Bad EKG Jolts 60 @ Sixty Training

Doing the right thing can be a pain in the ass.

As many of you know, I’m a little more than three months into a six-month training regimen in preparation for an epic mountain biking ride in July. To celebrate my 60th birthday, I’m planning to ride 60 miles of trail in the Cascades in a single day. In conjunction with the ride, I’m raising money for the Friends of the Castle Rock Library, Girls on the Run of Southwest Washington, and CurePC(pancreatic cancer).org. I’ve already generated more than $2,000 in pledges.

Training was going well, and I felt like I was starting to turn the corner. Then, in the middle of a Saturday ride, I began experiencing light chest and abdominal pains.

No lightheadedness. No extreme fatigue. No wheezing – at least no more than usual. We’d been doing some stout climbing and were breathing in and out quite deeply, so I thought I’d strained a muscle in my chest. Nothing to worry about.

Sher and I flew to Las Vegas on Monday. I worked out in the hotel gym on Tuesday and Wednesday, and the stomach and chest pains continued.

I’ve had occasional problems with ulcers and with pericarditis – an inflammation of the sac that surrounds the heart – and the symptoms had been similar to those I was now experiencing. I told myself the pain would go away if I stopped drinking cosmopolitans. They didn’t.

In a move that runs contrary to my nature, I decided to play it smart. Before we left Las Vegas on Thursday, I called my doctor’s office and scheduled an appointment for Friday.

It was at that appointment that the feces hit the fan.

The Cluster Begins
The nurse did an EKG and handed the printout to a physician I hadn’t met before. As he scanned the results, his eyes widened.

“I don’t like this at all,” he said. He pointed to a series of blips on the printout. “See where your P Wave heads into the Q-R-S Complex and then jumps here at the T Wave?”

Something told me I wouldn’t be going to the gym that afternoon. I tried to explain that I have a history of erratic EKGs, but by then he was on his way to fax the results to a cardiologist. As he left the room, he said, “There’s a good chance you’ll be going to the emergency room. And it’s likely they’ll be keeping you overnight for observation.”

Holy shit! All I wanted were pain pills for the pericarditis and an anti-biotic for the ulcers. Surely, one of the two would take care of the problem.

Word came back from the cardiologist. The EKG results were indeed very suspicious. I was sent to the hospital to have my blood drawn. An enzyme test would determine whether I’d had, or was having, a heart attack. I spent the next three hours drinking coffee, wondering where I’d be spending the night, and dreading the call I was going to have to make to Sher.

Nitroglycerin in My Pocket and a Song in My Heart
A call came. Good news. Enzymes were normal. No heart attack.

But I would need to see a specialist at St. Vincent in Portland on Monday and, the physician said, “No biking over the weekend.”

He wrote me a prescription for nitroglycerin and said to keep it with me at all times – “just in case.”

I spent the weekend hoping I didn’t have to pop the nitro and worrying about all the cliches that were ricocheting inside my head – Were our finances in order? Did the oil in Sher’s car need to be changed? Why hadn’t I climbed Mount Rainier? Where was my advance directive?

I spent about 10 minutes being pissed off at the injustice of it all. I stay in good shape and keep my weight down. It wasn’t fair that I might go out before the obese, couch-potato smokers I ran into on a daily basis. But justice is only a matter of percentages. I’d done things to reduce my risk, but there was no way to completely eliminate it.

I’m old enough to understand that the Great Equalizer knows my name. I was just hoping he hadn’t moved me to the top of his list.

Sign Here and Trust Us
It took nearly two hours to drive from Castle Rock to St. Vinny’s, southwest of Portland. The hospital is the size of a small city and hard to navigate. I found a parking spot, checked and re-checked directions with several staff members, and finally located the cardiologist’s office.

The receptionist said they were expecting me in Surgical Waiting. My nimble mind immediately converted this to “a place where people wait to have surgery.” WTF? I thought I was there for a conversation.

When I found Surgical Waiting, the woman at the desk told me I was scheduled for a “procedure” that afternoon. Someone was going to run a catheter into my heart to have a look around.

“Not gonna happen,” I said. “All I’ve had is an EKG. My enzyme test was normal. Until I get a stress test that says I have a blockage, I’m not signing on for a ‘procedure.'”

She was not happy. She phoned the cardiologist and sent me back to that office. The cardiologist and I had a long chat about my squeaky clean health history. No smoking. No family history of coronary heart disease. Plenty of exercise. I lied a little about my libation consumption.

