OT: Heart Attack

[BobO]

Just a PSA that I learned the hard way. Being fit does not mean that one cannot have a heart attack. I had been under an enormous amount of stress and drinking too much coffee for several months. That caught up to me in the form of a myocardial infarction yesterday. I have no blockages and the heart is healthier than a man half my age. The stress alone caused it.

Take care of yourselves.

[mktng]

damn. thats scary. i often tell myself the same thing. cool it with work, and dont stress so damn much. stress is the silent killer.

hopefully you are able to monitor and prevent further issues.

take care!

[AJosiahK]

Can relate to this ! Scary stuff indeed

Major life events taught me this very same lesson last year. My doctors never figured out what caused it aside from stress and anxiety. Which they never even mentioned.

Sometimes being selfish is a good idea.

Be well everyone! Glad to hear it wasnt worse BobO

[dbnm]

I am 49 and have had a bit of real stress the last couple of years.

I try to eat right.
I bike 150 miles a week.

And I take a xanax a couple nights a week to make sure I sleep through the night.

For me, rest and sleep are key.

Glad you're okay.

[BobO]

I got a script for Zoloft to try to help me manage.

[bigman]

Feel better - does coffee really play that big a role?

[Black Dog]

This sounds like a "good" scare. Try and use this a catalyst for change. Hope you are feeling better.

[Blown Reek]

Medical marijuana (or any marijuana) is such a better option than nasty, dirty pharmaceuticals. Corporation-marketed poisons? Oof. Everything in moderation, though. And that includes stress and coffee.

[kingpin75s]

Just a PSA that I learned the hard way. Being fit does not mean that one cannot have a heart attack. I had been under an enormous amount of stress and drinking too much coffee for several months. That caught up to me in the form of a myocardial infarction yesterday. I have no blockages and the heart is healthier than a man half my age. The stress alone caused it.

Take care of yourselves.

Crap. Coffee and stress is my bread and butter.

Thanks for the reminder that I need to focus on taking care of myself and not just others.

Stay healthy and keep the shiny side up.

[BobO]

Feel better - does coffee really play that big a role?

Without question coffee in large quantities is not good.

This sounds like a "good" scare. Try and use this a catalyst for change. Hope you are feeling better.

Thanks. Hopefully someone else will see this and not go down my road.

[joosttx]

Glad you are typing this post incident. Focus on changing your lifestyle so that it will not happen again.

One of my college buddies has had 2 heart attacks before 50. With 3 kids and a wife he supports things had to stop. He was a hard drinker, smoker and an A-type personality with a lot of responsibility.

Bottomline he now paints abstract paintings and bee keeps which are really funny hobbies if you know the guy because that was not his style. Well, we all support his new style because it means he'll probably live longer.

[avalonracing]

Glad you are okay. Can I ask how much coffee you were drinking? As you think it is a factor it must have been an ass-load.

[Bob Ross]

Yikes! Glad you're okay.

Giving up coffee would be tough for me, though I think if a doctor advised it I wouldn't think twice.

I've already got a pretty good handle on avoiding stress: For the most part I simply don't give a **** about anything.:banana:

[longlist]

a good friend of mine was 55 when he died of a massive heart attack. he was ranked 8th in the world in triathlon. had 2.5% body fat. crazy healthy. didn't drink or smoke. didn't drink coffee. he was out on a training ride with some people and they went ahead on a hill and he fell over and died. it can happen to anyone.

[BobO]

Thanks for the wishes.

Glad you are okay. Can I ask how much coffee you were drinking? As you think it is a factor it must have been an ass-load.

I was at 10-12 up to 15 cups a day. It's not just the coffee, it's the combination with the intense stress.

I DGAF may turn out to be what I need to learn. :)

[kgreene10]

Are stress and coffee known risk factors or is this a best gusss residual diagnosis having ruled out the standard causes? Without stress and coffee (but just 2-4 cups a day), I might cease to exist.

[Black Dog]

Are stress and coffee known risk factors or is this a best gusss residual diagnosis having ruled out the standard causes? Without stress and coffee (but just 2-4 cups a day), I might cease to exist.

Excessive caffeine consumption is a real factor when combined with other factors.

[bobswire]

Feel better - does coffee really play that big a role?

It did for me in the sense it was a trigger that brought upon Arrhythmia. High doses of caffeine pills or drinks had the same effect. Though I'm able to enjoy teas even black with no side effects.

[NHAero]

Really glad you're OK!
If you have no blockages, what actually happens in a MI?

[kingpin75s]

Thanks for the wishes.



I was at 10-12 up to 15 cups a day. It's not just the coffee, it's the combination with the intense stress.

I DGAF may turn out to be what I need to learn. :)

That is a buttload of coffee.

Don't think I have drank that much since I was 20 and had 2 waiter jobs, was going to school and pounded quad shot Mochas all night at work to keep me going.

Yep. DGAF if you can get there.

[Ken Robb]

I've known several fit cyclists who died on rides. I have no medical training so I don't understand how it happens when there were no warning signs.

