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Mulligan...

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Re: Mulligan...

Post  ounce on Sat Jan 06, 2018 11:18 pm

Down here, there are fewer gas stations that also fix flats and do mechanic work.  Gas stations with a '60s era full service gas pumps are even rarer.  I do run past one, on the way to Memorial Park.  It's one of the 'fewer' and 'rarer' gas stations.  It's in a ritzy, mansion filled neighborhood.  There gas is higher, too, at $2.79 for regular self serve and a $1 more for full service. 

As a comparison, gas stations on the freeway are around $2.39 and I'll get mine for $2.15.  Most of those stations do have a sign where the attendant will come out and pump the gas for a handicapped person or an old coot.
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Re: Mulligan...

Post  nkrichards on Wed Jan 10, 2018 12:28 pm

@ounce wrote:Down here, there are fewer gas stations that also fix flats and do mechanic work.  Gas stations with a '60s era full service gas pumps are even rarer.  I do run past one, on the way to Memorial Park.  It's one of the 'fewer' and 'rarer' gas stations.  It's in a ritzy, mansion filled neighborhood.  There gas is higher, too, at $2.79 for regular self serve and a $1 more for full service. 

As a comparison, gas stations on the freeway are around $2.39 and I'll get mine for $2.15.  Most of those stations do have a sign where the attendant will come out and pump the gas for a handicapped person or an old coot.

It will be very interesting to see if this changes things in Oregon and if so how.  It only applies to rural counties which is a bit confusing.

***
I got my run in on Saturday.  I walked the half mile of gravel at the beginning and end and then ran 3 easy miles on the pavement.  It went OK.  I kept it at an 11:00 pace but needed to slow a bit during the last mile to keep my HR in an appropriate range.  Avg. HR 138.  My legs were reminding me that it had been a long time since I asked them to run but it was all pretty subtle.  I was exhausted afterwards.  Probably a combination of a harder week and my first sustained run in a loooong time.  Sunday was a complete rest day.

I felt good Monday morning but it was a hard day and I was pretty tired by the end of the day.

  • Core/strength with Marty 30 minutes
  • Total Body Conditioning  I'm really enjoying this class.  It's challenging but doable.  It's a great group of 6 participants.  Sara is giving us lots of variety and keeping a close watch on our technique.
  • Masters Swim 2500 yds.  Anita asked Tim to up the yardage to help her reach her New Year's resolution.  Janice and I were determined to complete the workout.  Tim had to stay late to allow us to finish.  It was challenging from the start.  Janice completed all the intervals a bit faster than I did but I was able to stay within a body length even on the 500. 

Maura invited me to go on a run with her after swimming but I was exhausted.  I'm glad I chose to come home and get some rest.  I'm not discouraged about my fitness level but I am realizing that I have a long way to go.

Tuesday was hectic with family stuff but a slightly easier day.

  • Pilates
  • Aqua jogging 45 minutes
  • Bike spin w/single leg drills 30 minutes


Today will be a challenging day again.

I need to figure out what I'm going to do as far as the Half on Feb 11th is concerned.  I may need to wait a few more days and get in some more outdoor running before I decide.

I also need to settle on a plan for the Half IM.  Although I'd like to do more than just finish I'm afraid that if I set my goals to high or choose a plan that's to demanding I won't even make it to the starting line.  Maybe "just finishing" is going to have to be my goal this time.

Maybe it's time to transition to a new blog...
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Re: Mulligan...

Post  Julie on Wed Jan 10, 2018 11:02 pm

I'm glad the pt was helpful ! Yes, do watch for over training . It's easy to do, and easy when it's over training for you , but not for someone else who wrote a plan, or anything like that , but I've had too many injuries from doing too much .

Interesting about the gas. In my parents' small town there's one full service station. I have filled my own car once since my first pregnancy (I read it wasn't good to do while pregnant so my husband took over , and he's just kept it up).
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Re: Mulligan...

Post  Mark B on Thu Jan 11, 2018 11:31 am

@nkrichards wrote:Pilates, Aqua jogging and an easy 30 minute spin on the bike on Thursday.  I'm starting to feel stronger but I still tire a bit faster than normal.  I need to be cautious.

Friday I was busy helping with transportation for Gary's girls and we had freezing rain.  I managed to find time to swim but wasn't able to join the group.  I got in over 1750 yds...I lost count.  I worked on breathing on my weak side.  It's awkward and not very efficient!  Explanation below.

***

I had an excellent visit with the PT.  Brock worked on my plantar fasciitis back in 2009, put Marty back together when he shattered his arm just below the shoulder, and is an avid supporter of community events.  I wouldn't call him a friend but I definitely feel like we have a good, friendly relationship...more than just a professional relationship.

Brock said I was very strong and that I should be proud of how well balanced I was.  He was surprised that he didn't find some lingering overuse injury.  He said whatever I was doing to keep it up!  He especially encouraged me to continue doing Pilates...I do think Sara's Pilates class has helped with my core strength. 

