#Middlebury
DEAR DR. ROACH: I am a 62-year-old male. My aortic valve was replaced with a Carpentier-Edwards bovine tissue valve, and my ascending aorta was replaced in 2005. My question is about competitive powerlifting.
I compete in the bench press. I lift and train with between 50 percent and 100 percent of my max lift three to four times a week. How high does blood pressure go when lifting to the max on the bench press? Does it reach dangerous levels? Is the risk of damaging the valve slight, moderate or severe? Is there a risk of developing a second aneurysm? I want to compete, and I’m willing to accept some risks. What are your thoughts? – S.M.R.
ANSWER: Maintaining an active lifestyle can help prevent many diseases, and it’s useful as treatment for many more. The side effects generally are small. However, there are some exceptions, and this is one of them.
In powerlifting, many parts of the body are pushed to their physiological limits. In a maximum lift, part of the pressure of the weight is transmitted throughout the chest, which forces the heart to increase its pressure in order to continue blood flow. Measurements of elite-level lifters show that blood pressure can reach or exceed 300 mmHg (!) during a maximal lift. It is not uncommon to see bleeding from the nose or another body part as blood vessels burst under the pressure. Powerlifters are at increased risk for some kinds of heart damage and stroke during these lifts, but the risk for young, healthy lifters is not large, and bad outcomes are rare.
In your case, you have two potential weaknesses. The first is the prosthetic aortic valve, but the Carpentier-Edwards valve in particular has a reputation for strength. I think it is unlikely that you would damage the valve. It’s the abdominal aneurysm that concerns me.
Although the diseased part of the aorta has been replaced with a very strong graft, the attachment – where the graft is sewn onto your blood vessels – is a point of weakness. Also, it is possible you have weaknesses in other blood vessels. I can’t recommend powerlifting for you, competitive or not, as I think the risk is too great.
DEAR DR. ROACH: What is your opinion of neti pots? I use one as a preventive measure once a week, and if I have any symptoms of a cold or a stuffy head, I’ll use it more often. I haven’t had a cold or any bronchial problems in seven years. I’m 68 years old. – F.
ANSWER: It’s hard to argue with success, but you may be breaking out the neti pot more than you need to. A neti pot uses saline solution (made with sterile – distilled or boiled – water) to irrigate the nasal passages. The fluid gets rid of allergens, bacteria and mucus. Some people don’t mind the fluid sensation; others cannot tolerate it.
Using a neti pot at the onset of congestion makes sense. I’m not sure you need to use it as a preventive, but if you have symptoms when you don’t use it, it’s perfectly reasonable. The side effects usually are local and mild, such as nasal irritation and occasional nosebleeds.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
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