Cardiac Rehab questions

[old goat]

I shouldn't read this thread anymore

Goat sounds like a doctor the problem is I sit there and it all sounds like wha wha wha in the adult voices on charlie brown

Hate that sick to my stomach feeling and blurred confusion fainting

Hary, it's a lot to take in but you will be fine, seriously, eat right, exercise, and maintain a positive perspective. OG couldn't have explained things in anymore of a basic clear right to the point way.

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Thank you. It's fun to be able to spew all the stuff I never had time for when I was practicing. I think I've spent more time with Harry than with any of my real life patients outside of the operating room. I try to make it understandable for a non-medical person but it's a long time since I've been one so I cross the line sometimes. I'm happy to clarify anything I've said, in line or by PM. Because you guys can't sue me. I think.

A lot of the patients that were referred to me, the biggest thing I could do for them was tell them it was going to be ok. And it really sucked when I couldn't tell them that. And believe me, I know the fear from the patient's side. When I was looking at heart surgery I was terrified not so much of dying but of being left a vegetable or some other lower life form, of spending weeks on a ventilator, or of serious brain damage. I had a fantastic surgeon and once I had met him it helped a lot the way he talked to me. (He came to Kaiser Sacramento from Texas Heart. Lucky break for me.)

I'll shut up now.

[PB]

No shutting up allowed; keep up the spot on informationing.

[tgapp]

No shutting up allowed; keep up the spot on informationing.

Yeah OG I love this knowledge you're dropping on us. Keep it up.

And Harry - sending lots of good vibes your way. Wish I could do more to help.

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[Harry]

And Harry - sending lots of good vibes your way. Wish I could do more to help.

Need more coffee, do you still have my address ?



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[tgapp]

Need more coffee, do you still have my address ?



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Lol I can look and find it, but that's an easy request to accommodate. Ground or unground? Similar to last time or wanna try something new?

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[Harry]

Get jiggy with it. Something new as long as it has a story behind it. Mom loved having me read to her about what mountain in Africa that coffee was grown on and what family harvested it. Maybe shrunken head coffee from Indonesia, harvested by cannibals ?

Whole beans, I brought my grinder from Montana and put it in Mom’s pantry.


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[tgapp]

Get jiggy with it. Something new as long as it has a story behind it. Mom loved having me read to her about what mountain in Africa that coffee was grown on and what family harvested it. Maybe shrunken head coffee from Indonesia, harvested by cannibals ?

Whole beans, I brought my grinder from Montana and put it in Mom’s pantry.


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I think you want the one that comes out of the monkeys butthole

And as long as Doc OG is good with it, of course. Don't wanna be the jong that killed harry after all.

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[old goat]

I'm no expert on the medical aspects of coffee. I'll just link to the Mayo Clinic.
https://www.mayoclinic.org/healthy-l...e/art-20045678

[Harry]

Paging Doctor Old Goat,

I think I fuct up today. Feeling great, so I upped the speed, time, & distance of my rehab today.

Did 30 minutes of brisk walking at a 4mph pace. Heart rate was 65 to start, got up to 110 and stayed there. Also O2 sat got up to 98, highest I’ve seen it in 10 years of monitoring. After 20 minutes started sweating heavily but still feeling real strong so continued on to 30 minutes. Came inside and sat down feeling euphoric. HR came down from 110 to 90 in 5 minutes, 75 at 10 minutes, and back to 65 at 15 minutes. O2 slowly came down to 95. Ate a salad and an apple. Read a chapter of a book, went to my bedroom and took a 90 minute nap.

Fast forward to this evening, I feel like a ran a marathon. I am exhausted. Part of me says this is just getting my heart back in shape, part me says I fucked up and way overdid it. Any advice ?

Related question: is it possible for the stent to come loose if I overdue it ? I am somewhat paranoid about that happening.

Goal = I am going to the Jackson Gathering in January. Want to be in Best Skier On The Mountain shape by then. Not dead.


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[grinch]