Maybe passing my treadmill test shouldn't make me feel to cocky.

[Kirk007]

Similar stories with friends and contemplating a month in the Alps this summer at the beginning of 6th decade led me to a place called PotentRX in Seattle, run by a cardiologist and a sports physiologist. Work up includes genetic testing, resting EKG, carotid scan, ankle branchial test for peripheral arterial disease, VO2 Max test, etc. etc and then a tailored plan for addressing issues and for training. Really enlightening and for me reassuring. For instance learned that although my cholesterol numbers have always been very low, the size of my LDL particles is big and contributing to a genetic predisposition for plaque buildup. Luckily nothing too bad, nothing to interfere with riding but enough that I've getting a bit more scanning done.

Not cheap, but after 60 years with life's share of stress, well worth in my opinion to know what your dealing with!

[wc1934]

Thanks for sharing - get well soon - hope you can continue riding.

[bobswire]

I've known several fit cyclists who died on rides. I have no medical training so I don't understand how it happens when there were no warning signs.

Maybe passing my treadmill test shouldn't make me feel to cocky.

I've known a few too like Tommy Milton (Selle Anatomica designer), who died unexpectedly in 2010 doing a Double and Clay Mankin of City Cycle died in Woodside doing a solo bike trip to Santa Barbara. Both seemingly in excellent health and good long distance riders. They got me thinking the older one gets one needs to listen to our hearts and know when to ease up no matter one thinks his health is. My treadmill test was off the charts in a good way but I pay that no mind I listen to my body and I'm an aggressive but safe rider.

[dddd]

I'd stay off the coffee. Your adrenals will resume fully regulating within about three days, you'll feel better, sleep better, think better and your insulin will be much better regulated without caffeine.
Again, you will feel better without any jolts of de-regulating caffeine.
Don't forget to substitute water for the missing coffee.

[NHAero]

Hi there
Your post was very interesting. Do you mind saying what that whole work-up/testing cost?
Thanks
Marc

Similar stories with friends and contemplating a month in the Alps this summer at the beginning of 6th decade led me to a place called PotentRX in Seattle, run by a cardiologist and a sports physiologist. Work up includes genetic testing, resting EKG, carotid scan, ankle branchial test for peripheral arterial disease, VO2 Max test, etc. etc and then a tailored plan for addressing issues and for training. Really enlightening and for me reassuring. For instance learned that although my cholesterol numbers have always been very low, the size of my LDL particles is big and contributing to a genetic predisposition for plaque buildup. Luckily nothing too bad, nothing to interfere with riding but enough that I've getting a bit more scanning done.

Not cheap, but after 60 years with life's share of stress, well worth in my opinion to know what your dealing with!

[BobO]

Really glad you're OK!
If you have no blockages, what actually happens in a MI?

That I can't tell you, but my cardio says it is not all that uncommon.

I'd stay off the coffee. Your adrenals will resume fully regulating within about three days, you'll feel better, sleep better, think better and your insulin will be much better regulated without caffeine.
Again, you will feel better without any jolts of de-regulating caffeine.
Don't forget to substitute water for the missing coffee.

Trust me, I'm scared straight. :)

[BobO]

Thanks for sharing - get well soon - hope you can continue riding.

Thanks, doc says I can start back into riding in three weeks.

[Kirk007]

Hi there
Your post was very interesting. Do you mind saying what that whole work-up/testing cost?
Thanks
Marc

Take a gulp and a seat: $2400 for everything: intensive physical, all labs and physiological testing. Couple hundred more if you want a full nutritional assessment and plan.

That said I am assuming that I'll get a little back from insurance for the basic physical component, it was a 6 1/2 hour process, they provide breakfast and lunch, and then a 2 hour debrief, 70 page report and follow up plans. I think it was a lot more value than I've gotten out of a lot of medical expenditures.

[Clean39T]

Take a gulp and a seat: $2400 for everything: intensive physical, all labs and physiological testing. Couple hundred more if you want a full nutritional assessment and plan.

That said I am assuming that I'll get a little back from insurance for the basic physical component, it was a 6 1/2 hour process, they provide breakfast and lunch, and then a 2 hour debrief, 70 page report and follow up plans. I think it was a lot more value than I've gotten out of a lot of medical expenditures.

That honestly sounds cheap for everything you had done. Getting 6.5 hours from a specialist for under $10K is rare...

The main thing is - will it give you confidence and peace of mind to enjoy your trip and rides and life without worrying unnecessarily about your health, and/or will it point you in the right direction toward fixing some things before too late? If the answer is yes to either of those two, it's money well spent.

[Kirk007]

That honestly sounds cheap for everything you had done. Getting 6.5 hours from a specialist for under $10K is rare...

If the answer is yes to either of those two, it's money well spent.

