June 17: In Stow at Judy’s for my rehab.

June 16: Very interesting day indeed. Wednesday night was a pretty good night of sleep at home. So today was my first cardiologist appt. since the surgery. And I have to say that I was a bit nervous. Now I hadn’t mentioned a few things in this blog because I really wanted to run it by my doc before I kind of put it out there for everyone to read. Just didn’t want to jump to conclusion myself, OR have you guys take that same path. So I was nervous because, ever since about the second week after surgery I’ve noticed that I now have a skip in my HB. It can skip after 30 sec, after a min, after a couple minutes. It’s not consistent, but it’s there 24/7 no matter what I’m doing. So that really concerned me. 

Now I have been discussing eat with my sister, and she kind of put my mind at ease telling me it’s most likely benign. BUT she wanted me to go over this with my doc. Now the second that I’ve noticed is that I can really, I mean REALLY feel my heart beating, like almost in my throat at times. Sometimes when I’m lying down it just feels like it’s beating out of my chest. And honestly, I’ve really never felt that before all this occurred - unless I was just hammering like hell doing something athletic. So I had these two issues kind of making me feel a bit uneasy. The third thing that I had on my mind, though it didn’t manifest itself as something physical that I could sense, was this: Ok, so I had 5 grafts on my coronary arteries, but when you look at this 2-D diagram of my blockages, well there are about 9. So my question when looking at this is what’s up with the rest of the blockages? Obviously they were not able to graft enough with five grafts to cover everything. So what do we do down the road about the rest?

So those questions have been on my mind for a couple weeks. And man, I have to say I was nervous this morning as Mike took me up to the Clev. Clinic Main campus for my appt. Would any of these issues further impact me? Could my ticker be damaged? Would I have to live under some less than ideal parameters due to my disease? All that crap was just ping-ponging through my brain all the way up there this morning. 

Got dropped off and checked in, then off to my first test - the heart echo. Done, and off to the second test - the EKG. Done. Next Then I had to wait about an hour to see my cardiologist. Now this guy is so smart and so damned personable, and as I’d mentioned earlier in my blogs, he really get who I am and what I do, from an endurance performance standpoint. So I finally was called into his office and then taken to the examination room where I was tended first by the nurse who took my weight and BP. I was up about three pounds but my BP was a bit high. We did that BP twice, just to make sure. I was almost positive that it was because of my nervousness. 

Next up an assistant to the doc came in for further questions as to how and when I discovered my heart issues. So I reiterated the whole story about what happened. She also questioned me as to my volume and intensity of my exercise regime - including my resistance program and my cardiovascular program. So finally my doc comes and, and I begin with my most pressing questions, the physical ones concerning my skipping HB and the fact that I can feel my hear beating so much more now. So he explained what he thought was happening with that skipping beat issue, which he predicted was a benign issue and nothing to worry about. Sees that very, very often he told me…BUT just to be on the safe side he wanted me to wear this heart beat recorder for a day. So he wrote out a script for me to get this “Holter” put on this morning. Ok next was the feeling my heat beating thing. And again, he said that is so common with CABG patients such as myself. Could be the sensitivity of the chest cavity due to it being opened up. Said that should slowly go away. 

Ok, so far I’m feeling pretty good. Then I got out the 2-D drawing of my coronary arteries that was drawn for me after my heart cath back in Nevada. And I proposed the question as to what’s up with the remainder of the blockages that were not covered by the five grafts? And doc’s response was sobering! He told me that is really what he wanted to spend time with me discussing. Told me I have a very serious case of cardiovascular disease. Serious! I mean my blockages are just unprecedented. They got the biggies, but there are still numerous less intense blockages that they could not get. And he indicated that the 2-D diagram I have is very basic, because the real picture includes even more blockages. 

So at that point I’m ready for the bomb to drop, kind of like I see where this is going. He proceeded to tell me that I will likely have to live under some intensity parameters for the rest of my life. And this means not taking it to my physical and cardiovascular limit any more - no more Zone 5, the anaerobic zone! He said he could not guarantee that I’d have another cardiac episode if I enter that territory, but he said the chance is NOT worth taking based on the level of blockages left in my arteries. Could not say it would be 1 in 10 chance of a heart attack, or 1 in 100 chance, or even 1 in 100,000 chance. But it could happen if I pushed my heart to the limit, especially on a repeated basis over and over. 

