Tag Archives: Cardiac Rehabilitation

Ride Like A Pro… in my dreams!

Today I had an opportunity to “Ride like a Pro”, a cycling event sponsored by Jaguar UK and Team Sky. I was one of about 40 fellow MAMILs that assembled at our local Jaguar Garage. To be honest it was an intimidating group. As everyone casually milled around waiting for the “Grand Depart” you could tell they were sizing each other up and assessing each other’s equipment. It was all very light-hearted as we finally set off, formed a peloton and headed into the countryside.

Initially we all stayed together. It was great to cycle as part of a large group; it’s something I don’t get the chance to do very often. I managed to stay in the pack for the first 18 miles or so. I had to work hard to keep up as we were occasionally strung out, negotiating roundabouts and other traffic furniture, but I stayed in the group.

However, it all changed rather quickly when we hit the start of the first climb of the day…

Although I hadn’t cycled it before I was very familiar with the road we were on; it forms part of one of my regular routes but I have always ridden it in the opposite direction. As a result, I knew the hill was the first of several climbs that would come in quick succession. From the other direction it’s a fantastic descent (in fact, it’s the one that featured in my Foul Mouthed Cyclist post) but I knew that any attempts to keep up would be short-lived, and could potentially wipe me out for the rest of the day.

It appeared that many of the other members of the peloton had been cycling well within themselves. They were being polite, cycling in formation, biding their time. The first stiff hill was what they’d been waiting for! I drifted back through the pack very quickly; officially dropped!

I wasn’t the only one. Four or five of us negotiated the hills independently; oblivious to what was occurring ahead or behind. It was a bit of a reality check for me.

A drinks stop provided a bit of respite and allowed us to momentarily re-form a group (technically “re-join” as I think most people had managed to stay together). It was a brief moment. The gloves were off. At the first opportunity, the group took off again. I had managed to keep up for a few miles. Many hadn’t.

I found myself on the road alone. There were people up ahead and people behind, but I didn’t see another cyclist for over 10 miles. To be honest, I thought I’d taken the wrong route but I was on a familiar road with a fair wind behind me so I just kept plugging away.

An impromptu stop about 10 miles from home saw the whole thing repeat itself. However, it did confirm (1) that I was on the right route and (2) that I would pass my house to complete the ride before turning around and heading home again (while cycling along on my own, thinking I had taken a wrong turn the thought of heading directly home had briefly entered my mind).

We didn’t see much of the Team Sky support car during the ride. It led us out of the garage and for the first mile or so, but having let us pass so it could bring up the rear it must have dropped a long way behind to deal with some stragglers or mechanical issues.

Apparently it then had to set off in search of a couple of riders that had taken a wrong turning, last seen heading in the wrong direction, into deepest, darkest Aberdeenshire. I would have loved to have been able to raise my hand and be “attended to” but I guess it’ll have to wait for another time.

Overall, the ride was a different level of intensity than I’ve been used to. I was very tired when I got home, but I’m sure it’ll do me a lot of good. It was the type of experience that I wouldn’t want to repeat tomorrow, but next week would be just fine.

***

Despite today’s reality check, I’m keen to keep building on the foundation I’ve established. I have to remind myself that it was just under a year ago that I did my first post-Heart Attack ride: On 18^th August 2013 I managed to cycle 20km in 50 minutes along the railway line from Duthie Park to Milltimber and back. Perhaps in a couple of years I’ll be able to put the pressure on when we hit a hill!

Cruising

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It’s not often that you get a chance to see into the future. The long term impact of exercise and healthy living can be hard to quantify. Conversely, it can be hard to understand the potential negative effects of poor life choices.

I have friends whose lifestyles have been heavily influenced by their parents prematurely suffering with poor health. I am lucky in that my parents and in-laws are all fit and healthy, able to make the most of the opportunities the “Third Age” offers them. They are reaping the benefits of an active lifestyle in which treats are still considered a treat and excess reserved for special occasions and grand-children.

You could argue that having a Heart Attack should have been enough to open my eyes; after all it could have killed me. To a degree this is correct. However, death wasn’t necessarily the worst-case scenario, not for me at least. Long term incapacitation would have been worse, my quality of life could have been compromised, and with it those around me that I care about most. I was lucky.

The Island Escape… it’s not much but we like to call it home.