Probably the best investment I've made in years; better than yet another bike frame but you know, we are who we are :)

[NHAero]

If you feel that as a result there are some things you needn't worry about anymore, and other things that you hadn't thought about that improve your likely longterm health, I think it's money well spent. I wonder if there is something similar near Boston (a health care backwater for sure)

Take a gulp and a seat: $2400 for everything: intensive physical, all labs and physiological testing. Couple hundred more if you want a full nutritional assessment and plan.

That said I am assuming that I'll get a little back from insurance for the basic physical component, it was a 6 1/2 hour process, they provide breakfast and lunch, and then a 2 hour debrief, 70 page report and follow up plans. I think it was a lot more value than I've gotten out of a lot of medical expenditures.

[azrider]

Just a PSA that I learned the hard way. Being fit does not mean that one cannot have a heart attack. I had been under an enormous amount of stress and drinking too much coffee for several months. That caught up to me in the form of a myocardial infarction yesterday. I have no blockages and the heart is healthier than a man half my age. The stress alone caused it.

Take care of yourselves.

Scary! Glad to hear from your other posts that you're ok.

Have you ever tried meditating? I work in a very high stress environment and a work 'buddy' was telling me about the benefits he's seen from transcendental meditation or meditation in general. I always viewed the practice as something hippies do, and dream catchers, and lots of "ohhhmmmm"-ing.

Definitely not the case. I've started practicing it (once twice week) and it's pretty crazy how many other benefits besides stress reduction that comes as a result.

Give it a try. Seriously.

[cadence90]

.... ..
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[Ken Robb]

It is in fact not that uncommon at all. But, there is always some blockage in a MI. It could be less than 50%, in which case an angioplasty (stent insertion) might not be performed immediately, which in the op's case it was not if he is already home today. I hope and guess that there will be follow-up exams soon.

Since the op mentioned being prescribed Zoloft (which is primarily an anti-depressant) I would guess that fortunately nothing extremely risky was found yesterday. Anti-depressants such as Zoloft in heart patients have been found to act also as minor blood thinners, helpful but less extreme than thinners like Plavix which would certainly be prescribed in cases of more extreme blockage.

Stay on top of the follow-up exams and recommended care, op.


Those incidents were probably cardiac arrests (i.e. Michael Goolaerts in this last Paris-Roubaix) rather than heart attacks.

Heart attacks are the result of arterial blockage (blood flowing); cardiac arrests are the result of electrical failure (blood pumping).

Cardiac Arrest vs. Heart Attack (http://cpr.heart.org/AHAECC/CPRAndECC/AboutCPRFirstAid/CardiacArrestvsHeartAttack/UCM_473213_Cardiac-Arrest-vs-Heart-Attack.jsp)

Passing the treadmill test means one passed the treadmill test that day, and not much more unfortunately.

I could have passed a treadmill test one early afternoon, I'm sure. 12 hours later I was in the ER. The first angiograms revealed nothing but blood tests (for troponin) did. 48 hours later I had undergone a quintuple bypass.

Please do not take these early signs lightly, or worse ignore them completely; they are not innocuous at all.
.

Thanks for the info. I'll bet I'm not the only guy who didn't know the difference.

[benb]

Hope you're OK and doing well.

Scary stuff.

And the weird thing is while cycling can improve your health/fitness it can definitely cause stress as well if it's causing you to underperform in other areas of life.

[Likes2ridefar]

Scary! Glad to hear from your other posts that you're ok.

Have you ever tried meditating? I work in a very high stress environment and a work 'buddy' was telling me about the benefits he's seen from transcendental meditation or meditation in general. I always viewed the practice as something hippies do, and dream catchers, and lots of "ohhhmmmm"-ing.

Definitely not the case. I've started practicing it (once twice week) and it's pretty crazy how many other benefits besides stress reduction that comes as a result.

Give it a try. Seriously.

agreed. it is encouraged where i work and have recently been doing it. i find it very rewarding for the 10-15 minutes a day required. we have calls daily we can participate in for guidance or just do it solo...great stuff.

we call it "mindfulness" here.

[Chris]

Medical marijuana (or any marijuana) is such a better option than nasty, dirty pharmaceuticals. Corporation-marketed poisons? Oof. Everything in moderation, though. And that includes stress and coffee.

Spoken like a true kool aid drinker. You've just given the exact opposite of good advice in regards to marijuana and cardiovascular health. There is limited good clinical evidence for the use of marijuana as a self administered treatment option for much other than chronic pain, nausea/appetite difficulties, and glaucoma. There is lots of anecdotal evidence for other stuff, but the science just isn't there yet.

Where some good research does exist is in the realm of marijuana and heart disease. If you have any heart disease history and are trying to mitigate risk factors then you would be a moron to smoke marijuana or anything else for that matter. A.COMPLETE.MORON. People who have had had heart problems have chest pain sooner after smoking marijuana and people with heart disease are at a much greater risk for having an MI the hour after they have smoked marijuana. Jesus Christ it drives me crazy when people just throw out opinions as facts.

As for the OP, I hope you are doing better. The lack of blockage is great. Did the cardiologist mention a condition called Takotsubo? This sounds like what you could have experienced.

