July 26: I’m going to try not to drone on for this blog. So today was, in my eyes, a pretty big day in this whole process of CABG x5 (and again, that refers to Coronary Artery Bypass Graft x 5 bypasses) rehab. I mean everything I’ve been doing and striving for was going to kind of come to a head today at this visit to the Clinic for a second stress test with it’s accompanying echo. And this day today put me at the 10 week mark since surgery. Yea, 10 weeks since I was laying on a table under a bank of lights awaiting a small team of people to open my chest up, shut my heart off, put me on artificial devices to keep me alive, then graft 5 pieces of my own arteries onto 5 main branches of my coronary arteries, then restart my heart, sew me up and send me to the ICU with a gazillion pieces of apparatus hooked up to me. It still all feels like a crazy dream, that day. Like, did that really happen to me?

Yea, seems like so long ago. But the minute I hit that ICU I was determined to get my life back, despite some of the later talks I’d had with my cardiologist and my exercise physiologist which possibly pointed to the contrary. That’s all been on my mind this entire time, and that’s why I was so freaking nervous when I drove to the clinic this morning for the test today. There was a part of me, the glass is half empty side, that kind of dreaded the thought of my cardiologist telling me that my heart wasn’t going to work as it had prior to surgery, that they found some irregularities in my heart rhythm and that my heart’s mechanical operation had been compromised by the heart attack. 

Then there was the other part of me, the glass is half full side that over the last 3 weeks has really been kind of training for this damned stress echo test, hoping I’d just kick some ass and get the green light to begin harder cycling, and get the green light to continue with the adventures that I’ve just come to love doing - and sharing. I guess I’ve been worried and scared that a valuable piece of my life could very well be taken away from me, not by other people of course, but by my state of health, by fate, by my genetics. 

I’ve really tried to live in the latter of those two sides, to think positive, to believe that it’s possible to get through this, to have my cake - my life - and eat it to - my activity level. So this is why I’ve kind of taken the last couple days off to let my body recover from the hard workout on Friday (and I was feeling that puppy) and the piss poor ride on Saturday when I just couldn’t even get my HR up. Had to be recovered for that damned test! Took Sunday and Monday off just to REC a bit and get some strength back. 

Got up this morning, and I had to have been fasting 12 hrs prior to the test, with no caffeine! The caffeine thing was tough. Man I just LIVE for a good cup of strong java in the morning, so no brekkie and no java this morning. Up at 6 and out the door for the clinic at 6:15. Got there at 7 and hoofed it to the Main Campus and the J1-4 & 5 sections for my tests. Did the EKG first, and that was a snap. Blood test was second, and again, no problem. Yapped with the tech the whole time because I had a tee-shirt on with some rock climbing text on it. He told me of his bud who’d done Mt. Rainer then ended up having CABG x3 surgery not long thereafter. Said the guy’s goal now is to summit again post surgery. Wow, THAT dude could be my long lost brother! 

Then had a long wait for my stress echo. And I was nervous as hell. Just waited and waited and waited. And there people like me from virtually all over the world waiting to do their tests, folks from Spain, France, Sadi Arabia, Canada, and then a host of people from all over the USA. It was a bloody United Nations in there with all these people waiting for the 9 testing labs. I mean it was an assembly line of stress testing. Guess that speaks volumes for the Clev. Clinic with respect to its superiority in cardiovascular care. 

Finally got my call and did the long walk down to lab 7, where I was horrified to see there was no bike, just a treadmill and all the imaging and EKG equipment. Man was I bummed. I had to do this test on a freaking treadmill when I don’t even run anymore…plus my SI joint is just on fire right now from all the housework I’d been doing on Sunday and Monday during my “off days!” I even questioned them on choice of equipment. But there were no bikes up there. Told them I’d just soldier on and do the damn thing on the treadmill. 

