Today we want to share a Post by Author Richard King about the importance of rehab that may help you stay active. Richard has gone through a lot over the years and overcame the physical limitations of multiple surgeries. But even when rehab was lengthy and painful, Richard persevered. See below to read Rich’s Bio and purchase his motivational book about the importance of rehab, “…Staying active while aging…”. Enjoy!
Staying active while aging despite life’s curveballs
(two hip replacements and a heart valve replacement)
I enjoy challenges that inspire me to stay active. I’ve been participating in endurance sports by biking, running, and hiking my adult life. And I know that it’s important to stay active as we age, and I’ve found that the “inevitable” declines we hear “come with aging” aren’t due to aging after all. But they are due to inactivity. And the best way to keep moving is to find an activity you enjoy.
Back in 2002, I was 49 and diagnosed with hip arthritis. When that happened, I stopped running and increased other activities such as biking, walking, hiking, and rowing (canoe, kayak, and stand-up paddling, or SUP). Remember that it’s important to spare your ailing hip cartilage with non-impact activities. And after hip replacement surgery you can maximize the life of your replacement by avoiding high-impact activities.
Around this time, I was motivated to take strength training seriously and setup a garage gym. I also learned about doing shorter, higher intensity challenges rather than longer challenges such as marathons. I thought it would be a good idea to get myself to train hard without the temptation of overdoing the volume, so I started participating in the Bay Area Senior Games cycling time trial (5K). This challenge only takes about 10 hard minutes. I also compete virtually online against local cycling hill climbing challenges on Strava. Again, I chose spurts that take 10 minutes or less. There are a lot of talented cyclists in my age group locally to inspire me. But the point was to motivate myself to get better, not compete against others.
First Hip Replacement & the Important of Rehab
Fast forward, by 2012 my arthritis had progressed to needing a hip replacement. Fortunately, I had read about the anterior approach to surgery, and found a great surgeon to perform the procedure. My right hip was replaced in May that year, and I found rehab to be amazingly fast. I was walking briskly and stationary cycling within a couple of weeks and was able to go back to full activity within a month.
I did my physical therapy (PT) exercises diligently. After you have this type of surgery, you may find that you lose some strength in your glutes and abductors. This is due to the long period when your hip movement is impaired due to severe arthritis. Diligent work is required to get the strength back with exercises like the clamshell. These may not be fun but are important. My doc told me that lots of his patients don’t bother with the exercises and never get a proper gait back! Me? I don’t understand why you’d go to all this trouble to get your hip fixed then not do the homework required so you can walk right again. So, I did what he told me and worked hard to get back to my ‘normal’ self.
Second Hip Replacement
When my x-ray showed that my left hip was not far behind the right, I knew I had to have it replaced too. So, when I was 59, in September 2012, I had my second surgery for a hip replacement. Again, rehab to where I could resume my full activities took about 4 weeks, and after that I was lucky enough to be able to enjoy several good years of high-level activity. Especially for a 59-year-old.
Then Heart Surgery
The first hint something else was wrong was when I seemed to get badly out of breath after several minutes of exercising at high intensity. This would happen on more challenging bike rides or hikes. It turned out I had moderate “aortic stenosis”. This means the aortic valve, which is the heart valve leading into the aorta, was not opening enough.
After a few months it was getting worse, and I also found out that I sometimes got atrial fibrillation (AFib), a dangerous abnormal heart rhythm, when exercising intensely (a common side effect of aortic stenosis). I’d progressed to severe stenosis, which was confirmed by an angiogram, so it was time to get the valve replaced. I found another great surgeon for this procedure, and he also recommended the “Cox Maze” procedure to assure that the AFib would not come back. The surgery required cutting the sternum in half completely.
Please note that it is particularly important to go into major surgery like this (and the hip replacements) as fit as possible. This not only ensures that a good surgical outcome is more likely, but it will also decrease the time it takes for you to return to your normal activities. I remember reading one cardiac surgeon’s comment that “the ones who can walk a mile a day will do fine. It’s the inactive ones I worry about”. That’s not setting the fitness bar too high, but unfortunately most people aren’t active enough.
In August 2017, my doc got the complex procedure done in just over 90 minutes and the outcome was superb. The pathology report I showed I had a congenital condition, a bicuspid aortic valve, which had caused my stenosis.
Another Round of Rehab
Rehab for my heart surgery was a bit tougher than both hip rehabs because there was inflammation around my heart. This lasted for a few months and was caused by the trauma of the surgery which I found out was a common side effect.
