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Canoeing, Tripping, Camping with Heart Problems

Glenn MacGrady

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We've had some honest, interesting and informative discussions about canoeing with age and health problems.

I'd like to focus on heart issues. How have various heart problems affected, stopped, diminished, restricted, or not affected your canoeing or tripping? Do the problems affect mainly the paddling, the portaging, or the places you are willing to go? Are there mental aspects (e.g. fear) that are as debilitating as any physical limitations? How have you overcome these physical or mental aspects, or not?

I'm going to see my doctor next month for my EKG, etc., and am not looking forward to it. Although I haven't had any specifically diagnosed heart problems or procedures, beyond HBP and cholesterol, my overall energy and cardio fitness have been declining so rapidly in my mid-70's that it's depressing. For the first time in my formerly active life, my body and mind tell me I can't do the very things that would probably improve matters for me—more exercise. And I fear worse is coming.
 
I'm on seven stents now, it does weigh on me, particularly since my wife is very reluctant to let me go on any more solo trips. I try to stop when I get tired now, and I think I might be done with the portage clearing business.
 
I am in cardio rehab now. Stress test next week. I have had electrical issues fixed with ablation. Then plumbing issues fixed with 4 stents. It is daunting. I plan not to do any high elevation backpacking. Carrying a load, far from help in steep country at high elevation seems like a bad risk. In contrast boat trips, are at low elevations, do not require heavy lifting and low levels of exertion except for rapids.

Being outdoors is what I have always cared about. Taking meds, and good diet seem obvious. It is exercise that is the wild card. It requires diligence to stay busy even in bad weather. I plan to continue remote river trips even if there is some risk involved. It is too important to quit.
 
I experienced somethIng called an aortic dissection last fall - basically when the inside lining of the aorta partially delaminates from the outside (kind of felt like a zipper letting go from the back of my throat running down to my abdomen). Came out of nowhere, and I was about an hour away from having it take me out completely by the time I got to the hospital. Had emergency open heart surgery to swap in a large garden-hose sized graft in place of the ascending aorta, and a similar sized stent in the descending aorta to patch things up.

Was quite a rush, and I obviously have to think hard about what’s next. For sure things have changed, but I am pretty confident I can figure out a “new normal” that is still satisfying. Dealing with the fear factor will probably be the hardest part of this. Very curious what others who are still getting out have to say based on their experience.
 
I've told this story before. Back in 2016 I did a very tough mountain bike steep day climb. The next day I did an easy ten mile road bike ride but it just didn’t feel right; I had to return home early due to unexpected heavy fatigue. The next morning, I picked up my electric razor and I could swear it seemed to weigh more than ten pounds. Then I went picking blueberries out back and could not tell where my left arm was, even though I could guide it by sight. My wife noticed I was slurring my words and my face looked funny. A Call to 911 and I was soon in the ambulance to a special stroke center hospital nearby. After a couple of days I seemed to come out of it with no lasting effects, but was eventually diagnosed with PFO, Patent Foramen Ovale. A hole between the left and right upper heart chambers that allowed blood, along with potential clots to flow the wrong way and possibly toward the brain. That hole in the heart is present in all fetuses, but normally closes upon birth. Except it does not in nearly a quarter of the population, in most cases going unnoticed and causing no problems for life. Unless a clot is generated by something like aggressive mountain bike riding.

The cardiologist I first met put me on powerful blood thinners “for life” and told me to not ever stray more than 2 hours from any hospital. Well, that certainly put my life style as an Adirondack guide and wilderness trek leader trainer and solo canoe tripper in big trouble. Plus, I was due to return to the Yukon for another marathon canoe race the next season, and the next Adirondack 90 mile canoe race was coming up soon.

Luckily, two of my voyageur canoe Yukon race partners, a husband and wife, work for another major hospital in a nearby area. He was a surgical suite coordinator, she a PA for a renown cardiac surgeon. They could get me an almost immediate appoint with the doc. So within a couple of months, I was on the table with the new cardiologist, undergoing his new technique of sewing up the PFO via a probe inserted in my side. instead of opening my chest to insert a mechanical device as others would have done. Just six weeks (instead of 6 months) later I was exercising and training again. No more blood thinners required, not ever.

Since then, now in my 72nd year, I have trained for and completed seven 90 mile races, and one more 440 mile race on the Yukon River, and have led SAR teams on several formal wilderness SAR grid search incidents, all without any complications or experiencing any unusual physical effects.

I will say, however, that even though my bow paddle cadence is right where it should be and always has been, I am noticing I am a lot slower on the portages than I want to be. Always have been, especially with my often much younger partners running on ahead as I plod along behind.
 
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I've been in A-fib since 2008. It was discovered when I went to speak with my doctor about pain in my jaw. I was a long time first aid/CPR instructor so I recognized the signs. Also, my Dad had heart disease and I knew of the hereditary possibility. Long story short, since then I've had one stent and continue with my usual activity level. I still swim a couple of days each week (down from 4x's per week when I was working), hike, xc ski, snowshoe, bike and paddle in the warmer months. I cut firewood to heat our home and still split by hand; although I finally broke down and purchased a hydraulic splitter for the truly ornery pieces. Bottom line, I've tried to continue with everything I've ever done with my doctor's blessing. I definitely know I've slowed down some but my doctor wants me to continue on as long as I can so that's what I'm going to do. Hopefully you'll be able to do the same.