The one issue that he noticed was an obvious imbalance in my neck muscles.  After ruling out an old injury we concluded that it was the result of always breathing on the same side while swimming.  So I guess I need to learn to breath on the other side.  He said to work on it in training but to do whatever I felt was most comfortable and efficient during competition.  They actually discourage alternate breathing during triathlon races as it limits your oxygen intake slightly.

He did give me some exercises to strengthen my glutes...at my request.  He also gave me some exercises to strengthen muscles that will be used as I increase training...especially on the bike as I haven't done as much biking as I will be doing.  A couple are also to deal with the posture/shoulder issues that crop up when putting in long hours on the bike.

So here's what I'll be trying to incorporate into my weekly routine.

  • Goblet squat (with a kettle ball)
  • Another squat with the kettle ball...similar but not exactly the same.
  • Arabesque with a light kettle ball. That's hard...I had to practice without the weight before I could get the balance down.
  • Hamstring Curl with Stability Ball.
  • Single Leg Hamstring Curl with Stability Ball.
  • Bridge with alternate knee extension.
  • Single Leg Bridge with Stability Ball when able.  I do them from the floor now.  He said to gradually work my way up to the stability ball.  I'm starting on my foam roller.
  • Eccentric Calf Raises.
  • Eccentric Single Leg Squat on decline.  The decline encourages the knees to move in front of the toes...contrary to common thought I know.  He said this will strengthen the patellar tendon so that when I end up in a situation where I am stressing it (trail runs or on hills), it will be strong and healthy and able to withstand the stress.  He said to use caution and not do to many especially at first.
  • Bird Dog.  After a hard workout to help relax and get my body back into balance.
  • Chin Tuck/Retraction  This is to counteract all the hours looking up while biking.
  • Prone T on the Exercise Ball.  I already do Back Flys but he wants me to do them in 3 positions...with my arms forward, in a T, and arms backward.  Another one to help with all the time on the bike.


Some of these are similar to exercises that I'm already doing in my core/strength workout.  He thinks I should be adding a bit more weight...slowly...to challenge my body.  As I said several are more preventative than anything.  I just need to find time to fit everything in.  I probably won't add too much if anything to our regular workout while I'm doing Sara's Full Body Conditioning Class as I think we'll be hitting a lot of similar things based on what we did in the first class.  Once that ends...it runs through February...I'll try and alter my workout slightly to fit some of these in and still keep it within a reasonable time commitment.  If it runs too long Marty and I will be less likely to do it at all!  I may even need to put together two different workouts and alternate.

The other suggestion that Brock had was to walk for a couple minutes after every workout.  I mentioned that I always try and jog a one mile cool down.  He said to shorten the jogging portion enough to fit in a few minutes of walking without lengthening the time.  He thinks this allows you to kind of check out your body and see how you feel.  He said it's a time when he notices sore spots or niggles that are just starting and he can work them out before they become full on injuries.

He also warned me to be cautious of overtraining.  I seem to be hearing that a lot.  I hope I'm able to follow this advice.

My visit was very encouraging!  And he's encouraged me to stay in touch with questions and concerns before they develop into an injury.  I'm glad I took the time and spent the money to do this!

***

The sun is shining and it's 44 degrees.  I'm going to head out for an easy jog this afternoon.  I may have to drive to the pavement to avoid the mud.  The gravel road turns to mush after a hard freeze.

I know that I have a long way to go to get ready for a Half Ironman but I'm looking forward to the journey.

Wow! Those are some serious glute exercises. You'll be able to hop up Mount Everest on one leg with that sort of work. Impressive.

I'll second what your PT said about cool-down walks. Also, warm-up walks. They really do help, though it's a bit of a pain when it's chilly outside and you're dressed for running and not walking. It requires lots of layer management.

Nice job on the run, too, but ease into it. Your legs are good to go, but your pulmonary system might still be struggling a bit. Being exhausted after a simple short run is not what you're looking for.

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Re: Mulligan...

Post  Michele "1L" Keane on Sat Jan 13, 2018 9:19 pm

I remember thinking it was kind of nice that someone else still pumped your gas for you in Oregon.  I guess now New Jersey might be the only state left where it happens in all stations?  Here near me there is still one full service station that I know of where they will indeed pump gas as well as do actual service things, but the city wants them gone to redevelop the "downtown", so I'm guessing they probably won't be here too much longer.  

Remember Nancy you have plenty of time to work on fitness and get back in the swing.  There are no rules and no laws that say how fast it needs to take - just move at your own pace.  I keep having to remind myself of the same thing.  And remind Joe as well since he has gotten himself into and overtraining and overracing rut!   See you in June.
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Re: Mulligan...

Post  nkrichards on Mon Jan 15, 2018 9:04 pm

Michele \"1L" Keane wrote:
Remember Nancy you have plenty of time to work on fitness and get back in the swing.  There are no rules and no laws that say how fast it needs to take - just move at your own pace.  I keep having to remind myself of the same thing.  And remind Joe as well since he has gotten himself into and overtraining and overracing rut!   See you in June.
 Thanks Michele.  I know that you...and Mark and Julie are all right.  It's a tough thing to implement when you have a personality like mine.  I keep thinking that I'm not trying hard enough...  I do think that overtraining may have been the problem in my marathons so I do intend to try.

