"Boy, I'm so glad my surgeon is an athlete."

Triathlon Forum
1

I was just loading my truck, as I get back on the road to the Cleveland Clinic for my second endovascular aortic surgery, when I thought, “Boy, I’m so glad my surgeon is an athlete.”

Physically, physiologically, metabolically, and mentally, endurance athletes are a slightly different bunch, if somewhat OCD. I’ve been to a lot of physicians, often ignoring their advice if I considered it ill-conceived, such as recommending a beta-blocker for a BP of 140/80 (do you really want all those side effects for an essentially non-risk situation?), a strong anti-inflammatory drug plus Valium for TMJ (I preferred a short vacation and meditation, and the MD just could not get it, but it worked fine - it was a warning sign of worse to come), or statins (don’t get me started). But then, I am a veterinarian who loves his dog. I’m not dissing all doctors, just that you MUST get the right one for you.

So! Find a physician who is fit, understands your situation, and can relate to why you want to do the Ironman (saved my life in 2010!).

At the end of the day, it is your body, so take care what you put into it, and make sure you understand as much if not more than your medical advisors when it comes to your particular situation. They have to know it all, but you only have to know about you!

Hope you didn’t mind my saying all this, but it is really important, especially as you age.

OK off for surgery, and then back in training for IM in January - OH! Yes! Thinking positive also helps.

Finally, when your physician does save or improve your life, remember to say thank you! You might be back sooner than you think - I was!

Woof! Woof!

2

I feel equally lucky:

Primary Care Physician: Triathlete
Cardiologist: Cyclist
Orthopedic Surgeon: Competitive OW swimmer.
Internist: Runner/Marathoner

I had aortic heart valve replacement surgery 13 years ago, after which my docs encouraged me to do as much aerobic exercise as I could handle. That led me to do my first sprint tri ten years ago, three years post-op. A lot of my family and friends thought I was nuts/crazy/irresponsible, but my docs have always been supportive.

I’ve been very fortunate and have not had any cardiac issues whatsoever with my mechanical valve. And in spite of all the horror stories that you hear, taking Coumadin/Warfarin has been a non-issue. My biggest medical probs have been managing my degenerative Achilles tendinosis and patella tendinosis as I get older (60).

Good luck. Hope all goes well. Look forward to seeing you back here soon!

Mark

3

I was just loading my truck, as I get back on the road to the Cleveland Clinic for my second endovascular aortic surgery, when I thought, “Boy, I’m so glad my surgeon is an athlete.”

Physically, physiologically, metabolically, and mentally, endurance athletes are a slightly different bunch, if somewhat OCD. I’ve been to a lot of physicians, often ignoring their advice if I considered it ill-conceived, such as recommending a beta-blocker for a BP of 140/80 (do you really want all those side effects for an essentially non-risk situation?), a strong anti-inflammatory drug plus Valium for TMJ (I preferred a short vacation and meditation, and the MD just could not get it, but it worked fine - it was a warning sign of worse to come), or statins (don’t get me started). But then, I am a veterinarian who loves his dog. I’m not dissing all doctors, just that you MUST get the right one for you.

So! Find a physician who is fit, understands your situation, and can relate to why you want to do the Ironman (saved my life in 2010!).

At the end of the day, it is your body, so take care what you put into it, and make sure you understand as much if not more than your medical advisors when it comes to your particular situation. They have to know it all, but you only have to know about you!

Hope you didn’t mind my saying all this, but it is really important, especially as you age.

OK off for surgery, and then back in training for IM in January - OH! Yes! Thinking positive also helps.

I think you discussion is good and relevant … but I think you are missing some important issues:

  1. You need to personally make your physician know what your special needs may be with your athletic lifestyle. Most patients don’t have your expectations … so you can’t just be silent and expect your needs to be met.
  2. Physicians are expected to practice to evidence based standards. If you wish to decline treatments, that’s your right, but don’t be upset that something is offered to you because it is an expected standard of care for the physician.
  3. Just being athletic doesn’t cure your problems … it often leads to patients ignoring symptoms that may be life threatening to them because they think they can exercise themselves out of the problem.
  4. If you can find a physician that you can communicate well with … that’s a great start. If all needs can be met, that’s ideal … but just agreeing with what you think is needed isn’t professional … it can just be pandering to you.

Sounds like you found a relationship that is working for you … good job!