I am now four days into my first all-inclusive cruise, and it’s really helped bring things into focus. A little close personal observation (nosiness!) has provided a unique opportunity to see both the negative impacts and some of the underlying choices that have may have contributed to them.

The passengers on the cruise are a different demographic than on our holidays to date; they are primarily couples and slightly older. One of the overwhelming features is a lack of mobility; knee bandages and walking sticks are essential travel companions for many. The general level of fitness appears to be extremely low with some of the physiques having been “carefully nurtured” over an extended period of time.

Even Cardiac Rehabilitation didn’t give me such a powerful insight; I was aware that only a small fraction of people take up the opportunity to participate in rehab. That means that the majority are either unwilling or unable to attend, presumably choosing instead to rely on medication and / or luck for their recovery and future wellbeing. I suspect some of the non-participants might also be on-board!

It’s scary… scary for the individuals who seem to be struggling to perform basic everyday activities.* It’s also scary that until recently I was also on that course.

Fortunately everyone seems to be mobile enough to take full advantage of the “all-inclusive” part of the cruise… if you are unable to carry your plate or glass there always a helpful member of staff to assist. Ironically, the only constraint I’ve discovered is on the Cardiac Setting in the gym… limited to 5 minutes… for health reasons presumably!

***

* I appreciate not everyone has a completely free choice, but most of us are fortunate enough to have at least some level of influence over our physical well-being even though it may frustratingly diminish over time. I also appreciate that I am very lucky to have more choice than most having received my “wake up call” so early!

Lucky (Part 2)

Back to normal

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After the excitement of last week, the past few days have been all about settling back into everyday life. Any concerns about coming back to earth with a bump have alleviated. Instead, the whole event has left me somehow feeling a bit more “normal”. It’s really good to be home!

The Euro City Cycle (ECC) had become a very big deal for me. Understandable I guess given I’ve been working towards it throughout the winter. I signed up for it early in my rehabilitation, it was a real “stretch goal”.

At that time, no one really knew what I would be physically capable of, now or ever, so it was a bit of a risk. Not being able to complete it (or more likely, start it) would have been a real blow, and could potentially have caused a major re-think of life post Heart Attack.

My favourite selfie from the ECC

From my perspective, the level of risk has reduced with every mile I’ve cycled over the past 10 months. I’ve been confident over the past couple of months, but it was great to back up that confidence with a strong ride, and a quick recovery. I was fine throughout the event and have had no ill effects subsequently.

Having arrived in Brussels I had a couple of days rest. Time for my legs to recover, to warm up and dry off after the final days of the ECC. A sniffle flirted with me for a couple of days, but I managed to fight it off.

Someone else’s selfie caught me taking mine!

Getting back on the bike was interesting. It’s amazing how much more comfortable I am on it having been inseparable for four days. Just spending time together has made a big difference, it feels natural again, like it did when I was a kid. The key thing now is not to get complacent, particularly as I’m back on the roads rather than having the luxury of dedicated cycle routes.

The cycling routes on the continent were something else!

The biggest relief, perhaps, is that I’ve got the London to Brighton bike ride to look forward to in mid-June. This will give me a continued focus, a reason to keep going out on the bike and keep myself in shape.

The ECC was a journey within a journey. Fortunately it was a successful one. It marks the end of an important phase of my life, and the beginning of a new one. No time to stand still!

ECC Day 3: Why are we here?

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Why are we here? This isn’t intended to be a grand philosophical question, but some days you have to ask yourself why you’re doing what you’re doing. Some days everything seems to be against you. Today was one of those days.

The Day 3 route promised to be long; the longest of the Euro City Cycle. It was further than many of the participants (including myself) had done before. As well as being long, the route was complicated, circuitous and fiddly. It required navigation through the backstreets of towns and travel across several bodies of water by various means.

As it happened, the weather also conspired to make the day even more challenging. It had been suggested that it would be wet throughout; wet and windy… joy! So it was with some trepidation that we set out to make our way from Hoofddorp to Breda.

Time to cover up… here comes the rain (again)!

Each participant has their own unique reasons for participating in the challenge. As we battled against the elements, driving rain and near gale force winds, it would not have been unreasonable for some of us to question why we’re here. It wouldn’t have been a surprise is some of the group decided that catching a lift in the support van was a sensible move.