As for those who think they should get some testing done. Start with a heart scan. They are between $50 and $100 these days and are one the best predictors of future cardiac mortality.

[redir]

Dang BobO that sounds like a tough experience. One of my cycling teamates had a heart attack riding his bike to work, he was 35 years old at the time and in great shape. Thankfully he's alive for his 3 kids today.

Stress is a killer. What if you don't mind me asking, was causing it? If it's work then... get out! It aint worth it as I imagine you now well know given that's the case.

[nalax]

BobO - good to hear that you are on the road to recovery. How did they determine that there was no blockage?

I'm curious as I had severe blockage (over 75%) during a season of mtb racing and never knew until I saw my doctor for a routine physical. I had a stent put in my widowmaker (LAD) a few days after that visit. I was 60 at the time and they said my health was otherwise excellent. I had no warning signs other than on two occasions my heart was racing and took a long time coming back down during rest.

Cadence - you're right. A treadmill test may not detect heart problems.

Chris - thanks for the MJ response

[BobbyJones]

BobO- glad to hear you're ok.

The human body is an amazingly odd thing. Even the most fit athletes can have physical conditions that can result in an event- both Ryan Shay and Eddy Merckx come to mind. Physical screening is obviously important.

I was always under the impression that psychological and physical stress invoke the same physiological response in the body...some education a few years ago was a shocking eye opener as it's not that simple.
Theres a great book called "Why Zebras Don't Get Ulcers" that's a pretty good read if you're interested in learning more.

[Mark McM]

Where some good research does exist is in the realm of marijuana and heart disease. If you have any heart disease history and are trying to mitigate risk factors then you would be a moron to smoke marijuana or anything else for that matter. A.COMPLETE.MORON. People who have had had heart problems have chest pain sooner after smoking marijuana and people with heart disease are at a much greater risk for having an MI the hour after they have smoked marijuana. Jesus Christ it drives me crazy when people just throw out opinions as facts.

I'm asking because I don't know, so here goes ...

Smoking anything is generally bad for you, but there are more ways to ingest MJ (or active ingredient THC) than just smoking. Is anything known about the effect on the heart for other ways MJ may be to ingested?

[Likes2ridefar]

Spoken like a true kool aid drinker. You've just given the exact opposite of good advice in regards to marijuana and cardiovascular health. There is limited good clinical evidence for the use of marijuana as a self administered treatment option for much other than chronic pain, nausea/appetite difficulties, and glaucoma. There is lots of anecdotal evidence for other stuff, but the science just isn't there yet.

Where some good research does exist is in the realm of marijuana and heart disease. If you have any heart disease history and are trying to mitigate risk factors then you would be a moron to smoke marijuana or anything else for that matter. A.COMPLETE.MORON. People who have had had heart problems have chest pain sooner after smoking marijuana and people with heart disease are at a much greater risk for having an MI the hour after they have smoked marijuana. Jesus Christ it drives me crazy when people just throw out opinions as facts.

As for the OP, I hope you are doing better. The lack of blockage is great. Did the cardiologist mention a condition called Takotsubo? This sounds like what you could have experienced.

As for those who think they should get some testing done. Start with a heart scan. They are between $50 and $100 these days and are one the best predictors of future cardiac mortality.

Smoking isn’t the only route and there is very little science for obvious reasons.

[BobO]

My cardiologist did not mention Takotsubo, but is does sound interesting. I've been reading and I didn't see that it produces the enzymes, or did I miss that in my state?

[earlfoss]

so yeah go ahead with the huge bong rips and pot brownies

[BobO]

Thanks for all the well wishes.

BobO - good to hear that you are on the road to recovery. How did they determine that there was no blockage?
.

Via a contrast angio.

[Chris]

I'm asking because I don't know, so here goes ...

Smoking anything is generally bad for you, but there are more ways to ingest MJ (or active ingredient THC) than just smoking. Is anything known about the effect on the heart for other ways MJ may be to ingested?

In an effort to be consistent with my ideals expressed above, I will try not to extrapolate. Here's the rub in regards to other forms of marijuana derivatives. Marinol (medical THC) has been used and has been shown to decrease stress on the vascular system, primarily through the lowering of blood pressure. This is a good thing. Getting someone to go home with a prescription for a controlled means of ingesting THC compared to the preferred self-administered dosing is a difficult task. There are no cure alls. Some of marijuana's purported benefits are snake oil. Some likely have greater effects than have been realized because of the lack of research. But trust me, research is being done. There are interested parties in every demographic promoting research. I get that Jeff Sessions isn't psyched by it, but there are plenty of people who are interested.

The problem I had earlier is that just recommending marijuana or any other substance as a cure all and describing how much better it is for you than something that is regulated is just poor practice and ill informed.

[gasman]

Glad to hear you're okay. it's uncanny how many supposedly healthy people are walking around with coronary artery disease. Your risk increases with age and being male.
I had a cardiac calcium scan done the other day- miscode was quite low but not zero. I looked at the scans and saw two small are with calcium that can indicate plaque. Need to take my 81 mg aspirin a day, exercise and have a good diet.