And I will see you in June.  I've talked a lot to coach Sara who is onboard with my need to be careful not to overdo it.  Sara is training for a 70.3 the same weekend but can't make it to Victoria due to family stuff.  Maura is coming to Victoria.  I'm going to have to remind Maura frequently that I can't be as competitive as she is this time!  FYI Maura is in your age group and has won her age group in every 70.3 she's entered except for one when she injured herself during the race. 

My training goal needs to be to get to the starting line.  I can't finish if I don't!  Time goals are completely off limits!

***
So on that note.  Here's last week.

  • Mon - Core/strength, Total Body Conditioning, Swim 2500 yds
  • Tues - Pilates, 45 min Aqua jog, 30 min easy spin on bike trainer w/one leg drills
  • Wed - Core/strength, TBC, Swim 2500 yds, Run 5.5 easy effort
  • Thur - Pilates, 45 min Aqua jog, 30 min easy spin on bike trainer w/ 6 x :60 high cadence drills
  • Fri - Core/strength, Swim 2450 yds, Run 5.25 easy effort
  • Sat - Bike 28 miles on a chilly but gorgeous morning.  (With a snack/stretch break)
  • Sun - Rest day


I know that's a lot but I'm keeping the effort pretty easy.  My HR is still a bit higher than I'd like...both resting and during exercise.  I'm looking forward to discussing that with Dr. B on Wednesday.  I'm pushing moderately hard during TBC and swimming but most everything else is pretty low effort.  This week was definitely better than last week!  Swimming right after TBC is tough.  I need to figure out a way to get some fuel in me without upsetting my stomach.  Friday was a much better swim as we didn't have TBC that day.  I slowed run down even more on Friday and my HR was better but still not where I'd like it.  I'm walking a bit for WU and CD.

I really wanted to run on Sunday as I'm going to miss most if not all of Tues and Wed this week.  I resisted the urge and rested like I needed to.  I swam after TBC today and started to cramp a bit.  I could have toughed it out and finished but I decided that maybe I should listen to my body and cut the workout short.  I still got in 1950 yards.  Today will be a huge step back week due to conflicts on Tues and Wed.  I'm seeing gains from all the core and strength work I'm doing. Approval
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Re: Mulligan...

Post  nkrichards on Thu Jan 18, 2018 7:33 pm

This has been a forced easier week due to conflicts.  I'll update on the limited training I've been able to squeeze in later.  For now I'll give you an update on my visit with Dr. B yesterday.

👍to get on with training for the 70.3.  He noted my concern over my high HR but he wasn't surprised that it was high due to both my illness and lost fitness.  (HR was 73 in his office.  It was 48 last year but I was still on the metoprolol.  It settled into the mid 50's after I went of the meds.) He quickly realized that I had been/was pretty stressed about my illness and the effect it might have on my heart...and the uncertainty about which drugs it was OK to take...and my high HR...and my drastic loss of fitness.  He suggested that we schedule another nuclear stress test.  The last one was two years ago and he doesn't think the insurance company will object.  (With our high deductible we'll be paying for it anyway.)  He said he didn't need to see the results to feel comfortable telling me to get back to training but he thought it would help to reassure me and take away a bit of my anxiety.  So he put in a request with the insurance company and I should hear in a couple days.  I would imagine it will take a few more days to get on the schedule.  In the meantime I'm OK to train.

I didn't get a blood draw and testing for my liver enzymes and cholesterol before I went in.  I didn't feel the test results would be very accurate with everything that's been going on in my body.  He agreed and said I could stay at 10mg of atorvastatin for another 3-4 weeks while my body settled back down and then he'd like me to retest and we'll talk.  He's leaning towards trying to go back up to 20mg.  I'm nervous about the elevated liver enzymes but equally nervous about reducing the statin to much as it helps control inflammation (vulnerable plaque) which is a big risk factor for me. 

They did an EKG.  I can't read them...but they didn't panic when they looked at it.  They'll have the expert read it and interpret it and post the results in my chart.  I'll be able to look at his report and compare it to the last one once it's posted. 

Guess I better get this training plan in writing and go to work...at an easy effort...
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Re: Mulligan...

Post  Michele "1L" Keane on Thu Jan 18, 2018 10:32 pm

So Maura is who I'll be chasing as I doubt I'd win anything in an HIM - I'll just watch her zip by in awe.  Our weather has been awful so I have been unable to get in a ride outside and I only have the ability to go to spin classes when I can make it.  I know I could/should invest in a trainer - but it isn't as important when I really just use biking and swimming as cross training t omy running in the winter.

Keep it easy and keep it going.
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Re: Mulligan...

Post  Mark B on Fri Jan 19, 2018 10:50 am

Great news from Dr. B! And great plans for this summer. It's hard to not feel completely deconditioned and discombobulated after a bad illness, but things will start clicking again as your body realizes it's okay. Hope the tests go well.