Every time we crossed open ground the elements seemed to re-double their efforts to make the day difficult, to make us miserable. We slowly made our way along the route, back-tracking on many occasions as our guide grappled with the finer points of navigation. Ferry crossings required patience, breaking any rhythm we may have built. Even the railway crossings seemed to conspire against us, waiting for us to approach before flashing warning signs and bringing us to a halt.

In particular, the Moerdijk Bridge tested our resolve: The bridge spanned about 700m of open water. It was positioned perfectly to expose us to the worst the day could muster including gusts of wind of over 55 km/hr. The wind carried rain that was being propelled with almost enough force to draw blood. Each crossing was long and dangerous as we leant into the wind at a precarious angle, trying to adjust for every gust and lull. It was really windy, painful and more than a little bit scary!

Relief at reaching the other side!

Despite the challenges, everybody made it. Everyone made it across the bridge, and everyone made it safely to Breda. I didn’t hear anyone suggesting that they had had enough, they couldn’t do it or that they were going to pack it in.

There was relief at reaching Breda. There was a real sense of accomplishment (despite the route being slightly shorter than advertised). Individually and collectively we overcame the challenges the day could throw at us. Together we had made it!

Somewhere, over the rainbow… almost there!

It turned out that everyone’s answer to the question “Why are we here?” was enough to get them through. For me it is because I can be, because of all the hours I’ve spent on the Turbo Trainer over the winter to get myself in shape, because there is life after a Heart Attack, because I’m lucky, I’m alive. Not doing it isn’t an option.

Tomorrow promises to be another challenging day. I am confident that it will be another successful and rewarding one. Bring it on!

Fighting back

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Just over ten months ago I started my latest and most important attempt to get myself into physical shape. Having just been discharged from hospital after suffering a Heart Attack it was long overdue. Aged 42, years of neglect, complacency and idleness had taken their toll.

My quest for fitness started tentatively; a shuffle around the Cardiology Ward accompanied by daughter #1. She was scared of her father’s mortality. I was afraid of every twinge, every strange sensation. We both pretended things were normal, trying hard to mask our fear. Bravely, we managed a lap of the ward, perhaps 100 metres. Afterwards I returned to bed, exhausted by the effort.

Tomorrow morning I will set out on a 280 mile journey to cycle from London to Brussels via Amsterdam.

I’ve come a long way!

***

So far there have been several distinct stages to my physical rehabilitation:

Stage 1: Confinement

For the first 24 hours I was confined to bed, tethered to machines monitoring my heart, recording every beat.

Then I was cut loose of the wires. I was free to move around but not in shape for physical exertion. A shower was about all I could manage.

After four days of rest I was ready for the long shuffle out of the hospital to recuperate at home.

Stage 2: Finding my feet

My journey really started with “Dad’s little walks”; shorts walks from the comfort of the house. Five minutes was enough to start with, at a gentle pace. Twice a day; morning and evening. GTN spray to hand in case of emergency (fortunately never used!).

I added an extra minute each day as my strength and confidence grew. Eventually I was able to venture out unaccompanied, walking further and faster, my independence slowly returning. Occasional outings with Louise became a sociable evening stroll, slightly more relaxed each time, a pleasant change from anxious medical supervision.

Eventually I built up to 30 minutes twice a day. A good walk at a strong pace. The effort worked my heart, brought me out in a light sweat; proper exercise for the first time in a long time.

The results of the first 10 weeks

Stage 3: A helping hand

Eventually I was ready for Cardiac Rehabilitation, 40 minutes of supervised exercise twice a week. As part of a team, patients and staff, we worked together. Week by week, for 8 weeks, the intensity increased. My swagger returned as my stamina grew, as I was encouraged to (ever so carefully) push my limits.

My Heart Rate Monitor became my best friend, measuring my physical exertion, monitoring my well-being. The magic number was 118 beats per minute, 80% of my theoretical maximum.

I started cycling. Initially at home. Stationary, In the garage. I bought a Turbo Trainer and borrowed a bike. At first it was painful in so many ways, the shoes were too small, the bike poorly adjusted, cleats at the wrong angle and the saddle… the saddle was a sadistic joke.

15 minutes was enough. 15 minutes and a walk, a stretch, some relief. Day by day my tolerance levels increased. I pushed myself. Day after day: “The Long Scream” over and over.

I invested in a bike of my own.

By the end of Cardiac Rehabilitation I could manage a full 30 minutes on a cross-trainer. 30 minutes of continuous exercise, at the upper end of my Heart Rate range. It felt good. I felt good.

