Exercise & Diet with a PM

Had a good 3month follow up with my EP this morning. I'm 30y/o, HIS pacing, PM placed April of this year. A few questions for y'all:


1) my wife and I are considering a plant based diet. Have any of y'all found that to be optimal for cardiac care and performance? Or have any other diets you've tried or research you've done? 

2) I asked if I could get back to doing push-ups and he basically said that if it doesn't make my life less full, then don't do them so that I have less wear and tear on my leads. No, I'm sure my life will be just as good but I kinda want to do 50-70 push-ups every morning. I assumed I'd be able to get back into doing CrossFit also, but it makes me wonder. Maybe he just wants me to avoid chest exercises? But things like kettlebell swings, deadlifts, OH press would be ok? He is very conservative (which I appreciate) and I think part of the reason he doesn't want me to do much is that he got very good lead placement and wants that to last a long time. Have y'all crossed this bridge?


3) Feb of 2019 I completely ruptured my Achilles while playing basketball. March/April of this year I developed third degree heart block and ended up with a pacemaker. I have a desire to do an Ironman just to prove to myself and maybe to show others that you can recover from these major things and live a full life. Anyone here done an Ironman or any crazy endurance challenges with a PM? I won't be offended if you tell me I'm stupid or crazy. 


You're stupid or crazy

by AgentX86 - 2020-07-08 13:03:15

You said you wouldn't be offended. (Just can't resist an opening like that) ;-)

Welcome to the club. Given your interests, I'm sure you want to be here even less than most of us.

I'd never recommend a purely vegan diet for anyone. My brother was on one for a few years after a heart attack. He was a nut (there I go again) about trying to get the right proteins and all the stuff that a well balanced omnivorous diet gives. It didn't work and he had to go back to a more normal, fairly low fat diet. Forget every fad diet and listen to your doctors. Hire a nutritionist (one with a medical degree, not someone selling snake oil), if you must.

Weights, crossfit, and iron man. The only such restriction I was given was bench pressing free weights.  Machines are fine.

Break your neck (within the guidelines your EP gave you) on the other activities. You'll probably find some new limitations because of your pacemaker but fine tuning its settings should get you 90% there.


Diets....and exercise...

by ar_vin - 2020-07-08 13:04:31

Be careful about the so called "plant based diets" that limit your nutrition choices.

There's a lot of "snake oil" pushed by the likes of Dean Ornish, Michael Greger etc.

On the other hand many of us could benefit from adding more nutritious fruits, vegetables, seeds etc to supplement what we eat.

I don't see any reason to limit exercise or endurance activities ONCE you're fully healed from the implant procedure. As you well know already you probably have lost some fitness from the procedure and the limits placed by your condition prior to the implant. Take the time to ramp activity gradually. Too much too soon is the road to potential injury and misery.

It took me an year to get back to my prior level of fitness - that includes time to get the PM settings dialed during multiple visits to the device clinic and a lot of research here on the forums and my device maker's website. Ask questions and search the archives here - lots of useful info and very helpful people!




embrace the crazy

by Tracey_E - 2020-07-08 14:48:47

Once you fully heal, that lead isn't going anywhere. After the first year, it takes a specialized laser to get it out again. 

Your doctor is indeed very conservative. Mine is the opposite. He wants me to be fit, whatever form that takes. He believes keeping the heart strong is the best thing I can do for myself long term. He's head of ep in an adult congenital clinic in a large research hospital so sees a lot of people paced for a lifetime. I'd been doing Crossfit for a long time when I met him, he was thrilled and said keep it up. When I did a Spartan, I sent him muddy finish line pictures. The first time I met him, half the discussion was my heart, the other half was debate, where is the best skiing, CO or UT. I also love kayaking and ropes courses and roller coasters.