Youre scaring me Harry. I'd strongly recommend not rushing or overdoing it and build with consistency. With any training program that will make it easier to not burn out, overtrain, injure and just way more enjoyable and fun. The later , fun and enjoyment, is key to any training program. A pro athlete may start their program in the off season with the first week only containing a couple hours of training and its generally anything but their sport theyre actually training for. It promotes freshness. Keeping it fun so you dont get burnt out. They build slow and steady over a 5-6 week macro cycle maybe adding 15 minutes/week followed by 3-4 days off with light walks then 3 week macrocycles. The following macrocycle the 2nd week would be similar to the final week of the previous macrocycle. Rest is key and always an option. Light consistency is better than overdoing it. I wouldnt even think about harder efforts 80% of max heart rate for 4 months and probably less than 70or 75% for atleast a couple months.
That will pay dividends when it comes time to push because you'll recover faster and better after efforts. Teaches your body to burn fats and conserve sugars more efficiently for when you need them and you dont go into oxygen debt. You definitely want to stay below your anerobic threshold. Above that is hard to recover without adequate fitness and probably risky atm or atleat until you up to dpeed on things. Off season for cycling i didnt go above anerobic threshold until sometime in february and that was starting my program in oct. When it came time to push the pedals in late march or april i couldnt wait. I was ready willing and able to pull my self inside out by then and it felt great because i wasnt burnt out. Just endurance pace workouts and for oct nov and into dec anything put cycling, then just endurance pace(zone2) workouts spinning until lat feb. All about keeping it fresh and avoiding burnout. I would take my resting hr every morning when i woke. If it was elevated more than 5beats/minute it meant a rest day walk or something light. I had to get up and pee first and go back to bed and semi daze to take resting hr. If your holding a wizz it elevates your resting hr.
Id think youd want to be in zone 1 for a month or so and then settle into zone 2 and stay there. Youll gain the speed and power(zone3/4) when your doing your thing on skis after a lengthy endurance zone base. Zone 1 is great after an injury(55-65%max hr). Zone 2 is key to a fitness base to work everything else off of(65-75%). Zone 2 is endurance pace and i generally describe it as the point where you have a light sweat but can still carry a conversation. Your max hr is roughly calculated at 220 minus your age. Eg if someone was 60 yrs old their max hr is roughly 160(not recomended to go there) so zone 1 would be roughly 90ish beats/minute. Its amazing how fun the sports we do are with a huge endurance base. You may not have your top speed initially but youll recover quick to do it again and not be blown. You just stay smiling
This has a decent description
https://www.myprocoach.net/calculators/hr-zones/

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[Harry]

Youre scaring me Harry.

I definitely fucked up. Pride and vanity. I feel like a chump slowly walking, the other day I was at 90 bpm going 3 mph I was embarrassed to be seen going so slow. In hindsight, I should probably just do that for a week or two. I will definitely sleep well tonight, I am worn out. From a 30 minute walk…

My pulse is strong and steady, no chest pain. So hopefully I will be OK. I just ate a gummy. MMJ Card, so it is Doctor approved. Sort of..



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[grinch]

I definitely fucked up. Pride and vanity. I feel like a chump slowly walking, the other day I was at 90 bpm going 3 mph I was embarrassed to be seen going so slow. In hindsight, I should probably just do that for a week or two. I will definitely sleep well tonight, I am worn out. From a 30 minute walk…

My pulse is strong and steady, no chest pain. So hopefully I will be OK. I just ate a gummy. MMJ Card, so it is Doctor approved. Sort of..



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Haa we've all been there. I could never stick with my program as a young buck. Always overtrained especially if a rest day was sunny, no chznce. Now ive seen the enjoyment of endurance pace either after the ride/ski or the next day. Now i just occasionslly do too many days or hours but at endurance pace. Its obvious then and one day off is all it takes to get back out. Ill bet youll be make relatively quick gains just staying at zone 1 and have piece of mind knowing you can be safe and know youre building. One day on one day off can be good for the early days of a program. Then you get a complete recovery before you step out again. If youre worried youre not doing enough it can be good to keep a log then you can look back and build by smaller amounts. It takes 10ish days to lose noticeable fitness so i wouldnt be worried about a day off. That can be beneficial. Its ez to train hard but hard to train ez for us consumate overtrainers. Rest is key

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[phatboy64]

I was diagnosed with afib a few years back. My cardiologist told me about these. They are great. Medical grade ekg and you can save the outputs and share with your dr. Best $150.00 I have spent

https://www.kardia.com/kardiamobile6l/

[Harry]

Feeling good today, but can tell I got a workout yesterday. Can’t believe a 30 minute walk kicked my ass.


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[TBS]

Hoping for the best with the recovery Harry.

On the Lipitor - may want to check with your doc. Generic Atorvastatin is waaayyy cheaper and as explained to me, the exact same compound.

(My cardiologist is big on plant based diet. I try to eat a plant based meal at least once a month. Try to do better than that.)

I think you would like The Cowboy Dinner Tree in Silver Lake OR.
They have two entrees- 32oz steak or half a chicken.
The vegetarian entre is the steak - because cows eat grass

[Dantheman]

And as long as Doc OG is good with it, of course. Don't wanna be the jong that killed harry after all.

My IANAD recommendation would be for Harry to add 200-250 mg (~1/8 tsp) of L-Theanine powder to his coffee (contingent upon discussion with and approval by his cardiologist). There's strong clinical evidence that combining L-theanine with caffeine counteracts caffeine-induced increases in blood pressure. More broadly, it also seems to reduce BP spikes in response to stressful tasks and situations, and promotes relaxation without sedation.

References:
https://pubmed.ncbi.nlm.nih.gov/17891480/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3518171/
https://examine.com/supplements/theanine/

https://www.bulksupplements.com/products/l-theanine


eta: I'd also recommend supplementation with glycine (https://examine.com/supplements/glyc...ascular-health)

[Harry]

Hoping for the best with the recovery Harry.

On the Lipitor - may want to check with your doc. Generic Atorvastatin is waaayyy cheaper and as explained to me, the exact same compound.