It's too bad there aren't really any good studies about marijuana-just anecdotal reports. Since it's a schedule 1 drug ( no known medical purpose) the feds will never fund a study and the NIH would be a natural to fund studies.

[cadence90]

.... ..
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[54ny77]

Damned good thread. Should be a sticky.

Feel better OP!

[Blown Reek]

Smoking isn’t the only route and there is very little science for obvious reasons.

But don't tell the kool aid drinkers that. Marijuana usage is exactly as you see in Reefer Madness.

[Avispa]

This article is a good start for reference:
https://www.huffingtonpost.com/2013/04/19/adrenaline-cortisol-stress-hormones_n_3112800.html

Just a PSA that I learned the hard way. Being fit does not mean that one cannot have a heart attack. I had been under an enormous amount of stress and drinking too much coffee for several months.... The stress alone caused it.
Let me guess, was it work related stress? The amount of Adrenaline, Cortisol and Norepinephrine we release during stress is lethal in many cases.

And I take a xanax a couple nights a week to make sure I sleep through the night.
Why not a regular Melatonin complex? There are many, much healthier alternatives than these addicting drugs.

I got a script for Zoloft to try to help me manage.
More damaging drugs! I do not mean to be opinionated or offensive, but there are better alternatives!

Medical marijuana (or any marijuana) is such a better option than nasty, dirty pharmaceuticals. Corporation-marketed poisons? Oof. Everything in moderation, though. And that includes stress and coffee.

Yes, that's a good point and start. Yes, you may take marijuana products that leave the CBD, but that not have the TCH (what makes one high) and they will be very beneficial...

Look a couple of years ago, I went through a terrible experience with work and I started to develop all kinds of physical problems. Needless to say, I was super fit for my age, yet developed Spinal Stenosis and a test even found cancer cells on my bladder! I have never been on medication other than the times I was being "treated" and never felt physically worse in my life.

I was lucky to find a way out of the situation and I was back to normal within weeks!

Stress my friends, is the worse thing one can do to their health. Do not forget to take copious amounts of antioxidants when you are under stress (vitamin c is great).... they will help you cope with the effects of stress better...

Glad to hear you are fine and have discovered there's a way out of this!

[clyde the point]

I am reading "The Haywire Heart" by Zinn and others. Recommend.

[buddybikes]

Google THC and panic, pot is fine if your mind is in good frame of mind, but come upon urgent stress and it switches the other way.

Agree with TBD oil


PS: How Avistar - how did they fix your stenosis? I had fusion in 2015 L4/L5 now my L3/L4 has severe DDD, in constant pain - another fusion will probably impact L2/L3 as well as L5/S1, so whole lumber screwed. Riding is my one excercise I can do, can't even mow the lawn anymore.

[bigbill]

I had chest pains at work (aircraft carrier in port) on 12/30/2011 and walked to medical. By the time I reached the ward, I was in a bad way. The DR put me on a gurney and took a blood sample which was positive for troponin. I chewed up 4 aspirin, was put on oxygen, and an ambulance was called. The senior medical officer (family practice) was a also a cardiologist and gave me two blood thinner shots in my belly. I actually walked off the ship and climbed into the ambulance, all the while being followed by a group of medical guys with a crash cart.

At the hospital, the cardiologist said it was an MI and made me comfortable while they ran more tests including a ECG and more EKG's. I did a stress test the next day and with contrast found no blockages. The DR believed that I had a clot and that the shots given to me on the ship are what stopped the blockage. I ended up in the hospital for 4 days and had another stress test before I was discharged. I went home with beta blockers that I took for a month until another cardiologist told me to stop. After that, I had issues with a more pronounced arrhythmia for several years.

My job was completely stressing me out, I was working about 90 hours a week trying to finish up an overhaul that was already past schedule. In hindsight, there was nothing I could do but I let it stress me to the breaking point.

In January, VA did a full on physical on me with ECG and EKG and my heart rate was normal, no arrhythmia at all with a resting HR of 50. For the pot discussion, THC is not legal here, but I use hemp-sourced CBD oil for my inflammation and arthritis and have been able to stop taking Meloxicam.

[Llewellyn]

No-one pays me enough to die of a heart attack for them. It's an approach that works for me. Glad you're OK. Definitely a wake up call

[Louis]

No-one pays me enough to die of a heart attack for them.

I bet most folks don't realize how bad things are and that their job (and other life factors like stress, diet, whatever) might literally been killing them until it's very late in the game, sometimes too late.

Happily, in this case it isn't too late for the OP to turn things around.

[paredown]

BobO--thanks for the share--and good luck with your recovery.

For everyone else--thanks for sharing your stories--I learned a lot.

[Black Dog]

But don't tell the kool aid drinkers that. Marijuana usage is exactly as you see in Reefer Madness.

From the Refer Madness description: "innocent teens partake of the “demon weed” only to find that one puff plunges them into a hilarious web of murder, sex, lunacy, and jazz music".