Remember, there's always Maffetone, if you want to keep Fast Freddy at bay... Get competitive at keeping your HR at the target and not allowing it to rise. Make THAT the challenge. (Yeah, okay, so I know that'll never happen... but it IS an option.)

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Re: Mulligan...

Post  nkrichards on Tue Jan 23, 2018 11:33 pm

Michele \"1L" Keane wrote:So Maura is who I'll be chasing as I doubt I'd win anything in an HIM - I'll just watch her zip by in awe.  Our weather has been awful so I have been unable to get in a ride outside and I only have the ability to go to spin classes when I can make it.  I know I could/should invest in a trainer - but it isn't as important when I really just use biking and swimming as cross training t omy running in the winter.

Keep it easy and keep it going.
Maura is a good all around athlete and an especially good biker.  I think you have her beat on the run.

I hate my trainer...it's worse than the treadmill.  But I do us it occasionally.

I'm doing a lot but I'm doing it all easy effort.

Mark B
Great news from Dr. B! And great plans for this summer. It's hard to not feel completely deconditioned and discombobulated after a bad illness, but things will start clicking again as your body realizes it's okay. Hope the tests go well.

Remember, there's always Maffetone, if you want to keep Fast Freddy at bay... Get competitive at keeping your HR at the target and not allowing it to rise. Make THAT the challenge. (Yeah, okay, so I know that'll never happen... but it IS an option.)
We both know that I'm not capable of training in a true Maffetone way but I am doing much better than I have in the past.

***

So here's what I did the last few days.

Mon - Core/strength, TBC (Total Body Conditioning), Swim 1950 yds (started to cramp and I was the only one left so I called it quits early), Easy 30 min spin on bike

Tue - Board Meeting.  5.8 miles was all I could squeeze in.

Wed - Core/strength and then off to see Dr. B

Thur - Pilates, Aqua Jog 45 min, I intended to get in a short bike or run but I was tired so I opted to rest instead.

Fri - Core/strength, Swim 2500 yds (amazing how much better my swim went without TBC right before), 7.25 mile run

Sat - 4.8 mile group run followed by a cinnamon roll which I brought home and shared with Marty.  Fun run.

Sun - Family Day

Mon - Core/strength, TBC, Swim 2500 yds finishing up with a timed 600.  Janice and I swam it together and were both quite pleased with our time!, 17.4 miles on the bike.  Maura invited me out in the wind for a social ride.  It was longer than I expected but I really enjoyed it.

Tue - Pilates, Aqua Jog 45 min, 5.2 miles easy pace in the wind

As you can see I've been quite busy...no excuse for not posting.  I've kept all my efforts very easy with the exception of Sara's TBC class.  It's challenging but I'm really enjoying it.

***

So tomorrow is my stress test.  I was quite surprised that they scheduled it so quickly.  I've been totally off caffeine since 10:30 this morning.  No coffee, tea, chocolate, soft drinks, energy drinks, over the counter meds!  That last one isn't a problem but I can't even have herbal tea and I really missed my recovery chocolate milk today.  I can have a small early breakfast before my drive over the mountain and then nothing to eat or drink until after the test.  It's scheduled for 10:30 and takes 3-4 hours.  I'm nervous about driving over in the snow...Marty can't go with me this trip.  I'm more nervous about this stress test than I was the first one...I know what I have to do!

I'll try and post when I get home tomorrow evening.
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Re: Mulligan...

Post  ounce on Wed Jan 24, 2018 6:12 pm

I figure the stress test went well.  Fast Freddy is relieved there's no Maffetone in your future, but it would snip him some.
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Re: Mulligan...

Post  nkrichards on Wed Jan 24, 2018 9:01 pm

Exhausting day.  The stress test went OK but not as well as I'd hoped.  The staff seemed pleased but I wasn't satisfied.  I would imagine it has something to do with recovering from pneumonia...  I went for 12 minutes today and didn't feel like I recovered very well.  Last time I made it 13:15.  I'm sure 12:00 is still in the superior category but I was hoping for better.

I didn't feel well from the start today.  I probably shouldn't have done as much as I did yesterday.  I wasn't able to complete my normal after workout recovery nutrition and woke up feeling tired and sore.  And I wasn't able to have my morning coffee.  And I had to drive over without anything to eat or drink.  It was a difficult drive.  I felt off all morning.  How do they expect you to run well when you're hungry and dehydrated?  I was starving afterward but even after eating I felt off.  I'm sure it's just being out of my routine.

To top it off I got the results of last week's ECG this morning.  They post it in my chart and notify me that it's there.  It's abnormal compared to last years and I don't understand it.  I knew that my HR would be up significantly but the T axis changed significantly and the clinician mentioned "T wave inversion now evident in Anterior leads"  I can't find enough info on google to figure out what all that means but it isn't good.  I'll message Dr. B and see what he thinks.  They did several ECGs as part of my test today so we'll have another to look at in case the one in his office wasn't a good representation of my normal.

