Wednesday, June 8, 2011

End of 1st week

June 5th-Forest Park loop. Clockwise. Tower Grove to park, Clayton-Chouteau-39th home. 13.7mi.

June 6th-UT Pl laps x15. 12.3mi.

June 7th- UT Pl, Flora, TGP with Em. 11.4mi.

Ride Notes. Weather, as predicted, taking a toll on the effort. Em did better on her 2nd ride and was enthusiastic about riding. If I added correctly that's just a hair under 100mi for the week, so 400 for the month is more realistic. By comparison, my commutes to work were 56mi per 7 days, so I'm very much OK with the adjusted numbers.

A few notes about my more restrained effort on the bike compared to pre 2010. I'm not pushing anything. With a tailwind or downhill, I'm taking it easy. No more balls-to-the-wall stuff, staying as far out of the red zone as possible. Really didn't serve me well in the long run. Climbing in an easy gear and spinning. I've decided time is on my side.

Saturday, June 4, 2011

Days 1-4

June 1st-Utah to Broadway to the Arch. Wharf St. flooded, up stairs to Arch grounds. Thru the landing to NR trail. Across McKinley to Venice and back. Return thru grounds, up Market thru City Garden to 18th. Up Lafayette into park where this inspiration(?) struck. Continue on Lafayette to Compton to Utah. Home. 20.8mi.

June 2nd-Spring - Arsenal - Mackland - Oakland. Into park, 1 lap. Exit park, Euclid thru BJH and StLCoP. Thru the Grove, Chouteau - 39th - Magnolia- Grand. Home. 15.4mi

June 3rd-with Em. Circle UT Pl, Spring to park, 1 lap. 39th - Flora - Klemm -Magnolia back into park. (Em rests) 1 lap. Spring to home. 12.2mi

June 4th-Spring - Arsenal - McCausland/Ellendale/Wellington/Wabash -Lansdowne. Onto RDPG - CPG to Delore. Delore - Morganford - Utah. Home. 13.7mi

Ride notes thus far. First, the weather. I assumed when I started the weather would be a factor in some manner. My initial thoughts were about being rained out. I figured I had a couple weeks until the heat became oppressive. Wrong. Mid/High 90's with Heat Index in the 100's right outta the box. No relief in sight. Definitely gonna play a part in this, probably in the total mile count.

Second thing. By keeping the rules simple (e.g. 10mi) every few days Em can ride with me on a low mile, close to home day. We went Friday and she bonked. I was so pissed at myself. We went out about 10:30 and I didn't think to make sure she ate something, so all she had on her stomach was an ice coffee. She has some athletic ability that she's never pursued. If I want her to enjoy riding and get some road/traffic skills before she leaves home later this summer I have to do better. At this point I don't believe she'd even think about wanting to take her bike with her to school. Maybe too little too late on my part.

Friday, June 3, 2011

30 rides/30 days

To anyone who rides I realize this has pretty much of a "so what" quality to it. I got the idea two days ago on a ride which happened to be on June 1st. Could I get a ride in on every day in June? For me it becomes a bit more of a challenge considering last year from Apr '10 thru Mar '11 I can only recall riding once and that was late in the summer. It didn't go well. Early spring was crappy, cold and wet, so I didn't get out more than a handful of times. Lastly of course, I'm almost 6 months out from the second ablation (mid-December). Everything has been great to this point. Time to put it to the test. Modestly obviously. The rules are simple, in order to qualify, a ride has to be at least 10 miles. I figure most will be in 15-20 mile range, but I set it low thinking that on days when the weather is shit I could still get out and do a ride that counts. Not to get too caught up in numbers, but 500 mile for the month would be good. Also this last year added 7-8 pounds to my frame. I'm starting around 186#. Any change there would be a bonus.

My other goal was to get back to the blog and catch it up a bit. Work (or lack thereof), the aforementioned 2nd ablation, and some other stuff that nobody cares about but me.

Saturday, October 16, 2010

(I don't want to go to) REHAB

This spring, after 16 years in the house, it's time for a new kitchen. Actually when we moved in in 1994 it was time for a new kitchen, but we finally got around to it. The house is 100 years old as of August this year. Anyone who has rehabbed/remodeled know what this is like. So in addition to changing jobs and my balky heart, this is going on pretty much every day from late March thru early June. For the most part I was around all the time because I was between jobs (except when I was in the CCU).