That's all for now. Take care and until next time...be well.

snapper
 
On the other hand, a dear friend of mine, and fellow wilderness guide instructior who I had backcountry traveled with and had much joking fun with for over 30 years, just a year ago asked me what it was like to get an EKG. He was due to get one and knew that I have had several. Six weeks after his EKG, which showed no problems, he went on an easy near home trail hike with his wife, sat down, laid back and died for no apparent reason. Devastating.
 
I can relate to this discussion. My 75th year brought on one medical issue after another.. I am hoping that I am at the end of the medical surprises now as I recover from a total thyroidectomy due to cancer with lymph gland removal also. This is on top of several asthma flare up’s resulting in ER visits on an emergency basis and a further ER visit with extended pulmonary follow up for a blood clot and pulmonary effusion in a lung. All this in the past 15 months. It kept me from returning to Canada for a long planned trip last summer, a trip my buddy and I originally planned for 2020. Hopefully, this year we get the trip in. After all, how many more years do I have before my trips are just memories.
 
back when I was 43 I had flulike symptoms and low energy for a couple of days, while changing a lightbulb I suddenly experienced nausea and a nasty cold sweat, my jaw had been aching all the way down my neck for a couple of days, but that particular symptom was nothing new as it had been badly broken in an industrial accident years ago, requiring 5 surgeries to repair.
I told the wife I wanted to go to the hospital because "something didn't feel right". Good thing we only live 5 minutes away because I crashed on the ER floor with a 100% cardiac blockage. I was brought back by CPR, multiple hits from a defibrillator, and a couple of shots of adrenaline and clot busters- supposedly when I came to I said "hello boys, I'm baaack" which my wife took as a sign I really was back
Needless to say I underwent emergency surgery, got 3 stents and spent a week in CICU.
fortunately for me, my doc is quite the outdoorsman himself, having climbed Annapurna and made it to camp 2 on Everest, while also being a member of Doctors Without Borders, and understood I'd never be content with just walking around the block, so worked with me to develop a program to ease me back into my outdoor activities, which included weight training, cardio, stationary bike, treadmills and lots of time on a rowing machine
This all started Jan 14th, by the start of paddling season I was able to do light day paddling, by the end I did an easy overnight trip , and that winter I did a 3 day snowshoe trek (although my heart monitor was screaming the whole time), my anniversary EGG came back fine, showing almost complete recovery until I broke my back in 2014, that put me out for an entire year and left me with issues with my left leg (severed nerves)
Fast forward to about 6 years ago at 57 and it happened again, got another 2 stents and seemed fine until the following summer when I developed bradycardia (pulse regularly dropped to 38), that's what finally really slowed me down, I still try and do everything I used to, just at a much slower pace, a lot more care and planning, and a north canoe load of meds....
I figure I've got one life to live (well maybe 3 😉) , and I intend on living it on my terms and not to worry about the future...
 
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Other than a pacemaker and occasional afib, my heart is in pretty good shape. In fact it will keep beating for a while after I die. I didn't even know about the afib. My pacemaker data logs and ratted me out to the heart Dr. I will say that after you are diagnosed with any kind of heart issue you notice every little thing your heart does as in "what the heck now". I have about twelve years of battery life left, at which time I'll be 77. Whether I get it replaced will depend on my quality of life at that time. For now I'm just going to keep going as long as my body allows.
 
Don't worry, by then we are promised there wil be charging stations to plug into on every street corner across the country.
I love it. Thanks for a good laugh. Being I'm one of those Knuckle Dragers from a "fly over state", I'm thinking they will be long on promise and short on delivery. That will be fine with me as I time traveled back to the seventy's where I'm more comfortable.
 
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Back to the topic. For those with a heart condition wondering if they should still venture out, be pro-active. Don't just go and hope for the best. If your Dr approves, start a rigorous exercise program near home where you have medical care near by if you need it. If you are concerned about portaging practice in a park with somebody present for back up. Most of us could use to shed a few pounds.

I hope next Fall we all will be able to look back on a successful paddle season.
 
In the US we mostly have sick care, not health care. I find heart issues to be dauting emotionally and psychologically. Am I ever going to feel normal again and get my life back? Cardiologists have given me little reason to have hope for the future. The big moment for me in the hospital in December was when a nice looking nurse held my hand as I walked down the hall for the first time.

Now I am in cardio rehab. I work out three days a week with machines, but we are all heart patients. It is like a support group. People tell their stories. Once a month we get a visit from a psychologist. The benefits of meeting with these people every week is as important as the exercise.
 
After reading everyone's story, I must say I understand some of the comments. Even though my cardiologist says to keep doing what I'm doing (and I do), every time there's a "blip" along the way, I do wonder if something bigger is on the way. So far, so good. That doesn't mean it won't so I just move forward, do what I'm supposed to do with diet & exercise and hope for the best.

Honestly, at this point I'm more concerned about my knees holding out than my heart. I had the right one replaced back in 2009 (just after my A-fib was diagnosed) and now my left one is giving up the ghost. We'll see how long I can go without having to turn to my orthopedist again but I'll cross that bridge when I come to it. One advantage to having bad knees though is it's easier to justify a new canoe purchase as I move down in hull weight classes. Makes portages and getting the canoe on/off my truck a lot easier when you're not dealing with a lot of weight.

That's all for now. Take care, good health to all and until next time...be well.

snapper

PS - My heart stops up to 3 seconds at a time and I never know it. Doctor still can't figure out why I don't faint but hey, years of swimming have given me a strong heart that can handle the issue; at least that's what I've been told.
 
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