On a lighter side...apparently the staff had seen my chart and were making bets on how long I would go.  They didn't tell me until afterwards and wouldn't say who won and what they predicted but I guess it made for a fun morning for them. Smile Very fun but professional staff!

Time to rest...I'll let you know what I hear from Dr. B.
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Re: Mulligan...

Post  Mark B on Thu Jan 25, 2018 12:38 pm

Lots to think about here. Hope it all works out well. Keep recuperating!

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Re: Mulligan...

Post  ounce on Thu Jan 25, 2018 5:44 pm

Nancy, Thanks for the piquing of my curiosity of what a T-wave is and its siblings P, Q, R, and S.

You're probably way past the average person on cardiac knowledge, but this is what I found:

Explanation of a T-wave:  https://en.wikipedia.org/wiki/T_wave
Inverted T-wave:  http://www.patientcareonline.com/cardiovascular-diseases/inverted-t-wave-differential-diagnosis-adult-patient

Another Inverted:  http://www.patientcareonline.com/cardiovascular-diseases/t-wave-inversions-sorting-through-causes

This is the results of a 't-wave inversion' search on patientcareonline.com, of which the above 2 were apart.

There was a line in the wikipedia explanation that was telling:  T-wave inversions that appear suddenly and are new compared to prior EKGs are always considered to be abnormal.

Good luck with Dr. B.
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Re: Mulligan...

Post  nkrichards on Thu Jan 25, 2018 8:49 pm

@ounce wrote:Nancy, Thanks for the piquing of my curiosity of what a T-wave is and its siblings P, Q, R, and S.

You're probably way past the average person on cardiac knowledge, but this is what I found:

Explanation of a T-wave:  https://en.wikipedia.org/wiki/T_wave
Inverted T-wave:  http://www.patientcareonline.com/cardiovascular-diseases/inverted-t-wave-differential-diagnosis-adult-patient

Another Inverted:  http://www.patientcareonline.com/cardiovascular-diseases/t-wave-inversions-sorting-through-causes

This is the results of a 't-wave inversion' search on patientcareonline.com, of which the above 2 were apart.

There was a line in the wikipedia explanation that was telling:  T-wave inversions that appear suddenly and are new compared to prior EKGs are always considered to be abnormal.

Good luck with Dr. B.
That's the line that had me nervous Doug.  I found the same articles you did but they are so maybe this maybe that. 

I did get a message to Dr. B this morning and he responded this afternoon.  He wasn't surprised to see the T-wave inversion.  It shows up commonly in the case of right bundle branch block which I have as a result of the heart damage during my cardiac event.  His explanation for it showing up now but not in earlier ECGs was that it is often dependent on where the leads are placed.  A small movement can cause the difference.

He encouraged me not to worry and indicated that if there were any issues they would show up in the ECG's, photos and CT scan that they took before and after my stress test.  He said not to be discouraged by the stress test and to wait for the results.  He's not concerned.
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Re: Mulligan...

Post  ounce on Thu Jan 25, 2018 11:55 pm

@nkrichards wrote:
@ounce wrote:Nancy, Thanks for the piquing of my curiosity of what a T-wave is and its siblings P, Q, R, and S.

You're probably way past the average person on cardiac knowledge, but this is what I found:

Explanation of a T-wave:  https://en.wikipedia.org/wiki/T_wave
Inverted T-wave:  http://www.patientcareonline.com/cardiovascular-diseases/inverted-t-wave-differential-diagnosis-adult-patient

Another Inverted:  http://www.patientcareonline.com/cardiovascular-diseases/t-wave-inversions-sorting-through-causes

This is the results of a 't-wave inversion' search on patientcareonline.com, of which the above 2 were apart.

There was a line in the wikipedia explanation that was telling:  T-wave inversions that appear suddenly and are new compared to prior EKGs are always considered to be abnormal.

Good luck with Dr. B.
That's the line that had me nervous Doug.  I found the same articles you did but they are so maybe this maybe that. 

I did get a message to Dr. B this morning and he responded this afternoon.  He wasn't surprised to see the T-wave inversion.  It shows up commonly in the case of right bundle branch block which I have as a result of the heart damage during my cardiac event.  His explanation for it showing up now but not in earlier ECGs was that it is often dependent on where the leads are placed.  A small movement can cause the difference.

He encouraged me not to worry and indicated that if there were any issues they would show up in the ECG's, photos and CT scan that they took before and after my stress test.  He said not to be discouraged by the stress test and to wait for the results.  He's not concerned.
You may have told us about the right bundle branch block, but I didn't remember soooooo...
Ah, you have an electricity problem!  (It would seem.)

So looking at wiki's 'bundle branch block' here:  https://en.wikipedia.org/wiki/Bundle_branch_block
I bring your attention to the sentence at the bottom:  In more severe cases, a pacemaker may be required to restore an optimal electrical supply to the heart muscle.

