Sunday Club run to the hills

18-09-23 GH1

After the previous week, I was unsure whether to head out on the hilly ride with the steady green or slightly more ambitious blue.  When I arrived at the start point, there were very few riders, due to the Majorca trip, so the faster riders amalgamated into a blue ride.  I decide to stick with green, in case the pace got a little carried away.

It was a pleasant ride with two new members (actually members of Mansfield Road Club) marred only by one of them doing the slow motion clipped fall twice.  She later went to the hospital, and has to return on Wednesday for a scan. Overall quite slow, but I rode in and out and so made it a nice 45 miler.

18-09-23 green H1

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Weekend rides

Saturday’s ride was intended to be a short trip out to the avenue coking plant site to try the new wetlands path.  This did not take too long so I decided to try out the Five Pits trail, which is close by.  This was good for a few miles, but then I had multiple punctures from thorns left on the trail after hedge maintenance.   While mending the second puncture, I managed to break the Presta valve off the tube with the CO2 pump.  Unfortunately this was at the furthest point from possible rescue.  I had to walk three miles back to Grassmoor.  A costly episode; I was out of pocket for an inner tube, a COpump and three cartridges and a pair of Look cleats.

18-09-15 5pt

When I returned, Strava informed me that I had a 6th and 7th overall on a couple of trail segments, which did not really make up for the experience.

Sunday’s social ride was a very gentle trip out east, so I decided to ride in again.  Unfortunately, I was the only rider expecting a green ride, so my choice was to continue solo or to join the blue ride.

Blue F2 Sep

It was a very windy day, and the first half was mainly a tailwind.  I didn’t lead the group much; I was wary that I had a long ride planned.  Finally, I arrived home after 4 hours. Fifty-nine miles with rest periods at Bolsover waiting for the start, Edwinstowe at the cafe and two unplanned stops at Whaley, first for a dropped chain and then for a puncture (not mine this time)

This was a good ride: I ached a bit, but not too much and bagged the longest ride of the year.  Checking my records later, this was the longest ride since October 2014.  My symptoms started in early 2015 (when I thought I was just getting older and lazier), and diagnosis was a year afterwards in Feb 2016.

Sunday club ride

hardwick sep 18

I have been riding quite a lot recently.  Since my return from Florida I have ridden 17 days out of 25.  I have been feeling good, my heart is behaving and I feel more like a proper cyclist again.  The above is a picture of me from the club social hilly ride.  The route was over rolling hills to the SE of Chesterfield, which I normally use for my flat road rides, with 75 ft of climbing per mile.  The route was quite short, which allowed me to ride in to the start and then back home, and still only do 43 miles.

green h2

It was quite easy, although I bailed before three out of the remaining four riders decided to add one fierce hill in at the end.

 

NHS Heart age questionnaire

The members of the HealthUnlocked AF forum were getting upset about an NHS online questionnaire.

https://healthunlocked.com/afassociation/posts/138841186/more-on-the-%E2%80%9Cheart-age%E2%80%9D-questionnaire

Apparently the majority were given a Heart Age of 95 with an imminent stroke.

heart age.png

My figures seem better than most: heart age 60 (I am 55) with stroke or heart attack at 78. Not sure why I am different, but relatively low blood pressure/cholesterol and a BMI of 25.2 could be the reason.  The two bits of advice for me are to lower BP to below 120 (currently 123) and BMI to below 25.  If I could manage this I could reduce my heart age to 59, but would still be heading for a stroke or heart attack at 78.  I am now back to regular exercise and hope to drop a few Kg, but this questionnaire seems to suggest that it is not really worth the effort.

Ten years ago, I was invited into the GP’s surgery for a medical assessment; just blood pressure and a health questionnaire. I was given a heart age then of 50; I was very disappointed, given my level of fitness, I thought that my heart age should be the same as or even less than my real age. The nurse reassured me, saying that a heart age of 50 was the lowest she had seen in a 45 year old (in that surgery; I was living in a borderline social deprivation area). Her recommendation was to continue doing exactly what I was doing at the time. Ironic, as the exercise I was doing is what caused my AF.