I told her about my past problems with ulcers, pericarditis, and mutant EKGs. She eventually got around to verbalizing what I’d been telling people all along – a stress test was a logical next step.

She pointed to a large diagram of a heart on the wall. “You see that large artery on the upper left side?” she said. “We call that one the Widowmaker. If it gets blocked, it can kill you quickly. The Widowmaker takes out a lot of men your age.” 

Thanks, doc. I felt much better now.

She made a few calls. Bad news. The imaging center was unable to conduct the stress test because of a national isotope shortage. She said I could do “light exercise” but no mountain biking.

Can I Count the Treadmill Test as a Workout?
When I got home, there was a message from my physician. I was scheduled for a stress test in Longview on Wednesday.

When Wednesday rolled around, I was tired of feeling helpless. I’d spent the past two days waiting, worrying, and frantically contacting friends in the medical community to determine my best options if the test revealed a blockage. I’ll take my chances with the random server at Applebee’s but not with a cardio-vascular surgeon whose name was drawn from a hat.

I hadn’t been on my bike for 10 days and was desperate for exercise. I figured that if I hit it hard enough, I could count the treadmill test as a workout. When I arrived at the physician’s office, I was surrounded by octogenarians. A voice inside my head said, This is your peer group.

The stress test utilizes a treadmill, with speed and incline increasing every three minutes until you reach your maximum heart rate or have to surrender. Electrodes keep tabs on your heart rate while an IV shoots isotopes into your veins. 

The treadmill test lasted about 25 minutes and was the most fun I’d had since signing on to play chase-my-tail the previous Friday.

My max heart rate is supposed to be about 160. It took awhile, but I finally got there. The doctor said the speed and incline level was the second highest ever recorded in his office. Obviously, they hadn’t been testing the guys I bike with.

Romancing the Stones
One of the imaging techs took a series of pictures. By now, the isotopes had entered my heart and would provide a clear picture of my veins and arteries.

I had three hours to kill before the second round of images. I asked the tech if I could go to the gym. He laughed. “Nobody has ever asked that question,” he said. “The answer is ‘no’.”

I chatted with a guy in the waiting room who told me stories about life in Longview during the Depression. I also talked with the tech who handled the clinic’s ultrasound tests.

She’d assisted with the treadmill exam and was aware of my situation. “You know,” she said, “gallstones can sometimes cause the symptoms you’re having. I’ll see if I can work you in for an ultrasound.”

An hour later, she motioned for me to follow her to a different room. She cranked up the ultrasound and ran the probe over my upper abdomen. “Yep,” she said, “you definitely have gallstones. They might not be the cause of your problems, but you never know.”

Full Circle
When I finished the second round of images, a nurse told me they would read the test on Thursday and give me a call. If I had a blockage, I should expect to head  back to St. Vinny’s for an angioplasty. If not, I would meet with the cardiologist on Friday to discuss the results.

I received word  the next morning that the test had come back negative. For some reason, I still kept the nitro in my pocket.

I met with the cardiologist on Friday to discuss the stress test. Shockingly, my heart is in good shape for a person of my advanced years.

So.

She said the gallstones weren’t large enough to be an issue. She gave me some medicine to deal with the gastric pain and told me to limit my beer consumption. She wasn’t specific so I took this to mean that I should limit it to the better beers.

The Dream Is Still Alive
So, here I am. Nearly two weeks after the start of this fiasco, with nothing to show for it but four light gym workouts.

My weight is up and my fitness level is down. I feel like my body has atrophied, and I’m not sure that my bike will remember me when I climb on tomorrow morning.

This is a setback, but I plan to ramp up the effort and do my best to put this sordid incident behind me. The dream of 60 @ Sixty is still alive. In fact, I’m heading out right now to do some hill climbing.

Surely, you weren’t naive enough to think I was going to let you off the hook for those pledges.

5 thoughts on “Bad EKG Jolts 60 @ Sixty Training”

  1. I told you. This is why they refer to me as Dr. Dave at the hospital’s espresso bar.

    And regardless of what Sarah Palin says, our healthcare system isn’t the best in the world as you discovered.

    Welcome back!

  2. Jim, That is why I stay away from the doctors. Somehow you just know they will find an illness if they go looking, even if it is a false alarm.

    Welcome back. See you on the trails.
    Susan

  3. Quite a story. Glad it all turned out OK.
    Based on your comment I assume you have never climbed Mt Rainier. It is at least equivalent to riding the Boundary Trail in two days

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