Silent Danger: Cody's Aortic Aneurysm and the Importance of Heart Health in Athletics

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Boots Knighton [: 00:00:02

Hello, and welcome to The Heart Chamber. I am your host, Boots Knighton. Today on episode 22, I bring you Cody McKay or as he's affectionately known as Cardiac Cody. Cody had an ascending aortic aneurysm that led to open heart surgery when he was 29 years old. He has had an amazing recovery, and he shares all his tips and tricks on how he is thriving now post open heart surgery.

Boots Knighton [: 00:00:40

Welcome to The Heart Chamber. Hope, inspiration, and healing. Conversations on open heart surgery. I am your host, Boots Knighton. If you are a heart patient, a caregiver, a health care provider, a healer, or just looking for open hearted living, this podcast is for you. To make sure you are in rhythm with The Heart Chamber, be sure to subscribe or follow wherever you are listening to this episode. While you're listening today, think of someone who may appreciate this information. The number one-way people learn about a podcast is through a friend. Don't you want to be the reason someone you know gained this heartfelt information? And if you haven't already, follow me on Instagram. Two different places, @boots.knighton or @TheHeartChamberPodcast. You can also find me on LinkedIn as well as Facebook. But enough with the directions, without further delay, let's get to this week's episode.

Boots Knighton [00:1:52]:

So, thank you, Cody McKay, for your willingness to come on to The Heart Chamber. I found Cody through social media, the beauty of hashtags on Instagram. I was looking for people who would be willing to come on and share their stories of hope and healing from open heart surgery. And Cody caught my eye. He is a cyclist and super ambitious about basically paying it forward and helping those that come after him like I am doing, and so, I instantly was drawn to Cody's story. So, Cody, thank you so much for your willingness to be vulnerable and come on to this podcast because I know your story is going to inspire so many people.

Cody McKay [: 00:02:40

Yeah. No. It's really great to be here. Thanks so much for having me.

Boots Knighton [: 00:02:43

So, Cody, help us set the scene. Like, where are you? Tell us, like, what do you do? Your age? Give us kind of like the lay of the land of Cody McKay's life at the moment.

Cody McKay [: 00:02:56

Yeah. Sure. So, I'm based in Ottawa, Ontario. I'm, 32 years old now. My 9 to 5, I work as a policy analyst. But, basically, all other times, I'm on my bike, either trying to race it or use it as a tool to go on some adventures and see different communities that I haven't been into before. I previously was a cross country and track and field runner. And so, when I moved to Ottawa for work about 8 years ago now, I took it as an opportunity to try a new sport. I was kind of tired with running at that point, and, I wanted to try something new and very quickly found myself falling in love with racing my bike. So, a lot of similarities in the endurance side of things, but it was a new way to get me excited about continuing to be involved in sport as I entered or excited the kind of the varsity ecosystem of postsecondary and entered the working phase of my life.

Cody McKay [: 00:03:50

It was in: 2021

Cody McKay [: 00:04:47

Thankfully, I live in Ottawa, which is, home to the University of Ottawa Heart Institute, which is Canada's largest cardiac center, and they said, okay. We're going to send you off to the Heart Institute to do some tests. Naturally, as a 29-year-old and feeling like, you know, heavily involved in sport and so otherwise feeling fairly invincible, I thought not much of it other than the frustration I was still dealing with some shortness of breath issues and went in pretty mindlessly for my tests. So, they did, pin echocardiogram and then sent me on my way. And about a month after that, I got a message that said, we're going to send you in for a CT scan.

Boots Knighton [: 00:05:22

Help us understand the Canadian health care system. You said there was a month that went by from your echo till you were about to tell us about the next call you got. Does it take a while for you to get your results there in Canada?

Cody McKay [: 00:05:38

Once everything was sorted out, not really. I think it was more of a matter that I was a referral patient into the Heart Institute. And so, there is that period of, you know, I'm an outsider getting some tests that then have to be routed back to my doctor's office, that then have to be looked at to then say, okay, what's the next plan of action, rode it back into the Heart Institute, so on and so forth.

Boots Knighton [: 00:05:59

And all this happened without your, like, advocating? Like, you just went about your life. You went about riding your bike.

Cody McKay [: 00:06:06

Oh, yeah. I was completely oblivious to everything at this point.

Boots Knighton [: 00:06:08

Oh, wow.

Cody McKay [: 00:06:09

Yeah.

Boots Knighton [: 00:06:09

Gotcha.

Cody McKay [: 00:06:10

Still thinking about how to fix the shortness of breath issues, still thinking about, I mean, there wasn't really much racing happening at this point again because of COVID, but I had a really good season of training the year before that. And so, I was quiet, you know, excited to see that progression continue and was frustrated that this was kind of taking things off the rails. So, I was being a little bit, you know, boneheaded, stumbling, more preoccupied with thinking about that aspect of it, rather than saying, you know, I wonder what all these tests are about and, you know, could these be serious by any chance? But it was around when the CT got ordered that it was like, okay. These are not normal tests that you just send someone in for no reason. And so, shortly after for that, the confirmation came that I was currently living with ascending aortic aneurysm. And so, I very quickly went from, thinking about, you know, how do I get myself back on track, to training to going, oh, wow. This is pretty serious. When I first received the diagnosis, I didn't, I wouldn't say I didn't think much of it, but I was so naive to the whole ecosystem of heart and cardiovascular diseases.

