Aerobic Capacity Following General Anethesia?

[[email protected]]

Pete Cresswell writes:

> Anybody had the chance to compare their capacity before/after
> undergoing general > anesthesia?

> Had my gall bladder out in August and my take is that I'm still
> running at only about 60-70% of what I was before.

> Endurance is OK, but hills and top end cruising speed are still
> noticeably deficient.

> Anybody else?

I took two big hits in that respect, both major surgeries caused a
major loss in aerobic capacity that did not return. As you say,
endurance is good but I'm continuously out of breath climbing hills.
A lesser loss but also perceptible occurred recently when I had
reconstructive surgery on a three piece collar bone break.

Interestingly, the MD's either don't recognize this or they are
playing dumb. I have asked.

Jobst Brandt

 

[Leo Lichtman]

<[email protected]> wrote: (clip)both major surgeries caused
a major loss in aerobic capacity that did not return. (clip)
^^^^^^^^^^^^^^^
I'm having trouble thinking of any physical linkage between surgery and
aerobic capacity, except the what the medics call :"deconditioning." Jobst,
have you ever had a layoff from riding as long and total, without the
surgery? In my own case, I restarted riding after a hip replacement, and my
perception is that the only losses I experienced were due to the ten years
that didn't ride. Of course, it's impossible to separate the three possible
effects: aging, deconditioning, post-surgical effect.

 

[(PeteCresswell)]

Anybody had the chance to compare their capacity before/after undergoing general
anesthesia?

Had my gallbladder out in August and my take is that I'm still running at only
about 60-70% of what I was before.

Endurance is ok, but hills and top end cruising speed are still noticeably
deficient.

Anybody else?
--
PeteCresswell

 

[41]

Leo Lichtman wrote:
> In my own case, I restarted riding after a hip replacement, and my
> perception is that the only losses I experienced were due to the ten years
> that didn't ride. Of course, it's impossible to separate the three possible
> effects: aging, deconditioning, post-surgical effect.

Your situation is not comparable. If by 10 year lay-off you mean in
most all aerobic conditioning, then your VO2 max was too low for their
to be a big difference before and after. It's an entirely different
situation with someone operating at a high level.8

 

[Leo Lichtman]

"41" wrote: (clip) If by 10 year lay-off you mean in most all aerobic
conditioning, then your VO2 max was too low for their to be a big difference
before and after. (clip)
^^^^^^^^^^^^^^^^
I really didn't mean to have anyone use my experience as a data point in
this discussion. And, yes, I agree that a ten-year layoff should have
erased any fitness benefits that arose out of my previous riding history.
HOWEVER: I had a ten year layoff, and I was about sixteen years older than
when I started riding as an adult. In spite of this, I got going again with
less exhaustion than I had experienced sixteen years earlier. Don't ask me
why.

 

[41]

[email protected] wrote:
> Pete Cresswell writes:
>
> > Anybody had the chance to compare their capacity before/after
> > undergoing general > anesthesia?
>
> > Had my gall bladder out in August and my take is that I'm still
> > running at only about 60-70% of what I was before.
>
> > Endurance is OK, but hills and top end cruising speed are still
> > noticeably deficient.
>
> > Anybody else?
>
> I took two big hits in that respect, both major surgeries caused a
> major loss in aerobi c capacity that did not return. As you say,
> endurance is good but I'm continuously out of breath climbing hills.
> A lesser loss but also perceptible occurred recently when I had
> reconstructive surgery on a three piece collar bone break.

Questions:
1. How long since each operation?
2. How long were you anesthetized for each operation; local or general?
The longer and the deeper you were under general anesthesia, the worse.

Comments:
1. Out of breath climbing hills could be either reduction of aerobic
capacity, or reduction of anaerobic threshold. Do you have any
measurements of VO2 max pre/post op to compare? How about of your
maximum power output?
2. Surgery, with or without anesthetic, is a major injury which
requires recovery and produces scar tissue. Your immune system and
metabolism are mobilized in repair of the damage. Time frame at least
months.
3. Did you lose much blood during the operations, or were you given
either plasma or saline intravenous? Either will dilute the hemoglobin
count and this requires about three months for 100% recovery.
4. And of course their is the ensuing deconditioning-detraining cycle.


> Interes tingly, the MD's either don't recognize this or they are
> playing dumb. I have asked.

5. The possible long term after effects, apart from acute poisoning,
are only just beginning to be investigated:

<http://www.apsf.org/initiatives/outcomes.mspx>
and a guy from Palo Alto who was one of the first to discuss:
<http://chppcor.stanford.edu/news/537>

t

 

[BobT]

"41" <[email protected]> wrote in message
news:[email protected]...
>
> The longer and the deeper you were under general anesthesia, the worse.

Do you have any data to substantiate the above statement?

BobT

 

[41]

BobT wrote:
> "41" <[email protected]> wrote in message
> news:[email protected]...
> >
> > The longer and the deeper you were under general anesthesia, the worse.
>
> Do you have any data to substantiate the abo ve statement?