Just like this? Really? Jazz music....Noooooooo......:eek:

[Avispa]

Google THC and panic, pot is fine if your mind is in good frame of mind, but come upon urgent stress and it switches the other way.
Agree with TBD oil

PS: How Avispa(?) - how did they fix your stenosis? I had fusion in 2015 L4/L5 now my L3/L4 has severe DDD, in constant pain - another fusion will probably impact L2/L3 as well as L5/S1, so whole lumber screwed. Riding is my one exercise I can do, can't even mow the lawn anymore.

I was lucky it was a mild case, not nearly close to fusion at all... although enough to mess me up for one month! I was also lucky that my Doc adhered to this Voltaire quote very much:
The art of medicine consists in amusing the patient while nature cures the disease.

In any case, sports massage, stretching and chiropractor visits did the trick for me more than any drug I was told to take.

I have found out that sitting for long periods of time is terrible for your back and hip arteries. So, I try to use a desk that I can move to standing position often.

Also, your body weight has ha huge impact. I am lucky my body weight is 138-140 lbs most of the time. And I stretch for 20-30 minutes almost religiously after a ride.

[OtayBW]

Severals years ago, my EKG at the end of a stress test indicated that I went into 'ST depression' when I went anaerobic. ST depression is essentially the cardiac signal indicative of sudden death by heat attack, so you can imagine the concern.

I felt fine during the test and was ready to go to the next level, but the doc pulled the plug immediately, and I found myself in the hospital the next day for a cardiac cath. I was found to be 'clean as a whistle' which of course puzzled the cardiologist to no end. Three stress tests later, including a nuclear test, it seems that that is just what my body does at high stress levels. I've been given a clean bill of health by multiple doctors, and I have ridden many thousands of miles since then in all kinds of climate and terrain with no problem.

But it is weird.....:eek:

[biker72]

I recently completed a 9-week intensive cardiac rehabilitation program (Ornish) following my open-heart surgery. The program was excellent, and I and my fellow participants all showed good to excellent improvement even after such a short time. It is a lifetime lifestyle revision, really, but the effectiveness starts very soon.

The Ornish program comprises four modalities:

Exercise/Fitness
Diet
Communication/Support
Stress Management


The first three modalities are self-explanatory in terms of health benefits. The fourth, Stress Management, consists of gentle (not the weird aggro-television stuff), focused yoga and meditation, min 30 minutes max 60 minutes per day if possible (very hard to do even 30). Fortunately there is no "hippie-ness, dream catching, or "ohhhmmmm"-ing" about it at all...just very relaxed but very focused concentration. "Mindfulness", exactly...that is a term they used over and over.

Long-term studies have shown that while of course the other three modalities are critically important, Stress Management has been the component most responsible for not only cardiac health improvement but actually also reversal of the original (stress-induced) conditions.

I too was a real skeptic at first, and now instead am a believer in the effectiveness of proper stress management/yoga/meditation. Truly relaxing is critical and extremely helpful; it leads to much more energy, to much better sleep, to a healthier heart and mind, etc.
.

I had bypass surgery in 1987. At that time heart disease was considered non reversible. Dr. Ornih's first book came out around 1990. A lot of people thought this almost vegetarian diet was rather radical. Just another doctor trying to make a few bucks with a different approach to heart disease.

Dr. Ornish got results...big time. Tests have shown real reduction of plaque in arteries. I had a couple of friends that refused to do any lifestyle change after heart surgery. One died at 42 after a second heart surgery. The other was 51. Some people don't seem to get the message.

[ceolwulf]

your insulin will be much better regulated without caffeine.

Very interested in this. Any further information? Could be part of why I have such a terrible time losing weight.

I'm an unfortunate owl in a world where business hours are set by evil larks.

Was doing okay with not more than a cup or two until Daylight Savings Time and then it all went off the rails ...

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[2metalhips]

Dr Ornish is a leader in lifestyle medicine. More valuable research, Dr Esselstyn's "Prevent and Reverse Heart Disease" . Dr Greger's "How Not To Die". Documentary "Forks Over Knives". There are thousands of studies and decades of research showing that you cannot out run, out cycle, or out train a poor diet. One can look great on the outside while having clogged arteries.The first sign of trouble may be the last. The modern american diet of processed foods, dairy and animal products has been proven to lead to heart disease and other diseases. As others have mentioned "The Haywire Heart" has great information on electrical issues, A fib etc.

[BobO]

Update, I had a second event on Saturday. This one was not a MI, merely a massive panic attack. There was chest tightness and I came very close to passing out several times. At one point I had trouble breathing. The enzymes were still present but diminished after the actual MI.

I have since learned that a cardiac artery spasm can be brought on by intense emotional stress in people with risk factors, even in those who's arteries are clear.

https://www.mayoclinic.org/diseases-conditions/angina/expert-answers/coronary-artery-spasm/faq-20058316

It appears this is why my otherwise healthy heart had a MI.

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[Louis]

Would anti-anxiety meds help?

