I want to ride again- Neurologist/cardiologist/orthopedist question/diagnosis please.

[Sandy]

Unfortuately, I have done almost no cycling since I bought my new all steel CDA on January 7. I have barely 300 miles in 7 months. A few years ago I rode 5,800 miles, followed by 5,200 the next year, 3,500 the following, much less last year, and almost none this year. Probably a function of the energy/fatigue/depression problem I have.

I miss cycling and the camaraderie very much. I want to ride 50 miles or a metric with a friend from the forum the first week in September. I promised him I would ride for 10 consecutive days to get started. I rode a very easy and slow 25 mile ride with a friend yesterday.

I have medical question for those who might be able to give me some insight into strange symptoms I have had for a couple of days. Quick history- I used to be in superb condition, but the only exercise that I have done in the last several months is to walk my dog every day for several very slow miles and some yard work (he is a superb athlete and shows it off leash in the yard but on walks he moves slowly).

A few days ago, I was carrying some pieces of wood from the back yard to the front to be picked up and one of the pieces had some very short but sharp branches that pinched me a little in the chest as I was carrying them. The next day, maybe unrelated, I was walking my dog and felt a slight discomfort in my right chest area near my breast and armpit. The most amazing thing was that as I felt this very slight discomfort, I felt it simultaneously in the tip of my middle finger on the side opposite the nail. I did not feel it anyplace else. To add to the mystery, if I pushed on that area on the middle finger with my thumb, it would often cause the feeling to simultaneously occur in my right chest area again. So somehow there is a realtionship to the mild chest discomfort and the tip of my middle finger.

I would have zero concern about such except that a close family member had some discomfort (different symptoms) in his chest that were not those normally associated with a heart problem. Turned out that the family member had a siginifcant heart problem on the right side.

Any diagnosis/guess why I should get the symptom of mild discomfort in the chest area near my breast/armpit and in the tip of my middle finger simultaneously, and sometimes by just pushing with my thumb on that place in my middle finger, the feeling will occur simultaneously in my chest??

When I did go on my short ride yesterday, I felt no discomfort when climbing. I did notice that I slow down with application of pressure on that area in my middle finger more so than in my other fingers and I use that portion of my middle finger when I shift into larger gears. But, I have done almost no cycling this year as stated.

Any insight into possible cause of the above, please? Could it be heart related? Symptoms are certainly atypical of such, I assume.

Obviously any suggested diagnosis or whatever is accepted totally as speculation and would produce zero liability on your part.

THANKS. I really want to start cycling again. I need it both physically and emotionally, as I am in poor shape and gained back a lot of the weight I lost when I was cycling last year. I actually was on the lean side.


Sandy

[TACSTS]

When did you last visit your primary care physician? Sounds like you might need just a good thorough physical and workup, to 1) detect a problem if you indeed have an issue so it can be address appropriately, and 2) to clear your mind's worry if you get a clean bill of health.

Good luck and hope you get to feeling like your old self again soon. :)

[Sandy]

It has been well over a year. I did have a thalium stress test several years prior to that and did exceptionally well, but I was in excellent cardiovascular/aerobic condition at that time. but as time passes on and you age, changes do occur.

I appreciate your response. I will go see a doctor, not sure which one first. But I want to start cycling now. My brother, a cardiolgist, puts the odds of a heart problem at less than 10 percent. If there had not been an incident of atypical symptoms of heart disease with an actual family member that turned out to be heart problem, then he would put the probability of the problem being heart realted as below 1 percent. He is conservative. He wants me to take a stress test.


Thank you for your response. I appreciate it.


Sandy

[thwart]

Sandy, start with your primary care doc. He or she is more likely to be aware of the mind-body connection that may play some role in your symptoms.

Hang in there.

[Sandy]

Can never go wrong with starting with your primary care doctor. Mine retired last year. He was an older infectious disease doctor who also practiced general medicine. He is in a group so I can use someone in that group he suggested (if I remember who).

Really quite sure that the symptoms are there and not a mind/body experience in that I am imagining any of it, if that is what you are saying by mind/body connection.

Wait....I think I see the same yellow elephant in the room as yesterday....I must say hello.... :)

Thanks for the advice. Primary care doctor is always a most reasonable start.


Sandy

[hansolo758]

Sandman -- whatever you do, don't ignore it - do have it looked into. Don't assume it's nothing because your can do other things without symptoms. Your primary physician is a good place to start.

[Sandy]

Sandman -- whatever you do, don't ignore it - do have it looked into. Don't assume it's nothing because your can do other things without symptoms. Your primary physician is a good place to start.

Thanks. I appreciate the concern and suggestion. I will make at least one doctor's appointment on Monday.


