Brain Surgeon to Patient: Keep Lifting

[August West]

Rip,

I've read with interest some of the past threads here about blood pressure, valsalva, and other things people fret about sometimes. Yesterday I heard something that might interest you: the brain surgeon who repaired (or allowed me to continue living with) a cerebral aneurysm years ago said that lifting at max effort is fine, and may be beneficial from a cerebro-vascular perspective.

By way of background, about seven years ago I was diagnosed with a fusiform aneurysm in the basilar artery (brain stem, near where the vertebral arteries meet). Two of the three layers in the arterial wall had ruptured. I was 20 and had been having headaches, and a sharp (and attractive, hi Dr. Karen!) young ER doc ran an MRI and spotted it. They medevaced me by air from Wyoming, where I was working for the summer, to SLC. I got discharged, had a few weeks to figure out a plan, and talked to a few doctors about how to fix it. Some said stents, even more said don't try, it would be too risky and maybe you can live with it. Fuck living with that. I went with a doctor in Phoenix who is probably the best in the country, and he did something unique and drastic: did a craniotomy and clipped off the two vertebral arteries entirely. It wouldn't have worked for everyone, but it turned out I had enough collateral flow from the connectors and capillaries to keep me living like normal. There was a very dicey week in the ICU which I don't remember well, including an emergency second surgery to control a large clot and clear out fluid. But now I'm fixed: no stents, no ticking time bomb in my skull. This doctor and my family are friends now, which is unusual for him with patients. The guy is very physically active and he hates losing - I've been mountain biking with him and he will ride a section of trail 15 times until he cleans it.

I bought Starting Strength in November '09 and followed the program for about 7 months, culminating in my first PL meet. Since then I've kept training, mostly with a Texas Method setup, and competed again in November. My mom occasionally asked about blood pressure, do I hold my breath, and I mostly ducked the questions. Then she came to the meet in November and realized that yes, lifters do a hard valsalva. I had thought about it occasionally, but I know what an aneurysm feels like and I've never felt anything close to that while lifting.

So over New Years', she and my dad had dinner with this doctor (I wasn't there), and she asks him what he thinks about powerlifting. They talked about it for a half hour. He said the blood pressure within the brain is very carefully regulated - it's like a box of its own, which the body keeps apart from the rest of the system and will guard at all costs. A spike in blood pressure elsewhere does not equal a spike within the cerebrovascular system. In fact, he thinks that if anything was affected, it would be the smaller connecting vessels - he said they could benefit from it, and may even grow as a result. In my case, without those connectors, the surgery that saved my life would not have been possible. So not only am I lifting without problems despite the ruptured artery and titanium clips in my brain, I have approval from the brain surgeon who made it happen. I won't name him here, because it was a close conversation among friends and he doesn't need his name dragged around an internet board without his consent. But I thought you might enjoy.

Josh

[Mark Rippetoe]

I do, and we appreciate the post.

[toddmr]

. . . I know what an aneurysm feels like and I've never felt anything close to that while lifting.

That may be the greatest single line on the entire internet.

[Mark Rippetoe]

Yes. Not many get out alive with this information.

[pacificmonk]

Great stuff, August! I just want to wish you the best in all your lifting endeavors!