Recovering From Open-Heart Surgery

One of my friends is in pretty impressive condition but when you know what he has gone through, the condition he is in is nothing less than awe-inspiring. Here is the story:

About seven years ago, I was diagnosed with severe mitral valve regurgitation. This means that my mitral valve, the most important of the four valves in the heart, was not closing properly and a significant amount of blood was flowing backwards into the left atrium. This, in turn, forced the heart to work harder and was causing it to enlarge. If left untreated, this would have eventually led to congestive heart failure and an early death. So, basically, I had only one choice: open-heart surgery.

Luckily, my cardiologist had trained at the Mayo Clinic, the finest hospital in the United States, and he referred me to the best heart surgeon at that hospital. While many surgeons treat leaky mitral valves by replacing them with artificial valves, my surgeon used a technique whereby he fixed my native valve by carefully trimming the excess tissue and inserting a ring around the valve to prevent it from enlarging. By repairing rather than replacing the valve, my surgeon saved me from a lifetime of taking blood thinners (which pose a definite risk of stroke and other complications).

I was 39 at the time of my surgery and I was in excellent physical condition, so I was not particularly worried about whether or not I could bear the surgery. And I had an insurance policy that would cover the surgery, which cost a total of US$63,000. Needless to say, as an American, this was no trifling concern.

When I woke from the surgery in the step-down unit, I was literally a different person. You cannot have your sternum sawed down the middle and your heart stopped for 20 minutes without it having some deep effect on your being, even if you have no conscious recollection of it. I was up on my feet 24 hours after the surgery and I remember shuffling to the bathroom in my room and looking at myself. I had a strip of tape down the middle of my chest. And I felt like I had been run over by a Mack truck. But, I was alive.

I stayed in the hospital for four days and then I was released to a nearby hotel. I remember stepping out of the door of the hospital for the first time. It was fall and the cold Minnesota wind seemed to blow right through me. I know right then that I was much, much weaker than I had been when I walked into the hospital.

But, when I got home, I started my rehabilitation right away. I went for walks in the woods, going a little further and a little faster each time. I also did breathing exercises with a device that the hospital had given me.

Then, exactly one month to the day after my surgery, I climbed a small 350-meter mountain near my house that I used to climb every day before my surgery. I climbed at a snail’s pace and I stopped frequently for rests, but I made it. For me, that marked a major step in my recovery. From that point on, I stopped thinking of myself as an invalid and started to think of myself as a normal person.

Slowly I stepped up my workouts, adding swimming and biking to my usual hiking routine. While I feel that I have lost about 10% of my former aerobic capacity, most likely due to deformation of the left ventricle that occurred prior to my surgery, I don’t feel any major deficits. And I take no medicine and require no special precautions in any activities.

Since my surgery, I have climbed 4095-meter Mt Kinabalu in Borneo, and I have crossed a 4700-meter pass in the Himalayas with a heavy pack. I felt no unusual strain and I feel like I could probably get up to 6000 meters given enough time to acclimatize.

In closing, my advice to anyone considering mitral valve surgery is this: Find the very best surgeon you can. Go for a repair rather than a replacement. And, whatever you do, don’t think for a moment that open-heart surgery means the end of your active sporting life. After open-heart surgery you can run marathons, climb mountains and live life to the fullest.

Staying Lean Into Your 40’s

The below article has been contributed by my friend and Thai-boxing training buddy CR.

I asked him to share his personal approach, training and dietary strategies to stay lean and strong. Enjoy the read!

Let me start by admitting that I have an easier time staying lean than most people: I’m an ectomorph and both my parents are lean. So even if I eat like a pig and don’t exercise, I don’t get fat – I just get a bit soft and round near my middle. However, I’ve recently become leaner than I’ve been since my teenage years – I’d even call myself cut – and I’m happy to report that it hasn’t been particularly difficult. Indeed, at the age of 46, I’d say I’m much leaner than most people in their teens or twenties.


The catalyst for this came when I moved to Bangkok from Japan about a year ago. Here in Bangkok, I live in an apartment with an excellent 25-meter pool and a good gym. Also, in hot climates I find that I have less of an appetite, so I naturally eat less. Now, I work out six days a week and skip lunch almost every day. This simple combination has yielded remarkable results. Indeed, when I recently returned home, old friends kept commenting that I had lost a lot of weight and asked if I was okay. More than okay, I feel great and have more energy than I’ve had in a long time.