Ten years on, my heart age is only ten years older. Strange given the AF diagnosis, two ablations, and a year of medication including bisoprolol, amiodarone and rivaroxaban. I would have expected that kind of rough treatment to age it considerably more.

I suspect the calculations from either of those questionnaires have little basis in reality on an individual basis.

 

 

Return to club riding

This was a long overdue return to riding in a group.  I didn’t want to impose on one of the faster groups by potentially slowing them down, so I selected the “Green” social ride.  Unfortunately, only two other Green riders were out that day: Dave, who was also returning from injury and Zoe, of a local bike accessories manufacturer.  We had a steady ride around the local flatlands, with a visit to a cafe for a heart friendly bacon sandwich, and managed to hit the max average ride speed of 14 mph exactly.

group ride strava

An enjoyable day all told.  I should be back again next week.

return

A couple of spikes in HR

I have had two rides recently where the Garmin has recorded a momentary spike in HR.  The first was on a relatively steady ride on the canal, with a low average HR with a sudden spike up to 171, for less than a second.  I decided this was just a faulty reading, from static or a loose jersey.  The second was at the velodrome.  I had decided to return and retake my accreditation session.  My licence to use the velodrome had expired due to my time away.  This was a much more active ride; the tests are designed to simulate race activities.  I am allowed to use the Garmin to record, but it can’t be placed on the bars where I can see it.  I set it to alarm at 163 and informed the coach that I may leave the exercises if it alarmed.  I was relieved that it did not alarm even in the sprint simulations.  However at the end of the session, I reviewed the HR trace, and it seems that my max was 201, although it was too short for the graph to display it.  I am now not sure whether this was jersey related or whether I have recorded some momentary flutter.

So, I now have another thing to keep under review.  I will probably keep away from the velodrome until I am sure the spikes are not a problem.  Yesterday, I tried a road ride, not too arduous, but with a little bit of climbing.  I was watching the HR all the way round and saw no problems.  A total of 34 miles at 16.1 mph, which pleased me.

Florida

I have just had a two week holiday in Florida, with another family; four adults and three teenagers in one villa.  This was not my idea, but my partner chose for her 50th, so pretty non-negotiable.  The focus was on theme parks, which meant the holiday was to be based around a hot and humid atmosphere, high fat food, alcoholic temptations and attractions that all advertised their unsuitability for those with heart issues.

I was cautious, but prepared to join in and try the rides (as opposed to waiting in the sunshine while the rest of them queued).  This was not a major problem; I don’t find rides scary and they do not raise my heart rate.

I was generally well behaved, not too much running about, keeping well hydrated, wearing a hat and covering myself liberally with factor 50, I was also trying alcohol; not too much, just one or two bottles in the evening

I took my Kardia and was doing regular tests.  I was quite pleased to find that the holiday was having no effect.  One day however, this was not the case, I had lots of ectopics and a diagnosis of “Possible AF” (I don’t think it was AF, I just think the sheer number of ectopics confused the software).  The only difference in what I had done this day was caffeine.  I had a large coffee at lunch with a free refill.  Later we visited Starbucks and I had a medium cappuccino.  One of the kids came out with two frozen drinks; they had made one for her with several shots of espresso.  She had pointed out that this was wrong, they made her a new coffee-free one and allowed her to keep the mistake.  She passed it to me and it was so refreshing that I drank three-quarters of it.   My cardiologist had told me a year previously that coffee was not a trigger and that I could drink it with no problem. This particular day, I discovered that this was not true.  It took me two coffee-free days to recover fully.

I am now back in the UK and completely back to normal, except that my resting Heart rate is five beats above what it was before the holiday.

