You may recall that despite having cycled some 300,000 kilometres in this tired old body of mine I still managed to have an ischaemic event (yes, a heart attack) on this very day, New Year's, 2014. As I was doing over 200km a week up to that point it came as something of a surprise to feel a persistent, dull ache that said "stop now" as I crested a familiar hill. Of course being a hardened racing cyclist I pressed on anyway, gasping and yawning, determined to "ride through it".
Until, of course, I just had to stop. I knew, deep down, what it was. Still, I didn't accept it. It seemed so unlikely. So I struck a compromise and turned around, slowly, and crawled - grovelled - home. About 15 minutes after stumbling in the door, I accepted my fate and embarked on a 6 day medical adventure involving 2 hospitals, a late night ambulance ride, 2 cardiologists and 3 stents. A month later I blogged merrily on the topic of not ignoring the bleeding obvious.
So here I am, a year later, still acting the goat. I have just tempted fate and re-lived that epic New Year's Day ride, retracing the exact route and soaking up the pain. Fortunately without the hospitalisation, touch wood. I'd like to say that I've spent the past year steadily recuperating, building up the miles and strengthening my weakened heart. But I haven't. Mind you I started well, with good intentions. I kept to a gentle, progressive plan that got me onto the indoor trainer and then out the door, building gradually. And then the confidence grew. This reconditioned heart actually seemed just as good, if not better than the old one! I set some tougher goals and pressed on. Until I started to tire.
It seemed like I was repeating the very mistake that had got me into this predicament: if in doubt, double the training. Despite the still-fresh memory, I was doing it all again. The training was going up but my form was going down. And then I caught a cold.
Now colds may slow you down but they don't have to stop you, so I backed off and came back. But the cold "freshened up". So I repeated the formula - back off, come back. And the virus came back too. It reminded me of a six-month bout of a "mystery virus" that hit me back in the late 1980s, effectively ending my club-level A-grade racing career. I didn't get a blood test then, sadly, so I'll never know for sure, but a GP reckoned it was mononucleosis. The prescription was "rest". So taking a leaf out of that same book I have had a long, long rest since the end of May.
Which is not to say I haven't ridden. Once a week I've given the bike a spin and tested my form. And mostly my form has been lousy. Given that riding every day is my long-term habit, riding just once a week - and for only 20 minutes or so - hasn't been an easy pill to swallow. And it hasn't been the ideal way to make a post-ischaemic comeback, either.
Which is why re-living my "2014 first-ever heart attack ride" today hasn't been without its measure of risk - or even fear. Sure, I took it easy. Sure, I've done the distance a few times in the lead up. Sure, it's not a century ride. But I'm not nearly as fit as I was then, and the hills are unrelenting. I live on a hill. Getting home is hard enough without worrying about blocked arteries and damaged heart muscle as well.
Anyway, I made it. It could have gone horribly wrong but it didn't. The monkey is off my back (I have avoided riding that route for a full 12 months). Hopefully I will listen to my own advice from here on and build the miles up again - very, very gradually. Fingers crossed.
Showing posts with label ischaemia. Show all posts
Showing posts with label ischaemia. Show all posts
Thursday, January 01, 2015
Thursday, August 07, 2014
BMC's Lodewyck sidelined with cardiac arrhythmia - it can happen to anyone
Triggered by a crash and associated trauma? Brought on by subsequent medication? Or just going to happen one day anyway? We are only guessing.
The BMC Racing Team today announced that it has removed its Belgian rider Klaas Lodewyck from competition after he experienced irregular heart rhythms during racing and training.
"He had been experiencing some irregular heart rhythm during racing and training," team doctor Max Testa said. "We have been investigating it, first by having him evaluated by sports cardiologists in Belgium. The common decision between a specialist there and the BMC Racing Team's
medical staff is to rest Klaas for an undetermined amount of time while a thorough investigation is performed." BMC's Lodewyck sidelined with cardiac arrhythmia | Cyclingnews.com
Point is, it can happen anytime, to anyone. Cyclingnews lists a few more...