Cody McKay [: 00:07:08

You know, the name didn't mean much to me. It took some reading and learning and understanding to really realize the gravity of the situation I was in. This is not, you know, just a bum knee that you can ignore. This is, pretty life and death. And naturally, that meant that, my mental health went on a bit of a roller coaster as well. I went on from feeling quite invincible to feeling like, oh, you know, if I sneeze the wrong way, this thing might rupture and then goodbye, Cody, so.

Boots Knighton [: 00:07:31

Right. And walk us through that a little bit because and I would love to do a little bit of compare, contrast with American and Canadian health care systems too throughout your journey. But I know at least in America, for myself and many of the heart patients I've already had the privilege of meeting. The emotional mental components of heart issues are just not addressed, and then you are kind of left out to do your own management of basically your nervous system. So, yeah, I can only imagine how jarring this was for you. Like you said, you were invincible, prime of your life, and then bam. No. This X-ray finds something completely, like, out of the blue for you. That had to be quite the roller coaster.

Cody McKay [: 00:08:20

Yeah. Absolutely. I mean, I can certainly empathize with, you know, other individuals that have had their own journeys with heart disease or cardiovascular disease, and I feel like a lot of individuals may, with the types of challenges that I had, may have learned these types of things earlier in their life. But for me, it was kind of the total 180 of understanding of something happening within a in a 1 week or 2-week period, going from being, you know, Cody, the guy that really likes to push himself as a cyclist as hard as he can to Cody the guy that's living with a very life-threatening condition. It wasn't something that kind of was monitored and grew over time. In my instance, it was ultimately found be connected to a previously unknown congenital birth defect with my aortic valve.

Boots Knighton [: 00:09:01

So, did you have a bicuspid valve?

Cody McKay [: 00:09:03

I'm kind of straddling in a unique zone. My surgeon said I have some tendencies of a unicuspidal valve, so I really rolled the lucky dice on that one. You know, because a bicuspid valve is actually not, actually that uncommon in individuals, but a unicuspidal valve is a fair bit more uncommon. He wouldn't classify it as a full blown unicuspidal valve. There are just very minor amounts of fusing on some of the leaflets that would have kind of given it some of those tendencies. And so, when they saw that, they figured, you know, paired with a lack of any other credible reason for an individual like myself to have an aneurysm at my age, that was really seen as the what would have been slowly changing the impact of my aorta over multiple years of my life. But that in and of itself is a really crazy thing to think about in hindsight because that means that there were many years of my life where I was running as a varsity cross country and track and field athlete, was coaching freestyle skiing for many years, and now I've been racing my bike for many years. And this thing has been there the whole time. This isn't, you know, something that developed in the period of the week and few we caught it in time, I mean, we never really did much with it, but it was this unknown kind of ticking time bomb that was sitting there.

Cody McKay [: 00:10:12

And thankfully, nothing ever happened with it because there's certainly a scenario where that chest x-ray wasn't ordered or that, you know, the fact that they looked at my heart and not my lungs on that x-ray. There are so many different scenarios that could have happened there. And the outcome’s associated with that would have been, I would have continued to race and train and just be completely naive of this thing that was happening under my skin, and that one probably would have had a much worse, worse outcome.

Boots Knighton [: 00:10:35

Right. Right. And then wondering why you couldn't breathe. You know? Like, there was so much there. So, yeah, you were saying that you had the echo, and then a month goes by, and then you get a call.

Cody McKay [: 00:10:46

Yeah. And so, then I go in for a CT, and then it shortly after that where the confirmation comes that there is an ascending aortic aneurysm. And once I'm kind of routed into the Heart Institute, I'm assigned a cardiologist, and I'm working within their own team, directly, things really start to improve quite a bit. I'm super thankful to have had a great cardiologist who immediately looked at the situation, understood, you know, not just the biology or the physiology of the situation, but also the mental aspects of it as well as an individual who's heavily involved in sport and suddenly having that aspect of their lives. Life removed, the mental health associated with it, you know, just how do I live with this? Can I live with this? How is this going to change? What are the things that bring me joy in life, and can I not do those things anymore? Like, there's a much more holistic look at the pros and cons and how do we manage the situation. But also looking at it from a medical standpoint to say, you know, this is a very young athletic individual, the usual list of suspects for what causes an aortic aneurysm. A lot of these get removed quite a bit just even from the echo and the CT to say, you know, there's no stenosis, there's no calcification, there's nothing here that's really indicating that the aneurysm would have been caused by many things, and so very quickly, it was kind of by rule of elimination brought down to either genetics or a bicuspid valve. And because the echo wasn't really able to pick up the minor fusing on the valve, it looked tricuspid from the imaging, and so there was a lot of emphasis put on, okay, let's make sure there is no larger genetic issues at play here, you know, things like, Ehlers Danlos or Marfan or things like that. So, I had to do, you know, full genetic testing and get those things sorted out as well.