Period of calm

Things have settled down recently.  Since the ablations last year, I have had a few periods of AF, other arrhythmias or ectopics; for some of these there has been a possible trigger.

After the mini-maze on 7th April  I had a wobbly heartbeat for a few days, but have largely been in sinus rhythm ever since.

I had one day of AF after a very stressful work day on 16th May, but the cardiologist was unconcerned.

I noticed an excessive amount of ectopics on 15-16th August for no apparent reason, again the cardiologist was happy with this.

I experienced a lot of ectopics after coming off the Bisoprolol in the middle of November, which carried through on to 24th December.  I had one alcoholic drink (1½ units) on two occasions 12th and 17th December; these seemed to have no effect.  In fact I had several drinks on 21st December and the ectopics disappeared completely.   I was so pleased with this, I got a little carried away on New Year’s Eve, and woke up to a Kardia reading of possible AF, which returned to sinus rhythm with a few ectopics later in the morning.  I reduced my intake to almost nothing and by the middle of January I was experiencing no ectopics.

On 15th April, I had a Kardia reading of possible AF; this was while in the hospital visiting my very sick mother, so stress possibly a factor again.  I actually thought the trace looked more like ectopics, there was a visible p-wave and overall the trace was relatively consistent in rate.  There were similar one-off traces over the next few days.

My heart then behaved itself until the end of May, surprisingly including the period of the death of my mother.  Over the second bank holiday weekend in May, I had drunk a little over the limit and may have been rewarded for this with some very strange readings, which settled down fairly quickly.  Similar readings showing quite a lot of baseline noise continued until 10th June. I also had very bad indigestion through this period, so it was possibly due to a virus.  Since then things have been fine.  And my resting pulse has been returning towards something normal, 63 last night.

Throughout this period I have continued cycling steadily, I don’t believe that exercise has had any causality in my arrhythmic events.  I am starting to lose the weight I put on over the last two years, but still have another kilo to lose to get to a BMI below 25 (5Kg to get to full fitness; the weight I was in 2015).

There isn’t a clear correlation of my experience of ectopics, arrhythmias and noisy ECG traces with alcohol consumption, stress, exercise or anything else.  I have given up looking for triggers or patterns and have decided to just continue to live in relative moderation.  Following alcohol guidance, changing work patterns to avoid stress and maintaining exercise at predominantly at zone 1-2, with occasional peaks to the top of zone 3 (HR 163)  I am much slower than previously, but getting faster within these parameters as I return to fitness, but I am still cautious as I don’t want to risk reverting back to AF.

Back to the Peak

The heartburn subsided gradually, and I suspect that it was a bug of some kind rather than a health issue.  The kardia readings have also settled down, but I am still taking regular readings to check.

I have been steadily increasing the exercise while maintaining an HR of less than 165.  My last three rides have been hilly ones (60, 92 and 94 ft of climbing per mile) in the Peak District.  I am a little slower than a couple of years ago and I am regularly spinning in gears that were once reserved for serious climbs only, but I am beginning to feel like a real cyclist again.

Heartburn

I have become obsessive in my Kardia ECG testing recently; I have only had one spurious reading in spite of regular testing, although there has been the occasional ectopic.  I am still not 100% sure it is not a problem, but my blood pressure is good, my rhythm fine and general fitness improving.

I do have one new health problem: indigestion.  This is not exactly new, I have had reflux issues twice before: once in 1998 when I let my fitness lapse a little and again in 2008 when I had a gall bladder infection.  It seems my 10 years anniversary was due.  The latest occurrence started a few days ago with reflux but there was no obvious trigger.  It has now decreased in intensity and is affecting my left shoulder.  It is definitely not heart related; it only hurts when I breathe in or sneeze.  This is not good for hay fever season, and I do not want to take anti-histamines in case they awaken my sleeping AF.

I will give it until after the weekend and then seek medical advice if it hasn’t cleared.