Lodewyck is not the only rider to suffer from cardiac arrhythmia - former cyclo-cross world champion Niels Albert was forced to retire prematurely because of heart problems, and Belkin's Robert Gesink stopped racing in June to have an arrhythmia treated. Other riders who have had cardiac issues in recent years include Nick Nuyens, Haimar Zubeldia, Nicolas Vogondy, Nicolas Portal and Kim Kirchen.
Not surprisingly they didn't mention me. Whilst I can't speak for any of the above-named, I can of course speak for myself. I have ridden over 300,000km in racing and training, a very small amount of it at state "open" level but mostly at all levels of club racing. I never imagined that my heart would ever give me trouble. Even when I started to get the odd 'feeling' I dismissed it. And whilst I pushed myself pretty hard - as hard as my limited training time allowed - I rarely felt as though I had pushed "too" hard. Maybe sometimes, but isn't that what you are supposed to do? I always trained 'properly' before racing. I did my base miles. I even ate well, mostly, and hardly ever drank alcohol.
I guess I managed pretty well what I could control. Or so I thought. (Hypertension and stress might be things that I could have controlled a bit better, though.) The other factors - those out of my control - included my genetic predisposition. And in hindsight that's a pretty big one. Cardiac issues on both sides of my family should have given me a hint.
Coupled with starting a family a bit later than most and juggling racing, training, work and that growing family, I was probably cutting things a little fine. And when I then started at university intending to pick up a mature-age degree or two, I noticed that my health was going a little awry... aren't warning signs wonderful?
Only if you read them right! Naturally I thought, "it's stress" and decided to make things better by cranking up the pace - let's get this degree thing over and done with sooner rather than later. Probably not the right choice, but it was the choice I made. And thus an "unexpected" illness arrived in my life, coupled with medication that did nothing positive for my existing, if somewhat hidden, cardiac risk factors.
Of course I didn't ask for a heart attack. Indeed I thought that riding and racing would protect me from such a thing. But I was wrong. It doesn't have to be an outright ischaemia, it can be a mild arrhythmia. But with only one heart allocation per person it's better to listen carefully to your body and assess all of the factors involved. Life is a balance of positives and negatives. Striking the right balance is vital.
The BMC Racing Team today announced that it has removed its Belgian rider Klaas Lodewyck from competition after he experienced irregular heart rhythms during racing and training.
"He had been experiencing some irregular heart rhythm during racing and training," team doctor Max Testa said. "We have been investigating it, first by having him evaluated by sports cardiologists in Belgium. The common decision between a specialist there and the BMC Racing Team's
medical staff is to rest Klaas for an undetermined amount of time while a thorough investigation is performed." BMC's Lodewyck sidelined with cardiac arrhythmia | Cyclingnews.com
Point is, it can happen anytime, to anyone. Cyclingnews lists a few more...
Lodewyck is not the only rider to suffer from cardiac arrhythmia - former cyclo-cross world champion Niels Albert was forced to retire prematurely because of heart problems, and Belkin's Robert Gesink stopped racing in June to have an arrhythmia treated. Other riders who have had cardiac issues in recent years include Nick Nuyens, Haimar Zubeldia, Nicolas Vogondy, Nicolas Portal and Kim Kirchen.
Not surprisingly they didn't mention me. Whilst I can't speak for any of the above-named, I can of course speak for myself. I have ridden over 300,000km in racing and training, a very small amount of it at state "open" level but mostly at all levels of club racing. I never imagined that my heart would ever give me trouble. Even when I started to get the odd 'feeling' I dismissed it. And whilst I pushed myself pretty hard - as hard as my limited training time allowed - I rarely felt as though I had pushed "too" hard. Maybe sometimes, but isn't that what you are supposed to do? I always trained 'properly' before racing. I did my base miles. I even ate well, mostly, and hardly ever drank alcohol.
I guess I managed pretty well what I could control. Or so I thought. (Hypertension and stress might be things that I could have controlled a bit better, though.) The other factors - those out of my control - included my genetic predisposition. And in hindsight that's a pretty big one. Cardiac issues on both sides of my family should have given me a hint.
Coupled with starting a family a bit later than most and juggling racing, training, work and that growing family, I was probably cutting things a little fine. And when I then started at university intending to pick up a mature-age degree or two, I noticed that my health was going a little awry... aren't warning signs wonderful?