Boots Knighton [: 00:12:27

Wow. And then waiting for those results, how long did that take?

Cody McKay [: 00:12:31

That one took a while.

Boots Knighton [: 00:12:32

Yeah. It's like 6 to 8 weeks, right?

Cody McKay [: 00:12:34

Yeah. And surprisingly, I mean, nothing ever came back of those. I was told from the get go that there's a chance that you'll get a very slim chance on one end that you'll get a very firm no based on, you know, the amount of the human genome that's been decoded. There's a big gray area in the middle, and then there's a small sliver of, you know, a very hard yes. So, despite the improvements in genetic testing, there's still a lot of question marks that come from the results of genetic testing. And there is an expectation that I would probably fall within that gray area, something kind of pinging off and saying, okay. There's something a little bit not normal here, but we can't really say with a 100% confidence, yes, you have Marfan's or you have x. But they said the results came back in the know.

Cody McKay [: 00:13:16

And so that, again, was one of the things that ultimately pointed back towards a valve, mutation because I mean, there's still a lot of, like I said, a lot of the genome that needs to be decoded, and it will be something I'll have to keep an eye on. But at least for where the science is right now, there was nothing really to say genetics are a larger issue with muscle elasticity or tissue elasticity was at play.

Boots Knighton [: 00:13:37

me of year was this? You said: 2021

Cody McKay [: 00:13:50

Yeah. That also causes a little bit of delays in the in the whole delivery at that moment.

Boots Knighton [: 00:13:53

gery in the same year as you,: 2021

Cody McKay [: 00:14:09

really until midyear through: 2021

Cody McKay [: 00:15:21

egard again. And, ironically,: 2022

Cody McKay [: 00:15:41

ng the surgery in December of: 2022

Cody McKay [: 00:16:24

A lot of individuals live with medically managed aneurysms. And the last thing I'd want to do is give this perception that because you have an aneurysm, you have to live this, you know, sheltered bubble life. I was riding a 120, 150 kilometers quite easily with this aneurysm still in my body. It just meant I had to approach the ride a little bit different. And every individual is going to have different levels of what that means for them. In my instance, my previous training meant that I had a fairly high aerobic ceiling. And as long as I was kind of at a mid-grade percentage of that aerobic effort, it meant that I could still ride my bike no problem because the changes in the body at that intensity were not really going to be enough to cause a significant pressure against the aneurysm. Was my heart rate going to be elevated? Yeah. A 100%. But it wasn't going to be elevated in tandem with, you know, blood pressure and other issues in the body that could've put me at a significant level of risk. It's the same thing that I learned as I was going through the cardiac rehab program with weights.

Cody McKay [: 00:17:23

ncorporate over the period of: 2022

Boots Knighton [: 00:17:47

Wow. I have, like, so many curiosities and questions because, I, in the United States, particularly as a woman, women are oftentimes not referred for cardiac rehab, and I've actually joined a national organization called Women Heart that is pushing for better legislation out of DC and guidance from Women Heart and other organizations to encourage surgeons, cardiologists who refer women, always to refer women to cardiac rehab. There's such a disconnect between how men are treated versus women in the United States. And I hope that in Canada, it is better for women because I definitely was not guided on weight lifting or anything like that, and I just had to sit still and wait for my surgery. But I had a completely different issue than you. I do have a bicuspid valve, but that's not currently a problem, and my aorta is okay, thankfully. But when you're talking about the prehab, I have a couple of questions about that. The first one is you were saying that and help me with your wording or how they worded it for you.

Boots Knighton [: 00:19:04

You had to change the intensity because of how the body would respond. Can you speak to that a little bit more specifically and educate us on what that means? Because what I'm hearing is you can still be active, but you need these parameters. Are you able to, like, share with us what your PTs, how they explain that to you?

Cody McKay [: 00:19:29

Yeah. First of all, I'm not a medical professional.

Boots Knighton [: 00:19:32

Oh, yeah. We know. Don't worry. No one sue Cody, please.