As far as his explanation, think about it.  The patches for the P-T waves not exactly where they should be for you tweaks the output versus CT scan and photos are taking examples of what the heart is doing.  They have goals on what to record and they get in the best position based on seeing the beating heart in action.  That would imply a higher degree of accuracy, rather than a few leads on your chest positioned where it's supposed to be.

I'd like to know:
1.  Does the effect of the Nepalian Death Flu Wink on the heart resolve itself or is it a dent in the cardiac realm?
2.  Is there any effect, usually, on the next flu creating another dent?  In other words, are you permanently at some risk for future influenzas to affect something in the heart and would it always affect the same area each time?
3.  Are you more susceptible to the flu in the future, since having the Nepalian Death Flu?
4.  How close are you to having a pacemaker?
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Re: Mulligan...

Post  nkrichards on Mon Jan 29, 2018 1:25 pm

@ounce wrote:
@nkrichards wrote:
@ounce wrote:Nancy, Thanks for the piquing of my curiosity of what a T-wave is and its siblings P, Q, R, and S.

You're probably way past the average person on cardiac knowledge, but this is what I found:

Explanation of a T-wave:  https://en.wikipedia.org/wiki/T_wave
Inverted T-wave:  http://www.patientcareonline.com/cardiovascular-diseases/inverted-t-wave-differential-diagnosis-adult-patient

Another Inverted:  http://www.patientcareonline.com/cardiovascular-diseases/t-wave-inversions-sorting-through-causes

This is the results of a 't-wave inversion' search on patientcareonline.com, of which the above 2 were apart.

There was a line in the wikipedia explanation that was telling:  T-wave inversions that appear suddenly and are new compared to prior EKGs are always considered to be abnormal.

Good luck with Dr. B.
That's the line that had me nervous Doug.  I found the same articles you did but they are so maybe this maybe that. 

I did get a message to Dr. B this morning and he responded this afternoon.  He wasn't surprised to see the T-wave inversion.  It shows up commonly in the case of right bundle branch block which I have as a result of the heart damage during my cardiac event.  His explanation for it showing up now but not in earlier ECGs was that it is often dependent on where the leads are placed.  A small movement can cause the difference.

He encouraged me not to worry and indicated that if there were any issues they would show up in the ECG's, photos and CT scan that they took before and after my stress test.  He said not to be discouraged by the stress test and to wait for the results.  He's not concerned.
You may have told us about the right bundle branch block, but I didn't remember soooooo...
Ah, you have an electricity problem!  (It would seem.)

So looking at wiki's 'bundle branch block' here:  https://en.wikipedia.org/wiki/Bundle_branch_block
I bring your attention to the sentence at the bottom:  In more severe cases, a pacemaker may be required to restore an optimal electrical supply to the heart muscle.

As far as his explanation, think about it.  The patches for the P-T waves not exactly where they should be for you tweaks the output versus CT scan and photos are taking examples of what the heart is doing.  They have goals on what to record and they get in the best position based on seeing the beating heart in action.  That would imply a higher degree of accuracy, rather than a few leads on your chest positioned where it's supposed to be.

I'd like to know:
1.  Does the effect of the Nepalian Death Flu Wink on the heart resolve itself or is it a dent in the cardiac realm?
2.  Is there any effect, usually, on the next flu creating another dent?  In other words, are you permanently at some risk for future influenzas to affect something in the heart and would it always affect the same area each time?
3.  Are you more susceptible to the flu in the future, since having the Nepalian Death Flu?
4.  How close are you to having a pacemaker?

It's been a tough week.  It's unnerving to get test results that begin with "abnormal ECG".  That was how the stress test results began as well.  On the positive side I got a call from Dr. Beckerman's nurse before they posted the results on my chart.  He reviewed the results and looked at the images and encouraged me to continue training.  The abnormalities are the result of my initial event and not a sign of further deterioration.  The results did mention ischemia but at a low risk level.  It also said that even though my resting ECG was abnormal I had a normal response to exercise, a normal ECG response to exercise, excellent exercise capacity based on estimated VO2 max.  I also notice that my Ejection Fraction has improved to 71%.  That's at the top end of what's considered normal.  It was 55% in April 2015 when I left the hospital in Boston and 65% in July of 2015.  That's encouraging.  Another positive note is that my RHR prior to the stress test was 56 which is much more in line with what it was pre-pneumonia.

In response to your questions about the flu.  Dr. B assured me that lots of people with cardiac issues get the flu and pneumonia and it's not something that I should be concerned about.  He's confident that my issues are the result of my initial cardiac event and the fitness I lost while I was sick...not the result of cardiac changes while I was sick.  My cardiac issues have no affect on my immune system so I'm not any more susceptible to bugs.

As far as a pacemaker...My QRS duration is 132 which does indicate a complete branch block but my Q-T interval of 467 is in the borderline range for females.  It is at the upper end but doesn't yet fall into the abnormal range.

Off to Full Body Conditioning...more on training later.
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Re: Mulligan...

Post  nkrichards on Mon Jan 29, 2018 8:09 pm

So here's the training update that I didn't have time to post earlier when I discussed my stress test results.