Sandy

[Lifelover]

I am always amazed how pain in the body can be soothed or worsened with pressure/massage in what would seem to be completely unrelated areas.

It might be interesting to discuss this with an experienced massage therapist or even an acupuncturist.

[Sandy]

I am always amazed how pain in the body can be soothed or worsened with pressure/massage in what would seem to be completely unrelated areas.

It might be interesting to discuss this with an experienced massage therapist or even an acupuncturist.

I went to a beautiful 19 year old massage therapist. Now I don't feel my chest or finger anymore, but I am having severe headaches from being beaten in the head by my wife!! :rolleyes: :)


Stupid Sandy

PS- I might contact Too Tall about that. He would be able to help me on that.Thanks for the suggestion.

[Skrawny]

My brother, a cardiolgist, puts the odds of a heart problem at less than 10 percent. If there had not been an incident of atypical symptoms of heart disease with an actual family member that turned out to be heart problem, then he would put the probability of the problem being heart realted as below 1 percent. He is conservative. He wants me to take a stress test.

I agree with him.
It does not sound at all typical for cardiac chest pain. Many would not even suggest a stress test, but the more conservative ones would.

One of the challanges with doing a stress test with a low pre-test probability is that a positive test (bad) is very likely a "false positive." This is Bayes Theorem (http://betterexplained.com/articles/an-intuitive-and-short-explanation-of-bayes-theorem/) which is a thorn in the side of Drs everywhere, poorly understood by lots of people, and a significant cause of many "doctors don't know what they are talking about" gripes.

-s

[djg]

Sandy

Seems like a weird sort of referred pain, but what do I know? It's nice to see you getting good medical advice on the board -- namely, go ahead and see your primary care doc in person. You're on the north side of 60 right? You've got plenty of good miles left in you, I reckon, but it sounds as if it's been a couple of years or so since you've had a physical. If that's right, that basic backround situation, plus the fact that you've got a few complaints, even if they don't seem severe, plus the fact that you'd like to ramp up your exercise regime, suggest to me that it makes sense that you check in with your doc. I bet it all works out just fine, but picking up the phone and making an appointment seems like the right idea.

Hope to see you out there.

[Skrawny]

Sandy

Seems like a weird sort of referred pain, but what do I know? It's nice to see you getting good medical advice on the board -- namely, go ahead and see your primary care doc in person. You're on the north side of 60 right? You've got plenty of good miles left in you, I reckon, but it sounds as if it's been a couple of years or so since you've had a physical. If that's right, that basic backround situation, plus the fact that you've got a few complaints, even if they don't seem severe, plus the fact that you'd like to ramp up your exercise regime, suggest to me that it makes sense that you check in with your doc. I bet it all works out just fine, but picking up the phone and making an appointment seems like the right idea.

Hope to see you out there.

+1
-s

[Sandy]

Sandy

Seems like a weird sort of referred pain, but what do I know? It's nice to see you getting good medical advice on the board -- namely, go ahead and see your primary care doc in person. You're on the north side of 60 right? You've got plenty of good miles left in you, I reckon, but it sounds as if it's been a couple of years or so since you've had a physical. If that's right, that basic backround situation, plus the fact that you've got a few complaints, even if they don't seem severe, plus the fact that you'd like to ramp up your exercise regime, suggest to me that it makes sense that you check in with your doc. I bet it all works out just fine, but picking up the phone and making an appointment seems like the right idea.

Hope to see you out there.

+2

[Sandy]

Thanks for the additional push. Clearly the only thing that makes sense is to go see a doctor. I will see tomorrow who is available in the not too distant future.

Thanks! Sincerely appreciate it.


Sandy

[Larry]

Sandy,

Well..... amazingly, we are in this dilemma together.

My 16 month old CDA has been standing quietly in the music room.
Chronic chest pain on the left side from 44 years of violin training and teaching. Plus the depression, anxiety thing to boot.

I have an appointment with my primary care doctor tomorrow.
I'll get a physical and a report.

Take care.
Best regards.

Larry in Dallas

[Sandy]

Sandy,

Well..... amazingly, we are in this dilemma together.

My 16 month old CDA has been standing quietly in the music room.
Chronic chest pain on the left side from 44 years of violin training and teaching. Plus the depression, anxiety thing to boot.

I have an appointment with my primary care doctor tomorrow.
I'll get a physical and a report.

Take care.
Best regards.

Larry in Dallas


I mentioned in a post above that cycling is very important to me physically and emotionally. You mention depression and anxiety. Actual cycling does wonders for both- Depression and anxiety. Cycling literally moves you further and further from home which translates into increased confidence, substantially decreased anxiety, less depression, more interpersonal interaction and the signifcant friendships and comaraderie that evolve very naturally through cycling. Cycling produces physical and emotional well being and to let it go is almost foolish unless you replace it with something else of the same power. I have not and apparently you have not either.

