Sunday, December 28, 2008
It's Getting Better
I ran a 9:11 mile on Friday during my jog. I had the treadmill up to 6.7 mph (8:54 minutes per mile pace) for a while, but the heart rate eventually jumped to 172 so I had to back it down a bit. In all, I ran/walked 2.3 miles in 25 minutes, including a warm up and cool down walk totaling 8 minutes. I'm trying like crazy to stay within the prescribed limits but I'm too hard headed to comply 100%.
Thursday, December 25, 2008
Up to Speed
On Friday, December 19, I went to rehab. Ed had received my test results from the doctor. He said he had never seen results this good before. Simply stated, my heart was functioning perfectly at rest and when stressed. No concerns about damage to the muscle. He changed my workout and gave me the go ahead to run in addition to the rest of the normal routine. He said we would have to tweak the workout as we go. But he gave me a max heart rate of 165 and a starting point of 5.2 mph on the treadmill without an incline. I had 25 minutes to get it done, which includes a 5 minute warm up and a 3 minute cool down. So, 17 minutes of pure running. Ed said I'd probably want to run for about 5 minutes, then walk for a minute or two, then run again. He was wrong. I ran the entire 17 minutes uninterrupted. My speed maxed at 5.6 mph (just over a 10 minute mile) and my heart rate maxed at 165. It was a good start.
I had eaten lunch late that day and had a slightly full stomach when I went to rehab. Ed said that could affect my heart rate as blood was needed to support the digestion and the exercise at the same time. In short, if I eat at a normal time on Monday, I might be able to increase my speed.
The weekend passed as it usually does. I was told not to run outdoors until I had a few more sessions of monitored running behind me so I couldn't do a Saturday morning run yet.
So when Monday rolled around, I couldn't wait to get to rehab. I ate at a normal time. No afternoon snacks. The difference between Friday and Monday was tremendous. I was able to increase my speed without going over my heart rate. I ran a 9:22 mile during my 17 minutes of running. It felt great. The rest of the routine was just that...routine. I was so proud of myself, I practically dislocated my shoulder patting myself on the back.
Wednesday was Christmas Eve. Rehab closed early so I wasn't able to go. Instead, I had planned to walk for an hour in the morning before I left for work. Didn't happen. The alarm went off at 4:15 and I hit the snooze...again, and again...and again. Never got out of bed until it was time to get to work. Oops.
After work, my mother-in-law was at our house. Rachel and I decided to go for a walk while my MIL watched the girls. For the first time, however, I went against the advice of my rehab physiologist and we decided to run. I had my heart rate monitor and kept the 165 max rate in mind as we went. Three and a half miles later, we were back at home. We had run about 3.25 of it. We had to walk a few times to keep the heart rate down. I maxed at 170 going up hill. I also had a walking warm up and cool down. I found it difficult to contain the bravado. Just 11 weeks after a heart attack and a 3 day hospitalization, I ran 3.25 miles.
The rest of the day was a jumble of bravado, reflection and thankfulness because I realized how unbelievably lucky I was. I had had a heart attack but with no permanent damage. More importantly, I had an awakening without suffering a loss.
I had eaten lunch late that day and had a slightly full stomach when I went to rehab. Ed said that could affect my heart rate as blood was needed to support the digestion and the exercise at the same time. In short, if I eat at a normal time on Monday, I might be able to increase my speed.
The weekend passed as it usually does. I was told not to run outdoors until I had a few more sessions of monitored running behind me so I couldn't do a Saturday morning run yet.
So when Monday rolled around, I couldn't wait to get to rehab. I ate at a normal time. No afternoon snacks. The difference between Friday and Monday was tremendous. I was able to increase my speed without going over my heart rate. I ran a 9:22 mile during my 17 minutes of running. It felt great. The rest of the routine was just that...routine. I was so proud of myself, I practically dislocated my shoulder patting myself on the back.
Wednesday was Christmas Eve. Rehab closed early so I wasn't able to go. Instead, I had planned to walk for an hour in the morning before I left for work. Didn't happen. The alarm went off at 4:15 and I hit the snooze...again, and again...and again. Never got out of bed until it was time to get to work. Oops.
After work, my mother-in-law was at our house. Rachel and I decided to go for a walk while my MIL watched the girls. For the first time, however, I went against the advice of my rehab physiologist and we decided to run. I had my heart rate monitor and kept the 165 max rate in mind as we went. Three and a half miles later, we were back at home. We had run about 3.25 of it. We had to walk a few times to keep the heart rate down. I maxed at 170 going up hill. I also had a walking warm up and cool down. I found it difficult to contain the bravado. Just 11 weeks after a heart attack and a 3 day hospitalization, I ran 3.25 miles.