That was like a gut shot, hearing that. Just to know that I should give up a part of myself that I so loved to push to. Now let me clarify something here. I have not raced for 16 years. And I’ve known from the last race I ever did back in 2000 that I’d likely never race again. I’m truly done with that part of my life. I so enjoyed the 30 years or so when I trained like a fiend and raced all the time. But I just totally burned out with that lifestyle, and I knew I’d never go back to it again. There were just so many other thing I wanted to do in life, and most of it involved adventure and travel and coaching etc. So with that being said, developing and training with all that Z5 stuff, that’s integral to being a good competitive athlete. That’s your super high end you have to draw upon when your racing and training. Today, my high end, Z5 b & c sucks! Because I don’t regularly train in that realm. 

BUT, there are times when during some of my adventures that I’ve found myself hitting that anaerobic realm, if only for a few minutes a couple of times during a day. I mean it’s just human nature to push yourself like that say when you want to push up over the top of a high mountain pass. So though I don’t race and train to compete anymore, I still get into that “pain-locker” on occasions during my trips. But when the doc told me I shouldn’t crush myself during my adventure trips, that I shouldn’t just keep pushing like a madman, that hit home with me, that felt like a real crushing blow. I mean I could live without the racing, no problem. But when told I still have to watch what I do on my adventures, that hurts. His advice was that I should no longer push myself to the breakpoint in my trips. 

I did further questioned him about me doing all this stuff I currently do, but maybe backing off a notch and keeping everything in Zones 2-4, all aerobic zones. And he seemed good with that. But again there was a BUT. And this BUT hinged on me doing a series of graduated stress tests over the course of six months to make sure my heart does not do anything weird to indicate that even Z4 is off limits. So I’ve got my first stress test on 6/28. I’m hoping I can do this on a bike like I’ve done in the far past during my several VO2 max tests, rather than the freaking walking on a treadmill thing. 

Now there’s a bit of good news in this. The statin drug that I’m taking could indeed ever so slowly diminish the blockages I currently have. So it “could” get better. Also, my diet, and especially getting myself on a good healthy, low cholesterol  diet, that could also help the situation. But he said I’ll be working with a nutritionist in addition to my PHD exercise physiologist who will be administering the stress test and giving me my workout HR zone parameters and my resistance parameters. 

So I was feeling ok after the taking with the doc, but then I got somewhat melancholy afterwards, I guess because I felt that I was loosing a part of myself that I really identified with. I just loved the fact that I could push myself to the brink of total exhaustion - even in my adventures. I admit it - I’m a sick puppy. I just LOVE to suffer! I relish suffering, I crave suffering, I seek out suffering. It’s just a part of me that I really feel good about. And suddenly I’m told that I really should stay away from that territory. And there were a few, well more than a few, times when I was sitting in the clinic after my visit with the doc where I’d just think, “the hell with that, I’ve pushed like a madman with all those “unfixed” blockages. Why can’t I just do the same with a much better situation? What if it is 1 in 1000,000 or 1 in 1,000,000? Could I play the odds the rest of my life?”

Then I’d kind of get myself back to reality, and think of doing all this stuff at Z3-4 - if my stress test goes ok - and just back off when I begin to go anaerobic. And that was one of the things he did tell me: You can go do your ass-busting (not his exact words)  trips, but when you get to that area where you’re really pressing, you SHOULD back off. So this is where I’m at right now…still mulling all this over and wondering how it will change my life, my personal NOT my professional life. My next stage is to do the stress test and see how that goes. I think right now I’m just seeing too much negative. Got to get back into the positive and chill out a bit.

So talked to my sister and she kind of just let me vent, and then followed that up with some logical talk of all the pluses. Got fitted for my HR monitor, the Holter, and then Kim took me home later in the day. 

Had a nice ice cold Fosters Lager and watched the Cavs game that night and just chilled and tried to keep a positive spin on everything. I did joke with Kim and Judy that, “I had to start my training regime for the stress test in two weeks because I didn’t want to embarrass myself!” That went over like a lead balloon. Forgot to mention that I still have to go easy with the upper body for 2 more weeks to let me sternum heal. It is healing quite well so far. Also, told the doc I was up to 5 miles of walking at RPE 3-4, wondering if he’d scold me for going too far. Nope, he was good with any volume that I wanted to walk, just so I didn’t get goofy and go too hard so as to stress the new artery grafts. 

Well, that’s about it. New and positive attitude tomorrow all the way. By God I’m going to make this work!