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bluecamo
Jun 12, 2006, 11:26 PM
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I have been climbing for the last five years. I climb trad , Ice and alpine mostly.
Over Christmas I had a heart attack(bad genetics)
A month latter I was out climbing ice
I've been to half a dozen doctors and they all freak out when I tell them I'm heading out to the Bugaboos. I can train and run a marathon but climbing is out for life(their words) Has this happened to anyone else or does anyone know of anyone this happened to?
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mike_gibson
Jun 12, 2006, 11:33 PM
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Quote from bob kamp's web site, http://www.bobkamps.com/
"He had a massive heart attack while making a move and was gone by the time Jim had lowered him. He died with his climbing shoes on."
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potreroed
Jun 12, 2006, 11:39 PM
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I suffered a heart attack (while leading the fourth pitch on an overhanging wall--huge epic) and since then I have bolted and climbed about 100 new routes, many of them long, multi-pitch. All of this, however, was at El Potrero Chico, where approaches are short and medical help is available nearby. I don't think I would put myself in a situation where I couldn't get to a hospital within 2 hours.
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devils_advocate
Jun 13, 2006, 12:18 AM
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That's a tough call not knowing your history, not that's it's easy if we do... besides you shouldn't listen to medical advice on here anyway.
But you asked. I think referencing someone who had a heart attack and died while climbing isn’t proof you shouldn’t climb if at risk (and I’m not implying that’s what the poster’s intentions were). People die of heart attacks sitting in a chair. 18 year old girls die of heart failure (post-partum Cardiomyopathy), 20 year old drug users, 35 year old professional athletes (ventricular hypertrophy), etc.. I know you said heart attack, but it is a term often used by laymen to include everything from a myocardial infarction (MI) to the above, to diseases such as pericarditis and Coronary Artery Disease (CAD). Then there is that whole subject based on a word you threw out there, genetics. Something you have absolutely no control of, and I personally (and this is just my way of thinking, I advocate it to no one) refuse to live my life in fear of something that I can’t control and may or may not affect me.
I’m assuming that you had an MI, which means you’re ischemic (i.e. there is dead tissue in the heart somewhere). How big and the location of this ischemia means a lot. Some people can’t walk down the hall because of theirs, others are completely asymptomatic. If your doc gave you the green light to do a marathon I would think it was relatively minor. Which suggests what I think you were hinting at – climbing is ‘unknown’ to most who have had no interaction with the sport or athletes that partake. I could see how such a doctor would play the conservative route and simply say no. Although fear can get the blood going, I can guarantee that my cardiac output while climbing is no where near that of when I run.
But there are a lot more factors at play, and as someone mentioned above, I wouldn’t wander to far away from civilization. You’ll always be at risk for a recurrence, it’s up to you to choose how far you’re willing to stray from a hospital. But if you can run a marathon without health issues, then in my non-qualified medical opinion, you aren’t putting yourself at any higher risk by climbing.
Sorry, I know this doesn’t offer any answers to your question, but I’m not going to tell you what to do, that’s your choice. This is just kind of what I know, and how I feel about it. To me, I wouldn’t give up my [social/physical] life and the things I love for an unknown, it’s not worth it to me. But that’s coming from a single man, if I had a family I’m sure I would feel different.
Btw, how are your coronary arteries, in terms of patency? Did you get a stent?
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bluecamo
Jun 13, 2006, 12:30 AM
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I have a stent and all the tests show minimal damage to the least important part of my heart (took me awhile to wrap my head around that one)My other arteries show some blockage but not enough to warrent any surgical intervention.
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crimpstrength
Jun 13, 2006, 12:35 AM
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Climbing a month later? Blockage in your coronaries must not have been bad enough to do surgery. CABG (coronary artery bypass grafting) is the open heart procedure for coronary artery disease (CAD) severe enough that medicines alone will not help. Perhaps your doctor (I am assuming you have a cardiologist) is worried about other arterial issues such as your aorta and its strength. Often, if coronaries are blocked, or beginning to get blocked, there are other clotting issues in other parts of the cardio pulmonary system. Clotting on the aorta can calcify the vessel and put huge risk of aortic dissection and many other problems (dare I say - stroke). A fall with a sudden stop and dissect your aorta and it can be over in seconds. We see it alot in our area in motorcycle accidents. The deceleration injury causes aortic dissection. Anyone should you climb? You need to communicate better with your doctors. You need to find out why they said no climbing. You need to nail down exactly where the heart attack came from and why it happened. When you find the problem, your options will be clearer. Perhaps they are worried about the effects of stress on your body - stress that they think comes with climbing? My advice - communicate better with your doctors. Express exactly what you want to do. Ask about your condition. Get a cardiac catherization. Knowledge is power.