Dave

Finally, when your physician does save or improve your life, remember to say thank you! You might be back sooner than you think - I was!

Woof! Woof!

4

I think it is important to be your own Patient Advocate and remember that any doctor may be motivated by things that don’t match up with or wants or needs.

i believe that most 99% of doctors still operate under the “Do No Harm.” mantra, but I also believe that they are under increasing pressure to mitigate liability. Therefore, they are often prone to over prescribing or advising you not to do something that may result in your next of kin suing their pants off.

it is important to find the right doctor and then having an open dialogue with them about what your wants/goals are from their services. If your doc is unwilling to engage you in this way, find another one. Chances are there is a doc out there willing to work with you to get you better.

good luck

5

I feel equally lucky:

Primary Care Physician: Triathlete
Cardiologist: Cyclist
Orthopedic Surgeon: Competitive OW swimmer.
Internist: Runner/Marathoner

Luckier still:

Primary Care Physician: Don’t have one
Cardiologist: Don’t have one
Orthopedic Surgeon: Ironman triathlete
Internist: Don’t have one

(55 and very lucky)

6

I feel equally lucky:

Primary Care Physician: Triathlete
Cardiologist: Cyclist
Orthopedic Surgeon: Competitive OW swimmer.
Internist: Runner/Marathoner

Luckier still:

**Primary Care Physician: Don’t have one **
Cardiologist: Don’t have one
Orthopedic Surgeon: Ironman triathlete
Internist: Don’t have one

(55 and very lucky)

IMNSHO not having a PCP is a dumb idea - preventive medicine will keep you from needing others

7

I feel equally lucky:

Primary Care Physician: Triathlete
Cardiologist: Cyclist
Orthopedic Surgeon: Competitive OW swimmer.
Internist: Runner/Marathoner

Luckier still:

Primary Care Physician: Don’t have one
Cardiologist: Don’t have one
Orthopedic Surgeon: Ironman triathlete
Internist: Don’t have one

(55 and very lucky)

Glad you’re healthy! My only response is that one of the reasons I’m still around is because I got annual checkups and both my PCP and Cardio knew when I needed my heart surgery. Been seeing the same PCP for 28 years and one of my concerns is finding someone else I feel comfortable with whenever he retires.
Mark

8

I feel equally lucky:

Primary Care Physician: Triathlete
Cardiologist: Cyclist
Orthopedic Surgeon: Competitive OW swimmer.
Internist: Runner/Marathoner

Luckier still:

**Primary Care Physician: Don’t have one **
Cardiologist: Don’t have one
Orthopedic Surgeon: Ironman triathlete
Internist: Don’t have one

(55 and very lucky)

IMNSHO not having a PCP is a dumb idea - preventive medicine will keep you from needing others

Perhaps I’ve just had poor PCPs in the past, but I have never had one that did more than cursory examinations that I can’t do myself (other than
the prostate exam, of course!). What value might a good PCP provide? What questions/tests might be asked/done that I don’t think of asking myself?

I do have a cardiologist recommendation from my ortho to see what I can do about what appears to be postural hypotension (nearly fainting after finishing a hard triathlon).

9

I get back on the road to the Cleveland Clinic for my second endovascular aortic surgery

Hey, hoping your surgery is successful, and that you come out way stronger/better/healthier for it. Please update us and let us know how it went.

10

I feel equally lucky:

Primary Care Physician: Triathlete
Cardiologist: Cyclist
Orthopedic Surgeon: Competitive OW swimmer.
Internist: Runner/Marathoner

Luckier still:

**Primary Care Physician: Don’t have one **
Cardiologist: Don’t have one
Orthopedic Surgeon: Ironman triathlete
Internist: Don’t have one

(55 and very lucky)

IMNSHO not having a PCP is a dumb idea - preventive medicine will keep you from needing others

Perhaps I’ve just had poor PCPs in the past, but I have never had one that did more than cursory examinations that I can’t do myself (other than
the prostate exam, of course!). What value might a good PCP provide? What questions/tests might be asked/done that I don’t think of asking myself?

I do have a cardiologist recommendation from my ortho to see what I can do about what appears to be postural hypotension (nearly fainting after finishing a hard triathlon).