Cody McKay [: 00:19:36

And every situation is going to be different. So, again, in my instance, I've been training for my sport that I compete in, for many, many years, and that gave me a bit of a leg up on the ceiling for me. In my instance, it was looking at essentially the intensities of my heart rate, how that would co-relate to things like, blood pressure within the body as well, and essentially looking at aerobic system, the anaerobic system, neuromuscular system, those energy systems, and the way the body responds as you ride at different intensities or, you know, pursue an activity at different intensities. And so, for me, it was essentially looking at kind of like a zone 2 to zone 3 intensity of heart rate, which my max heart rate is in and around mid-190s. My kind of threshold heart rate, if I was going all out for, you know, a 20-minute effort or a 30-minute effort would be around 180. And so, for my team, they felt quite comfortable giving me a ceiling of around 140 to 150. They said, when you're riding in and around that rate and you're, you know, not going above it, this isn't like a 140 average that has a bunch of spikes, but you're approaching it as, keep it that or lower. What's happening in the body is it's, like, a less strenuous impact on the body.

Cody McKay [: 00:20:50

That was kind of how I had to reapproach riding. So, when I come up to a hill rather than kind of just get out of my saddle and mash up the hill as hard as I can to just get it done with, that means I have to, you know, go into an easier gear, continue to spin up the hill, and try and keep things a little bit steadier. So, the way I had to ride was changing, but, again, it didn't mean I couldn't ride at all. And actually, with the ceiling that I was given personally, it gave me quite a bit of freedom to do quite a bit. With that kind of heart rate, I was still able to cruise around at 30 to 35 kilometers per hour. And so, you can still see quite a bit of the countryside in that way.

Boots Knighton [: 00:21:24

Wow. That's so fortunate for you. My arteries were being compressed, and they were basically not refilling with blood. My heart was just short of oxygen. So, yeah, we had completely different situations going on. And with the weight lifting, tell us a little bit more about that. Be a little more specific.

Cody McKay [: 00:21:42

So, for me, it was, I've heard different ranges. Some individuals have restrictions that are a little bit lower. Some have them a little bit higher. For me, it was about 20 pounds. It meant that I could use weights up about 20 pounds, but I, and I could build a modified program to do different strength activities with weights up to about 20 pounds. So, I'm not doing, you know, a 160-pound squat or anything like that, but it meant that I could do, like, a goblet squat with a 20-pound weight or I could do different activities, like incorporating those types of weights. So, again, the reality and the takeaway message that I'd encourage individuals to have conversations with their medical teams about us to say, okay. What makes sense for me? We don't live in a binary world where it's either a 100% you can do every single thing you want to do or you do absolutely nothing.

Cody McKay [: 00:22:27

Some people may fall in the 50%. Some may fall in that kind of 20% of what they used to be able to do. Some may be able to do, like, 60% of what they used to be able to do. But learning and tailoring and finding a solution is going to keep everyone healthy while they're living and managing whatever challenges that they're working with.

Boots Knighton [: 00:22:44

Okay. So, you had surgery in: 2022

Cody McKay [: 00:22:54

It went pretty smoothly as far as I know. I wasn't really, wasn't really around for it. But very straightforward, the goal was to remove the aneurysm, replace it with a synthetic graft and potentially do some work in and around my aortic root and valve. But once they got in there and they looked at everything, despite having some minor mutations on the aortic valve, they found it worked reasonably functional compared to a normal valve. Not really significantly less than any sort of normal valve.

Cody McKay [: 00:23:24

And with that in mind, they looked at it and they said, you know, any sort of repair work or putting in a new aortic valve, both of these outcomes are going to come with a reduced quality of life for you. Could this valve fail at some point in the future? Maybe. But at this point, your odds are as good as anyone else's feeling in the future because it works perfectly fine. And the fact that you developed an aneurysm over the course of many years, but your valve still works so well, we usually see things the other way around where the valve starts to go before the mutation can cause the type of change in your aorta that would cause an aneurysm. And so, given that, if you've been able to push it through the rigor of many years of competitive sport and it still looked the way it did when we had you opened up, you're better off with this valve as it is. And so, they left the valve. That simplified the procedure to just be focused on descending aortic aneurysm not getting into the root and anything like that. And then they closed me up and sent me on my way. And the surgery itself had its ups and downs.

Cody McKay [: 00:24:18

I was really surprised with how I felt in the, first 24 hours after the surgery. I was quite upright in the bed, in the ICU. When my mom and, my partner, Emily, came in to see me after the surgery, I was, you know, chipper and upright in bed and just having conversations and they're looking at me like, can you just have a surgery? Like, I don't know. I guess it was that easy. This is great. And then, of course, once the IV lines and the intensity of the amount of drugs they were pumping into me started to subside and wean me off the highest amounts of drugs, that's when things really started to take a turn for the worse. I'd say the next 48 hours after that initial 24 were probably the hardest part of the journey for me.

Cody McKay [: 00:24:58

And there was a lot of time there where I was thinking, you know, I really made a mistake here. I was right on the cusp of needing the surgery, but I probably could've pushed it for another year or two. Maybe a couple more years, why did I do this? I had such a great year of riding my bike. Sure. I wasn't racing, but I was, you know, living life to my fullest. I was having a great time, and I just, I can't imagine feeling normal again because this just feels so horrible. I couldn't get comfortable. I was just, like, covered in sweat, couldn’t sleep. I was never awake, but never asleep really.