Kenny, my contractor does a great job. He sweats every detail. This is his third or fourth job for big job for me and he always tries to make seem like I'm the one making the decisions. When there's a choice of options on how to do something he'll always give you all the options. What you don't know is which one of them is correct. He knows. But he ain't sayin'. So you guess. Then you watch his facial expressions until you hit on the right response. Then he say's, "Yea, that's how I'd do it if it were my house". He fuckin' kills me with this. Here's a guy my age who does this for a living vs. me who comes to him with a project every 3-4 years and he won't just tell me how to do it. Hilarious. My wife got a taste of it when I was in the hospital. She said one morning Kenny, her and the tile guy stood around the kitchen talking about where the tiles start and which way the pattern runs. Of course Kenny already knew. She said making decisions like this while I was laying in intensive care was very surreal.

Here's some pictures. Items of note, we saved the Vitrolite off of the old walls and re-used it. Notice the old knob and tube wiring that is still in service throughout a large portion of the house and oh yea, when the plumbers tried to tie the new drains into the existing sewer lines the cast iron was all rusted out. So we tore the shit (literally) out of the basement too.

Monday, October 4, 2010

Friday, September 10, 2010

Take A Look At My Heart

Starting last Fall (09') I became sort of vaguely aware of a change in the way I felt on my bike commutes to work. I pretty much attributed it to the fact there was all this BS going on at work and I wasn't handling it very well. You know, stress. But I figured since I am over 50 now I should probably have it checked out. I had just gone through an insurance physical in anticipation of needing a term policy if I did indeed changed jobs. My rating status for that came back as "Super-Preferred". My financial guy said he had never had anyone get that rating, let alone a 50yr old client. So I'm feeling pretty puffed up with myself. Eventually I get around to seeing a cardiologist. The appointment was pretty much unremarkable. Talked to a cardiology fellow and an attending, the opinion is whatever I'm feeling probably isn't heart related. I'm OK with that, at this point the symptoms I'm having don't really present as cardiac and are fairly nonspecific. They do recommend a stress echo. Yea, whatever.

Over the next couple of months shit gets more specific. Colder weather, less biking, more jumping rope, which has been my indoor cardio work for years. I also started wearing a HR monitor during workouts. After about 15min, with my HR running about 150 or so, I feel the same sensation in my chest as I felt on the bike, with a new twist. When I stop and my HR slows, my heart starts skipping beats. This can't be good. PVCs. Premature Ventricular Contractions. Basically what happens is the ventricle contracts before it's full, ergo, no blood to pump, no pulse. Exercise induced PVC's. Great. I do all the research I can and find out PVCs are common, a lot of people deal with this shit their whole lives and they're mostly benign if there's no underlying heart disease or structural heart defect. In very rare instances they can degenerate in ventricular tachycardia. (that's foreshadowing, do you see where this is going?) Also cardiologists don't take them very seriously. Maybe now is the time for that stress echo.

I go in for the stress test in the first week of January. The set up is a treadmill with all the telemetry equipment and a table with the echocardiogram machine. You get the on the treadmill with gradually increasing rate and incline until your heart rate is crazy high, then they shut it off and hustle you over to the table to take the echo of your heart to get a picture of function during the period of high stress. Some background here. I'm really not much of an endurance athlete. I've never been a guy with a slow HR. Even when I was in great shape ( young, running track, etc) I'd sit around with a resting HR of 72bpm while other guys in similar shape were about 10bpm less. Anyway, fast forward to now, put me a stressful anxiety producing environment and I'm sittin' there about 85pbm without even moving. The test starts and I'm almost immediately at 90bpm, not unusual for me. The woman waiting to do the echo is sitting there watching all the telemetry info and she keeps making comments about how fast my HR is increasing. SHUT UP bitch. After about 30min my rate is 190, the nurse shuts it down and hurries me over to the table for the echo. I'm laying on my side, the imaging tech is doing the echo and I'm starting to recover. I'm catching my breath and my HR is coming down, then the fun starts. I feel the PVC's start up in a big way. Even though I'm laying down I start to get a little dizzy. I hear the nurse say, "oh!". Out of the corner of my eye I can just glimpse the EKG on the screen. Fuck. I'm no expert but I'm pretty sure that's not a normal wave. There's nothing there that even resembles a normal QRS complex. The nurse leaves the room and I can hear him trying to remain calm as he asks the attending cardiologist "can you come here a take a look at this?". I'm recovering a little by now, although my rhythm is not exactly back. The attending looks at the EKG and asks echo girl if she could see this coming. Echo girl says no. Doctor says, "It's just an arrhythmia" and leaves the room. They keep me for about another half-hour until I've recovered completely, then send me on my way. My cardiologist's office calls me the next day, no heart disease and no structural defects. They want to start me on a beta-blocker and need to know what pharmacy to call. They don't even want me to come in to the office. I find out later that there was no printed record of the episode of ventricular tachycardia because the fucking nurse had shut down the fucking machine. What a jackass.