For recovery from anesthesia in the normal time frames that are
typically considered, say hours to 10 days, this is standard medical
knowledge ("the worse" meaning the longer the recovery). I believe the
easiest search term you could Google would be BIS monitoring. These are
systems to check for the hypnotic effect of anesthesia, with a view
toward getting a big enough dose to get a proper anesthetic effect, yet
as low a dose as possible to allow for the most rapid recovery. As with
any other drug, the bigger the dose the longer the recovery time.

For the longer term effects more of interest to this thread, the
research is only beginning. In the second link I gave, you should be
able to chase down that fellow's research. S

 

[[email protected]]

Leo Lichtman writes:

> (clip)both major surgeries caused a major loss in aerobic capacity
> that did not return. (clip) I'm having trouble thinking of any
> physical linkage between surgery and aerobic capacity, except the
> what the medics call :"deconditioning."

I've been off the bicycle for longer than the surgery and
rehabilitation and come back to better conditioning. For instance,
after my bicycle torus in the Alps, I usually take as much as three
weeks traveling by rail to visit friends and relatives, sitting on my
butt most of the time. When I got home and on the bicycle, none of
this was noticeable but after my resent collar bone surgery, where I
was riding long distances before and after the two day respite, loss
of aerobic capacity was striking.

> Jobst, have you ever had a layoff from riding as long and total,
> without the surgery? In my own case, I restarted riding after a hip
> replacement, and my perception is that the only losses I experienced
> were due to the ten years that didn't ride. Of course, it's
> impossible to separate the three possible effects: aging,
> deconditioning, post-surgical effect.

This is not conditioning but aerobic capacity. You have no idea how
hard I must breathe to climb hills. It is a step function of
significant size. My explanation is that capillaries in the lungs are
permanently damaged from no inflation during surgery. Younger people
can probably regenerate these losses. The difference was striking and
permanent from before to after. It's not like being out of shape, but
rather, out of breath, as I take up to 140 mile rides in the Santa
Cruz mountains.

Jobst Brandt

 

[[email protected]]

George King writes:

>>> Anybody had the chance to compare their capacity before/after
>>> undergoing general > anesthesia?

>>> Had my gall bladder out in August and my take is that I'm still
>>> running at only about 60-70% of what I was before.

>>> Endurance is OK, but hills and top end cruising speed are still
>>> noticeably deficient.

>>> Anybody else?

>> I took two big hits in that respect, both major surgeries caused a
>> major loss in aerobic capacity that did not return. As you say,
>> endurance is good but I'm continuously out of breath climbing
>> hills. A lesser loss but also perceptible occurred recently when I
>> had reconstructive surgery on a three piece collar bone break.

> Questions:

> 1. How long since each operation?

Two and four years. The collar bone was after my crash in the Alps
this summer.

> 2. How long were you anesthetized for each operation; local or
> general?

I don't know but mitral valve replacement is fairly deep.

> The longer and the deeper you were under general anesthesia, the
> worse.

No doubt, but even shorter stints are no good.

> Comments:

> 1. Out of breath climbing hills could be either reduction of aerobic
> capacity, or reduction of anaerobic threshold. Do you have any
> measurements of VO2 max pre/post op to compare? How about of your
> maximum power output?

How long I was out is not known but the before and after was a large
loss in aerobic capacity. I was shocked how just riding up a road
underpass affected me the way a long hill used to. Immediately out of
breath.

> 2. Surgery, with or without anesthetic, is a major injury which
> requires recovery and produces scar tissue. Your immune system and
> metabolism are mobilized in repair of the damage. Time frame at
> least months.

As I said, the last event, the collar bone nailing, was only a day off
the bicycle.

> 3. Did you lose much blood during the operations, or were you given
> either plasma or saline intravenous? Either will dilute the
> hemoglobin count and this requires about three months for 100%
> recovery.

I don't know. At rest I felt OK but walking stairs and especially
getting back on the bicycle, trivial hills became a major hurdle.

> 4. And of course their is the ensuing deconditioning-detraining cycle.

As I said, I've been off the bicycle for weeks and not had any loss
other than endurance that came back with a couple of rides.

>> Interestingly, the MD's either don't recognize this or they are
>> playing dumb. I have asked.

> 5. The possible long term after effects, apart from acute poisoning,
> are only just beginning to be investigated:

http://www.apsf.org/initiatives/outcomes.mspx

> and a guy from Palo Alto who was one of the first to discuss:

http://chppcor.stanford.edu/news/537

These reports seem to indicate a previous cavalier attitude about the
subject. It's like the titanium wire sutures the heart guys wanted to
leave in my breast bone... because most old farts who have such surgery
are fat and have lots of padding there. I could not lie on my stomach
and the wires were visible as bumps under the skin.

They got removed but I had to press them on it.