Yes, all my prescriptions are Generic versions. I just used the brand names in my post upthread to make it EZ to read.



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[abraham]

I was diagnosed with afib a few years back. My cardiologist told me about these. They are great. Medical grade ekg and you can save the outputs and share with your dr. Best $150.00 I have spent

https://www.kardia.com/kardiamobile6l/

Thanks, passed that on to my dad. Do you use the subscription? I'm not sure I understand the difference between the two models offered. Did you look at both options?

[old goat]

Paging Doctor Old Goat,

I think I fuct up today. Feeling great, so I upped the speed, time, & distance of my rehab today.

Did 30 minutes of brisk walking at a 4mph pace. Heart rate was 65 to start, got up to 110 and stayed there. Also O2 sat got up to 98, highest I’ve seen it in 10 years of monitoring. After 20 minutes started sweating heavily but still feeling real strong so continued on to 30 minutes. Came inside and sat down feeling euphoric. HR came down from 110 to 90 in 5 minutes, 75 at 10 minutes, and back to 65 at 15 minutes. O2 slowly came down to 95. Ate a salad and an apple. Read a chapter of a book, went to my bedroom and took a 90 minute nap.

Fast forward to this evening, I feel like a ran a marathon. I am exhausted. Part of me says this is just getting my heart back in shape, part me says I fucked up and way overdid it. Any advice ?

Related question: is it possible for the stent to come loose if I overdue it ? I am somewhat paranoid about that happening.

Goal = I am going to the Jackson Gathering in January. Want to be in Best Skier On The Mountain shape by then. Not dead.


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Doesn't sound like you did any harm. You're getting back in shape. Dial back the speed next time. When that no longer tires you increase it again.
It sounds like it's your overall fitness that was stressed, not your heart.
Walking 4MPH is booking it. (Do the young people still say that.)
No, the stent won't come loose.
No, you will not be in Best Skier On The Mountain shape by January. Or dead.

[phatboy64]

Thanks, passed that on to my dad. Do you use the subscription? I'm not sure I understand the difference between the two models offered. Did you look at both options?

I don’t use the subscription. If needed Ijust email any ekg to my Dr directly from the app.

The 6l is comparable with a 6 lead ekg so it is a more in-depth ekg we’re the other is a comparable to only a 2 lead ekg.

For the extra ~$50.00 the 6l is worth it.

[old goat]

Harry, I'm jealous you can get your HR over 100.

[Talisman]

Harry, I'm jealous you can get your HR over 100.

Harry went to jump school at Ft Benning so it takes a lot to get his HR into triple digits.

[Harry]

Been doing 30 minutes walking, at slow pace, for the past 3 days. HR about 90. Feeling good.


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[fastfred]

Thank you. It's fun to be able to spew all the stuff I never had time for when I was practicing. I think I've spent more time with Harry than with any of my real life patients outside of the operating room. I try to make it understandable for a non-medical person but it's a long time since I've been one so I cross the line sometimes. I'm happy to clarify anything I've said, in line or by PM. Because you guys can't sue me. I think.

A lot of the patients that were referred to me, the biggest thing I could do for them was tell them it was going to be ok. And it really sucked when I couldn't tell them that. And believe me, I know the fear from the patient's side. When I was looking at heart surgery I was terrified not so much of dying but of being left a vegetable or some other lower life form, of spending weeks on a ventilator, or of serious brain damage. I had a fantastic surgeon and once I had met him it helped a lot the way he talked to me. (He came to Kaiser Sacramento from Texas Heart. Lucky break for me.)

I'll shut up now.

no need to shut up spew on

the vegetable things is real at least in my head I go through fazes mostly after a bunch of stellar bad news where I'm scared to fall asleep cause I might not wake up
time to get all the living will and will and trust or whatever all those reams of paper work together pretty sober to do but the end result and hope is that the hospital follows the directive and pulls the plug mine is pretty specific and it says pull the plug bitches

there was some old dude in my cardiac rehab retired heart surgeon living in vail guy was skiing at least a 100 days a year up until they had to cracked him open he was looking forward the next season

[old goat]

no need to shut up spew on

the vegetable things is real at least in my head I go through fazes mostly after a bunch of stellar bad news where I'm scared to fall asleep cause I might not wake up
time to get all the living will and will and trust or whatever all those reams of paper work together pretty sober to do but the end result and hope is that the hospital follows the directive and pulls the plug mine is pretty specific and it says pull the plug bitches

there was some old dude in my cardiac rehab retired heart surgeon living in vail guy was skiing at least a 100 days a year up until they had to cracked him open he was looking forward the next season

When you do the living will make sure you specify no tube feedings. That's how they keep vegetables alive.

When my son was training for ski patrol, the first day he was certified to work without supervision his first call was an older guy who had tumbled down a steep double black into a tree. According to his friend he didn't seem to be moving voluntarily as he fell. When they cut open his clothes to do CPR there was a big heart surgery scar on his chest, so hopefully he was already dead before he hit that tree, because I can testify that hitting a tree doesn't feel good.