Only if you read them right! Naturally I thought, "it's stress" and decided to make things better by cranking up the pace - let's get this degree thing over and done with sooner rather than later. Probably not the right choice, but it was the choice I made. And thus an "unexpected" illness arrived in my life, coupled with medication that did nothing positive for my existing, if somewhat hidden, cardiac risk factors.
Of course I didn't ask for a heart attack. Indeed I thought that riding and racing would protect me from such a thing. But I was wrong. It doesn't have to be an outright ischaemia, it can be a mild arrhythmia. But with only one heart allocation per person it's better to listen carefully to your body and assess all of the factors involved. Life is a balance of positives and negatives. Striking the right balance is vital.
Friday, March 21, 2014
Update on recovery from ischaemia
Well as you may already know I had a heart attack on January 1 this year. To be perfectly honest, upon reflection, it was fairly minor as far as ischaemic events go - but ignoring it wasn't an option. Well 60-odd years ago ignoring it was probably the only option. I remember one of my grandfathers (who 'survived' in some senses service in 2 world wars) took 'angina tablets' when the pain came on. He probably had a blocked artery or 2 but there was little you could realistically - or affordably - do about it back then. Whereas in my case they simply inserted a few stents and inflated them, unblocking the blocked artery. It took 45 minutes (if you discount failed attempt number 1, an ambulance trip and brief stays in 2 hospitals). Fixed!
Well, mostly fixed. I'm not exactly the same as I was, psychologically or physically. I am unblocked, with a renewed blood supply to the organ in question, but said heart now has muscle tissue damage, some of it irreparable, if to a minor degree. Nevertheless my heart beats strongly and regularly, and after almost 3 months of training on the bike (half on the trainer and half on the road) I am back to where I was in December last year - doing at least 200km a week on the road. Mostly flat and only 60% intensity, though. And just a few intervals at 80% or so. And no long, hard climbs for now.
Yet there remains a small, disquieting fear that the heart will be weakened, unable to cope with "normal" training (let alone racing) loads. And statistically that is borne out by those who have repeat heart attacks after their first. So I'm tentative, still. A new clot could form over the stents themselves, for example. But with each passing mile I get more confident that I'm OK. Indeed I feel "better" in many ways. Whereas I was grinding it out for the previous few months (before the attack) I am now refreshed and eager. My body is responding positively if slowly to the training load, whereas it was only slowing down and going backwards before.
Another realisation is that heart attacks can be - indeed often are - "silent". You may not notice you are having one. The one I had, whilst distinctive, was dull and incapacitating for a couple of hours, like dragging a heavy weight around, rather than endlessly sharp and totally, unavoidably crippling, if you can see the distinction. Indeed I began to feel "better" after about 3 hours of this crushing bore of a monumental chest and arm pain. I could see a way out. But by then I was in hospital, which is the best place to be if you want to get "fixed".
Still, I could see how ignoring it and just avoiding strenuous exercise forevermore may - in some cases - work out. But for me I wanted to ride again, and I didn't want to risk the statistically significant attack number 2, the one that would sneak up on me and do me in for good. And it made me ask, 'ok, this is different, it's really bad - but have I had one of these before, just milder?'. And my answer would be "yes". This was just a new level of pain and injury.
Hindsight is a wonderful thing but the last 3 months of training pre-attack, sometimes in terrible heat, often had me thinking 'what's wrong?'. And whilst I could do it, I could finish the rides - and the occasional races - I didn't push to my old limits. I backed off. I let the bunch go on the last lap. I gave in to the "pain" of the effort. Whilst it wasn't that distinctive full-on crushing pain, I now recognise that what I thought was "not enough training" or "just old age" was probably a very mild form of heart attack. I have no firm evidence, no blood tests or angiograms to back that up, but it's what I suspect. Whilst my heart attack represents a certain event, the rupturing of some plaque and for a time the complete blockage of a coronary artery, in truth that artery was significantly narrowed for years.
My heart was under attack from reduced blood flow for a long time. I just didn't read the signs.