Cody McKay [: 00:25:26

And that was kind of what defined the next 48 hours when I was in the step down ward. But very quickly after that or throughout that period as they started to get me up and walking, you know, just getting out of bed was a crazy experience, and then walking 10 feet was a really hard experience. And each time when they said you're going to be walking this much farther today. I was like, absolutely not. I'm not going to be doing any of that because I feel horrible. But then I did it, and then it kept on getting better. And then they said, okay. Today, you're going to walk without a walker.

Cody McKay [: 00:25:52

And I'm like, absolutely not. And then I did it. And that just kept on continuing to be the journey and walking up the stairs. Oh, are you kidding me? And then I did it. That really defined the entirety of that hospital stay after those 48 hours or the darkest 48 hours, I'll call it. Things really started to exponentially improve. And quickly after that, I was ended up being discharged a day early. And so, they said, you're good.

Cody McKay [: 00:26:17

You're on your way. And I walked out of the hospital. I got out of my bed that I was in, out of the room I was in, put on my shoes. No wheelchair. No nothing. Took the elevator down to the front door and strolled up the front door, got in the back seat of my car with my pillow. If you look on my Instagram account, kind of, the first post that I made in this new approach of being a lot more of an advocate and demonstrating, you know, this was my own personal experience because of the lack of that awareness and wanting to have that before my surgery and wanting to share that experience for others who may be going through it or will be going through it in the future. You'll see within the kind of 4 or 6 photos, you know, the ICU Day, the days after, the days when I'm just knocked out and in the bed in the ward, and then the days when I'm walking and it looks like I may be going, you know, I'd be losing a race to a tortoise. And then literally the next day, I'm walking out with, like, hands in my pockets just like, yeah. Hey. This is great. So, it was a, yeah, a real roller coaster of an experience in and of itself.

Boots Knighton [: 00:27:17

It's amazing how quickly it does change, and I just felt like I just relived my entire hospital stay through your story, and my husband, Jason, took a video of me walking the next morning, like, they made me get up out of the bed several hours after surgery too, and I was like, you guys know. But I was so busy vomiting, you know, so I had other better things to do, like getting all those toxins out of my body. But he got a video of me the next day walking in the ICU hallway, and my memory says I was so fast. I laughed when you said a tortoise could have beat you because I was so slow, but I've felt like I was so fast, but it was because my heart was finally getting oxygen, and, like, I realized I wasn't going to die anymore. The roller coaster you go through physically, emotionally, mentally, it's hard to really find the accurate words. So, you were 29 at the time. So, how many days total were you in the hospital?

Cody McKay [: 00:28:24

I think it was 4 or 5 days overall.

Boots Knighton [: 00:28:28

Okay. Yeah. I was the same. And then the United States, at least, I don't know if they had this kind of the same equation for Canada, but for every decade that you are alive equals a day in the hospital after surgery. So, I was let out a day early also, but, yeah, it's like, my dad also had open heart surgery, ironically, and for different reasons, but he was in the hospital for 7 days because he was in his seventies. Right? So, yeah, it's just kind of an interesting calculation that they use. So, you go home. Do you get a heart pillow also at the Ottawa Heart Institute or hospital?

Cody McKay [: 00:29:11

Kind of. I've seen a lot of the photos online, and I was hoping to get, you know, a nice heart shaped pillow, but mine was actually just a rectangle. But,

Boots Knighton [: 00:29:17

what?

Cody McKay [: 00:29:18

It was all brand, yeah. I know.

Boots Knighton [: 00:29:21

That needs to be part of your project heart is to, like, bring heart pillows to Canada. Okay. So, you get home and tell us about your recovery. Let's just for all intents and purposes, I'm calling you a pro athlete. K. So, you went into this at an advantage than I would say a lot of heart patients have. So, how was recovery for you?

Cody McKay [: 00:29:45

Yeah. So, I mean, just to give some context going into the surgery, I was really physically active, like, right up until the surgery date, my last ride. Because it was in December, I was riding inside at that point on Zwift. But my last ride was literally maybe 12 hours, 8 hours before the surgery, like, the afternoon before I went in at 6 AM the next morning. So, I was pushing it right up until the last day. And so, on the other side of the surgery, I had my walking program and rehab kind of really picked up quite quickly. I think I was within a week of being discharged from the hospital. I mean, I was still sleeping quite a bit, and I was very thankful to be on disability at that point so I could really treat my recovery like a full-time job.

Cody McKay [: 00:30:26

And so, if the body said I needed rest, then I was giving myself rest. If my body said, you know, move around the house, then I was moving around the house. And I really focused on the signals that my body was giving me and doing my best to, you know, get a nice healthy diet in, really focus on every aspect of it that I could. And I was sleeping quite a bit. I mean, at that point, the week I was in the hospital and the first week out of the hospital, I think I was sleeping anywhere from 15 to 18 hours a day. Like, it was quite a bit. And I was really focused on saying, if that's what my body needs, then that's what my body needs. But as soon as I started my walking program, it started very short.

