Follow Your Heart? – No Rep!

This could have been much worse. They could have used an AirDyne.

This could have been much worse. They could have used an AirDyne.

As part of my ongoing quest in being pro-active about my health, I just completed my Echo Stress Test.

For those who may be unfamiliar with this procedure, it is a echocardiogram of your heart, followed by a treadmill stress test, immediately followed by another echo.

The first echo establishes a baseline at rest, the second shows the effects of stress on the heart. It is the same ultrasound technology that permits you to have a picture of your grandchild on the fridge months before he is born.

The treadmill is standard fare, it seemed the same to me as it was twenty years ago. The Technician hooks you up to an EKG, takes your Blood Pressure, and then the test begins. The belt turns at a walking pace, and at three minutes, the tech takes another BP reading and the incline and speed rise. Rinse and Repeat until you hit 85% of your max heart rate.

The Tech hooked me up and I was left alone in the room for about five minutes. I am a geek by trade, so I went to the monitor to observe what was presented on the Dashboard Display. It showed my heart rate was 80. I wanted to lower it, so I performed some meditative breathing and within less than a minute I had it down to 69. I was ready to get the show on the road.

I measured my BP at home when I arose at 4:30 a.m.. It was OK (for me), at pre-hypertension levels. When the tech measured me it was 150/100. During the test it rose to 165/100 and when I stopped it was 175/100 with my pulse at 140. The tech turned to me with a wink and said, “Go home and take your Beta-Blocker.” That was not what I wanted to hear.

I get teased by the ladies at the gym for my disdain of metcons. I hate cardio-intense WODs. I’ll do strength work and heavy WODs. They insist that I would love Bootcamps. I seriously doubt it. Though this stress test was nothing compared to a CrossFit metcon, my BP was through the roof.

I hate running, I love Rowing. The treadmill was obviously closer to running but with minimal impact. But I will admit, my calves were getting heavy. When I’m running, if it’s too much of a grind, I simply change the pace and slow down briefly. With the treadmill, the speed is constant and you are stuck with keeping pace or you fall on your face.

As I was walking through the fourth set I noticed my heart rate was 140, so I knew I was at, or near, my 85% max heart rate threshold, and sure enough, at the end of this set, she shut me down and I hurried to the table for the Ultrasound Tech to continue her work. I was appalled how heavily I was breathing.

The first tech was still watching my EKG and the Dashboard. My heart rate recovery was a bit slower than I was expecting it to be. I am a CrossFitter! How can two years effort of diet and fitness be scuttled by a stupid 12 minute walk on a treadmill?

As I have begun writing this blogpost, I have not yet seen the results of the Echocardiogram, so I do not know the doctor’s assessment of my heart. But to me, my BP is alarming. It stayed elevated for two days. This morning it was normal again, after a good night’s rest. So I decided to perform an experiment.

I went to the gym and did a 20 minute AMRAP metcon, 15 Kettlebell Swings, 10 Burpee Box Jumps, 200m Row (I subbed because I wasn’t doing 200m sandbag runs today). I finished 5 rounds, less the final row. I was not disappointed with my performance. I wore my heart monitor and my pulse never exceeded 122 bpm.

As soon as the WOD was finished I hooked up my Blood Pressure Cuff and measured: 167/102 with heart rate of 103. Heart rate recovery was fair, but BP is bad. Four hours later, it has dropped slightly.

This metcon produced a similar result to the controlled environment stress test at the cardiologists office, but I performed a lot more work for a longer period of time. This is mimicking the trashed feeling I had a few weeks back when I redlined in a local Masters Comp.

For those of you who may be wondering, CrossFit is not the cause of my problems. I’ve been dealing with this for 20 years. In fact CF has me in the best health I have been in for over thirty years. But it is becoming obvious that certain elements of the CrossFit regime do not serve me well in my current state of being.

As I am writing this, I am still await my follow-up meeting with Dr. Cardio to review my Echo before determining the next course of action. I will tell you I was disappointed with the Stress Test. Fool that I am, I went into it thinking it was just another WOD. Wrong!

As I discussed these events with my Gal Pal, WOD Partner, Julia, she offered her observation. I’ve been distracted, absent-minded, tired and stressed. She’s a Professional Shrink and a cup of coffee and a non-Paleo breakfast yielded a free assessment: stress is doing this to me. Physical stress and work stress are affecting my health. I cannot relax. I cannot turn off my mind. Deep down inside, I knew that. But Julia reminded me and drove the point home.

I can only get so much free counseling for a cup of coffee, so tell me, what do you do to calm your mind, heart and body (preferably non-chemically)? Herbs, Acupuncture, Floatation? I really want to know, and for some strange reason, I am sure I am not the only one reading this article who is curious about non-pharmaceutical options for reducing stress and hypertension.

Four Tips to Manage Your Doctor

When your breakfast requires three plates you know you're doing it right!

When your breakfast requires three plates you know you’re doing it right!

Anyone who has read Defiant Wellness for some time is aware of my frustration with our Disease Management System, sometimes referred to as the Healthcare System.

OK, I admit that introductory sentence reveals a negative bias. But that has been my experience in the past, but things are starting to change. I have been blessed by “insiders” who have counseled me regarding my approach, thereby enabling me to influence change.

Over the past two weeks I have had a one-year follow-up with my Cardiologist and a six-month follow-up with my Primary Care Physician. Last year when I met each of them,  they were both amazed with my progress brought about by diet and exercise. But they were both aghast that a man my age would be reckless enough to do CrossFit.

Both gents were also appalled that I would do that “caveman diet”, and ignore their advice regarding “heart healthy” options like vegetable oils, whole grains, fat free dairy, few eggs, etc. They were of the opinion that by eating four slices of bacon with six eggs and bulletproof coffee for breakfast, I was playing Russian Roulette with my heart.

So they were thrilled with my results, BUT they seemed genuinely offended that I obtained them by rejecting all their advice. Furthermore, they were stunned that I would take the advice of a few quacks on the internet, over their wisdom.

Now I reappeared six to twelve months later and they are still amazed that my results are holding fast, with minor fluctuations. They both are amazed that my EKG is excellent. They are in awe that an old man can consume a diet so rich in saturated fat and have an excellent blood profile. They are dumbfounded that a 63 year old man can consume 3000+ calories per day, and maintain his weight for two years.

The key difference between this past month’s appointments and previous ones is that I controlled the agenda. When I showed up at my cardiologist’s office I had all my discussion points on a page on my phone. I told him right up front that after he performed my EKG and measured my blood pressure, I wanted to have a frank discussion about where we were going with my care.

I began with my meds. I have been on three different pills for a period of 10 to 20 years. I reviewed the dosages and changes I had initiated on my own. I explained that since we had last met, I took it upon myself to reduce my Calcium Channel Blocker dosage from 10 mg/day to 5 mg/day, for a period of six months with no ill effects. I showed him my average Blood Pressure and Heart Rate info for that period. Then in March of this year, I began taking that reduced dosage every other day, still monitoring BP and Pulse.

I politely challenged him as to why he was still prescribing this medication. He relented and then agreed it was time to cease taking this drug. Hooray, One Down, Two to go!

My next challenge was that all these meds were prescribed after a heart attack twenty years ago, back when my stressful hi-tech sales job and a sedentary lifestyle were killing me. My career has changed. My diet has changed. My sleep has changed. And I am anything but sedentary with the influence of CrossFit in my life.

I challenged him to give me a stress test, to prove to both of us that my heart is healthy in my current level of fitness. This week, I will have a stress test followed by an echo. I am looking forward to breaking his treadmill.

Next I challenged him on why he and my PCP are targeting certain lower BP levels when a study published by JAMA in February of this year suggested treatment for hypertension of patients 60+ years of age should be considered at the threshold blood pressure of 150/90?  We had a healthy conversation on that subject as well. He was able to convince me that my takeaway from that article was based upon a personal bias and we put that issue aside for the time being, since we had just eliminated one prescription.

Tip 1 – Control Your Healthcare Agenda

If you simply walk into the doctor’s office like every other patient and do not immediately take charge of the meeting, the Doc will be expecting his typical, passive patient who simply goes through the motions, and either takes advice at face value, or who nods his head in agreement, only to leave the office ignoring everything he was told. By setting the agenda, you put the doctor on notice that you are in charge of your health, and the doctor is a hired professional.

Tip 2 – Arm Yourself with Facts

By preparing yourself with personal statistics and facts regarding your lifestyle, including diet, fasting blood sugar, blood pressure, resting heart rate, etc., you ensure that the doctor is not basing his recommendation or prescriptions on readings from a single point in time, which may have no relevance to normal trends.

If you broke your leg 10 years ago, would you accept a doctor who still treated you by insisting you use crutches? I doubt it. So why settle for a lifelong prescription of a medication? Do your research. The internet is filled with studies regarding medications, side effects, alternatives, etc. Do your homework and come prepared for an intelligent discussion.

Tip 3 – Be firm but Polite

Recognize that your doctor has been trained in his behavior by passive patients who oftentimes just want a pill that will fix their ills and permit their continued unhealthy lifestyle. You are challenging that norm, and it may be disruptive to the doctor’s routine at first. He will also find himself in role reversal, where you control the dialogue and he is reduced from authority figure to advisor. Some doctor’s may find this quite refreshing, but others may find it offensive to their ego. Beware of this, it may take more than a single appointment before this is acceptable or even welcome.

Tip 4 – Be Proactive with Next Steps

Take charge of what is next. What are you doing over the next six months regarding your health and wellness that you wish to engage your physician’s help in monitoring? Perhaps you are making a major dietary change and you want to come back in three months for more blood work to compare certain markers. Perhaps you wish to collaborate with your doctor to establish some statistical benchmarks for tracking your progress in subsequent visits.

I know most of my readers are “take-charge” types. We “Masters” athletes buck the norms. We are statistical outliers, and as such, we mustn’t let a grossly sedentary and overweight population set the standards for our healthcare. We must be as proactive with our medical professionals as we are with our fitness. We set our goals and we must surround ourselves with “can do” people to help achieve those goals.

Be Defiant! Be Well!

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