Mon - Core/strength, TBC (love this class and it's a great workout), swim 2500 yds, bike 17 mi fun ride with Maura.

Tue - Pilates, Aqua jogging, run 5 mi.  Still doing my runs slowly (11:15-11:30 pace).  My HR is still a bit higher than I 'd like to see but I can't run any slower and maintain my form and walking...well...I do make sure I spend some time walking before and after.

Wed - Stress Test.  It was a long day!  Results mixed but it is good to know that Dr. B is not uncomfortable with my training efforts and that my struggles are most likely related to the fitness lost when I had pneumonia.

Thur - Pilates, Aqua jogging, easy 30 min spin on bike.

Fri - Core/strength, run 5 mi easy, swim 3200 yds. Fun swim!

Sat - Another trip over the mountain for a funeral.  Old family friend.  As funerals go it was very nice.  Nick was a farmer and construction worker as was my Dad and Marty.  His boys went to school with us as well.  We were able to share lots of stories about working on the farm with our Dads.  Marty and I were also able to catch up with some friends from school.  Long emotional day but it was OK.  We also got to spend time with both our Mom's.

Sun - Marty's birthday celebration!  His birthday is actually today but the kids and grandkids were all free on Sunday so we celebrated early.  We made it an Australia Day celebration as well even though Australia Day was Friday.  I made sausage rolls and we were able to get some Anzac biscuits.  I managed to squeeze in a 30 minute spin on the bike.

As you can see I have some hard days...and some easy days.  It's tough to complete the Masters swim workout right after TBC but I muddle through and slow down a bit if necessary.  I've been spending a lot of time working on core and strength.  A normal week includes 3 40 min. core/strength workouts with Marty, TBC for an hour two times and Pilates for 45 minutes two times.  I'm enjoying it and I think it will payoff in the end.  It's also something I can do even with my lack of fitness right now.  I often stay for aqua jogging after Pilates especially if the weather isn't very nice.  All that does make it hard to fit in my swim/bike/run workouts but I'm managing to get in 3 swims most weeks and at least two bike and two run workouts.  Most of my biking has been on the trainer as the wind has been ferocious!  I try and fit in three runs if possible...that's the thing that's been coming back slowly.  It will get better once the weather improves and TBC only runs through the end of February.  I'll also skip aqua jogging if I can train outdoors.  Life seems to be getting in the way more than normal but it is what it is.

And life goes on...
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Re: Mulligan...

Post  Mark B on Tue Jan 30, 2018 9:35 pm

Whoo, this has been a rough couple of weeks for you, Nancy.

One other weird thing on the flu/heart connection is that people with the flu are significantly more likely to suffer cardiac problems during and after the flu symptoms. I wonder if that had anything to do with your abnormal EKG readings?

It's good at any rate that your heart responded appropriately to exercise. Hopefully the doctors will get to the bottom of the issue and help give you some peace of mind.

Until then -- or even after then, keep at it. It's clearly helping.

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Re: Mulligan...

Post  ounce on Wed Jan 31, 2018 3:35 pm

"The abnormalities are the result of my initial event and not a sign of further deterioration."


To get the cardiologist to tell you to keep on training, that discounts, as not an issue, everything in the reports.  Seems like Fast Freddy has his own set of ears, too.

Good job on the Aussie party!
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Re: Mulligan...

Post  nkrichards on Wed Jan 31, 2018 11:39 pm

@Mark B wrote:Whoo, this has been a rough couple of weeks for you, Nancy.

One other weird thing on the flu/heart connection is that people with the flu are significantly more likely to suffer cardiac problems during and after the flu symptoms. I wonder if that had anything to do with your abnormal EKG readings?

It's good at any rate that your heart responded appropriately to exercise. Hopefully the doctors will get to the bottom of the issue and help give you some peace of mind.

Until then -- or even after then, keep at it. It's clearly helping.

@ounce wrote:"The abnormalities are the result of my initial event and not a sign of further deterioration."


To get the cardiologist to tell you to keep on training, that discounts, as not an issue, everything in the reports.  Seems like Fast Freddy has his own set of ears, too.

Good job on the Aussie party!
Thanks to both of you.  I appreciate the support and encouragement.


It has been a tough couple weeks but it's getting better. 

Both Dr. B and my local GP assure me that I don't need to worry about the flu any more than everyone else.  My heart damage is the result of my cardiac event.  It's not a progressive disease like congestive heart failure.  I am at a higher risk of another event due to my vulnerable plaque but the statins are supposed to help stabilize them.  They both assure me that I'm fine...it just took me a few days to listen.

***

So...training...

Mon - Core/strength 

  • TBC
  • Swim 2500 yds.  Tough swim after TBC but I did it and I finished with some nice fast 50s.  They were a few seconds off my fastest but they were close!