There are no restrictions/guidelines for my workouts so I go back to doing what I have always done, except that now the PVCs start up every time I work out instead of just occasionally. As this progresses I find myself sometimes getting dizzy and having to sit down while I recover. If you miss 2 or 3 heartbeats in a row, it'll fuck with ya. Now we're getting into a gray(er) area. If you pass out from PVCs it's considered to be like dying only with the advantage of waking up. Sudden Cardiac Death (SCD). You know, those guys who fall over dead while they're working out. (he looked fuckin' great 'till he died) I have a scheduled cardiology follow up in March. Pretty much unremarkable again. I tell them the latest stuff and they increase the beta-blocker dosage. The fellow tells me that as PVCs go mine aren't really that bad. Oh, ok.

This uneasy accommodation with my heart continues until mid-April when shit finally comes to a head.
Wed 4/15--I'm at home working out, have finished jumping rope and am doing some light dumbbell work. I have found through trial and error over the past few weeks that my HR recovers faster with fewer PVCs if I bend at the waist while I'm between sets of exercise. That's the position I'm in, standing and bent over, while watching my HR monitor on my wrist. I straighten up. Rubber legs and lights out. I'm aware of myself staggering backwards, but I can't do anything about it. I hit the wall and the weight machine behind me and end up sitting on my ass with the dumbbells still in my hands. I remember saying out loud "that was it". I sit there trying to gather myself. I never really lost full consciousness, but it was close. I took it easy over the next few days and even did a couple light workouts without incident.

Wed 4/22--Been wanting to see Mark Knopfler since the days of Dire Straits. I bought these tickets about 6 months ago. I meet a buddy for a few PVC inducing alcoholic beverages before the show. Dinner and 2 beers later we head off to the concert. We end up parking about 4 blocks away from the venue and walking slightly uphill to the Fox. By the time I get to the theatre the PVCs are rollin'. Bad. I wasn't in a normal rhythm the entire night. The worst night of my life. Probably back and forth between PVCs and V-tach the whole show. By the end of the show I'm kind of settled down. After the show we head back to the car and I drop him back at the restaurant where he's parked. The walk back to the car has lit me up again. I limp home. I have to pull over and stop during the 4 mile ride home. In hindsight I was probably in V-tach the whole way. Why I didn't degenerate into V-fib I don't know. I should have gone to the hospital that night, but I just laid down. I remember thinking there were worse places to die than your own bed.

The next day found me still alive so I called the cardiologist office and they ordered an event monitor for me. It's basically a device that you activate when you feel something strange and it records heart activity and what was happening a minute or so prior to when you activated it. I also made an appointment with my primary doctor. I had only started seeing him the previous October and I was pretty impressed with him. At the time of my first appointment this heart thing wasn't a blip on my radar so I wanted bring him up to speed and get his impressions.

The next 4-5 days aren't very good. PVCs all the time with minimal exertion, like walking DOWN a flight of stairs. I go see my primary physician on Tue 4/28. I fill him in on everything, we talk about it, there's really nothing to be done until the event monitor shows up in the mail. He says "you know where this is headed don't you?" I say yea, ablation or ICD. That evening I start to walk to the pharmacy to pick up a prescription. I get to the end of the library parking lot, about 150ft from my back door, and I can't walk any farther. In retrospect, V-tach. Again.