Jobst Brandt

 

[Leo Lichtman]

<[email protected]> wrote: (clip) My explanation is that
capillaries in the lungs are permanently damaged from no inflation during
surgery.
^^^^^^^^^^^^^^
That makes some sense. If the capillaries are damaged, this could affect
the ability of oxygen to migrate into the bloodstream. But, since you
mention lack of inflation, I wonder whether you really meant to say the air
sacs in the lungs lose some of their elasticity, something like emphyzema.

In another thread, there has been an ongoing discussion about the possible
after effects of antibiotics on performance during recovery. Is this
possibly related to the problem we are discussing here?

 

[Martin]

(PeteCresswell) wrote:
> Anybody had the chance to compare their capacity before/after undergoing general
> anesthesia?
>
> Had my gallbladder out in August and my take is that I'm still running at only
> about 60-70% of what I was before.
>
> Endurance is ok, but hills and top end cruising speed are still noticeably
> deficient.
>
> Anybody else?

Armstrong had fairly major surgery to remove brain tumours. It didn't
seem to affect him much in the long term.


--
Removed z before replying by email.

 

[Leo Lichtman]

"(PeteCresswell)" wrote: General anesthesia or a spinal?
^^^^^^^^^^^^^^^^^
Spinal.

 

[George]

> This is not conditioning but aerobic capacity. You have no idea how
hard I must breathe to climb hills.
Jobst Brandt

I do have an idea! Even I passed you up OLH; you were huffing like a
steam engine... although it COULD be the 20 year age differential... .
No anaethesia for me!

George

 

[George]

>But did he (Lance Armstrong) have general anaesthesia?
--
PeteCresswell

Yeah. They opened up his head, gouged out his tumors, and gave him a
couple of aspirin for his discomfort. Yeah, he probably had a local,
which explains why he still can climb... .
Sincerely, George

 

[Alfred Ryder]

"(PeteCresswell)" wrote
> Anybody had the chance to compare their capacity before/after undergoing
general
> anesthesia?
>
> Had my gallbladder out in August and my take is that I'm still running at
only
> about 60-70% of what I was before.
>
> Endurance is ok, but hills and top end cruising speed are still noticeably
> deficient.
>
> Anybody else?

I have two small data points:

Many years ago, I suddenly found that I was completely out of breath just
walking across campus. An x-ray showed that I had "spontaneous pneumothorax"
which healed itself within a couple of weeks or so. For a fairly reliable
note on the subject, see
http://www.mayoclinic.com/health/pneumothorax/HQ01228
The note says that "A partially collapsed lung may slowly re-expand without
treatment. But a severe collapse will probably never re-expand on its own
and may require surgery if untreated."

In the following reference, the Mayo Clinic says that "collapsed lung" can
result from heavy sedation.
http://www.mayoclinic.com/health/atelectasis/AN00775

A couple of weeks ago I had general anestheselogy and probably was out for a
couple of hours. I did my usual 30 mile ride the day before the surgery and
a couple of days after and did not notice any difference. I wish I had known
about the potential problem before the surgery so that I could have been a
little more observent.

 

[41]

[email protected] wrote:

[many relevant details +]
> I don't know but mitral valve replacement is fairly deep.

OK, I see in fact there are a lot of factors here. If you got a ball
and cage or other mechanical replacement, that would explain it all.
Pig valves are better but still not the original.

By the way you are in good company. Do you remember Ron Clarke (AUS)?
Track (running), world record holder, 10,000m. Then there is Ahnuld....


> http://chppcor.stanford.edu/news/537
>
> These reports seem to indicate a previous cavalier attitude about the
> sub ject.

Absolutely. Remember also that ether used to be used as an anesthetic.
However, I don't think it is the source of your problem It is
definitely not the capillaries. Damaged capillaries leak and that would
have been very noticeable, in a different way.

>It's like the titanium wire sutures the heart guys wanted to
> leave in my breast bone... because most old farts who have such surgery
> are fat and have lots of padding there.

Actually I think such surgery is more common for younger people (age
40-55?). I suspect your high level of conditioning allowed you to get
along with the old valve for much longer than normal.

 

[(PeteCresswell)]

Per Leo Lichtman:
>In my own case, I restarted riding after a hip replacement, and my
>perception is that the only losses I experienced were due to the ten years
>that didn't ride.

General anesthesia or a spinal?
--
PeteCresswell

 

[(PeteCresswell)]

Per Martin:
>Armstrong had fairly major surgery to remove brain tumours. It didn't
>seem to affect him much in the long term.

But did he have general anesthesia?
--
PeteCresswell

 

[41]

George wrote:
> >But did he (Lance Armstrong) have general anaesthesia?
> --
> PeteCresswell
>
> Yeah. They opened up his head, gouged out his tumors, and gave him a
> couple of aspirin for his discomfort. Yeah, he probably had a local,
> which expla ins why he still can climb... .

Well, brain surgery is typically performed with the patient still
conscious, because you need their input to tell you where not to zap.
Brain tissue has no pain receptors of its own. Don't mind the circular
saw through the skull while we get there though...

Dr Penfield anyone? (Google: Wilder Penfield)i