Please obtain your test results and move forward positively.

Any time that you can make it, you are welcome to come to the DC area and we will ride. Promise you that. My house is small and full, but I will find you a place to stay.


Sandy

[Bud_E]

Sandy and Larry -

I don't know you personally and I can't contribute any useful advice but FWIW my thoughts are with you and I hope you can put your current troubles behind you very soon. Best luck.

[Larry]

I agree...... physical and emotional well-being from cycling.

If we do not ride, it is obvious that we all need to discover a new,
energy-burning sport. None that I know can replace the cycling fix.
Golf??? Not for me.

What a PROBLEM!

[Larry]

Sandy and Larry -

I don't know you personally and I can't contribute any useful advice but FWIW my thoughts are with you and I hope you can put your current troubles behind you very soon. Best luck.

Thanks, Bud.

But...... I just keep reminding myself of the great experiences in my life.

We all suffer through tough times, but I know that many people deal with more severe problems than I can possibly imagine.
....Life that is unfair and unkind to many that survive on a day to day basis.

[Sandy]

Thanks for the very kind thoughts. My energy/fatigue/depression problem is truly almost inconsequential compared to most who have probelms of that nature. Just difficult for me to get started and to continue doing something I know I want to do and need to do.


Sandy

[Viper]

Sandy,
I hope you see your Dr. asap, get a full scoop on the situation and eliminate any heart related issue. I think it takes a lot of courage to post as you do about energy/fatigue/depression. We've all suffered from lack of energy, fatigue and being sad, acknowledging them and fighting them longterm must be a challenge. As men, we think we are invincible, it's on our DNA, right next to the jackarse strand of DNA. :rolleyes: Keep us posted, there's much more to life than the bike.
Best regards,
Viper
PS. I am a fan of Sandy's, pitbulls, not so much. :)

[Dave B]

Ok boss, keep us updated. What is the deal, what did the doc say?

Clue us in when you find something out. Some of us are very interested in your well being and have too much joy from knowing you.

Dave

[Len J]

Sandy:

Get thee to a dr.

In addition, calibrate your expectations & just get on the bike and ride. Rediscover the freedom, smell the roses, reignite the love.

Len

[Ginger]

No one can ride the bike for you Sandy.


You rode the day before and it was ok. I suspect you're viewing the metric century with dread because you *feel* you aren't prepared and 10 days of forced riding sucks in some ways and doesn't really give you time to recuperate. If you managed 25 yesterday without much problem, you could probably go out and drop the 60. It'd tire you out, but you'd make it to the end. So...right now you have this weird little thing that you need to get checked out. Get it checked out by your doc.
AND get on your bike and ride today. Just a little ride around the neighborhood. Active recovery and all that.

Good luck!

[Ahneida Ride]

Sandy

Get a checkup as soon as possible. Please ....

The bike should be fun. don't set goals. just go out ride and have a
blast.

My Best

[Sandy]

Sandy,
I hope you see your Dr. asap, get a full scoop on the situation and eliminate any heart related issue. I think it takes a lot of courage to post as you do about energy/fatigue/depression. We've all suffered from lack of energy, fatigue and being sad, acknowledging them and fighting them longterm must be a challenge. As men, we think we are invincible, it's on our DNA, right next to the jackarse strand of DNA. :rolleyes: Keep us posted, there's much more to life than the bike.
Best regards,
Viper
PS. I am a fan of Sandy's, pitbulls, not so much. :)

You and I are certainly at opposite ends (not totally) of the continuum relative to pit bulls, and we don't always agree on the forum, but you are a very insightful and highly intelligent person who has a great wealth of content to offer. I genuinely appreciate your very thoughtful post.


Sandy

[Sandy]

Sandy:

Get thee to a dr.

In addition, calibrate your expectations & just get on the bike and ride. Rediscover the freedom, smell the roses, reignite the love.

Len

Thanks. That sentence tells it all so well.


Sandy

[Sandy]

Ok boss, keep us updated. What is the deal, what did the doc say?

Clue us in when you find something out. Some of us are very interested in your well being and have too much joy from knowing you.

Dave

Really appreciate the thought. Sometime we will meet and ride together. Want to meet the rest of the family and see you on that gorgeous Moots ti creation.


Sandy

[Kevan]

Why...in the good ol' days, when you were in shape, I remember you'd drive over to one or another college there in D.C. proper and take to chasing the female freshmen around the quad? Course, you'd have to spend a night in the pokie, but it was worth it; you had such a glint in your eye!