First the EKG chick took my BP, which was stupid high. And I told them my BP had been great for weeks prior to coming into the lab. She told me it wasn’t uncommon for people in the lab to exhibit high BP’s because of being nervous. Well, that was definitely me. Up next I had an echo done, where they use this ultrasound device to look at and in the heart. They can measure wall thicknesses as it’s beating, they can measure chamber diameters and volumes, ejection fraction, more stuff than I could ever understand. Hell it’s just amazing what they do with this thing, and I can watch the screen and see my heart working. So we did this echo as I’m in a rested state, which took about 15-20 minutes. Then came the real deal - the stress test on a damned treadmill. 

Got hooked up on what had to be 8 leads for the EKG, and as I’m standing there was told the treadmill would go up in inclination & speed every three minutes, and to tell them when I couldn’t continue. I looked at the chick, and asked, “like REALLY can’t continue?” To which she responded yes. I was thinking, “been there, done that, but I had the plug pulled early in that first stress test on the bike.” So I was a bit dubious about the “can’t continue” statement. Got it going with a brisk walk, where at the end of three minutes I was asked for the level of perceived exertion while at the same time I had my BP measured before preceding on to the next level of difficulty. That first level was bloody easy. Well, by the third increase in speed an inclination I was running. Now I could hold one hand on a rail in front of me or on the right side of me, but NOT both hands on both rails. That was cheating they told me. So I was up to about moderate perceived exertion by then. The whole time I was kind of bumming because it was running and not cycling. Hell, my legs felt like shit running and my low back, my SI joint was feeling cranky. But I kept it going. So by the 6th increase I was feeling like I was running up a GD wall for gosh’s sake. I mean I was really starting to hold those rails for fear of being spit off the back of that high speed fan belt. 

Now by that time I’d gotten my HR up to 160, and for the life of me I just couldn’t get it to go any higher. The legs were feeling rubbery and my breathing was more like hyperventilating. I had pretty much run out of gas and hit the proverbial max wall. So I signaled that I was done, and then as I was gasping for O2 the other chick had me lay back down on the table for another echo as my heart was racing. She even had me hold my freaking breath several times as she did these measurements. Man I was just gassed!

So I’d felt kind of bummed that I didn’t get any higher in HR, but then I began to wonder if the meds had stunted my max HR, another question I would ask my cardiologist when I saw him. So as I was getting the second echo, the EKG chick said that no one had gone that long in like three years, and I was thinking, “are you kidding me, I SUCK as a runner right now.” That’s when I told her they would have been pissed at me had we done the test on a bike because I’d still be on that fracking thing! I mean hell, I’d kind of been training for that damned test on the bike for weeks now. Had I known it was a run I’d have included some running in my rehab workouts. 

Nonetheless, felt good to know they thought I did well. Got dried off then went to wait for my appt. with the doc to go over all the results. Again, a whole army of people were coming in and out of the labs pre and post testing. Finally got the call to head into the doc’s office where I first had a nurse take weight, height, go over my med stuff, then do a BP test on me - which was exactly what it’s been for months, about 114 over 76. So that kind of put me at ease. So the doc came in with an assistant who was doing her fellowship in sports cardiology. Shook hands with both the doc and the fellow and he immediately told me I absolutely crushed it on the stress test. Said everything, echo, EKG, BP measurements, everything looked great. Now I had a list of about 14 questions for the doc, but upon hearing that I was just totally stunned.

He went on to tell me a bit more in depth how things looked amazingly well. And after that I began with my first question. And I prefaced it with, “now this might seem ridiculous but my most important question has to do what how hard can I go now with respect to HR.” He smiled, and I proceeded further, telling him about how I cheated with my volume in cycling. Again a smile. But how good I felt with the prescribed HR zone - Z3 - sandwiched between an hour or so of Z2. Also told him of my 1 hour of solid Z3 at top end of the prescribed zone, where again I felt really good. Then I told him how much I wanted to get back to long bouts of steady state Z4, and how much I wanted to get back to 4-5 hour rides etc. More smiles. I even showed him my chart from the three cycling sessions I’d done at the clinic under supervision. He and the fellow went over that and they looked happy about the results, especially the pre and post BP measurements. 

