surprise to me at that point. Some time later saw my GP about an unrelated issue and she spotted in my notes that the exercise test hadn't been followed up on so she said she look into it. A week later I get a very apologetic phone call from St.Thomas' Hospital cardio unit (not local to me at all). The chap said I'd basically fallen through the cracks in the system! Saw a surgeon there and he laid it out...if you don't have a heart bypass you're life expectancy isn't going to be very good at all! Eventually had the op. and recovered incredibly quickly and was gently jogging after a couple of weeks. All good now....but it took a long while to sort out. Once it was escalated to St.Thomas' I felt that I was being properly looked after.

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Yeh, definitely a very similar story to mine. During the cardiac phone consult, she offered me a course of 1-hour physical rehab sessions. As my general health is pretty good (I regularly walk 4 miles with the dog), I said I'd let her know. Next thing I get a message saying I'd been booked onto the course. After phoning them to say that I was still considering my options, I received a letter saying if I didn't attend the course in the next 2 weeks I'd be discharged from the cardiac unit completely.

OK, clearly we need to work within the system to allow them to do their job properly, but it did feel like they were using the opportunity to get me off their books as soon as possible. I'm going to wait until I get back from skiing in mid-March (just to bring it back on-topic Very Happy

) and then ask for a new set of bloods to check my cholesterol. I don't think they'll ever be anything but elevated, but I'm trying to work at it with them.

After all it is free

@Pasigal, why the limitation on altitude? Something specific to you?

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I'm not saying he's a role model - and he has a history of ignoring medical advice (e.g. when he cut the tips off his own frostebite damaged fingers) but Ranulph Fiennes has done quite a bit since his double bypass...

https://en.wikipedia.org/wiki/Ranulph_Fiennes

Help!!

Skiing Post Triple Heart Bypass

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