I grew up with my heart condition and before I was paced was not able to be active. No gym class, no sports growing up. When I got the first pacer, I bought roller blades, a tennis racket, and joined a gym. Haven't really slowed down since! I've always seen it as liberating, not limiting. I'd never run other than as part of a wod and wanted to do something new to mark the milestone when I'd had the pacer 20 years. Made the mistake of dragging my daughter along and she fell in love with running and dragged me to my first half marathon three years ago at age 50. In Feb, she wanted to do a particular half with me, one known to be a really good one so I'd casually said sometime we'll do it. I'd already signed up for a mud run when I realized it was that same weekend. She wouldn't let me off the hook for the half so I signed her up for the mud run and we did both of them together, one Saturday, one Sunday. 

We have other members a whole more athletic than me who have done multiple marathons, Ironman, the longer Spartans/Trifecta. Don't let the pacer keep you from doing what you want. I make a point of posting active pictures in the gallery here to balance out all the hospital and scar pictures. I want newbies to see that having a pacer doesn't have to be limiting. 

There aren't enough active people who have been paced a long time for there to be a definitive answer, there have been no studies that I'm aware of. We occasionally get a member here who damaged leads working out. There are a whole lot more like me who do what we want, live active lives, and have never had a problem. I trust my ep. I trust the cardiologist I had before him, who also said do what I want. I trust my SJM rep who I've known since I got my first pacer in 1994 so he sees hundreds of patients and said he hasn't seen leads damaged from exercise.

Bottom line, do what you are comfortable with. I don't feel I'm taking a risk by pushing my limits. My doctor is cool with it. In 26 years paced, I've never held back and never had a problem related to activity. I don't feel that I'm taking a risk but if it turns out I am wrong and I did manage to damage a lead, I really don't think it would stop me from getting right back to the box as soon as it was fixed. YMMV

As for diet, I've never been told to stick with any particular diet, just use common sense. I minimize red meat but when I've gone with no meat I lost my energy so plant based is not for me. One big pitfall (in my personal not-a-professional opinion) of vegan is falling into eating processed foods and a lot of soy products. I have a couple of friends who think they are super healthy because they are vegan but they live on what I consider junkfood, just because it doesn't have meat doesn't make it healthy.  I felt great when I was strict paleo but found it hard to maintain longterm so I'd say my diet is loosely paleo now. I avoid anything fried or processed, eat lots of lean protein and fresh veggies, and if I eat grains, stick with whole grain. Everything else in moderation.  My ep said a glass of red wine a day is good for me, and who am I to ignore doctor's orders?? lol We all have different make ups and lifestyles, do what works for you. Get yearly bloodwork to keep an eye on cholesterol and tryglycerides. Maintain a good weight. Whatever diet gets you there is right for you. 

edited to add, one diet I would not do is keto because ketosis can be hard on the heart. https://www.pennmedicine.org/news/news-blog/2019/april/a-cardiologists-take-on-the-keto-diet


by ar_vin - 2020-07-08 21:25:44

"a cardiologist born in India who was plant based"

FYI - People from the Indian subcontinent have some of the world's highest rates of: obesity, diabetes and heart disease. Is it their diet? You don't want to try and find out.....and die trying!

"The World Health Organization projects the majority of the world's heart attack patients will be Asian Indian within a few years. South Asians, who are predominantly Indians and Pakistanis, make up one-third of the world's population and have the highest prevalence of heart disease and diabetes."

More at.....




Wouldn’t Recommend Push Ups

by Impala67 - 2020-07-10 02:46:39

My cardiologist did a few stress test on me and confirmed that the motion of a push up puts additional strain on the leads. Now- that's just my case so I don't know how that applies to others.

In addition to the leads themselves- I personally have broken more leads than I would care to admit, the base of the leads are so imbedded in my heart that they cannot be removed. Due to the issue of my now limited real estate I have had a leaky lead for years now because my doctors don't want to waste the precious space. All in all, leads do break and if it's something you can avoid - I would recommend it, there are plenty of great workouts that will put less strain on those wires. 

Full Recovery

by Jdky - 2020-07-21 10:05:16

Generally speaking, what do you consider time frame for a full recovery? 

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