Cody McKay [: 00:31:00

It was, you know, start with 10 minutes a day. Then it was 2 times 10 minutes a day, then 2 times 12 minutes a day, then 2 times 14 minutes a day, and it was just a little bit more every single time. And thankfully, we had a very mild, at least, start to winter in Ottawa last year, and so I was able to do quite a bit of this walking outside and not worry about the frigid, you know, minus 30 degrees that we deal with up in Canada. I was able to do, you know, I think, 90% of the walks, 95% of the walks unless it was a snowstorm outside. But very quickly, the timeline of I think it was supposed to get up to about 2 times 40 minutes a day. And then once you hit that, then you're supposed to try and target a certain distance within those 40 minutes. And I think halfway through the period of, I was supposed to hit it, I was like, oh, oops. I'm already there, and I walked too fast.

Cody McKay [: 00:31:44

So, the recovery went really quite well, and then I just continued to focus on it from there. So, I just kept on walking. For any cyclists that are listening to the podcast, obviously, the, you know, the cafe ride concept is a very popular one, and so I just kind of borrowed that concept. Caffeine really wasn't having much of an impact on my blood pressure, and so I didn't have to, you know, go cold turkey on anything like that. I'm a big lover of coffee. And so, I just walked to a cafe, and I'd get a coffee, and then I'd walk back home. So, the exact same concept as the cafe ride except while walking. So, after about 6 weeks, I'm supposed to go in and do my first proper checkup, see how the incision is healing, see how the breastbone's healing, see how everything's going, that unfortunately got canceled because my surgeon was sick that week. And so, then I called the team that was responsible for all the patients at the heart institute and talked to the lead nurse there and said, you know, we were going to have conversations around how the recovery is going and whether, you know, the sternum's fused back together enough to start thinking about supporting a little bit more weight. Probably would have been cleared at this point. How would you feel if I tried to get on the bike? She said, well, you know, you've been walking a lot. It's been going really well. Don't be dumb. Don't, you know, stand up and get out of saddle or anything. Don't be reefing on the handlebars or anything.

Cody McKay [: 00:32:57

But if you think you can comfortably hold your upper body while on your bike, then give it a try and see what happens. And so, pretty much 6 weeks to the day from the surgery was my first bike ride after. And from there, I just didn't look back. It was a blend of walking, riding, obviously, a lot of low intensity still. I was still on so many different drugs. It looked like we had a pharmacy up in our bathroom.

Boots Knighton [: 00:33:18

Mhmm. What drugs were you on?

Cody McKay [: 00:33:20

You know, aspirin, beta blockers, like, just all the kind of typical things that they're using to just keep the heart protected in those early days of recovery, and then those would slowly get weaned off as the recovery progressed. So, I think around the 2 to 3-month mark was when I was more or less just on a baby aspirin at that point. But I was able to continue to do some riding, do some walking, and the recovery just continued to progress that way. And around the 3, three-and-a-half-month mark was when I went in for my stress testing, and they did stress testing for me on a bike because they wanted to, you know, kind of match the sport I'm involved in. And, for me, I didn't really get to see a whole lot. There's a lot of, you know, data being collected in the background, but all I could see was, on the bike was a minute clock that would count down. I had to keep my cadence within a certain range, and I was hooked up to an EKG and VO2 max, blood pressure.

Cody McKay [: 00:34:15

So, they were doing all the testing across the board to see how the heart would respond as I pushed myself up to a higher and higher intensity and see at what point, you know, as things started to signal, okay, the heart's not ready to do this level of work yet. Well, as it turns out, I knocked the results off the chart page that they were testing it on. I think at the beginning, they thought I was being maybe a little bit overly optimistic or exaggerating. You know, I used to race bikes, and I'm hoping to get back to racing bikes and things like that. Okay. That's nice Cody. Just do your test. And after a while, I was like, oh, wow. You're on, like, step 17. We don't usually see people go past, like, step 8. And so, I got to the point where the resistance was so high with the cadence I had to hold, I was, like, rocking back and forth. The bike was kind of, like, lifting the legs up and down a little bit, and they're like, okay. This is enough. We have enough data. I think you're fine. I ended up getting my heart rate up to, you know, pretty much right up to a typical max heart rate for me in the 190s. No significant arrhythmias or anything forming on that stress test day, blood pressure was what would be expected for the various intensities. And so, at that point, they said, you're good. There is really nothing happening now that would indicate to us you need to live a modified recovery, and, you're ready to go back at it. And so, at that point, mid late March, racing starts in North America usually end of April, beginning of May. And so, I looked at it, and I said, you know what? I want to try racing this year. So, I had about 6 weeks to bootstrap a training program, and then I jumped right back into racing about 5 months post heart surgery.

Boots Knighton [: 00:35:46

And that was May of: 2023

Cody McKay [: 00:35:48

Yeah.

