Training after Subdural Hematoma

Medical Q&A [Moderated]
1

Hello doctors,

My question is regarding my father. He is 69 years old, had CABG (4 arteries) at September 2017. He has Type 2 diabetes for already about 30 years, even though he was never fat at all. He weigh 68kg at 170cm. He has never strength trained (only about 4 sessions with me couple of years ago). About a month ago he fell and got a hit in the head, and about 2 weeks afterwards the symptoms of a left-frontal subdural hematoma showed up - he had hard time talking.

After the CT scan, they inserted a catheter and drained the blood. The procedure is being considered as small and easy. Operation went good and the next CT scan showed 50% reduction in bleeding. He got released the next day. 5 days afterwards, symptoms came again.
Anyway, at the moment he is in the hospital and having convulsions 1-3 times/day, treated with medicine. The doctor’s opinion at the moment is that he’s gonna get out of it and we should just wait for the blood to be absorbed naturally while treating the convulsions. The short term, he said, is not a problem. As for the long term, he said that due to his age and the diabetes, there’s brain atrophy, which makes the brain smaller than the skull; that makes him very fragile regarding shaking and sharp movements of the head, due to the room between the brain and the skull.
It will take, he said, about 2 weeks and he will back to probably 100% function.
He has Osteoarthritis in both his knees, but it definately won’t kill him. Mechanically, his range of motion in both knees is not enough for the squat, but he can deadlift, press, bench press and chin. And he can also do half-squats.

Questions are:

  1. Regarding his CABG and subdural hematoma, is it safe to start strength train after he’s past the subdural hematoma?

  2. I’m also going to ask his surgeon, but is it possible to reverse / stop the brain atrophy?

I know it’s tough to tell anything specific about him, but even a general opinion about training after CABG / subdural hematoma would be helpful.

Thank you very much in advance :slight_smile:

2

Sorry to hear about this, sounds like a scary situation. Hopefully they can get the bleeding and convulsions under control.

  1. He is going to need physical therapy after all of this in order to maintain any degree of physical function, as the risks of complete bedrest/inactivity are far too high. Therefore, if/when he is deemed safe for physical therapy by his physicians, he would be able to strength train (as this is part of physical therapy) assuming appropriate loading/dosing under supervision.

  2. Probably not.

3

Thank you very much for the answer,
Definately scary situation. At the moment the convulsions are under control, but he is drugged quite heavy so he is very tired and confused.

Regarding valsalva, no problem regarding the CABG / Subdural Hematoma? (of course with a proper loading and very slow progress in weights etc)

4

No concerns regarding the CABG, especially given that it was several years ago.

I will defer specifics on the acute subdural to his physicians.

5

I have the feeling that they would be “frightened” by my question, about deadlifting etc. I mean, for a healthy 25 year old man it is quite common to hear that deadlift is dangerous and should be avoided.
In your opinion, if they will say that lifting is dangerous / anything other than walking is forbidden etc, how can I know whether it has some solid reasoning, or is it just a common misconception about lifting weights?

Thanks again

6

There is nothing uniquely risky about “deadlifting” compared to other forms of strength exercise. It’s literally just picking something up.

Therefore, the question is: is he safe/cleared to exercise, or not?

7

My guess is that they will tell that he’s cleared for walking, but not for anything of a big effort, not even gradually. That’s what one of the doctors has already said. “Only walking”. If that would be the final advice, how can I know if he’s okay for strength training, which involve valsalva and a higher RPE than walking? (gradually, of course)

8

It is not plausible or appropriate to recommend that he do nothing but walk for the rest of his life.

At some point he should undergo physical therapy. I cannot tell you when that is; if his doctors never recommend it, I would pursue a second opinion.

9

Great help,
Thank you very much Austin :slight_smile:

10

Great help!
Thank you very much Austin. See my video for burn fat simple at home Great help,

11

Hi again,
Sorry if it’s not comfortable… I didn’t want to open a new thread.

He has started physio therapy but in a really bad condition, he’s confused and he communicate not so good. Physically after 4 weeks on the bed, he’s unable to stand up or walk etc. My question is regarding creatine and/or protein in his condition. I have seen your videos about protein intake while being hospitalized and about creatine. I figured that it may be a good idea to give him protein (I don’t think he’s eating more than 35g/day at the moment and he doesen’t eat that much at all), and also creatine due to the 10th point in your video: https://www.youtube.com/watch?v=ffLWfXb2zGs which state that creatine is showed to improve cognitive abillity - which is really poor at my father’s condition.

Do you see any reason to not add protein and / or creating to his daily intake?

Thank you very much :slight_smile: