Dr's orders

[jrwinter01]

Hello Mark, I am 17 years old and I had followed the starting strength program for a few months during the summer. I have a heart condition known as a bicuspid aaortic valve. Normal hearts have a tricuspid valve. Since mine is bicuspid, my heart works harder to pump the blood through. My doctor told me that I shouldn't be lifting to a point where I was grunting or needed someone to spot me. I took my doctors advice and I started the program again but this time doing more reps with less weight. Before I did 3x5 squat, 3x5 bench, 3×5 press, 1x5 deadlift, and 5×3 power clean. Now I am doing the same amount of sets except double the amount of reps and decreased the weight. I am trying to make gains, do you think this will effect my ability to gain more muscle??
weight: 170
Height: 6'1
Macros: 170p/85f/340c
If so what correction might I make the solve this problem?

[Mark Rippetoe]

If you change the reps from 5s to 10s, you change the effect of the work, as described in the books. We use 5s for a specific reason, and your doctor/coach doesn't apparently understand this. And you're eating about half as many calories as necessary to make best use of your growth potential, for reasons you have not stated. What specific problems were being caused by the 5s that prompted you to change to 10s?

[PowerDaClean]

Arnold was born with a bicuspid aaortic heart valve

didnt stop him obviously

[Paul1]

There's either more to the story than the valve, or there's nothing more and the doc is being overcautious.

If there's more to the story, i.e. the valve really functions poorly, you have left ventricular disease as a result, he's talking about getting the valve repaired / replaced, then this is really not a conversation about 5s vs 10s -- it's about getting your heart right.

If this is all there is to the story -- it's just a bicuspid aortic valve with nothing more -- then you might just tell your doc that you're going to train how you want, you'll come to see him if you have 1) leg swelling 2) passing out 3) difficulty breathing or whatever -- and maybe you can get an echocardiogram twice a year or so to make sure there's no issue that coincides with training.

Is this, by the way, a cardiologist or a pediatrician seeing you?

[Bolson32]

Arnold was born with a bicuspid aaortic heart valve

didnt stop him obviously

Apparently he had surgery on it as well.

Might be worth digging into and possibly getting a second opinion, this article(if Rip let's me share) was a pretty cool read. Not sure where you fit, but this seemed like it might resonate with your situation.

"One situation that seems particularly ripe for differences of opinion is that of the athlete with BAV, no significant stenosis or regurgitation, but with an aortic diameter of 4.5 to 5.0 cm. This is an unfortunate situation for the athlete patient because the consensus guidelines do not yet recommend operation, yet advise against strenuous sports activities. My personal approach to endurance athletes in this situation would be to offer operation if the patient wanted to continue to participate in endurance sports (after operation) and was willing to assume the risks of operation. But I recognize that not all cardiologists or heart surgeons would agree."

[jrwinter01]

Well the 5s makes me grunt, or strain myself which my doctor said I shouldn't be doing, which I don't know if he knows what the hell he is talking about. He said I should do less weight with higher reps which is why I switched to 10s. And for the food consumption, Im not exactly trying to become a huge power lifter I just want to gain lots of lean muscle. Would I still eat double of what im eating now?

[Mark Rippetoe]

You didn't answer my question.

There's either more to the story than the valve, or there's nothing more and the doc is being overcautious.

In the absence of an answer to my question that indicates there was a problem, he's just being a Doctor. Doctors always tell everybody to "lift lighter weights and just do more reps." Always. Doesn't matter what's wrong. They are apparently taught this in Doctor School.

[Adam Skillin]

Doctors always tell everybody to "lift lighter weights and just do more reps." Always. Doesn't matter what's wrong. They are apparently taught this in Doctor School.

They're indoctorinated.

[jrwinter01]

There's either more to the story than the valve, or there's nothing more and the doc is being overcautious.

If there's more to the story, i.e. the valve really functions poorly, you have left ventricular disease as a result, he's talking about getting the valve repaired / replaced, then this is really not a conversation about 5s vs 10s -- it's about getting your heart right.

If this is all there is to the story -- it's just a bicuspid aortic valve with nothing more -- then you might just tell your doc that you're going to train how you want, you'll come to see him if you have 1) leg swelling 2) passing out 3) difficulty breathing or whatever -- and maybe you can get an echocardiogram twice a year or so to make sure there's no issue that coincides with training.

Is this, by the way, a cardiologist or a pediatrician seeing you?

He is a cardiologist. I left out that my heart is also enlarged and has a small leak. I think I will change to 5s and see how my body reacts.

[Mark Rippetoe]

Where is the "small leak"?