Boots Knighton [: 00:35:49

Incredible.

Cody McKay [: 00:35:50

Oh, I'm just wrapping up now a full season of racing. On paper, was it very monumental? No. I mean, a lot of mid pack and or not finishing type of results, but that in and of itself was a pretty special experience, especially when you consider that I missed most of the typical training period for cyclists, which is the winter month.

Boots Knighton [: 00:36:08

In my book, you won every race.

Cody McKay [: 00:36:10

Yeah. Yeah. It was fun to have conversations with folks on the start line beforehand, then a couple of times, you know, announcers would make, you know, no. This guy in the group today is a post open heart surgery, and he's here racing. And then people are like, woah. Can I see your scar? And, you know, what? You had what? So, it was fun to have conversations with different people.

Boots Knighton [: 00:36:29

And now people call you Cardiac Cody.

Cody McKay [: 00:36:31

xperienced over the course of: 2022

Cody McKay [: 00:37:26

And it was so wholly lacking. And so, it just made me realize, you know, if I can share my story and there's a future version of myself that's going through the same thing, then at least they can latch on to that piece. And, you know, you said at the beginning of the podcast, you found me through hashtags. That's just what I started to do. I started sharing my story on Instagram. I rebranded my account to Cardiac Cody to make it a little bit more, you know, connected to this heart journey that I'm on and started sharing information about aneurysms, pieces of my recovery, talking about the experiences I've had as someone who's now kind of a heart advocate on the other side of this whole journey, and it's been really amazing. And what it really taught me is just how many people are living the exact same experience that I lived that equally like myself thought I'm the only one that's going through this. No one else is like me, and I have to suffer this in silence and alone because there's nothing about me here.

Cody McKay [: 00:38:21

I think I've talked to maybe 50 or so individuals around the world, you know, people over in Europe, people in the States, people in Canada. Some of them are featuring a new diagnosis. Some of them just had the surgery. Some of them are waiting for the surgery, and the conversations vary. Sometimes it's just as simple as, you know, what was the surgery like? I'm really nervous. Can you just talk me through the experience and just put me at ease? Some people are like, I'm on the other side of this surgery, and I'm really struggling with x. Did you also struggle with x, and how did it get better for you? Some people are just trying to learn a little bit more about their new diagnosis. And so, all of them, you know, just through the same way that we connected in the messaging function of Instagram, we’ve been able to have a lot of really great connections, and I've been able to hopefully have a positive impact on their lives because like I said, that's really what I was looking for. And yeah.

Boots Knighton [: 00:39:08

Incredible and so generous of you. I think of the people who are afraid to be seen, who are afraid to ask for help, and that's such a shame because it's proven in the research that when we are alone, that directly affects our physical health, and there is so much beauty that can be shared when you are willing to be helped or help someone else. So, tell me about Project Heart.

Cody McKay [: 00:39:39

Yeah. So, I mean, it's fairly early stages right now. It's kind of what I've started to brand this effort that I've put in over the last year. So, like I said, I made a strong effort to connect with individuals who have gone through some form of heart or cardiovascular disease themselves. But equally started to try to do some awareness raising within, you know, within the sport of cycling, but I think there's a lot of messages that can be, applied to other forms of life as well. I think everyone can benefit from learning a little bit more about their own heart health regardless of whether they've had a challenge or experience related to their heart that dictates whether or not they should. So, within the sport of cycling, you know, in recent years, there's been a number of significant, and we're talking about, you know, Tour de France level cyclists who are dealing with cardiac issues. Some of them have been forced to retire.

Cody McKay [: 00:40:27

One individual went into cardiac arrest as he crossed the finish line. It's something that can impact our sport and become a problem for us regardless of whether we were born with something or exist with something. And that's kind of the way I framed it is to say, you know, everyone's dealt a different hand at birth. Some get a less lucky hand than others. But during the course of our lives, there's many things that we can do that are going to, you know, cause some form of cardiac remodeling in a way that's going to have a negative impact over time. There's a huge correlation in endurance sport with arrhythmias developing in the later years of life. And so, this doesn't have to be, you know, a traumatic one day, I smashed my heart rate up to the 190s, and the next day, something really bad happened. But over multiple years of doing things, if you're not thinking about how to live a heart healthy life, these things could come back and haunt you in the future as well.

Cody McKay [: 00:41:19

And so, this doesn't have to be, you know, creating a culture of fear. This doesn't have to be scaring people away from doing things, being active, and getting our bodies moving is incredibly healthy. But to think that you can do that without any repercussions, full stop, is also something that I'd say, well, you know, maybe give that a bit of a second thought. So, when it comes to the sport of cycling, for example, the very basic advocacy points I would talk about are, you know, do you use a heart rate strap? Do you know what your heart rate zones are? Do you know what your max heart rate is? Do you know what your normal heart rate zones would be? Have you ever taken your blood pressure before? Have you ever thought about learning a little bit more about those baselines? Because the more you learn about your baselines, the more you can identify when something is starting to deviate from the norm. There's been individuals I've talked to, and it's like, oh, yeah. We had a really hard group run, and my heart rate was, like, in the 200s. And it's like, I mean, that might be normal for you. That might not be very good either.