How can I say all this? I work in the cardio thoracic department at my local hospital. I shadow the cardiac guys, watch surgeries, do research and get papers published for them. What I have stated above is in no way an attempt to solve your problems. I am in now way trying to offer solutions. I am just trying to help a fellow climber.
This post isnt going to get me in trouble is it?
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veganboyjosh
Jun 13, 2006, 1:08 AM
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by no means am i suggesting that you (or anyone else, for that matter) stop climbing.
i would say i'm much more of the school of thought that says "you could die of a heart attack (or less) while crossing the street, while waiting in line at a movie theatre, etc...so why limit yourself? keep on climbing..."
that said, one thing i (would like to) think i'd consider in this situation is how it would affect any partners...ie, while i'm on belay duty, while we're 4 pitches up, etc.
other people are most likely gonna be affected by any complications arising from backcountry/multipitch heart issues. not just partners, but possibly search and rescue personnel, friends and family, and/or nearby climbing parties...
edit:meant to type "parties" instead of "partners" in the last line...
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jabtocrag
Jun 13, 2006, 1:50 AM
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The doc's reaction doesn't surprise me at all. I'm a 30 year old male, who besides a few unexplained afib episodes over the past 10 years, is in very good physical condition. I lead a very active lifestyle that happens to include climbing. My doc had pretty much the same reaction as yours.
Docs probably think along these lines. Mainly due to the remote nature that climbing may require, and the possible physical harm that can come to me during a climb, it's just one more risk that could turn a bad cardiac situation into a deadly situation. I'd also say that the general public's ignorance when it comes to climbing exacerbates his reaction. In the end, he feels a professional responsibility to express his disapproval.
I shut him down pretty quickly by saying there is no chance I'm going to stop climbing under these conditions. :D
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billcoe_
Jun 13, 2006, 1:59 AM
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30 years old having a heart attack? Wow.
Here's an interesting story Malcom at Trango had, he was way far from a hospital, but not necessarily medical care.
http://www.trango.com/malha.php
starts out:
"I had just had a major heart attack. It came out of the blue, with no warning, no family history: a wake-up call for me as I was strolling into middle age with the cavalier confidence shared by many aging athletes. Here’s my story................."
I think you should head there to check out Trango gear if nothing else, but I was impressed with this story.
__________________________________________________________
I would think that taking proper precautions, having outdoor physical activities would ultimately be very beneficial to you.
Take care of yourself, life's too short already eh?
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chezdillon
Jun 13, 2006, 2:00 AM
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In reply to: I've been to half a dozen doctors and they all freak out when I tell them I'm heading out to the Bugaboos. I can train and run a marathon but climbing is out for life(their words) Has this happened to anyone else or does anyone know of anyone this happened to?
I have been climbing with serious heart problems for 13 years now. Most recently I was in the hospital for another pacemaker (number 6) and a catheterization. My heart stopped on the cath table and it took them 4 minutes to get it going again. 3.5 months later I was standing on top of Castleton Tower in Utah after leading every pitch.
The doctors doing rounds while I was in the hospital insisted that I should stop climbing immediately. One purported to have some climbing experience - enough to quiz me about which climbs I had done in Eldorado Canyon.
The encouraging thing for me was that my cardiologist and electro-physiologist, people I have known since I was 11, both said that the goal was to support my lifestyle, not change it. I owe those two everything. Not only have they literally saved my life, they also kept me and everyone else focused on the reason for keeping me alive.
So to answer your question - yes, I have been discouraged from climbing by physicians / cardiologists. I have also been encouraged. I think it has a lot to do with how well they know you and the sense they have for what you are capable of.
In reply to: that said, one thing i (would like to) think i'd consider in this situation is how it would affect any partners...ie, while i'm on belay duty, while we're 4 pitches up, etc. other people are most likely gonna be affected by any complications arising from backcountry/multipitch heart issues. not just partners, but possibly search and rescue personnel, friends and family, and/or nearby climbing partners...
I make it a point to tell everyone I climb with my situation. I fully expect people to tell me up-front if they are uncomfortable with me as a climbing partner. That said, I have been very fortunate to have found many people willing to risk climbing with me.
I have personally carried seriously injured climbers from the crags to rescue personnel, and I hope others would do the same for me; heart condition or no heart condition.
- Jeff
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ullr
Jun 13, 2006, 2:06 AM
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In reply to: I have been climbing for the last five years. I climb trad , Ice and alpine mostly. Over Christmas I had a heart attack(bad genetics) A month latter I was out climbing ice I've been to half a dozen doctors and they all freak out when I tell them I'm heading out to the Bugaboos. I can train and run a marathon but climbing is out for life(their words) Has this happened to anyone else or does anyone know of anyone this happened to?