It was time to sign up for a longer term challenge… the Euro City Cycle.

Before the winter hit we managed a few gentle outings, cycling’s equivalent of “Dad’s little walks”. I was followed every mile by a good, caring and patient friend. I started to find my legs; 17 miles became 25, then 30.

Cycling buddies… the early days

Stage 4: Laying the foundations

Continuity over the winter built my conditioning. I exercised six days a week come rain or shine. I rotated my cycling routines to provide a little variety; The Long Scream, Angels, Hell Hath No Fury… “The Sufferfest” guiding every spin of the wheel, every turn of the pedals.

I ate well. I looked after myself. No alcohol. No caffeine. Low fat. High fibre. I lost over 45 lbs. A shadow of my former self, approaching my fighting weight.

I added swimming to the routine to provide some extra variety, to improve my flexibility and build my core strength. Far from a natural swimmer, it worked me harder than anticipated. It was a welcome rest for tired legs, and it’ll provide a challenge for another day!

Christmas came and went. A brief relaxation of the strict regime allowed roast potatoes and gravy for Christmas dinner, a tasty treat!

Then back to the training, cranking the pedals, dreaming of warmer climes, of venturing outside.

Stage 5: Head for the hills

Emerging after a winter on the Turbo Trainer was literally a breath of fresh air. The hours on the bike had prepared me well.

Flat and gentle at first, the weekend rides became increasingly long and challenging. Hills were gradually introduced, providing a new challenge to my strength and stamina.

With reassurance from the Cardiologist, I became less obsessed with my heart rate. I continue to monitor it, but focus more on the level of effort, my breathing. Relieved of the tight constraints, my cycling has become less stressful, more relaxed, free.

Cycling has become part of my life. It has made me strong and confident again.

Over 10 months of discipline, a new lifestyle, regular exercise have stood me in good stead. It hasn’t happened overnight, no fads, it has taken time and effort.

With over 2,000 miles in my legs this year, I am ready to take on the Euro City Cycle. A distant dream has become a reality!

I’ve come a long way, but my journey is not complete!

***

I am lucky.

I had a chance to fight back, a second chance. A chance to make a difference, for my family and myself.

If I can do this anyone can. I had a “wake up call”, but there’s no need for you to wait!

I’m ready!

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My preparations are almost complete. I’ve successfully completed my final training ride. The dirty kit is in the washing machine. The train tickets are printed. Time to put my feet up!

If I needed convincing that I am ready to start the Euro City Cycle, today’s ride was enough. A steady 60 miles, however it featured an ascent of the Suie (from the North, i.e. the hard way).

The hill has become a bit of a mythical beast over the past weeks, not helped by the fact that it’s the feature climb on the Ride the North. It’s an elevation of just over 230 metres at gradients of up to 12%. There are more challenging mountains to take on, I just haven’t cycled up them yet.

The nerves were jangling as we approached the lower slopes, but it didn’t take long for them to be wiped out by the physical exertion. In the end there weren’t any major dramas. There was a bit of huffing and puffing, but a successful climb was never in doubt!

The beast tamed. My physical preparations are complete. 🙂

The view from the top. Worth the effort in so many ways!

Logistical preparations are also complete, although a Tube Strike in London promises to make the transfer a little bit less predictable. I’m going to have to just suck it and see. Hopefully a considerate cabbie will take pity on me!

A few hours of focused packing will complete the kit preparation. Louise thinks it’s hysterical that I’ve given so much thought to the kit and associated packing. I’ve never been one to spend a lot of time preparing for travel. I’ve always taken the view that as long as I have my passport and a credit card then nothing can go wrong.

For this trip, there are so many items that could ruin (or at least significantly disrupt) the trip in so many different ways, that I’m a bit nervous. In no particular order: bike, passport, medication, rail tickets, wallet, cycling shoes, towel, laptop, helmet, etc. etc.

As I say, a few hours of focused packing is required!

That just leaves me with the small matter of “raising money and awareness”. I’m really grateful to everyone that has sponsored me. Together we’ve raised over £2,500 for the British Heart Foundation. It’s not too late contribute… just click here.

As far as awareness is concerned, I’m also very grateful for your help! I’ve been working on the basis that if my experiences help one other person than it’s been worthwhile. The more people that are aware of the risks of heart disease, or able to recognise the symptoms of a heart attack, or understand that a major medical incident doesn’t necessarily take away hope, the better.

