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 |

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, July 11, 2014

Yet another sealed drivetrain

Planetary gears, this time. Sealed into the bottom bracket of course. And no, not for the first time! Still, it's  a good idea, especially when you run in mud, dust and grit. The downsides will as always be weight, weight and weight, followed by serviceability, longevity and, yes, weight again. You can throw in friction losses as well, but that may be quite minor compared with, umm, weight. We shall of course see!

Nuseti mountain bike features a sealed drivetrain

Thursday, July 10, 2014

Life goes on, even for Froome.

I watched Froome drop for maybe the 4th time in this year's TdF and thought to myself, "he'll stop now". He has an amazing acceleration on steep climbs, perhaps better than anyone else, yet he always looks ungainly, as if he is about to lurch sideways off his bike. He also has bike skills I can only dream of, although clearly he could improve on those a bit, too. He was also in pain, clearly. And he was about to reach the first cobbles.

Nibali appears better than most at predicting "what happens next" and avoiding the worst of it. For some reason when riding and racing I could 'usually' sense when it was about to go pear-shaped, too. Sometimes that worked well, in that I missed going over the top, other times it was a false alarm and I had to work harder to regain lost ground. Sometimes I just hit the deck anyway. But stopping in a club crit is very different from stopping in Le Tour. But Froome stopped anyway.

In my case I have fallen, recovered and ridden again. I have trained, lost or won, and ridden again. I've managed to block an artery and be hospitalised, yet here I am riding again. I think it's just life. You go on. Froome will pick himself up and ride again. Some riders are luckier than others, of course. Froome has had a bit of bad luck and only he knows for sure how much of that luck he attracted to himself. Was he unfocused? Was he too fearful? Was he too far back or on the wrong wheel? I can't be sure, but he knows. Whatever the truth of it, he'll be back.  

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.   

Do we need this? Darwin Bicycle folds forward for the climbs and sprints

Do we need this? Do we "need" anything (other than food, drink, shelter, love...) anyway? In some ways it makes sense, that you remain seated and stable in particular holds great promise. However it becomes rather tricky to keep an ideal, or perhaps optimal (shades of grey there) riding position when the bike keeps adapting around you. There's power output to consider, sure, as well as cadence, weight distribution and areodynamics to consider. To get all of that right on a moving, adjusting frame could prove tricky, especially for the rider who just wants to move forward a bit to stretch. Still, a bike that adapts to you sounds "right" somehow. As long as it doesn't weigh too much, of course.


Darwin Bicycle folds forward for the climbs and sprints

Thursday, February 13, 2014

Confidence is everything - the psychology of cycling

Or the psychology of everything, really.

I can tell you how to train your guts out, how to identify your strengths and weaknesses and how to position yourself to win, but none of that will help at all if you don't truly believe in yourself.

I used to train 10 to 15 thousand kays a year - not enough, I know - but it got me into the ballpark (as an A-grade clubbie, anyway). I had some condition. I had some strength. I didn't fade too early. I was there.

I enjoyed the physical side of training and it got me fit enough to be in the game - but I needed some psychological help, too. I needed both the skills of a racer and the motivation to execute my plans. The skills came about by watching, by listening and by practising. By running it through my head as well as actually racing it out on the road.

Winning is first of all about surviving. Getting dropped is the pits. And if you have the condition - enough of it - then it's all about timing and positioning from there, really. Positioning and timing to avoid crashes, to avoid missing the break and to be there - in the right place, on the right wheel - for the sprint. Simple, eh? But how do you get it right?

For me, my head had to get it together. The training helped, the sprint repeats and intervals, the mindless laps all played a part. But it was my head that desired to win and it was my head that had to learn the hardest lessons.

My head had to understand that getting dropped hurts enough that I didn't want to get dropped ever again. And I had to be smart enough to recognise the signs and avoid the danger zones, those points in a race when getting dropped is a very real possibility. Sometimes it's positioning for a hill, sometimes it's just gritting the teeth, chasing and absolutely not letting them go!

My head also had to handle the fight for the break - be in it! Get in there, but only when it's the right move. Size it up, make a judgement. Then commit. Totally.

My head also had to mix it up in the fight for the pre-sprint positioning as well as the tussle for line honours. Sometimes it's frustrating, sometimes just plain dangerous. It's reactive and exciting, physical and mental. It's the end game and it's mostly played out in your mind!      

Tuesday, February 11, 2014

Heart problems bring Kaisen's career to a premature end : SBS Cycling Central

Timely indeed, given my own situation. This is Lotto Belisol's Olivier Kaisen on his heart problem:

"At training camp in December I was able to train in perfect circumstances without any problem. Now I think my moderate season in 2013 might be caused by it." Kaisen first noticed the problem during the Tour Down Under in January."After the second stage at the Tour Down Under I didn't feel well. It had been a very tiring and extremely hot day and I had ridden much at the head of the bunch for AndrĂ© Greipel. I did start the next stage, but immediately after the start of the third stage I felt something was wrong. I was scared and together with sports director Herman Frison I decided to quit. He said I couldn't take any risk.

The thing is, and I know this from hindsight more than any analytical brilliance, as you tend to grow into your body over time, it so rarely surprises you. You simply get used to its quirks. After all, you don't get to experience what other hearts are like, although you may still realise that there's a huge diversity in what are "normal" rhythms and rates of beating. Some are fast, some are slow and some are all over the shop. Yet they "do the job". Mostly. So you get "used" to your own quirks and they fade into the background... until one day...