The rest of the day was a jumble of bravado, reflection and thankfulness because I realized how unbelievably lucky I was. I had had a heart attack but with no permanent damage. More importantly, I had an awakening without suffering a loss.
Catching Up (again)
So once again, a few weeks have slipped by since I last updated. I took a second stress echo test on December 11. The test usually runs for up to 12 minutes. Most people don't go the entire 12 minutes. The point is to reach a target heart rate and then get pictures of the heart while it's pumping at that rate. My target rate was 185. After 11 minutes, I was only up to 170. I was at 4.5 mph and a 16% incline. A fast walk. As we neared the 12th minute, the doctor said he had what he needed and was going to stop the test and take the pictures. I asked to keep going because the speed was about to increase to 5.2 mph, a slow jog. He said he would let it go one minute over. At an 18% incline and with a ton of wires strapped to me and a blood pressure cuff on my arm, I finally got to jog. It was only for a minute. But it was fun.
When the test was over, the doctor looked at the pictures. His initial evaluation was positive. He said he didn't see a thing wrong. Next step...wait for my doctor to look at the results.
Friday's rehab was normal. They wouldn't increase my workload again until they heard from the doctor.
On Saturday, December 13, I picked up message on our home voice mail to which nobody had listened. Doctor Newton had called the day before with the test results. He said everything looked great and that I could start running again immediately. He cleared me to work my way back up to 10 mile runs within 30 days.
On Monday, I went back to rehab. Ed had not heard from Doctor Newton directly so no changes to my workout. Same for Wednesday. But on Friday, December 19th, everything changed.
When the test was over, the doctor looked at the pictures. His initial evaluation was positive. He said he didn't see a thing wrong. Next step...wait for my doctor to look at the results.
Friday's rehab was normal. They wouldn't increase my workload again until they heard from the doctor.
On Saturday, December 13, I picked up message on our home voice mail to which nobody had listened. Doctor Newton had called the day before with the test results. He said everything looked great and that I could start running again immediately. He cleared me to work my way back up to 10 mile runs within 30 days.
On Monday, I went back to rehab. Ed had not heard from Doctor Newton directly so no changes to my workout. Same for Wednesday. But on Friday, December 19th, everything changed.
Monday, December 1, 2008
Moving Forward - Rehab Days 4 - 9
We started over. Back to light work outs so Ed could gain the level of comfort he needed to ensure no more blackouts and no other issues. Treadmill was 4.0 with 2% incline for a few days. Rower, Monarch, Arm Bike and Leg Bike were all at minimal levels. Boredom set in until today.
December 1...new month, new workout. Ed adjusted the workload up. Everything went swimmingly. At the end of the workout, Ed said he might remove the telemetry after Wednesday and we can start running...maybe...in a week. I'm certain that Pat will celebrate when the telemetry is removed as she has been nice enough to put it on me every visit.
It has been 64 days since my last run. I have put on about 10 pounds. The holidays certainly were not good for me. Time to get serious. Time to take advantage of the time remaining in rehab to drop weight, strengthen the heart and get Superman out of the Kryptonite cellar.
December 1...new month, new workout. Ed adjusted the workload up. Everything went swimmingly. At the end of the workout, Ed said he might remove the telemetry after Wednesday and we can start running...maybe...in a week. I'm certain that Pat will celebrate when the telemetry is removed as she has been nice enough to put it on me every visit.
It has been 64 days since my last run. I have put on about 10 pounds. The holidays certainly were not good for me. Time to get serious. Time to take advantage of the time remaining in rehab to drop weight, strengthen the heart and get Superman out of the Kryptonite cellar.
The Highly Anticipated Stress Test Results
It took 2 days. Doctor Newton finally called me and confirmed the beta blocker caused my blood pressure drop. He took me off of it. He said the stress test pics looked good. He had no worries about the heart rate and said he can't find any damage in the heart. He said Ed can move forward, remove me from the telemetry and move up the work out load.
Of course I couldn't wait to get to rehab that day. Ed didn't share my enthusiasm. He wondered how I could have a "normal" outcome of a stress test when I passed out. He understood the point of stopping the medicine, but felt that he still had a lot of work to do. First, he had to monitor me and get baseline data when I'm not on the beta blocker. Second, he wanted to be sure I was having follow-up appointments with Dr. Newton. Now here's where Derek's situation becomes more important. Had I not known that Ed's insistence and intervention lead to fixing Derek's pacemaker, I would have considered Ed paranoid. However, I trusted Ed not as paranoid, but concerned and I followed his lead. It meant more rehab at lower paces, but better safe than sorry.
