Intensity: It Might Just Save Your Life

Paul Milligan was out of breath, and he didn’t know why.

The 64-year-old had made the 400-m jaunt out the garage doors of BARx CrossFit and back dozens — if not hundreds — of times, and usually, all he needed was a quick pause at the turnaround point before darting back. But this time, he rounded the mailbox that marked halfway and walked for a block. He chalked it up to a bad day.

A couple weeks later, sometime in late October of 2021, it happened again — this time before he’d even reached the mailbox. Still, he’d just done a bunch of sit-ups, push-ups, and barbell work.

Milligan’s coach, Stephanie Teague, pulled him aside.

“What’s up?” she asked.

“I don’t know,” Milligan lamented. “I’m having to walk more than I used to have to walk.”

After confirming Milligan felt no pain or tightness in his chest, Teague sent him on his way with an admonition to take it easy.

A visit to his primary-care physician in early November was little help. He’d put on about 5 lb in the last year, and the doctor said a little breathlessness was to be expected. But that didn’t make sense to Milligan. After all, he’d completed the RAGBRAI — a 430-mile bike race across Iowa with just short of 12,000 feet of climb — only a couple months earlier with no problem.

So he went back to CrossFit the next day. The workout called for a 400-m run buyout.

“And I didn’t even make it (halfway) before I turned around and walked back in,” Milligan recalled.

“You need to talk to your doctor,” Teague told him.

One failed cardiac stress test and a coronary angiogram later, he had an answer: 60-70% blockages in four arteries.

The quadruple bypass was done before Christmas.

“The cardiologist told me if I had just been a jogger or cyclist and did not exercise at a CrossFit (workout) level of intensity … my five-year survival (prognosis) was less than 50 percent,” Milligan said.

 

“The cardiologist told me if I had just been a jogger or cyclist and did not exercise at a CrossFit (workout) level of intensity … my five-year survival (prognosis) was less than 50 percent.

A Silent Killer

Coronary heart disease can be sneaky.

It does not always present with symptoms, leaving those at risk — whether due to lifestyle or genetic predisposition — vulnerable to heart attack, stroke, and death with little to no warning. Such was the case for Milligan’s father, who had his own bypass surgery at 50. By the time he experienced any chest pain, his blockages were up to 95%. Though he survived, he’d sustained irreparable heart damage.

After his father’s incident approximately two decades ago, Milligan deliberately chose to lead an active lifestyle in the hopes of avoiding the same fate. He did triathlons and marathons and cycled regularly. He also adopted a vegan diet.

Figuring he ought to add some strength training to his routine, Milligan joined BARx CrossFit about 10 years ago and has trained three times per week ever since. While what he loves most about it is the social element, he says CrossFit has improved his mobility, flexibility, and strength for activities of daily living, such as loading the car with luggage or landscaping.

“I think about it all the time when I pick up a 50-lb bag of mulch,” he said, adding that while he has a “little beer belly” and doesn’t think he looks “like a super fit athlete, cardiovascularly, I am.”

Hence Milligan’s surprise when he found himself taking breaks mid-workout. It wasn’t just the run, either — wall-ball shots in sets of 25 used to be modus operandi for Milligan; last fall, he could barely do half that. And yet, endurance work alone posed no problem.

But he did notice one common thread: heart rate, as measured by his watch. The shortness of breath, as well as what he described as a feeling of “fullness” in his chest, only presented at rates higher than 140 bpm — when he was working near his maximum heart rate.

These phenomena were replicated in Milligan’s stress test at the hospital, where cardiologists likened CrossFit training to a stress test in its own right.

“If I wasn’t doing CrossFit, I would have never known this was happening,” Milligan said.

PR-ing Recovery

As Milligan hazily awoke post-operation, he overheard the nurses talking during a shift handoff.

“This guy just got here,” one said.

“You mean yesterday?” a second nurse asked.

“No, he just got here an hour ago,” the first clarified.

“But he’s not on a ventilator!”

It was just one of several records Milligan set in his recovery, likely due to his high level of fitness pre-operation.

“‘We’ve never had anybody come up from bypass without being ventilated,’” he recalled the second nurse saying.

A few days later, a physical therapist came to see Milligan in his room.

“You ready for a walk?” she asked.

“I haven’t even sat up yet,” he protested. Still, he pushed back the covers, swung his legs over the side of the bed, and stood up.

After a lap or two around the floor, Milligan hiked a couple flights of stairs.

“Well, you’re cleared for discharge from our point of view,” the therapist said.

Four days after quadruple bypass surgery, Milligan went home (most patients require more than a week in the hospital). Seven weeks later, he was back in the gym.

 

Do CrossFit; Live Longer

Under Teague’s watchful eye, Milligan modified the daily workouts at BARx CrossFit, following his doctor’s orders to limit weightlifting exercises to 10 lb per arm.

Just two months after surgery, it was business as usual in the box for Milligan — deadlifts, squats, wall balls — and running. Today, at 65, he’s already notched a few more 5K races and a stair-climb challenge for charity.

Even better?

“You don’t even have cardiovascular disease anymore,” Milligan’s cardiologist said.

And for that, he credits CrossFit.

“It really did very likely save my life,” he said.

 

All photos courtesy of Paul Milligan