And if you race - or even train hard - you are putting a hefty load on that single point of failure. That load can be extreme in a race, especially if you are dehydrated or have some other variation from the "norm" that one day may create that "perfect storm" that is ischaemia. Now hindsight is a wonderful thing and I don't want to put anyone off cycling to their full potential - far from it - but we can't see into our bodies as we go about our daily lives (well, not without some help, anyway). We have to go by feel. And that's why we need to look after ourselves, eat, rest and train right, and keep a look-out for anything that feels 'unusual'. It could be a sign that shouldn't be ignored.   

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.

Did you want some pictures to go with that ischaemia, sir?

Did you read this: 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.   

Something else to add to my long list of broken bits!

Well I've never broken a gear hanger before... but by the glory of Felt I've done it now! (And I wasn't even changing gear - it just cracked and let go.) (This is a catch-up post, BTW.)

Monday, February 10, 2014

Double the training used to work. Now I'm not so sure. Or don't let age slow you down!

OK, so it 'used' to work. When I was 25 or so, anyway. Even when I was 35. But it started to go awry when I turned 42 or so. I'd always been relatively sensible in terms of avoiding over-training, making sure I ate right, or close anyway, and getting a bit of sleep. But the rules of thumb seemed to be breaking down. One moment all was well and consecutive 100km races on a weekend were fine, the next... not so good.

My rules of thumb? Number one, given a healthy diet and enough rest, is to train three times the distance of any given race per week, averaged over at least one month, preferably 3. After 3, back off, recover and build up again (preferably to a higher level). So if you want to race 100km, train at least 300km per week, average. That gives you base miles, basically. Build on that with specificity. I do have other rules of thumb but that's the main one.

Anyway, it worked for me until I was about 42 or so, but the signs of a problem were there from about 35, if I'd cared to look. I'd injure more easily. I couldn't mix-and-match sports as well as I used to (I was becoming highly cycling-specific but not entirely by choice!). And I was getting sick (mostly colds, mouth ulcers etc; irritants rather than 'show-stoppers') too often. And then it all went pear-shaped from my late 40s onwards. Now some of us will be luckier than others - some even less lucky than me - but my body reacted to aging by randomly mutating, as it were. It may have been stress-related, or environmental exposure to something I didn't even see. And it sent me on a medical-merry-go-round that hasn't ended.

But I persisted with training and racing, even if my racing suffered somewhat and became less frequent (I also had a young family, so was time-poor.) And that continued activity may have helped me fend off stage 2 of my medical maladies. Good aerobic fitness may well have protected me from the worst of my genetic (and perhaps dietary) failings. Which is to say that my heart attack at age 56 (whilst training, of course) was less severe than it may have been. And after 6 days off the bike I was back on - the trainer, anyway. A month or so later I am back on the road, feeling good - if a bit tentative.

What struck me down was high blood pressure, genetics and perhaps a love of dairy products. One coronary artery was significantly clogged and (since this was a new experience to me) I didn't recognise all of the early signs. Sure, I was 'treating' the high blood pressure with training (it works, up to a point, too). And I was still strong - still setting and re-setting Strava KOMs for example - but I became exhausted far too easily. There was no 'pain' as such, just lethargy and a feeling that I should 'go easy' today. Almost every day. At the time I put it down to all of the other medical issues I have collected (as you do) as well as "getting older". But when these new, sudden pains came I recognised immediately that although I had never experienced exactly this crushing sensation before, or the pain in both arms, I knew what the problem was: the heart. And I realised also that I had come 'close' to a similar feeling at the sharp end of a long sprint after a hard crit, several times. But unlike previous occasions I remained breathless and in pain, and it didn't go away. Not when I slowed down, nor even when I stopped.

Being both stupid and a cyclist (the 2 go hand-in-hand) I rode home with the pain, if rather slowly. I ran through some alternative options and even saw an ambulance and thought about flagging it down. I also remembered I had a mobile phone, my wife could pick me up in the car. Then again, I thought, maybe this is just an adverse reaction to the usual prescription medication I took this morning and it'll get better. Maybe I can just ride through this?

Oh yeah, and I live on a hill. My GPS data tells me it was the slowest I had ever ridden that hill, too. But I still wasn't the slowest. (Yes, I checked in Strava to be sure.) Although I knew with 90% certainty it was a heart attack I still wondered how I could ride home, uphill, whilst having an attack. Is that possible? And since I was averaging 200km/week I wondered how it was even possible that this could be happening at all. But it was.

The best part of 5 days in hospital and 3 stents have 'fixed' the clogged artery, now I just have to rebuild and get confident again. It takes time. So today's lesson? Don't think it can't happen. Cyclists - even long-time obsessively daily trainers like me - can have heart attacks. So be alert and react quickly and appropriately (like, stop riding and get medical help). Don't hesitate.

And yes, that daily training probably minimised the damage as well as fended off the day of the eventual heart attack itself. But listen to your body; if you aren't getting the training effect you used to get - and you are even going backwards - don't double the miles, instead take a rest or even have a chat with a doctor. It may just be over-training, lack of rest - or even an early warning sign of something far, far worse!

Some stats and other nonsense. And more.