First the backstory, from my post-pulmonology report last Friday, which some of you have already seen on FB:
. . . A pulmonary stress test is actually kinda fun. Until you hit your anaerobic threshold. But then they stop. So, fun.
Why fun? Because you have no clues. Especially after they take your glasses away. No real feedback on how hard you are going, so no depressing awareness of how hard you are breathing at pitifully minimal efforts. And hard exercise does feel good. Also, they ramp you up fast – just a minute at each level, so it’s over pretty quickly.
. . . Dr. M thinks it’s probably tachycardia of unknown origin, maybe caused by the special kind of hyperthyroid that doesn’t show up on the initial screen for thyroid stuff and for which I have none of the symptoms other than tachycardia.
He also vaguely mentioned “stress”, which people always feel compelled to mention. Funny story: A good friend in passing made reference to the “scare” I’d had this spring. And though I don’t quibble with word choice in casual conversation (because: casual conversation, don’t put deep meaning into offhand comments) . . . I was thinking to myself: I wasn’t scared. It doesn’t count as a “scare” if you aren’t scared.
To clarify: the prospect of dying is intimidating, because that is well known for its unpleasantness. And I’m a total whiner about unpleasantness, so long painful illnesses, no thank you. But actual death — the part that comes after the unpleasant part? Sure, I have a healthy concern for the state of my soul, no presumption there. But I’m also aware that it’s not like I’m suddenly going to get amazingly holy when I turn 85, either. Pray for the gift of final perseverance, do your best to report for duty at holiness-school each morning, not much else for it.
But I always find it comical when someone (as was not the case in this comment, I don’t think, it was just a random word, not a deep thought) gives me the emotional pat on the back because surely I’m so anxious about xyz situation, and I’m thinking . . . you get anxious about this stuff, but I don’t. Weirdly, no one ever reassures me about the things that do make me anxious.
Continuing with the pulmonology update:
. . . We ruled out weird variant asthma pretty roundly. Lung function better after exercise than before. Hard not to like that. Hereby excused from the evil dreaded methocholine test. Victory.
. . . More or less ruled out structural heart things, because O2 sats never dived, which they will if you have, say, a valve problem that occurs under load.
. . . So the new experiment is to try a beta-blocker to bring down the heart rate, see if that works and thus allows me to do normal things (like: exercise!), without dropping the BP so low I do abnormal things (like: faint!). As experiments go, I’m good with this one, because prescription = $3.38 at Walgreens. I’d spend a full four bucks on this if it came to it.
Drug in question is propranolol, picked because you can take it selectively (such as before exercise) rather than all the time. Little pink pill.
So I got home from Mass today, tired tired. Not super-bad tired, but not perky. I don’t do perky very much lately. Took pink pill at noon, ate lunch. 1pm decided it was time to do a test and see if this thing worked. Spouse asked me how I felt.
“My head feels a little funny, but that could be whatever.”
“What do you mean, it feels funny?”
“Like I want a beer and a coffee.”
“So it could just be Sunday afternoon?”
Took my pulse before I went out, and it was bobbling around in the “normal” zone, 70′s-80′s, which is about as good as it ever gets. Walked down the street to the track at the school. Walked a mile and some.
Yeah. A mile and some.
No super fast, but not slow either. Wasn’t tired. Not at all. Not short of breath. Chatted with a lady about her puppy towards the end of that mile.
Made myself come home so I didn’t give myself some @#$%^& injury from over-doing it. Back home again by 1:30, so I was in that normal walking-speed range, which I would not normally consider a fitness-y pace by any stretch of the imagination, but I figured for someone who last took a walk in late January, start easy. HR stayed below 120 the whole time. Not out of breath. At all.
–> In contrast, Friday afternoon on the treadmill, after two minutes of walking, one minute at 1.0 mph and one minute at 2.0 mph, my heart rate was at 126 and I was already feeling like I was exerting myself.
So then, sit-ups.
I check in with the spouse when I come in (not winded, at all, or tired, or anything), and then since I’m restless but determined not to do anything really stupid, I decide I’ll sneak back to the bedroom and do some sit-ups.
[This is my favorite exercise because there are only muscles involved. So I can do them without injuring things. All the other exercises involve tendons and nerves and who-knows-what, and I'm constantly on the brink of pulverizing something. I have good muscles but bad everything else. Sit-ups I can do. I love sit-ups.]
So all spring the routine goes like this:
- Lay down flat on back, wait for pulse to come down to the low eighty’s.
- Do a set of ten, or maybe even twenty if I’m feeling crazy. Be totally winded.
- Wait a minute or two for HR to come back down.
- Do another set.
- Wait another minute.
- Another set.
So it takes like 10 or 15 minutes to do 110 sit-ups, because otherwise I’d explode.
Except today: Wonder drug. I go back there. Do fifty, pause for ten seconds because: muscle burn. 30 more, another ten-second break, then finish. Done. In a few minutes. Done. Not tired. Not winded. At all. At all.
Just wow. That was a good benchmark for better-living-through-chemistry analysis, because unlike going for a walk, I had a really clear idea of how much effort was involved in doing sit-ups because I could actually do them all spring, with the modified approach.
The pre-pill / post-pill difference was kind of like the difference in effort between walking up the side of a mountain with a 60lb pack on your back versus walking down the sidewalk with no pack, except that in reality, if you are fit, walking up the side of a mountain with a 60lb pack on your back is not that hard. You’d never get anywhere if you had to stop every thirty seconds for a minute break.
So yeah. Nobel prize for James W. Black, earned. And a big shiny star for Dr. Maybe. I’ve got to find out what kind of beer he drinks. Or scotch? Scotch.