I agree you need to find a good PCP who will actually examine/ talk with you ( I do want to see you do your rectal exam yourself :-))
I’ll start a small list … 1) Screen you for cardiac risk factors since you’re 55 (so we don’t need to pluck you out of the water) … didn’t you get an echo/ stress test for Sloman???
2) Arrange your colonoscopy to be sure you don’t have polyps/ colon cancer
3) Screen you for prostate cancer
4) Be sure you don’t have diabetes/ pre-diabetes
5) be sure you don’t have Hep C and no symptoms
… I could go on for a long time … but I think you get the picture.

Dave:-)

11

I don’t have a regular doctor either. If it ain’t broke don’t fix it. However
I’ll make up for it when I die by getting the fastest triathlete/mortician I can find.

12

I was just loading my truck, as I get back on the road to the Cleveland Clinic for my second endovascular aortic surgery, when I thought, “Boy, I’m so glad my surgeon is an athlete.”

Physically, physiologically, metabolically, and mentally, endurance athletes are a slightly different bunch, if somewhat OCD. I’ve been to a lot of physicians, often ignoring their advice if I considered it ill-conceived, such as recommending a beta-blocker for a BP of 140/80 (do you really want all those side effects for an essentially non-risk situation?), a strong anti-inflammatory drug plus Valium for TMJ (I preferred a short vacation and meditation, and the MD just could not get it, but it worked fine - it was a warning sign of worse to come), or statins (don’t get me started). But then, I am a veterinarian who loves his dog. I’m not dissing all doctors, just that you MUST get the right one for you.

So! Find a physician who is fit, understands your situation, and can relate to why you want to do the Ironman (saved my life in 2010!).

At the end of the day, it is your body, so take care what you put into it, and make sure you understand as much if not more than your medical advisors when it comes to your particular situation. They have to know it all, but you only have to know about you!

Hope you didn’t mind my saying all this, but it is really important, especially as you age.

OK off for surgery, and then back in training for IM in January - OH! Yes! Thinking positive also helps.

Finally, when your physician does save or improve your life, remember to say thank you! You might be back sooner than you think - I was!

Woof! Woof!

for sure, wish there were some around here. Mine passed away.

13

I think in terms of prescriptions in particular, it’s a bit naive to expect the physician to only have your best interest at heart. See this lovely case of Johnson & Johnson bribing doctors to prescribe their drugs even when they won’t do anything (or are not proven to be entirely safe):

http://www.nytimes.com/2011/04/09/business/09drug.html?_r=0

14

I feel equally lucky:

Primary Care Physician: Triathlete
Cardiologist: Cyclist
Orthopedic Surgeon: Competitive OW swimmer.
Internist: Runner/Marathoner

Luckier still:

**Primary Care Physician: Don’t have one **
Cardiologist: Don’t have one
Orthopedic Surgeon: Ironman triathlete
Internist: Don’t have one

(55 and very lucky)

IMNSHO not having a PCP is a dumb idea - preventive medicine will keep you from needing others

Perhaps I’ve just had poor PCPs in the past, but I have never had one that did more than cursory examinations that I can’t do myself (other than
the prostate exam, of course!). What value might a good PCP provide? What questions/tests might be asked/done that I don’t think of asking myself?

I do have a cardiologist recommendation from my ortho to see what I can do about what appears to be postural hypotension (nearly fainting after finishing a hard triathlon).

If you think your PCP is really not that well trained, you’re in for a really rude awakening when you see how much they actually can do when a really sick patient comes in.

For the young healthy people, yes, odds are high that things are fine without any special treatment/knowledge. But that’s not what you’re worried about - it’s the stuff that’ unusual, subtle, and easily missed but will kill you that you will need them for. When you get older (especially retirement years), PCP’s are really, really crucial. But even for young people, I think you might find that the moment you get one more than trivial illness/injury, you’re going to be overwhelmed with all the medical choices and specialists and tests without the PCP to tie it together.

15

I feel equally lucky:

Primary Care Physician: Triathlete
Cardiologist: Cyclist
Orthopedic Surgeon: Competitive OW swimmer.
Internist: Runner/Marathoner

Luckier still:

**Primary Care Physician: Don’t have one **
Cardiologist: Don’t have one
Orthopedic Surgeon: Ironman triathlete
Internist: Don’t have one

(55 and very lucky)

IMNSHO not having a PCP is a dumb idea - preventive medicine will keep you from needing others

Perhaps I’ve just had poor PCPs in the past, but I have never had one that did more than cursory examinations that I can’t do myself (other than
the prostate exam, of course!). What value might a good PCP provide? What questions/tests might be asked/done that I don’t think of asking myself?