Of course I couldn't wait to get to rehab that day. Ed didn't share my enthusiasm. He wondered how I could have a "normal" outcome of a stress test when I passed out. He understood the point of stopping the medicine, but felt that he still had a lot of work to do. First, he had to monitor me and get baseline data when I'm not on the beta blocker. Second, he wanted to be sure I was having follow-up appointments with Dr. Newton. Now here's where Derek's situation becomes more important. Had I not known that Ed's insistence and intervention lead to fixing Derek's pacemaker, I would have considered Ed paranoid. However, I trusted Ed not as paranoid, but concerned and I followed his lead. It meant more rehab at lower paces, but better safe than sorry.
The Highly Anticipated Stress Test
So Superman's ego had been deflated. I thought I would breeze through rehab and start running again in only 2 weeks. That is until the "crash". On Monday, November 17th, I went for my stress test.
The test was administered by Dr. Weaver as Dr. Newton, my Doctor, had appointments elsewhere that day. Dr. Weaver and I didn't get off to a good start. Her bed-side manner didn't agree much with me. I told Dr. Weaver of Friday's setback. She kept it in mind.
For those who have never had a stress test, you essentially get on a treadmill from the 1970s, strapped to a machine with about 10 electrodes and heavy cabling. You start out at a slow pace with no incline. Every 3 minutes, the technician increases speed and the incline. The goal...get the heart rate over 155 then very quickly jump on a bed and have the tech take pictures of your heart before the heart rate drops to its resting level. Simple, right? Not so much.
To avoid boredom with the details, the program ran about 12 minutes. My heart rate got up to 125. Someone forgot that the beta blocker I take would keep my heart from getting any higher, even though they reviewed my meds package before starting.
Ok...so here I am only 20 seconds away from hitting my first real jog since the heart attack (5.2 mph) and the blood pressure fell off again. I had no choice but to move to the bed and have them take the pics with a heart rate of 125. Unfortunately, within the 20 seconds that it took to move to the bed and get in position, my heart rate already dropped to below 90 when the tech snapped the pics.
Dr. Weaver in her very "calming way" told me either I needed a meds adjustment or open heart surgery. She'd let Doctor Newton decide which. Oy!
The test was administered by Dr. Weaver as Dr. Newton, my Doctor, had appointments elsewhere that day. Dr. Weaver and I didn't get off to a good start. Her bed-side manner didn't agree much with me. I told Dr. Weaver of Friday's setback. She kept it in mind.
For those who have never had a stress test, you essentially get on a treadmill from the 1970s, strapped to a machine with about 10 electrodes and heavy cabling. You start out at a slow pace with no incline. Every 3 minutes, the technician increases speed and the incline. The goal...get the heart rate over 155 then very quickly jump on a bed and have the tech take pictures of your heart before the heart rate drops to its resting level. Simple, right? Not so much.
To avoid boredom with the details, the program ran about 12 minutes. My heart rate got up to 125. Someone forgot that the beta blocker I take would keep my heart from getting any higher, even though they reviewed my meds package before starting.
Ok...so here I am only 20 seconds away from hitting my first real jog since the heart attack (5.2 mph) and the blood pressure fell off again. I had no choice but to move to the bed and have them take the pics with a heart rate of 125. Unfortunately, within the 20 seconds that it took to move to the bed and get in position, my heart rate already dropped to below 90 when the tech snapped the pics.
Dr. Weaver in her very "calming way" told me either I needed a meds adjustment or open heart surgery. She'd let Doctor Newton decide which. Oy!
Rehab Day 3 and the Crash
(Ok. I've fallen behind in my documenting efforts. Thanks Jeffry for reminding me to continue the story...if not for others, then at least for myself. This picks up on November 14th.)
Looking forward to my stress test on Monday, I couldn't wait to get to rehab. With any luck, they would remove my monitor pending the outcome of my stress test. Plus, Ed upped the workout. I might actually break a sweat.