[BobO]

Would anti-anxiety meds help?

Seem to.

[BobO]

My doctor has advised me to take another four weeks off of the bike. That means I will be six weeks off total. Prior to the attack I had been in what is solid racing fitness for me. Obviously that's going to diminish to an extent by the time I get back into it. Which, I'd like to try getting back to a race fitness level. There was no heart damage and per the doctors there is no reason I shouldn't expect a full recovery.

The question is, how to go about getting back at it? It seems like it would be unwise to jump right into four hour endurance rides and intervals. Initially my thought would be to do some light Z1-2 spinning on a trainer a few times a week for the first couple of weeks. Then after I've established some confidence start to introduce 60-90 minute rides on the road. After a month or so, if all goes well, I can start a base phase with an eye towards peaking for a fast century in November. Any thoughts?

[tuscanyswe]

I recently completed a 9-week intensive cardiac rehabilitation program (Ornish) following my open-heart surgery. The program was excellent, and I and my fellow participants all showed good to excellent improvement even after such a short time. It is a lifetime lifestyle revision, really, but the effectiveness starts very soon.

The Ornish program comprises four modalities:

Exercise/Fitness
Diet
Communication/Support
Stress Management


The first three modalities are self-explanatory in terms of health benefits. The fourth, Stress Management, consists of gentle (not the weird aggro-television stuff), focused yoga and meditation, min 30 minutes max 60 minutes per day if possible (very hard to do even 30). Fortunately there is no "hippie-ness, dream catching, or "ohhhmmmm"-ing" about it at all...just very relaxed but very focused concentration. "Mindfulness", exactly...that is a term they used over and over.

Long-term studies have shown that while of course the other three modalities are critically important, Stress Management has been the component most responsible for not only cardiac health improvement but actually also reversal of the original (stress-induced) conditions.

I too was a real skeptic at first, and now instead am a believer in the effectiveness of proper stress management/yoga/meditation. Truly relaxing is critical and extremely helpful; it leads to much more energy, to much better sleep, to a healthier heart and mind, etc.
.


Glad you seem to be recouping from this and taking steps to insure a health longterm situation.

Mindfullness is truly a game changer for anyone trying it with an open mind and sticking to it for a while. I still tend to forget just how much better i feel when i do schedule to "relax". Bit weird im not more rigorous about it considering how much better i feel in general from it.

Heal well

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[BobO]

The goal isn't really "some fast century in November" first and foremost, but it can of course be a motivator. The goal is to feel better, and to actually be healthier, tomorrow, and then the day after, and then the day after that. November will come on time or not. If not, there will be another.

Best wishes for a strong and healthy recovery.
.

.

Thanks,

Correct, the goal really isn't doing the century in a PR, the goal is to work towards fitness and re-establish my routine on the bike.

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[BobO]

In my case, reducing the stress may not be all that hard. For the past eighteen months I have been taking on every project that came down the pike and working every day of the week 12-15 hours a day. Once something went sideways it became impossible to manage. This way of living is gone, I'm not doing it anymore.

[Tandem Rider]

In my case, reducing the stress may not be all that hard. For the past eighteen months I have been taking on every project that came down the pike and working every day of the week 12-15 hours a day. Once something went sideways it became impossible to manage. This way of living is gone, I'm not doing it anymore.

This is it right here.

After some life changing discoveries in the last couple of years I had to realize the same hard fact. Nobody on their death bed has ever said "I wish I had worked more and spent less time with my family".

[BobO]

Six months later I was able to do a solid set of intervals, including 20 minutes at more than 290w. It's not fully recovered, but it's a big indication of moving in the right direction. :banana:

[weisan]

Six months later I was able to do a solid set of intervals, including 20 minutes at more than 290w. It's not fully recovered, but it's a big indication of moving in the right direction. :banana:

Nice to hear that, Bob pal....how's the coffee...and the stress? :rolleyes: :p

[Black Dog]

Six months later I was able to do a solid set of intervals, including 20 minutes at more than 290w. It's not fully recovered, but it's a big indication of moving in the right direction. :banana:

Right on Bob. A little better every day.

[BobO]

Nice to hear that, Bob pal....how's the coffee...and the stress? :rolleyes: :p

The coffee is under control. Stress is a process, working hard to learn some tools to cope.

[weisan]

The coffee is under control. Stress is a process, working hard to learn some tools to cope.

Good to hear, Brother! Same here.

[BobO]

Good to hear, Brother! Same here.

For me it's keeping a focus on what really matters, family.

[Dekonick]

Hang in there - just be smart and listen to the doc's. Try to find a cardiologist who rides... or at least does some endurance cardio work. That way they 'get' what you do and can give objective advice, not just medical advice.

I was just put through the ringer myself. Every year we get a comprehensive physical including a (bull**** in my opinion) BRUCE protocol stress test. Well, this year I forgot to skip the coffee 24 hours before exam... and I threw a few extra runs of stuff on my ekg during my stress. Still passed no problem to the NFPA firefighter standard, but off to the cardiologist...