Curious, what is your age?
Family history, diabetes, hypertension, high cholesterol?
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jabtocrag
Jun 13, 2006, 2:06 AM
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In reply to: 30 years old having a heart attack? Wow.
Definately not a heartattack for me....just afib.
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dutyje
Jun 13, 2006, 2:30 AM
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I'm dealing with bad genetics as well. Once I turned 30, I bought a bottle of aspirin. I keep a half dozen aspirin in my work bag, half a dozen in the first aid kit in each car, half a dozen in the backpacking/hiking first aid kit, half a dozen in my desk drawer at work. In fact, today at work I was planning my trip for this weekend, and the thought crossed my mind that I should really start taking them up with me when I climb.
I usually climb in cargo-type shorts with a lot of pockets, and they've got a perfect pocket for dropping in one of the little EZY-Dose pill bags with some aspirin. CHEW two tablets at the first symptoms. Hard coughing as well will actually help to keep you alive while you work out the escape plan. Always consider what you will do if the worst should happen. Keep your aspirin supply up to date (don't let them just sit around for 15 years). Put it on your standard checklist so you think about it for each trip.
It's a definite concern, but I don't think it's something to keep you from climbing. Although I would say that your heart probably isn't ready for you to be out climbing just yet. I assume your doctor has you on some statins. Just keep an eye on your health. Don't be afraid to seek another opinion from a doctor. In the end, if you have a hard time finding a doctor to tell you what you want to hear, maybe it's time to face the facts.
A heart attack at age 40 was the end of my dad's recreational basketball days, but that's a far more strenuous sport. I think if the doctor understood the low level of cardiac stress in climbing, he'd give you the OK.
I'm NOT a doctor. My dad and grandfather were both physicians, and both have had major heart trouble. So obviously, all the words I took the time to write here are nothing more than an uneducated opinion. If nothing else, your question helped me to analyze my own situation. Thanks!
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bluecamo
Jun 13, 2006, 2:38 AM
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high cholesterol(my numbers were above normal but not at risk was my main enamy here. I'm 43, never smoked, never did drugs, low to moderate drinker, have allways been active in sports
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bluecamo
Jun 13, 2006, 2:41 AM
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funny my doctor suggested basketball as something I should switch to
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dutyje
Jun 13, 2006, 3:19 AM
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In reply to: funny my doctor suggested basketball as something I should switch to
You might want to get a second opinion. First on the climbing, then on the basketball.
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majid_sabet
Jun 13, 2006, 6:50 AM
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Here is what a friend told me after we returned down hill from a similar situation however no matter what we did, we could stop this process. I deeply thought about his comment that day and made all kind of sense to me (You do not have to buy it).
When your soul wants to leave your body, you get a warning
Call it whatever in the medical terminology.
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ikefromla
Jun 13, 2006, 7:30 AM
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Didn't Randy Grandstaff suffer heart failure, which resulted in his "rapelling accident" a few years back at Red Rocks? scary stuff.. glad i'm young and fit.... i'll still probably die before 30 though, so whateva.
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devils_advocate
Jun 13, 2006, 4:49 PM
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Crimpstrength, of course this post is going to get you in trouble. This is the internet, so we’re all know-it-alls.
I do agree with some of your comments (e.g. Knowledge is power), others not so much. He seems to know the blockage of his coronary arteries, so I would assume he's already had a heart cath. And I’m surprised you would mention CABG if his patency is good. Stents can be deployed entirely percutaneously, and should suffice if the blockage isn’t significant.
Although as you mention, the high cholesterol does bring in worries such as atherosclerotic plaque and the myriad of sequela it can cause. That is something the OP should absolutely discuss with his doctor... and, as you stated, get a general idea of what his concerns are. I do think there is a good possibility that the doctor is just scared of the unknown. I keep falling back to the marathon. To me anyone capable of running a marathon isn’t doing that bad.
I too work in the field, although I work with devices, and one of our main focus is quality of life. Unfortunately it’s a difficult parameter to quantify, and it’s completely subjective. For some people it is just prolonging their life so they can spend time with their family, see there grandchild born, etc. But for others, it’s about maintaining the ability to follow your passion, the things that give you life. Well, I guess it could be argued that that’s the same for the former group, it’s just different things that give them passion. For a lot of people, and I would think many here, that passion comes from the outdoors, from the thrill, from the enjoyment of physical exercise... and you just can’t take that away. Those people, in this situation, are going to take the risk. I would.
Edited because I just now noticed that the OP already mentioned he does have a stent. I will go sit in a corner and work on my reading skills now.
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j_ung
Jun 13, 2006, 6:27 PM
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This is a fantastic thread. Thank you all so much for sharing your stories and advice.