What happened, man? Eye of the tiger, man! Eye of the tiger!

[palincss]

Why...in the good ol' days, when you were in shape, I remember you'd drive over to one or another college there in D.C. proper and take to chasing the female freshmen around the quad? Course, you'd have to spend a night in the pokie, but it was worth it; you had such a glint in your eye!

What happened, man? Eye of the tiger, man! Eye of the tiger!

You two have indeed heard the chimes at mindnight, Master Kevan.

FALSTAFF

Come, I will go drink with you, but I cannot tarry
dinner. I am glad to see you, by my troth, Master Shallow.

SHALLOW

O, Sir John, do you remember since we lay all night
in the windmill in Saint George's field?

FALSTAFF

No more of that, good Master Shallow, no more of that.

SHALLOW

Ha! 'twas a merry night. And is Jane Nightwork alive?

FALSTAFF

She lives, Master Shallow.

SHALLOW

She never could away with me.

FALSTAFF

Never, never; she would always say she could not
abide Master Shallow.

SHALLOW

By the mass, I could anger her to the heart. She
was then a bona-roba. Doth she hold her own well?

FALSTAFF

Old, old, Master Shallow.

SHALLOW

Nay, she must be old; she cannot choose but be old;
certain she's old; and had Robin Nightwork by old
Nightwork before I came to Clement's Inn.

SILENCE

That's fifty-five year ago.

SHALLOW

Ha, cousin Silence, that thou hadst seen that that
this knight and I have seen! Ha, Sir John, said I well?

FALSTAFF

We have heard the chimes at midnight, Master Shallow.

SHALLOW

That we have, that we have, that we have; in faith,
Sir John, we have: our watch-word was 'Hem boys!'
Come, let's to dinner; come, let's to dinner:
Jesus, the days that we have seen! Come, come.

-- 2 Henry IV, Act 3 Scene 2

[Sandy]

No one can ride the bike for you Sandy.


You rode the day before and it was ok. I suspect you're viewing the metric century with dread because you *feel* you aren't prepared and 10 days of forced riding sucks in some ways and doesn't really give you time to recuperate. If you managed 25 yesterday without much problem, you could probably go out and drop the 60. It'd tire you out, but you'd make it to the end. So...right now you have this weird little thing that you need to get checked out. Get it checked out by your doc.
AND get on your bike and ride today. Just a little ride around the neighborhood. Active recovery and all that.

Good luck!

Thanks for your advice and insight. I have two Dr. appointments tomorrow- one with a cardiologist and one with a neurologist. Really don't think there is much of a chance of anything significant, but I am 67 and a sibling had atypical symptoms of hear disease but had a very significant problem.

No fear of trying 50-60 relatively flat miles. Just need to get the impetus to start riding/training.

Thanks!!!!


Sandy

[Sandy]

Why...in the good ol' days, when you were in shape, I remember you'd drive over to one or another college there in D.C. proper and take to chasing the female freshmen around the quad? Course, you'd have to spend a night in the pokie, but it was worth it; you had such a glint in your eye!

What happened, man? Eye of the tiger, man! Eye of the tiger!

Problem is that several years ago, I caught one of the female freshman..... recevied a terrrible beating........traction for a year.......rehab........emotional stress due to being whipped so badly by such a sweet young lady..... :)



Sandy

[Dekonick]

Come visit - I can think of several hills to stress test you...

and as an alternative how about a 50 mile relatively flat spin?

I left you a message on your answering maching a few weeks back...

I'll even drive up to your neck of the woods!

Dek.

[zray67]

After seeing the primary care MD. I would get a referral to an Endocrinologist.

As a layman, I find that cyclists mistreat their bodies by abusing substances - caffine, sugar, simple carbohydrates(pasta, breads).

After, I switched to almost a complete veggie diet and got rid of the above substances my health slowly returned.

Two authors help me in my return to health.

William G, Crook, "The Yeast Connection"
&
Phillip Maffetone's web site, especially, diet and carbohydrate intolerance

For me, what reversed my downward spiral was going vegetarian and giving up coffee(all caffine products) plus sugar and cutting way, way back on simple carbohydrates.

It took a number of years for the substance abuse of my body to effect me. So, it takes a year at least for a return to health.

Best of luck and please keep us updated on your progress.

[Dekonick]

give up caffeine!?!

[djg]

give up caffeine!?!

They can try to come and get it if they think they're up to it.

[Sandy]

Come visit - I can think of several hills to stress test you...

and as an alternative how about a 50 mile relatively flat spin?

I left you a message on your answering maching a few weeks back...

I'll even drive up to your neck of the woods!

Dek.

OK. How about a ride this weekend? Easy one?


Sandy