As always, I started with the treadmill for 20 minutes. While walking, I met Derek. I thought I was the youngest patient by far for the first two days until meeting Derek, 43, and was once a runner like me. Derek had been sick for about a year and had a pacemaker installed 5 weeks before I met him. In my first few days, I watched Derek interact with Ed and the nurses about a clear problem he suffered. After talking to him today, I learned that his heart rate would not get up over 65 during exercise. Ed thought the pacemaker was set wrong and advised Derek to see his doctor for an adjustment. After 2 appointments (and a great deal of persistence by Ed), Derek convinced the doctor to take another look. Sure enough, they missed a setting. They did a quick fix (non-invasive). An hour later, Derek hit the treadmill and said he felt like a different person. This event has a second level of importance...you'll see in 2 more posts.
As I said before, my workout was increased. I went from 4.0 mph on the treadmill with a 4% incline to 4.0 with a 6% incline. Not yet a run, but it was closer. After the treadmill (on which I finally broke a sweat) I hit the arm bike. Two minutes moving at a rate of 1.8 revolutions per minute. No problem. Then came the leg bike.
I started the leg bike for 10 minutes at 1.8 rpm and moved up to 2.2 and eventually 2.4 for today. About 6 minutes in, I started to get winded and felt "funny" I stopped pedaling to catch my breath. Adele was monitoring and she asked if I stopped early. I said yes. Next thing I knew, I was laid out on a stretcher with people taking my blood pressure and pouring water down my throat. The pressure dropped quickly from 100/60 to 80/42. Not enough to sustain consciousness apparently. Within 20 minutes, it came back up and Ed released me.
First thought...I'm not Superman. It was a bummer. I always thought I had a Superman quality. One who could stand a lot of stress, absorb a lot of push back and recover quickly from illness or injury. Clearly, I was not taking this seriously enough. It didn't help that one of the other patients chuckled and said "sucks when you find out you can't do what you used to". (These words will hold some significance in a matter of weeks...you wait.) And my Superman complex....well...it flew out the window. I was left sitting on the bench. Still sidelined for the season.
They say if you can't be an athlete, at least be an athletic supporter. Rachel ran the Richmond Marathon on November 16th and did awesome. We loved being out there to cheer her on and to remind myself that I'll be back here next year once again.
Looking forward to my stress test on Monday, I couldn't wait to get to rehab. With any luck, they would remove my monitor pending the outcome of my stress test. Plus, Ed upped the workout. I might actually break a sweat.
As always, I started with the treadmill for 20 minutes. While walking, I met Derek. I thought I was the youngest patient by far for the first two days until meeting Derek, 43, and was once a runner like me. Derek had been sick for about a year and had a pacemaker installed 5 weeks before I met him. In my first few days, I watched Derek interact with Ed and the nurses about a clear problem he suffered. After talking to him today, I learned that his heart rate would not get up over 65 during exercise. Ed thought the pacemaker was set wrong and advised Derek to see his doctor for an adjustment. After 2 appointments (and a great deal of persistence by Ed), Derek convinced the doctor to take another look. Sure enough, they missed a setting. They did a quick fix (non-invasive). An hour later, Derek hit the treadmill and said he felt like a different person. This event has a second level of importance...you'll see in 2 more posts.
As I said before, my workout was increased. I went from 4.0 mph on the treadmill with a 4% incline to 4.0 with a 6% incline. Not yet a run, but it was closer. After the treadmill (on which I finally broke a sweat) I hit the arm bike. Two minutes moving at a rate of 1.8 revolutions per minute. No problem. Then came the leg bike.
I started the leg bike for 10 minutes at 1.8 rpm and moved up to 2.2 and eventually 2.4 for today. About 6 minutes in, I started to get winded and felt "funny" I stopped pedaling to catch my breath. Adele was monitoring and she asked if I stopped early. I said yes. Next thing I knew, I was laid out on a stretcher with people taking my blood pressure and pouring water down my throat. The pressure dropped quickly from 100/60 to 80/42. Not enough to sustain consciousness apparently. Within 20 minutes, it came back up and Ed released me.
First thought...I'm not Superman. It was a bummer. I always thought I had a Superman quality. One who could stand a lot of stress, absorb a lot of push back and recover quickly from illness or injury. Clearly, I was not taking this seriously enough. It didn't help that one of the other patients chuckled and said "sucks when you find out you can't do what you used to". (These words will hold some significance in a matter of weeks...you wait.) And my Superman complex....well...it flew out the window. I was left sitting on the bench. Still sidelined for the season.
They say if you can't be an athlete, at least be an athletic supporter. Rachel ran the Richmond Marathon on November 16th and did awesome. We loved being out there to cheer her on and to remind myself that I'll be back here next year once again.
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