I found myself severely out of breath when simply walking upstairs so I knew I had a lot of work ahead of me. But I was able to walk fine on a flat surface, though slowly at first, and increased my walks to more than 40 minutes over the next 6 weeks. I kept a positive attitude but knew the importance of rehab and chipped away at improving.
I saw my surgeon for a follow-up at one-month post-op. He said I now had a normal heartbeat (no AFib) and cleared me to go as hard as I wanted with cardio. Hurray! Needless to say, I was incredibly happy! He also recommended starting cardiac rehab as soon as possible, so I went to a great nearby rehab facility for 30 sessions.
My heart rate was constantly monitored for arrhythmias by an amazing staff of nurses and physical therapists (PT’s). I routinely ran my heart rate up to as much as 140 and we never saw arrhythmia in any of the sessions, which was a real confidence booster.
Interesting Observation during Rehab
There was an interesting contrast at the rehab place among the patients. Some, like me, understood the importance of rehab and were chomping at the bit to get back to being fit. If anything, the PT’s had to rein us in a little. The others seem to find it a chore and were skating by with the minimum effort, and the therapists had to prod them to try a little harder. And 2/3 of cardiac surgery patients don’t even bother to do rehab. I think the importance of rehab cannot be overrated as it’s vital to keep active for the long term after the surgery to assure a good outcome (and maybe avoid future surgeries). Again, the key is to find activity that is enjoyable for you. An activity that isn’t a chore, but an enjoyable time you look forward to.
So, after about 4 months post-op, I was cleared to ride and hike (carefully!) outdoors, which I did on non-rehab days, and I also was cleared to start strength training. My 65th birthday came in January 2018, about 5 ½ months post-op. By this time, I was feeling great and able to do all the activities I enjoy. My performance was still a bit subpar but under the circumstances I didn’t care. I considered my recovery to be a nice birthday present and looked forward to continued improvement.
The Importance of Rehab
As I write this, I’m about 18 months post-op, and back full steam to all my favorite activities, with no limitations. Considering the severity of my previous condition and how much tougher rehab turned out to be than I anticipated, that’s not bad at all. I consider myself extremely fortunate and happy that I kept so active. If you have similar circumstances, I cannot over stress the importance of rehab to your ability to bounce back from surgery.
The main change to my training now is that I now take what’s called “polarized” training seriously. A couple of times a week I do strength training and go hard on my bike with interval training. The rest of the time I go at an easy pace, or what I think of as “brisk but comfortable”. Too much training at moderate intensity can trigger AFib, as described in the book, The Haywire Heart, so I try to avoid that intermediate zone.
My replacement valve is a tissue valve (bovine), which can last up to 20 years. Fortunately, there is a minimally invasive procedure that can be performed at that time. But the life of the replacement valve is affected by diet. Essentially a “heart healthy” diet is also “heart valve healthy”. Knowing this, I’ve cleaned up my eating quite a bit by emphasizing fruits and veggies and other whole foods. I also eliminate processed foods, aka junk foods.
There are many people who have overcome more severe limitations than me to stay active. I think it’s especially important to work around obstacles and keep moving. As you can see, the importance of rehab cannot be overrated.
About the Author:
Born Jan 12, 1953 in West Point NY, I am a 66 year old mechanical engineer (PhD, Stanford, 1980).
Growing up in central New Jersey (near New Brunswick), I graduated from Rutgers University as a Civil Engineer in 1974. I practiced engineering as a Civil/Structural Engineer at the National Bureau of Standards (now the National Institute of Science and Technology) in Boulder, Co. , then IBM research in San Jose, CA. Returning to grad school, I switched to mechanical engineering at Stanford. I co-founded Rasna Corporation which was acquired by Parametric Technologies corporation. I am now enjoying being a freelance consultant and writer.
See below to buy Richard’s book and visit his website at Bionic Old Guy. Enjoy!
Good News! You can buy Richard’s book on Amazon…
If your doctor recommend rehab or PT and you are thinking about skipping it, read how Richard ‘bit the bullet’. He overcame what could have been debilitating setbacks and has been able to enjoy a better quality of life for doing so. And if you, or a loved one, are going through a similar situation, with a skilled physical therapist, you can achieve your physical fitness goals too. Don’t ignore the importance of rehab. It’s really is that important.
We hope you enjoyed Richard’s story about staying active, despite life’s setbacks. Thank you for spending part of your day with us! Wishing you the best of Health!