Sunday, July 3, 2011

Medical Answers in the EKG

Well... now we know.  After doing significant miles, watching the diet and other changes to my own personal training habits (without results) I have a (partial) answer to the root cause.

A full work week at a desk job had me doing 58 hours in four days.  I work a lot as an independent coach and management consultant.  An "average" week is 60 hours + coaching (20 hours) + training 15 hours - there are 168 hrs possible in a week.  I also spend 2 hrs commuting (each way) to my client unless I get a hotel.  In this economic depression, you work when there is work.  Coaching and management consulting first and all else second.  I did manage to swim three days and run three days (even if I was only able to average ~3 miles - it was better than nothing).  Friday, the long awaited physical from an actual MD.  Not a physician's assistant.  Not a nurse.  Not a cardiology tech with golf on his mind testing for a large beverage company.  A real doctor looking at me and some of the experiences I've had recently.  He actually took the time to look at my experience and combine the factors.

I joked around (I admit nervously) with the nurses.  When they weighed me I flexed and said, "This is how they do it before big Vegas prize fights."  When asked about my height I responded with, "5' 8" with the afro."  I had several other jokes that had the nurse cracking up.  Including singing "Moon River" - watch Fletch if you don't get that one.  Hey, I'm the last patient of a holiday week and I am a full physical.  The office was cracking up.  My doc is next to a funeral home.  I joked, "Hey, if we get the diagnosis wrong at least you don't have to roll my body too far."  That got a nervous laugh understandably.  I even managed to ask, "Will I be able to play the piano after this test?"  The nurse said, "Sure."  I responded, "Cool, I've always wanted to play piano."  Took her totally by surprise.

I don't take any supplements with regularity.  This includes vitamins.  In my build period I was great about taking Vitamin D, fish oil and a veggie replacement along with eating right.  Are those supplements?  Technically yes.  They aren't in my diet.  I haven't taken the time to figure out what is legal and what actually works.  I like coffee, but only drink it once or twice a week.  I made it through overtraining in college without it.  I'm not a soda hound.  It's cheaper to drink water.  I'm cheap about certain things.  Sugar water that is one.

You ever get a  (fill in the blank) ?  I hate when that happens. 
I started really training and watching my diet in September of last year.  Balancing my diet to the calorie versus workouts.  Training in the right zones - lower even.  Consistency at the levels rivaling 2003 Ironman training.  I felt something may be wrong when I didn't see more than an eight pound fluctuation in my weight.  Hmm, this can't be right.

First, a bit of family history.  My mom's mom - is from a region of Italy (Italian Alps) where people have high HDL cholesterol and no heart problems.  They have other heart problems.  Many live into their 100s with: "heart flutter" (symptom #1 for me - not all the time), #2 occasional profuse sweating - sitting at a computer - I keep a towel in my work computer bag, #3 numbness in my arm (occasionally - lately, daily - but normally - once in a blue moon), #4 extreme fatigue - ask Lorrie - I can sleep 12-14 hours any day of the week no matter how much I've slept.  #5 The last one is a elevated blood pressure.  130/90 - odd because when I'm training this much I'm usually down around 105-109/58-65.  #6 This plus the incredibly odd heart rates and power numbers I've had led me to seek out a new doctor who.  One who went from "keep an eye on that" to "Let's test this now.  You're a better athlete than this."  Helps to have a doc who actually talks to his patients and participates in athletics.  Doc left me with this, "If you had any one of these symptoms and it was 2003, we would slap you on the back and wish you well.  These days - we are more careful.  I don't want you dropping dead in a training session or race."

Both of my Italian grandparents had heart issues, but lost battles to cancer.  Same side of the family, same region of Italy, my uncle Gino passed away at 106 in his sleep.  My aunt Mary walks to mass every day at 103 - she will be 104 in August.  My father's side of the family - grandfather had congestive heart failure - smoking unfiltered cigarettes won't help you much.  He passed away at 76.  My grandmother just passed away of "old age" - in her sleep.  I believe her heart just quit as a complication of other factors.

This winter I trained at the "Mark Allen" prescribed 137-139 heart rate and did miles.  Running, cycling and swimming - check the ego at the door.  Get passed by 75 year old women kinda "check".  I ramped it up in the pool and a little on the bike as the running numbers just didn't work out properly.  The training response wasn't there.

In the Florida 70.3, my heart rate was either in the 120s or 160s.  160 felt like 210.  I averaged 158 for 6:30:00 in Florida.  For the record, I've always been able to get my heart rate up to "crazy high" numbers.  Research seems to show that if you were trained as a runner or swimmer as a kid - you can do this as an adult.  For example, I "warm up" in the pool around 150-160 (6 second count starting with a 0 measuring at the pectoral - rounding the heart rate - so, a warm up would be a 15 or 16 count in 6 seconds).  I'm "working" at 180-190 and can hold that for most sets.  For all out efforts it is not difficult for me to be at a 21 count.  Going into Florida - I DID the training.  I really did.  I heat acclimatized in my office by jacking the heat up to 94 for the month before the race.  10 hours a day - heat and humidity.  Explains why on race day I felt great - just lethargic.  It was the heart (if this is not just a bad test).

What does it all mean?
Worst case scenario: In short, my doctor tells me that the left side of my heart "could be" miss firing. This means that all the blood the right side is pushing out to the body could be more.  Left isn't getting enough blood into the lungs for oxygenation.  This explains why I'm out of breath all the time.  Why recovery is taking days and not hours.  Why when I use compression gear - I feel much better.  To look for a positive... I could be in much better shape and something in my body is misfiring and not allowing me to achieve like I'm used to when I try.


It could be too much or too little of something in my diet.  Too much potassium would give us the same result.  Not sure yet.  I'm hoping it is a diet thing.

Rx for now - "take it easy" - no hard training sessions, no hills, walking instead of running, no races.  I've got more medical tests to do.

Someone asked me, "What will you do as a triathlete who cannot train or race during the peak season?" I told them (and don't take this the wrong way), "Well... first of all, I'm way more than just a triathlete.  Triathlon is part of my life, but it is not the only part of my life.  Maybe Greta and I are supposed to go dominate 'dock dog' competitions now.  Perhaps I'm supposed to go into full time coaching and develop the first Olympic champion from the USA.  Maybe I'm just supposed to be more grateful for the physical abilities I have and I need to take care of myself better than I have.  I fish really well.  Perhaps the Pro Bass circuit is in my future.  How about another degree?  Just a 'triathlete'?  Hardly."

Time to go workout - for dock dogs.

My family's youngest athlete.

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