I do have a cardiologist recommendation from my ortho to see what I can do about what appears to be postural hypotension (nearly fainting after finishing a hard triathlon).

If you think your PCP is really not that well trained, you’re in for a really rude awakening when you see how much they actually can do when a really sick patient comes in.

For the young healthy people, yes, odds are high that things are fine without any special treatment/knowledge. But that’s not what you’re worried about - it’s the stuff that’ unusual, subtle, and easily missed but will kill you that you will need them for. When you get older (especially retirement years), PCP’s are really, really crucial. But even for young people, I think you might find that the moment you get one more than trivial illness/injury, you’re going to be overwhelmed with all the medical choices and specialists and tests without the PCP to tie it together.

yes and knowing you when you are healthy and screening for all the things mentioned above. Catching things when they are subtle before they become a big deal

and yeah postural hypotension has many causes cardiac being ONE - a PCP can do the proper workup to get you to the right specialist (if needed)

16

Hey, I’m delighted to see you back on the forum again, and best of luck with the surgery!

After a bad experience a few years ago with another doctor who wasn’t familiar with the physiology of a healthy, fit patient (only the typically American out-of-shape overweight kind), I changed PCPs. My current doctor is active in our track club and a strong advocate of active lifestyles. I’ve also been fortunate enough to find an Ironman/marathoner surgeon for my two knee surgeries.

Unfortunately, I expect to be moving across the country (to the Phoenix area) in about a year, and I’m going to have to go through the process of finding the right kind of doctor(s) all over again. I suppose that when the time draws near I’ll have to start an ST thread to that end.

17

Luckier still:

Primary Care Physician: Don’t have one
Cardiologist: Don’t have one
Orthopedic Surgeon: Ironman triathlete
Internist: Don’t have one

I got you beat…

I’ve had no luck finding a doc that I’d bother visiting unless it was really obvious that I needed something fixed. Last time when my BP was 135/85 and drugs were recommended to keep it in check, because “high blood pressure causes all sort of problems”… I asked, “but what is causing the high BP in the first place?” No clue and don’t care… just take some drugs.

18

This has been my experience too. Maybe its partially because I live in Wisconsin but when I got a physical/bloodwork done early this year, my new to me PCP seemed amazed that my bloodwork was all good and my vitals were good.

He was seemingly concerned that a 31 year old would just “get a check-up”. I think he thought there was something I wasn’t telling him. The nurse was also concerned at my pulse which really isn’t that low I don’t think.

In the short term I think he’s fine/qualified, but longer term I would like someone who better understood my lifestyle regardless of if he/she was an athlete.

19

I feel equally lucky:

Primary Care Physician: Triathlete
Cardiologist: Cyclist
Orthopedic Surgeon: Competitive OW swimmer.
Internist: Runner/Marathoner

I had aortic heart valve replacement surgery 13 years ago, after which my docs encouraged me to do as much aerobic exercise as I could handle. That led me to do my first sprint tri ten years ago, three years post-op. A lot of my family and friends thought I was nuts/crazy/irresponsible, but my docs have always been supportive.

I’ve been very fortunate and have not had any cardiac issues whatsoever with my mechanical valve. And in spite of all the horror stories that you hear, taking Coumadin/Warfarin has been a non-issue. My biggest medical probs have been managing my degenerative Achilles tendinosis and patella tendinosis as I get older (60).

Good luck. Hope all goes well. Look forward to seeing you back here soon!

Mark

In the spirit of the conversation, and just to expand a bit on my previous post, I’ve also “fired” a few doctors over the years:

A gastroenterologist who botched my first colonoscopy and put me in the hospital for three days with intestinal bleeding.

A urologist who wanted to give me cipro for a “suspected” UTI, then got huffy with me when I refused to take the cipro and asked for an alternative anti-biotic. I ended up not taking anything and was just fine.

An oral surgeon who botched an implant post, which got infected, had to be re-done, taking a six months to finally finish.

At the end of the day you need to be an informed consumer and be your own advocate when it comes to health care. While I feel lucky with my PCP, Cardio, Ortho, and Internist, not all docs are created equal.

Caveat emptor.

Mark

20

Not to be a jerk, OP, but maybe you could have avoided or delayed your aortic surgery had you taken the beta blockers and the statins. . .just saying. . .