Cody McKay [: 00:42:10

These are, you know, don't look at that kind of situation and be like, oh, yeah. That's fine. That's not a problem because it will just do that. It's like, well, you know, these are maybe you should take an easy day the next day. You know? Are you kind of approaching whatever sport you're involved in, running, cycling, swimming, whatever, where you're thinking, okay. In the same way that you wouldn't go and do a leg day every day or do, you know, your biceps every single day, and you wouldn't go into a gym thinking, I can infinitely push weight. I can pick up this 300-pound dumbbell and push it because there is no ceiling to what my muscles can achieve. You've got to think about your heart, which is also a muscle in the same way.

Cody McKay [: 00:42:50

So, yes, you can push it to great limits and you can achieve great things with it. But like any other muscle in our body, it also needs rest. It needs the chance to recover. And that there is a point when it's like, yeah, maybe you're pushing it a little bit too much.

Boots Knighton [: 00:43:01

What I'm hearing you say is that, Project Heart is really about building awareness of one's heart and body.

Cody McKay [: 00:43:10

Yep. A 100%. And so, for individuals who have not experienced something related to their heart on their own, there's a wealth of opportunity they can learn about their own heart health and habits that they can adopt to live a heart healthy life. For individuals that have faced some struggle or challenge in the past, Project Heart for me is about demonstrating that you can still achieve great things. Because in those early days, I certainly wondered whether I'd ever be the same athlete again or even able to compete again. And, you know, every individual is going to have a different story, but I think the common denominator there is everyone can still achieve greatness. That greatness might be redefined, but do not let any sort of diagnosis get in the way of living a full life and doing, you know, following your hopes and dreams. And then the other aspect of it for me is really raising and supporting awareness related to the Heart Institute. Again, as I mentioned, Canada's largest cardiac center, heavily involved in research on the global stage to advance treatment with heart and cardiovascular diseases. And so, you know, you think about something like what I've gone through with open heart surgery to address an ascending aortic aneurysm, is there a point in the future where the endovascular related treatments of descending aortic aneurysms or abdominal aneurysms where we don't actually have to open up the body anymore, can we start to get to those more or less invasive solutions? I've talked to a number of individuals, quite a few who are in the UK, who are going to be having, the PAIRS procedure, and I forget what that acronym means. But essentially, they wrap the aorta rather than replacing the disease tissue or the aneurysm is they basically reinforce it and put a supporting piece around it. And one of the big benefits that's toted with that model of treatment is that you don't have to go on bypass. So, where a lot of risks come with the bypass component, you don't actually have to do the, you know, heart stopping component of open-heart surgery. You still have to open up the sternum, but it changes some of those dynamics. And so, there's so many different aspects of how we can advance the treatments related to heart disease that are going to improve outcomes for patients. And so, I want to make sure that whatever I'm doing through Project Heart is supporting that on a global stage while also having a really intimate relationship with my own experience on a local stage as well.

Boots Knighton [: 00:45:21

Cody McKay. Cardiac Cody, you are amazing, and I know that anyone listening to this episode has found this incredibly inspiring, hope filled. You are a ninja. Thank you so much for your generosity and sharing your story from start to finish. Before we hang up, I would love for you to give those facing heart surgery or their caregivers one piece of advice that you think would be most helpful.

Cody McKay [: 00:45:59

I would say just don't give up. Days will get better. There are hugely dark days and hugely challenging days, but there is always going to be a sunnier and a brighter day. And don't get caught up in the mindset that every single day is going to feel like that dark and stormy day because you will always surprise yourself with how much sunnier it can get on another day. And so, keep pushing. Keep trying. Keep working towards that recovery. Keep working towards living that full life, and you will be more than satisfied and more than grateful, I think.

Boots Knighton [: 00:46:28

Wow. Very wise words, and I could echo those for sure. Thank you. And listeners, you will be able to find all the ways to get in touch with Cody in the show notes, be sure to follow him on Instagram for inspiration, and be sure to come back next Tuesday for another inspiring episode of The Heart Chamber.

Boots Knighton [: 00:46:53

Thank you for sharing a few heartbeats of your day with me today. Please be sure to follow or subscribe to this podcast wherever you are listening. Share with a friend who will value what we discussed. Go to either Apple Podcasts and write us a review or mark those stars on Spotify. I read these, and your feedback is so encouraging, and it also helps others find this podcast. Also, please feel free to drop me a note at boots@theheartchamberpodcast.com. I truly want to know how you're doing and if this podcast has been a source of hope, inspiration, and healing for you. Again, I am your host, Boots Knighton, and thanks for listening. Be sure to tune in next Tuesday for another episode of The Heart Chamber.