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dirtineye
Jun 13, 2006, 8:16 PM
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Good luck to you, Bluecamo.
I'm with the guys who say that maybe your docs don't understand climbing, or maybe it is the distance and time from care that worries them.
Perhaps you could get a doc who understands your situation and the demands of climbing to make up a special med kit for you, with the proper drugs in it.
But in my view, it is MUCH better to die while climbing, than in a hospital, wishing you had gone climbing. I've come close to the hospital part, so I have some idea of what's going on with you.
GOod luck again.
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majid_sabet
Jun 14, 2006, 3:54 AM
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My personal experience dealing with those having heart attack in the wilderness has not been so good.
If you are close to a clinic either via helicopter or an ambulance, you will get a chance but been out there in the middle of nowhere is just much harder and people do not carry AED in their medical survival kit to jump start you like a old FORD trying to restart after 10 months been parked in the garage; CPR is not going to help after 5 minutes and even with best cell phone and best doctor next to you, you are still hours away if not days from any real help.
What should you in such a case in the wilderness? Let me open my book
1-Relax take a deep breath , you are out there for long time
2-Get a cigarette and fire it up, if Vodka, Tequila, whiskey handy get a glass
3-Think about what you done good and bad in the past before the heart attack
4-Do check and balance and make sure the KARMA level stays within the limit.
5-relax again and ask yourself this
6-Did I enjoy this life like I have too if not, when you get a chance to go back with that helicopter , make sure you enjoy life cause next time there will be no warning.
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papounet
Jun 14, 2006, 9:50 AM
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In reply to: My personal experience dealing with those having heart attack in the wilderness has not been so good.
Pray tell us a bit more about your personal experience, like how many times, where, how,... ?
In reply to: If you are close to a clinic either via helicopter or an ambulance, you will get a chance but been out there in the middle of nowhere is just much harder and people do not carry AED in their medical survival kit to jump start you like a old FORD trying to restart after 10 months been parked in the garage;
A the doctor of a group in very remote area (aka a expedition) will carry a very small set of general drugs (even true aspirin will help).
In reply to: CPR is not going to help after 5 minutes
Go and take your emergency help training again
In reply to: and even with best cell phone and best doctor next to you, you are still hours away if not days from any real help.
a medicalized helo will have a lot of support to get the injured person to the hospital
A true story (2002, french alps): a friend of mind, after falling 35m in a crevasse was recovered in a very bad shape, he was extricated and flown to the hospital, he did 2 cardiac arrests while in flight, the doctor in the helo got him back, he died at the hospital.
In reply to: What should you in such a case in the wilderness? Let me open my book 1-Relax take a deep breath , you are out there for long time 2-Get a cigarette and fire it up, if Vodka, Tequila, whiskey handy get a glass 3-Think about what you done good and bad in the past before the heart attack 4-Do check and balance and make sure the KARMA level stays within the limit. 5-relax again and ask yourself this 6-Did I enjoy this life like I have too if not, when you get a chance to go back with that helicopter , make sure you enjoy life cause next time there will be no warning.
where can I get your book ? :roll: :roll:
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cchas
Jun 14, 2006, 10:46 AM
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Just as a forward to this. I am not a medical doctor. Have worked in the field, developing drug eluting stents and establishing clinical trials for the use of adult stem cells for post-AMI and HF treatment.
Query your doctor what is the source of his concern. He knows the specifics of YOUR disease state better then anyone on this or any other website. Discuss with him climbing and find the root of his recommendation. With this information you can make your own decisions.
Take him up on his suggestion of training for a marathon. Aerobic training results in the development of collaterals. With a highly collateralized vascular bed in the heart, if you have a blockage (from either a progressive flow limiting stenosis or a rupture of an unstable plaque- which is actually the leading cause of death) much less of the myocardium will be at risk. Listen to your doctor about diet. Lipid levels, LLDL, LDL and HDl levels along with sources of oxidants (such as smoking, stress, heredity) are important for plaque progression and stability. Your doctor has probably already gone over this with you so I won't harp on it.
Heart disease is not a simple thing. It was ironic that my old boss, one of the worlds leading interventional cardiologists died of a car accident, probably initiated by a heart attack (heredity and also complained of symptoms the previous week)
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shakylegs
Jun 14, 2006, 3:14 PM
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Having a heart attack isn't a death sentence, nor is it a reason to stop all activity.
Hell, if climbing is one of your big joys, then by all means continue it. I started climbing after massive surgery, and the only thing that stopped me for a while was the fear that my sternum wasn't properly fused after they cracked my chest open. That fear was allayed.
I thought my cardiologist would tell me to stop, but in fact he took it up himself. So, there you go.
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