I appreciate I’m very lucky. I’m hoping we can give other people a little bit of luck too!

In need of re-inflation

Living life on the edge

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Don’t tell anyone, but yesterday I went on a Water Slide. Given my Heart “Condition” it was an illegal act, but one that was considered at length (well, considered at least) before I took the plunge.

I’m not sure exactly where the perceived risks lay; it certainly wasn’t too frightening nor particularly exhilarating, it didn’t require significant physical exertion, and it didn’t expose me to dramatic changes in my environment. Still, it was forbidden and I did it, and it felt good (apart from slightly battered elbows).

If the exhilaration doesn't get you, the stair might!

If the exhilaration doesn’t get you, the climb might!

Following the Heart Attack, it took me a while to get comfortable re-exposing myself to life’s risks. What I’ve discovered is that they generally fall into one of two categories:

Sudden trauma; “one off” events that don’t happen on a day to day basis. Accidents would fall into this category, events that are outside our direct control. I would also include extreme sports where the activity, situation or environment is a factor.
Steady decline; day to day behaviours that are detrimental to our wellbeing or our health. The things we do where the numbers conspire against us over time. A single occurrence is unlikely to get us, but the compound effect might.

I’ve come to believe that the second category is most dangerous. It takes no effort, no thought but is guaranteed if you’re on that path.

Of course, there’s a third category… the risk of doing nothing; opting out, becoming irrelevant, out of touch. Becoming so cautious that life loses excitement, hope.

For many years, I was in steady decline, arrested only by the Heart Attack. It kicked my behind and prompted me into action.

Now I’m back on the right course, I’m not going to throw it away by taking silly risks, but at the same time I’m going to live my life. I will think about what I’m doing, weigh up the risks, and from time to time live life on the edge!

OK, so I won’t be doing that any time soon!

Epic journeys

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There are just 31 days until I start the Euro City Cycle (London to Amsterdam to Brussels, 300 miles over 4 days) and I’m entering the final stages of my preparation.

When I originally signed up for the event it really was a stretch target. No-one was in a position to tell me I would be able to do it. I was still in Cardiac Rehab. The medical professionals weren’t going to encourage me to push myself too hard, and the rest of us had no idea what I’d be capable of. I really was heading into the unknown. To be honest, it would have been considered a challenge even without the Heart Attack given my lack of physical activity.

Committing to the event was scary too. It set a hard deadline. If I hadn’t been able to do it due to medical concerns it would have said something about the impact my Heart Attack was going to have on the rest of my life. It would have been much easier for me to “wait and see”, to only to commit to something I knew I could do, but that’s not really me, and certainly not how I want to live.

***

Yesterday’s cycle served as a reminder of how far I’ve come…

Having got a solid winter’s training under my belt, primarily inside on the Turbo Trainer, I’ve been slowly building the distance outside. Yesterday saw a big jump to 80 miles! If the truth been told, it was probably too big a jump (from just under 60 miles). We weren’t really monitoring the miles, we just followed a route. It was a tough ride, but good to complete!

A few weeks ago I took on “proper” hills for the first time. My initial hilly cycle resulted in me walking for part of two of the three main inclines. I hadn’t considered that I would need to develop a strategy for hills, to learn how to cycle up them, but that’s exactly what was required. Now I’ve got to the point where I enjoy a good climb. Each one represents an honest, visible and tangible challenge, laid out right in front of me.

Over time I’ve also become less obsessed by my Heart Rate. I constantly monitor it, but I’m more relaxed. The last time I visited the Cardiologist he was comfortable with me cycling and was happy that the medication would prevent me from pushing myself too hard. It’s therefore become less of a concern for me, less of a constraint.

The drugs are working. My short term recovery is amazing. It’s a combination of the medication and my improving fitness but, after having pushed myself hard, my Heart Rate can drop off by 30 beats per minute in a couple of minutes. I feel it too. I enjoy regular breaks to eat / drink, but I don’t need long before I’m good to go again.

***

Having completed yesterday’s epic cycle I’m going to take a few days away from the Road Bike. Instead, I’ll have some fun on the Mountain Bike, a machine that has been horribly neglected over the past few months.

There are just four more Saturday outings before I head south for the Euro City Cycle itself. It’s just a milestone on my rehabilitation journey, but it’s an important one. My key goals at this point are to stay fit and healthy. Fingers crossed!