Well, mostly fixed. I'm not exactly the same as I was, psychologically or physically. I am unblocked, with a renewed blood supply to the organ in question, but said heart now has muscle tissue damage, some of it irreparable, if to a minor degree. Nevertheless my heart beats strongly and regularly, and after almost 3 months of training on the bike (half on the trainer and half on the road) I am back to where I was in December last year - doing at least 200km a week on the road. Mostly flat and only 60% intensity, though. And just a few intervals at 80% or so. And no long, hard climbs for now.
Yet there remains a small, disquieting fear that the heart will be weakened, unable to cope with "normal" training (let alone racing) loads. And statistically that is borne out by those who have repeat heart attacks after their first. So I'm tentative, still. A new clot could form over the stents themselves, for example. But with each passing mile I get more confident that I'm OK. Indeed I feel "better" in many ways. Whereas I was grinding it out for the previous few months (before the attack) I am now refreshed and eager. My body is responding positively if slowly to the training load, whereas it was only slowing down and going backwards before.
Another realisation is that heart attacks can be - indeed often are - "silent". You may not notice you are having one. The one I had, whilst distinctive, was dull and incapacitating for a couple of hours, like dragging a heavy weight around, rather than endlessly sharp and totally, unavoidably crippling, if you can see the distinction. Indeed I began to feel "better" after about 3 hours of this crushing bore of a monumental chest and arm pain. I could see a way out. But by then I was in hospital, which is the best place to be if you want to get "fixed".
Still, I could see how ignoring it and just avoiding strenuous exercise forevermore may - in some cases - work out. But for me I wanted to ride again, and I didn't want to risk the statistically significant attack number 2, the one that would sneak up on me and do me in for good. And it made me ask, 'ok, this is different, it's really bad - but have I had one of these before, just milder?'. And my answer would be "yes". This was just a new level of pain and injury.
Hindsight is a wonderful thing but the last 3 months of training pre-attack, sometimes in terrible heat, often had me thinking 'what's wrong?'. And whilst I could do it, I could finish the rides - and the occasional races - I didn't push to my old limits. I backed off. I let the bunch go on the last lap. I gave in to the "pain" of the effort. Whilst it wasn't that distinctive full-on crushing pain, I now recognise that what I thought was "not enough training" or "just old age" was probably a very mild form of heart attack. I have no firm evidence, no blood tests or angiograms to back that up, but it's what I suspect. Whilst my heart attack represents a certain event, the rupturing of some plaque and for a time the complete blockage of a coronary artery, in truth that artery was significantly narrowed for years.
My heart was under attack from reduced blood flow for a long time. I just didn't read the signs.
Tuesday, February 11, 2014
OK, last post on this for a bit...
More screenshots of the "ischaemic event"... even more self-explanatory!
My original post on how it all happened. Plus some stats and other nonsense.
My original post on how it all happened. Plus some stats and other nonsense.
Did you want some pictures to go with that ischaemia, sir?
Did you read this: http://addicted2wheels.blogspot.com.au/2014/02/double-training-used-to-work-dont-let.html? Want to know more? Sure, how about some pics? No, not of the stents being inserted (although... now that I think about it, maybe tomorrow?) just some Strava screenshots of me having a "medical event" during a training ride....
It's fairly self-explanatory... 2013 wasn't a bad year for cycling but not great either. I peaked a couple of times with semi-decent months but got sick a few times that wrecked my race season (which turned out to be a good thing, maybe). I was playing catch-up all year. And then 2013 ended and 2014 went off with a bang (or a whimper perhaps)...
Just another year? And then...
One ride too many!
I didn't feel well at all...
And the figures prove it!
'Creeping' is the word
As I said, I ride a bit
And I'm still riding!
Hopefully I'll keep it up...
My original post on how it all happened. Some stats and other nonsense. And more.
It's fairly self-explanatory... 2013 wasn't a bad year for cycling but not great either. I peaked a couple of times with semi-decent months but got sick a few times that wrecked my race season (which turned out to be a good thing, maybe). I was playing catch-up all year. And then 2013 ended and 2014 went off with a bang (or a whimper perhaps)...
My original post on how it all happened. Some stats and other nonsense. And more.
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