Wed 4/29--I feel ok in the morning, no PVCs. So it's time to go push it and see what I can do. Right? I start mowing the grass. That's walking behind a self-propelled mower. It becomes quickly evident that this isn't going to work. Again. By now I been in full blown V-tach about a half dozen times and it always resolves spontaneously. I re-challenge myself a couple more times over the course of the day. Same result every time. I call the cardiology office and leave a message. I don't get a call back from the doctor. I call my primary late in the afternoon. He calls me back from his car on his way home from the office. He says it's pretty obvious my body is trying to tell me something. Head to the E.R., he'll call ahead. At this point I figure I'll wait until my wife gets home from work. I'm back in normal rhythm and fine unless I exert myself (i.e. walk more than 50 paces). She gets home, we head to the hospital.

Now, the last thing I want to do is show up at the mess that is the the E.R. with a normal rhythm, wait there for 3hrs with the rest of huddled masses and then tell some nurse that "4hrs ago I was having an arrhythmia" and then hear, "well you seem to be ok now". I make a plan. We're going to park at the north end of the medical campus and do a brisk walk to the E.R. at the south end, about 4 blocks away. My plan works to perfection. About half way there I feel everything in my chest start rolling. We walk into the E.R. and it's packed , they got 'em hanging from the rafters. I'm about fourth in line to the desk. I tell the nurse I'm having PVCs and if they want to see them they need to hook me up right now. She checks my pulse, says it's way too high and hustles me into one of the trauma rooms.

The next 15 minutes were impressive as the trauma nurses sprang into action. I've had some less than stellar visits to this E.R. from a patient care standpoint, but these nurses were great. In a matter of minutes I had 18 gauge bilateral IV access and a 12 lead EKG hookup in place. This is a teaching institution and obviously I was the most potentially interesting case in the house at this time. A crowd soon gathered. At one point the E.R. attending came back to check in on me, sees the mob of onlookers and says, "WHY is everyone standing around staring at Mr. Haynes?". They were just waitin' for me to go into V-Fib so they could break out the paddles. Sorry to disappoint. The amiodarone bolus did its job. I was in normal rhythm. Move along folks, nothing more to see here. I was left literally, completely alone while they tried to figure out what to do with me. What a difference an hour makes.

They put me in the CCU. Probably overkill, but all they really knew was some guy showed up in the E.R. in V-Tach. I knew as long as there was no exertion I was fine. I was the healthiest guy in the cardiac care unit. My wife said that was like being the tallest midget. The intern doing my work up loved how I managed to be in V-Tach when I came into the E.R. He told the story that night to the cardiac fellow on call who then walked into my room, said "Don't do that again", then turned and left. The story had legs and was retold numerous times during my stay until pretty much everyone in the unit knew about it. Like any good tale it became a little more fantastic with each retelling, until I had sprinted to the hospital from somewhere in the Central West End.

They have some good pictures from the V-Tach in the E.R. The electrophysiologist decide cardiac ablation is the best option. I'm not going to go into great detail on the procedure. You can look it up on any number of sites. is a good one. Also a cyclist named Craig Cook did a much more thorough blog a couple years ago while he went through this ( However, I will say that if I never have to have another foley inserted it would be OK with me. Also the part where they say you will be sedated and not feel/remember much is bullshit. I was awake for the entire procedure. The current thinking is that sedation makes it more difficult to keep the foci active for mapping and ablation. The area where they were working on me is apparently sensitive because it stung like a motherfucker when they burned it. I went to the E.R. on Wednesday night, ablation on Friday and home early Saturday afternoon.

So how am I now, 5 months post procedure? Well, it wasn't a magic bullet for me anyway. June was a great month with no PVCs. In July/August I began having a few "resting" PVCs, which I had never had before. Then in September some mild runs post exercise and during stress situations, but the resting PVCs have pretty much gone away. Alcohol definitely lowers my threshold, more than it seemed to prior to the ablation. To date no V-Tach and I'm working on managing the whole thing better. More moderate workouts with max HR 130-140. No more balls to the wall stuff. Still it's a disturbing trend for me. Interesting thing about the stress/anxiety PVCs is the thing I'm most anxious about is having and extended run of PVCs or slipping into V-Tach. So it's a chicken/egg thing. I've relayed the resurgence of the symptoms to my EP, but as long as there's no V-Tach there doesn't seem to be much interest. Remember what I said about cardiologists and PVCs. A big part of my problem is I don't know what the new "normal" is or even if there is one. Probably shit changes week-to-week or month-to-month from here on and I just deal as it changes. Mayo Clinic has a sports cardiology clinic and I'm thinking about taking a run up there to see what they say. So all in all--we'll see.

Saturday, September 4, 2010