Well, I picked a cardiologist I know from years of working together... and he threw everything at me. No fun. 30 days of ekg monitoring, echo-cardiogram, another ekg, (no coffee this time), and a nuclear stress. Everything short of a catheterization. I tried to get him to cath, he wouldn't do it. Result - I drink too much coffee. Heart is healthy, but when I drink 10 cups or more of coffee and exercise it throws lots of extra premature ectopy... I figured as much. Damn... Now I limit myself to 9 1/2 cups in the morning.

Moral - It is hard to do what we should, even when we know it.

:help:

Best of luck

[Big Dan]

Great news..!!

[wallymann]

wow! makes my 3-4 cups a day look like childs play.


I was at 10-12 up to 15 cups a day.

[redir]

Great news, glad to hear it!

[BobO]

Well, round two complete. Stress induced coronary artery spasm caused MI. Different source of stress this time.

This time doc wants me to go the route of a calcium channel blocker to prevent the stress induced coronary artery spasms. Separate the stress component from the heart attack. It remains to be seen what impact that will have on power and endurance.

[Robot870]

Had a scare a few months ago and definitely changed my ways ! Sry to hear this!

[BobO]

Had a scare a few months ago and definitely changed my ways ! Sry to hear this!

Glad you're ok. It is eye opening when it happens.

[Dekonick]

Did your doctor mention prinzmetal angina or prinzmetal syndrome?

Glad you are O.K. It sucks to have a scare like this but it sure beats the alternative.

Keep us up to date and wishing you the best.

Dek.

https://rarediseases.info.nih.gov/diseases/7465/prinzmetals-variant-angina

[BobO]

Did your doctor mention prinzmetal angina or prinzmetal syndrome?

Glad you are O.K. It sucks to have a scare like this but it sure beats the alternative.

Keep us up to date and wishing you the best.

Dek.

Thanks Dek.

Yes, he says it's Prinzmetal, but, in my case it goes into ST segment elevation and elevated troponin. These are not major heart attacks, but then, there's no little ones. The cycle was broken in the ER with nitro and aspirin.

[Dekonick]

Thanks Dek.

Yes, he says it's Prinzmetal, but, in my case it goes into ST segment elevation and elevated troponin. These are not major heart attacks, but then, there's no little ones. The cycle was broken in the ER with nitro and aspirin.

That was what I was thinking. Sounds like your cardiologist is all over it - you are getting good advice.

For the record, there are some new studies out showing that taking aspirin as few as 3-4 times a month can have a protective effect; I doubt it will make any difference in Prinzmetals, but it can help elsewhere or if you do have stenosis. (sharing for others) Worth asking about.

Cardiologists are great with the heart, but for stress might I suggest a therapist and psychiatrist? Hear me out: There are constant discoveries, etc... No practitioner can stay abreast of every field. Psychiatrists are brain and brain chemistry specialists - Therapists work hand in hand with them to help with a multitude of issues. Therapists work from cognitive and behavioral aspects while the psychiatrists addresses medication support. The two together can help in many ways too complex to get into here... They will probably involve lifestyle changes, diet, you already do the exercise, and some medications. Together they can help reduce your stress. Don't be fooled by Hollywood and the general public view of 'mental health' as everyone has a brain and all brains can benefit from proper advice that is followed and medications when needed to address chemistry tweaking.

When someone says big pharma is bad and then touts xyz oil as a fix, be wary. Sure you can drink St. Johns Wort tea or foxglove tea or chew willow bark... OR you can take a measured, regulated, and known pill form of the active ingredient and not risk overdose by accident. St. John's Wort tea works like a SSRI - common prescribed anti-depressants. Foxglove's active agent is digoxin... prescribed for irregular heart rates... Willow bark - aspirin... Marajuana? Well - there are prescription pills for the active agents too - but you won't hear that from the 'natural' pushers. My point: prescription drugs are not bad. They aren't good. They are controlled - known sources and known doses and known release times. Known metabolism pathways. We know how much tylenol it takes to kill a liver. A mushroom? Tea? Etc?

Given a choice between a known, measured source V.S. something that has the ingredient - but in unknown quantities, I choose USP. Rant over.

Best

D.

[BobO]

Trust me, learning how to handle the source issues are of primary concern. I don't mind using zoloft or the like to help, but identification of the root cause(s) is the goal. Unfortunately, that is not a simple or quick process. I've been all in on dealing with the cause since the first MI. This one caught me by surprise from an unexpected source. Sort of a psychological trip wire. I'll call it a learning experience and move forward with my growth. Definitely with the help of some professionals.

[vav]

had 2.5% body fat. crazy healthy. .

I don't know but I wouldn't call a 2.5 % bf crazy healthy. And the heart of any triathlete or any extreme endurance athlete is also under heavy stress.

[Rpoole8537]

I spent some time studying mindfulness along with my boss. We were managers in a crazy and stressful environment. I recommend Awake At Work. Helped us keep things in perspective. Best of luck in your recovery!