Ummm. Just to confirm IMNZ is in March. Advice from the hospital stroke consultant is highly intensity exercise is good for recovery. So this is in line with medical advice and gives the rehab a nice positive goal.
Honestly, that may end up becoming a 16.5hr walk to finish goal. Or the 70.3 on same day. Or if will be the sub 11hr I was always aiming for.
But there are some specific things I was looking for from people that may have been through a similar event, or have an appropriate background. And then thought someone else in the future may be looking for the same thing, so some record they can relate to would be handy. I note the well meaning intent, but some of the emotive language misses the mark a bit.
For the record, as you brought it up. I’m not afraid of dying, I’m afraid of existing without living life.
Disclaimer: MD here but not a neurologist!
Thank you for sharing your experiences and providing a thread that others might be able to relate to in the future. From my years on this forum I have not seen many neurologists or neurosurgeons as regular users who might be able to offer advice or share experiences.
I don’t have any pearls of wisdom to share in relation to specific tips for recovery after stroke, although I have a number of things I can share in relation to somewhat devastating injuries and having to readjust long terms plans and goals.
A few comments/questions: is there anything in particular which is making them think that a PFO is the potential reason you have thrown off a clot? Have they done a transthoracic echo? (I know you have stated they have a transoesophageal one booked, which is generally what is needed to check for one completely). Have they found a clot elsewhere? It is important to realise that the PFO is just the pathway that a clot takes to bypass some structures and head into the main circulation, it still means you have developed a clot somewhere and that in itself can be cause for concern.
You asked the question about is it realistic to target IMNZ next March…I am a bit torn in how to reply to this question!
On the one hand, it is great to have stretch goals and if this is a bucket list race or something you had already planned your 2025 around then it may still be a realistic goal. Goals are great to help with motivation and to help give you something to focus on and look forward to.
On the other hand, this is still early days. Whilst in some people a stroke could be a “one off” event that was just an incredibly unlucky sequence of events, in most people it is the end product of some underlying medical issues that significantly change the risks of you having further issues and other medical issues in the future. As you have seen already, you have some risk factors you now need to address, such as your cholesterol, and there may be other things that need to be optimised for you moving forward. Your recovery seems to be going really well at the moment, but there may still be hiccups to come.
The reason I take the more conservative line above re this being early days etc is that in general, Ironman training and completion is not really an example of “ideal” physical conditioning and actually puts a massive inflammatory stress on the body (which can predispose and increase the risk of cardiac and all sorts of other events). It is important to know your motivation to do 2025…if it is just to prove a point and show you can do it after a stroke then it may not be a good idea. If it is because of the impression that training and doing an IM shows excellent fitness etc then I would also say it is not a great idea.
Having been in these sorts of situations before personally (not with a stroke but with devastating injuries) I know both how motivating it is to want to be back where you were but then also how the recovery period is often filled with hiccups and unexpected occurrences.
Personally, I would take the approach that what you want is what is going to result in you being physically the healthiest specimen you can be (so you can decrease all those modifiable risk factors). Set targets for weight, blood pressure, exercise per week etc. Have a view to potentially get back to some events in 6-9 months time depending how your weakness etc it. See how things are in 6-9 months time and then depending on how things are start thinking about whether an IM could be on the horizon.
I guess the TL:DR response is no, I wouldn’t target IMNZ next March!
Good luck for the recovery, be great if you can keep this thread updated with how things are going and where you are at.
I am including the “UpToDate” guidelines on physical activity after a stroke just for completeness. This website is a rather expensive medical site which has theoretically up to date, evidence based information on a wide variety of topics. It is not always cutting edge but generally provides robust information.
Physical activity and exercise — Patients with ischemic stroke or TIA who are capable of regular exercise should engage in moderate-intensity physical exercise performed for a minimum of 10 minutes four times a week or vigorous-intensity exercise performed for a minimum of 20 minutes twice a week. Moderate-intensity exercise is defined as activity sufficient to break a sweat or noticeably raise the heart rate (eg, walking briskly, using an exercise bicycle) 12]. (See “The benefits and risks of aerobic exercise”, section on ‘Benefits of exercise’.)
Increasing evidence suggests that low physical activity and prolonged sitting increases the risk of cardiovascular disease, including stroke 4,63,64]. Additional support that physical inactivity is a risk factor for stroke comes from studies showing the benefit of increased physical activity and exercise for reducing the risk of cardiovascular events 65].