Tue - Pilates

  • Aqua jogging
  • Run 10 miles.  Yes 10!  I started slow.  11:21 pace for the first 5 miles.  Very easy effort.  Avg HR 151.  Higher than I'd like but better than it has been.  I slowed for a drink and a gu and headed out for another loop.  I continued easy for the first couple miles but felt surprisingly good and my HR was staying pretty constant.  I progressively speed up the last 3 miles and it felt really good.  I ended up doing the last 3 miles at 11:01, 10:28, 9:34.  WOW!  I haven't done that in a long time!  Pace for last 5 miles was 10:44.  Avg HR for the full run was 154.


Wed - Core/strength

  • TBC
  • Swim 2300 yds.  Finished the workout strong again today!!
  • Bike 12.2 miles  It wasn't fast but it felt good.


It's amazing what fear can do to your body.  I still have a long way to go but I'm convinced that I'm making progress and I'm enjoying it once again.
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Re: Mulligan...

Post  Mark B on Sat Feb 03, 2018 9:05 pm

Glad your doctors are so confident, Nancy! It's easy to get rattled when the Nepalese Death Flu knocks you down so effectively. It's good to know it was just the bug and not something more.

Nice work on the 10-miler, especially with the fast finish! Fast Freddy must have been very pleased.


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Re: Mulligan...

Post  nkrichards on Tue Feb 06, 2018 11:31 pm

@Mark B wrote:Glad your doctors are so confident, Nancy! It's easy to get rattled when the Nepalese Death Flu knocks you down so effectively. It's good to know it was just the bug and not something more.

Nice work on the 10-miler, especially with the fast finish! Fast Freddy must have been very pleased.


You're not the only one who is glad my doctors are confident!
Not sure the 10-miler was fast enough to please Fast Freddy but I was pleased.

***
Thurs - Pilates

  • Aqua Jog 45 min
  • 4.3 mi w/4 at moderate pace as opposed to easy.  It went well.


Fri - Core/strength

  • Swim 3100 yds
  • Off to the beach with Marty's Mom (age 88), Royce and Owen (ages 3 & 5)  My Mom backed out as she was having trouble with her hip after a fall earlier in the week.  Questioning my sanity! 


Sat - Family/beach stuff.  The boys loved the Undersea Garden.  Fun but stressful.  Kevin, Natalie and Connor (6 months) joined us. 2.5 mile walk on beach

Sun - Managed to sneak out before breakfast for a 3 mile run on the beach.  Enjoyed the run and the peace and quiet!  Quick visit to the lighthouse before watching Izzy's (age 11) gymnastic meet.

Mon - Core/strength

  • TBC
  • Swim 2800 yds
  • 5 miles easy effort


Tues - Pilates

  • Aqua jog 45 min
  • Bike 12 miles...slow



I'm pleased to report that I'm seeing a slight improvement in my HR both at rest and during exercise.  It's not a huge improvement but it's a step in the right direction.  I'm still keeping most of my activity at a pretty easy effort but I'm seeing a very slight increase in speed along with a slightly lower HR at the same effort.

Ultreya...
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Re: Mulligan...

Post  Mark B on Tue Feb 06, 2018 11:56 pm

Progress! It feels good, doesn't it?

Wow, I haven't been to Undersea Gardens in Newport since I was probably your grandkids' age. I hope it's improved. Even as a kid, it seemed kinda low rent and cheesy. Now, the Oregon Coast Aquarium, on the other hand, is very nice.

Glad you got a beach run in! Those are so much fun. And to have Oregon beaches where you can go for miles and not see a soul? Even better.

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Re: Mulligan...

Post  nkrichards on Thu Feb 08, 2018 10:23 am

@Mark B wrote:Progress! It feels good, doesn't it?

Wow, I haven't been to Undersea Gardens in Newport since I was probably your grandkids' age. I hope it's improved. Even as a kid, it seemed kinda low rent and cheesy. Now, the Oregon Coast Aquarium, on the other hand, is very nice.

Glad you got a beach run in! Those are so much fun. And to have Oregon beaches where you can go for miles and not see a soul? Even better.

Yes, beach runs are fun!  I don't get to do them often.

We had actually planned to take the boys to the Oregon Coast Aquarium but Royce (3 year old) was skipping around the room at 4:30 on Saturday morning singing "lets get this party started".  We headed for the beach at daylight and by the time the aquarium opened we were all fading fast.  We took the boys to see the sea lions on the bay and Marty realized we were right next to the Undersea Gardens.  We opted to spend $30 to take the boys to the cheesy venue rather than spending $100+ to take them to the Aquarium.  It was a good choice.  It doesn't begin to compare to the aquarium but it was a fun option to occupy them for an hour before their parents arrived.

Another good day yesterday.

  • Core/strength
  • 5 mile run.  Easy effort but times and HR continue to show slight improvement.
  • TBC  We went outside for part of the class today.  It was gorgeous outside.
  • Swim 2700 yds.  I wasn't sure if I was going to make it through the full workout as I was pretty tired when I started.  I kept my sport drink handy and decided to do what I could.  Fortunately it was an endurance workout at a steady pace that didn't require a hard effort.  I settled in and felt pretty good throughout the workout. 


Life is good.
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