The basics of my diet and exercise routine are simple. I start my day with a workout. On Monday, Wednesday and Friday mornings, I swim in the pool, usually about one kilometer. I’m a former competitive swimmer, so this is my natural and preferred workout. On Mondays, I usually swim two easy 500s, combining freestyle, breaststroke and backstroke. On Wednesdays, I swim about 1 kilometer of continuous individual medleys of butterfly, backstroke, breaststroke and freestyle. Needless to say, the butterfly is the killer here. On Fridays, I’ll usually swim a set of five 200s of freestyle, which is also a killer workout, both aerobically, and for the arm, chest and shoulder muscles. Despite having been a swimmer for most of my life, this set really leaves me panting, especially if I push it.


On Tuesday and Thursday mornings, I do a workout in the gym. I normally do about eight minutes on the treadmill, with a few incline sprints at speed, interspersed with a slower pace. Then, I’ll switch to the stationary bike for about five minutes of pedaling, again, alternating fast bursts and slower rest periods. Then, I’ll do about 50 sit-ups on the incline board, about 50 pushups, broken into five sets, and a variety of low-weight/high-rep exercises on the machines. I avoid weight training like the plague and don’t like machines much, but I do a bit of work on the machines in hopes of building strength for swimming. But basically my time in the gym is to work on my legs, since swimming doesn’t do much for the legs.


After either swimming or working out in the gym, I jump in the sauna for 10 minutes and sweat it out. I find that this relaxes my muscles and I think it’s good to keep cycling a lot of water through the system.


On Saturday afternoons, I do a muay Thai workout in Lumpini Park with Thomas, which is a killer workout, both aerobically and anaerobically. I find that the sets of high kicks bring me to my aerobic max, and I think this has a huge effect in terms of burning fat. Also, the kicks and punches work core muscles that are missed in my other workouts.


On Sundays and a few other days of the week, I do a short five-minute routine of stretches, which is basically the same stretching routine I learned when I ran track in high school. Staying flexible is essential for preventing injury and I believe it also keeps one from becoming brittle, a condition that is very common in middle aged and elderly people.


My morning workout usually leaves me in a very good mental state. I then return to my apartment, shower, and then eat breakfast. I eat a simple breakfast of muesli with pieces of a banana on top of it. I drink orange juice cut at least 50% with water (I find that most commercially available juices are so thick and sweet that they may as well by syrup). I also have a cup of tea. After breakfast, I tend to drink several glasses of water as well, to replace fluids lost during the workout and in the sauna. In Bangkok, I find that I have to drink almost continuously just to “break even.”


I then go to work, usually at a coffee shop with wifi (I’m a freelance writer and editor). I’ll drink a café latte or two while I work. I don’t worry about the calories in the sugar or milk. But, I don’t eat lunch and I don’t find that hunger is an issue. If I do get hungry, I might eat some crackers or nuts when I get home in the afternoon. I find that if I do eat lunch, I almost always have to take a siesta and the afternoon is basically a write-off.

My wife, who is Japanese, usually cooks dinner and this means that my main starch is usually rice, which suits me just fine. I find that a rice-based diet is far superior to most Western diets, because rice does not contain fat and is prepared without the addition of fat. Also, the Japanese diet tends to contain a lot of fish and vegetables, both of which are healthy and delicious. We end the meal with some fresh fruit, of which Thailand has the world’s greatest selection. In the evening, I snack if I feel like it, usually crackers or nuts, but occasionally potato chips, which I eat without feeling any guilt whatsoever.

In closing, I’d like to emphasize how easy this routine is: I exercise six days a week and I find every workout enjoyable. The workouts set the tone for a positive and constructive day. I never feel hungry and I don’t spend much time thinking about what I eat. The two keys are simple and easy for anyone to adopt: merely get one workout in a day, skip lunch, and eat a rice-based diet. Not only will you get lean, you’ll feel better and be more productive.


Weekly Routine

Monday: Swim 2 x 500m medleys (minus butterfly)

Tuesday: Workout in gym, focusing on legs and cardio (bike and treadmill)

Wednesday: Swim 10 x 100m medleys (including butterfly)

Thursday: Workout in gym, focusing on legs and cardio (bike and treadmill)

Friday: Swim 5 x 200m freestyle

Saturday: Muay Thai workout

Sunday: Stretching

by CR