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Enero 28, 2008
Memoir - Chapter 5: The Doctor
Note: This is part of a larger series. Start here to read the whole thing.
I went back to the Cardiologist in early November. This is a letter I wrote to my friends and family after that visit:
I wanted to write in some more detail this afternoon about my discussion with the doctor on Friday. This was the first time I had been back to see him since I left the hospital. Naturally I had lots of questions, and mostly what I got was good news. Let me tell you about it.
In the hospital Dr Salerno had found a cardiomyopathy –and in my research, all the athletes that die on the field suffer from what is called hypotrophic cardiomyopathy. (Essentially a thickening of the heart muscle, or enlargement of the heart). The marathon runner that died at 5 miles of the Olympic trials two weeks ago suffered from this. Well that is not me! Mine is a dilated cardiomyopathy, which means my heart doesn’t pump out completely. And it is a mild case. Now less is known about this case, including exactly what causes it, and whether there is prognosis toward it getting worse. However there is treatment, toward ultimately correcting the issue – and that is the medication I am on.
Another unknown is whether this is familial – or genetic. Doctor Salerno does not think I need to be concerned about my kids at this point. We will continue to watch my EKG to see if abnormalities persist that could be found easily in them. But my concern for them has greatly eased.
We then turned to lifestyle, and to exercise. I had accepted that high intensity exertion was not in my future at this point. The defibrillator I now have would interpret high intensity as arrhythmia and try to shock me out of it. But I asked Doctor Salerno if there was risk of long duration low intensity work. Frankly – this is the sort of activity I have enjoyed. I am not a sprinter or a racer – I enjoy the long ride at lower intensity. He cautioned me that electrolyte imbalance can bring on the arrhythmia that I suffered on October 6. I knew that, and will be much more careful with hydration and nutrition during rides. But when I asked if long duration would affect the cardiomyopathy he said he did not think so. There is no definitive knowledge here (no long term studies, etc).
Then Dr Salerno told me to go back to cycling. But to take it slow, to be careful with keeping my heart rate under 75% of max and to pay attention to what my body is saying to me. He told me about other patients who have continued active lifestyles combining their running with the monitoring of heart condition.
As you may imagine this is huge news for me. I celebrated this afternoon by heading out to the hills of missionary ridge for my first hour on the bike since that Saturday. It felt great to rush down and power up the hills. I monitored my heart rate after climbs, and recognized that I was pushing too hard. I will probably invest in a monitor to alert me constantly. But after an hour I felt great. I don’t think I’ll be doing centuries again, but I certainly am going to enjoy riding. Friends asked Marialice if she was worried about my return to the bike. She has seen how much I love and enjoy riding, and has been hugely supportive. Her joy with me has been a great thing. (so these friends said they would worry for her…).
All this good news comes in the midst of the darker reality. I did suffer a major cardiac incident. I did almost die. I have been diagnosed with a condition that in serious cases requires heart transplants. I am forced to depend on the technology of a defibrillator. In the midst of a very strong moment of my life this weakness has been exposed. All these things have emotional impact that I am slowly unpacking. But tonight, the emotion is gratitude. I’m happy to have flown down the back of Shallowford road and then climbed back up the hills to our house. I’m happy to hug my wife and walk with my kids. I’m happy to listen to a soccer game and look forward to good work tomorrow. God has been good, and I am grateful.
Sincerely
Rob.
| By rob | 10:10 AM
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