Also told him I was still good with staying away as much as I could with anaerobic Z5. But man, I was just hoping for the moon to be able to go into the LAT zone again. I was just a jabbering, babbling knucklehead. I finally let him get a word or two in. And that’s when he said he saw no problem with LAT workouts and with long riding - BUT I had to hydrate with water and electrolytes all the time - that was a must! Bingo, my wish had just come true! He also discussed going anaerobic, and described it as “Risk/Reward”. He reiterated he had no proof on one side or the other if my going into high Z5 or max HR would or would not result in a cardiac episode. I looked perfectly fine in the max test I’d just done on the treadmill, but you never know. 

So he had zero issue with anything in the Z4 range. Now he did mention I shouldn’t do hard riding during any kind of viral infections like the flue etc, as that could stress the heart out much more than normal. Same for heat/humidity situations, where I’d need to back off the intensity such that I wouldn’t put undo stress on the heart. But otherwise I was just good to go. We then went over some of my resistance questions. Said I still need to stay with the unilateral exercises and NO rock climbing for 2 more weeks. Then at the three month mark, two weeks from now, I can begin very light bilateral exercises and super easy rock climbing. Had to do a gradual build from there. 

Asked a couple questions about my meds. He thinks staying on the statin for the rest of my life is a good thing, especially since I seem to have the genetic propensity for severe coronary artery disease. He also wants to stay with the super low dose of BP med because of my activity level and the intensity I take everything to. Told me if I were just a normal Joe, he wouldn’t even prescribe the BP med, but my volume/intensity kind of changes things due to the high BP’s you get during intense exercise. He did say this is totally adjustable and I can go off it if my BP is going too low. Only other meds I’m on is an anti-spasming drug for my left forearm where the left radial artery was removed, and I’ll be on this for just 3 more months, and a children’s aspirin and a multivitamin. 

Also asked him about the somewhat stunted max HR I’d gotten in the test, and he affirmed the meds did indeed stunt the max. They’re a kind of governor on my HR. This would totally SUCK if I were still racing, but today I could give a shit less. I just want to be able to maintain hard efforts in the backcountry and when out with my friends and clients, NOT the kind of efforts you put out in a CR’s or road races. Seems my HR zones are about 10bpm off right now. Oh well, I can definitely live with that one. 

And finally we talked about the peripheral blockages still in my coronary arteries. Doc revealed that recent studies indicate the blockages can begin reducing as soon as several months after statin drug and/or Mediterranean dieting. Now he said we cannot actually look at that with a heart cath, but we could see it through testing down the line, the same kind of testing as I’d done today. With all bases covered he told me I’m good to go for a year. No more testing, no more visits. I’ll go back in July of ’17 for the same workup as I’d gotten today to see if I’m at least where I was today, if not much better.

I left his office feeling as if I’d just gotten my life back. I mean I was just elated! I can go out and do my thing now, with relatively little in the way of restrictions. Just have to work back slowly with the resistance and rock climbing. So this is where I’m at, and I feel just wonderful about my prognosis. I did indeed win the lottery and get that second chance in life, and it’s like I got the cake and I can eat it to! I’m totally dedicated to the lifestyle changes in eating, stress, and indulging in too much brew at times. Going to do all I can to NEVER lay on that operating table again to have my chest split open for heart surgery. 

So that’s the scoop, and I think this is just the right place to end my blog for this season. American Dirt will get finished in Spring of 2017, in addition to a number of other little adventures on the hit list. I am going to take Judy on a well deserved mini-vacation to Prince Edward Island in Canada on the Atlantic coast. There’s a fabulous gravel bike trail - the Confederation Trail - there that goes for about 200 miles from west to east across the island. We’ll do it as a mellow vacation and just have some fun in the Canadian Maritimes. Haven’t done an R & R vacation for a while, so this should be great. Then next year when I’m pretty much in the best shape I can be in with respect to my heart being tip top, I’ll return to the beat-down-fest stuff like AD. 

Want to thank several people by name for helping me get my second chance in life: my sister Kim, my cousin Sue, and my girl Judy. Without these three, wow, I wouldn’t know where I’d be right now. So I look forward to seeing you all on and off the road the rest of this year. Take care all and thanks to everyone, too many of you to name, for all your kind cards, emails, phone calls, and visits. You guys are just amazing………pete