Friday, February 22, 2019

I'm Back

Physiotherapy Assessment - Part 2

The new normal

It's been a couple of weeks since my last update and nothing much has changed until today! February 19th I went in for my actual PT assessment after completing my Bloodwork, Fitness Stress test and attending my nutrition and stress classes.
Oh and of course this is was the day that there was the United Convoy heading from Arnprior to protest on Parliament Hill and possible traffic disruptions. Well the convoy did not disrupt me as there was more than enough warning to let people know that there was going to be oh about 200 vehicles coming down the 417 EB to head downtown. So luckily I left extra early on Tuesday and got to work early enough to leave and head out to my appointment at the Heart Institute. Oh and the parking as usual was a nightmare. I managed to find a spot, but with all the snow we had the last couple of weeks it made for street parking sketchy, but it worked. As usual I paid my fee and went up to the Cardiac Rehab centre where I met with Guy-Anne who was assigned to me to go over my results.

We had spoke on the phone a week before the appointment and discussed what Roxanne had taken from my intake appointment. We reviewed my vitals and she asked if my HR was still elevated. But as you know from my last post my HR returned to "normal" or at least it dropped down to a "normal" resting HR.
Having all those details in mind we reviewed my results. First up the stress test which is going to help determine what sort of fitness I can do. Since the test was abnormal when I took it as my ECG demonstrated Atrial Flutter it was hard to get the "normal". Seeing the trend here with the "normal"? Well there was a lot of calculations that was done and now the interpretation by my PT were that from the data of the stress test based on the start to the max output and I would be able to do 9 METS (Metabolic Equivalents).
As defined by PubMed:
One metabolic equivalent (MET) is defined as the amount of oxygen consumed while sitting at rest and is equal to 3.5 ml O2 per kg body weight x min. The MET concept represents a simple, practical, and easily understood procedure for expressing the energy cost of physical activities as a multiple of the resting metabolic rate. The energy cost of an activity can be determined by dividing the relative oxygen cost of the activity (ml O2/kg/min) x by 3.5. This article summarizes and presents energy expenditure values for numerous household and recreational activities in both METS and watts units. Also, the intensity levels (in METS) for selected exercise protocols are compared stage by stage. In spite of its limitations, the MET concept provides a convenient method to describe the functional capacity or exercise tolerance of an individual as determined from progressive exercise testing and to define a repertoire of physical activities in which a person may participate safely, without exceeding a prescribed intensity level.
Your science lesson of the day. So 9 METS is or is my current max "normal". I was given a nice chart to compare my exercise output and maintain a moderate exercise regime. So I will be studying that chart to get a good feel for this new "normal".
Next up my Aerobic Exercise Guidelines! Priority One is to ensure I do a proper warm up and cool down. I know if I'm in a class that is not a problem, but really I don't spend a lot of time doing this on my own so this will be a new challenge to tackle. In general, I need to exercise 5-7x/week at MICE (moderate intensity continuous exercise) and for HIIT 3-4x a week.
Can you feel the excitement in my blog?
Now with that in mind, my moderate HR zone should be 120-136 bpm for MICE and 126-142 for Hi HIIT and back to 90-105 for low HIIT (recovery). So this will be a bit tricky with my OTF, but Guy Anne has reminded me that not to hit those high rates so for OTF standards staying in my Green zone and below. So if I can still carry on a conversation then I'm good, but if I'm gasping then it's not so good. The message is clear that slow build back to to me is required. I don't know if I'll get back to the old me, but I'm just happy that I can get back to it again.
So on a side note, my blood work which I did almost a month ago showed amazing results. When I say amazing I have to admit my diet as an endurance runner has been terrible. So I've learned from my nutrition classes that I need to change that, but also follow the 80/20 rule and try to be healthier. So not only have I got a bit of a slow build, but I need to work on my diet and it's true. I have the next several months to change and I'm in no rush as part of the nutrition classes that fad diets may work in the short term, but long term effects are not the greatest. Now that my heart condition is potentially controlled. My best chance is to make sure I keep it that way so nutrition and exercise are important.
Now that I've been given a program it was now on to moving to getting the 2nd ECG. We called up to my EP and they agreed to get a 2nd follow up from my assessment in January to see if I was back in Normal sinus rhythm.
I was escorted by Guy-Anne to the waiting area where I waited to be served. Since it was the lunch hour I wasn't sure how long it would be and so I waited. In the meantime I was checking my email and I was supposed to meet up with a Comms person who had the hoodie I ordered. I wanted a memento to remind me of my journey at the Heart Institute so I ordered myself a hoodie.
So I met Judith who thanked me for being a social media ambassador and gave me my hoodie! It was awesome!
My new HI swag hoodie
 After meeting Judith I went up and got to the room where they wired me up and took my ECG which really only takes like a minute to do a capture and it would be read by the nurse/doctor to see what it showed, but I requested a 2nd copy and provided it to Guy-Anne and gave her the results and she gave me her interpretation and said it looked good, but since she's not qualified to actually tell me the official results until she confirmed it. So I sent it to Nurse TK and she told my P waves are back. So in layman's terms I'm back in rhythm.
I have rhythm
So to confirm I get a call the next day from Guy-Anne and she confirmed I am back in normal sinus rhythm. It is a huge relief and again another message to work with my new "normal" and rebuild and get back to training. I'm in no rush, but hopefully with some MICE and HIIT I'm well on my way. I think the best medicine for me has been prescribed and now to keep moving forward. One foot in front of the other. For now I'll enjoy the moderate exercise and will be on my recovery rebuild.

Saturday, February 9, 2019

Cardiac Rehab/Progress Update and Team Awesome appearance

Cardiac Rehab/Progress Update

Two Months

Quick Recap and then to about 3 weeks ago I had been slowly increasing my workouts and then around the 7th of Jan my HR shot up to 90-100 bpm. It stayed that way until about this past Thursday, February 7th. In between that time I had an ECG and it showed my heart was in Atrial Flutter and my ventricle rate jumped 40 bpm from my post Ablation ECG. 
ECG - Jan 22/19
But like I said my HR seems to have come down on its own and my resting HR seems to be back in the 60’s. I haven’t had my follow up with the EP but I have an appointment with the Physiotherapist on the 19th. Hoping I can get them to send me for an ECG to see if I’m back in normal rhythm. 

So my activities have been on hold until things calm down and as I’ve been reminded that it could take up to 3 months for this to pass.
Hoping I can get back to it but this is my new normal.

In the meantime, I had another stress test on the treadmill February 1st where I was only allowed to walk at a speed build to a maximum of 4 mph.
I met Karl who set me all up and he sent another ECG off to the cardiologist before I started just to make sure that I was ok to proceed. Upon his return I got the green light and was able to do my brisk walk. In the end I was able to go about 11 mins and the incline got to about 10%. At least that is my guess as when I had this stress test the 1st time around they start you off at an incline almost right away. They just want your heart to start working quickly. Also each time the incline went up Karl took my BP. 
I'm personally happy, but at the same time it's always the unknown and the wait to know what is happening.
Also as part of my rehab I have to take some nutrition course as well as a stress for the heart class which I will be attending February 13th so hopefully this might help me feel more centred. More to follow the next couple of weeks.

Team Awesome Appearance

Bank Street Marathon Clinic
I had the opportunity to speak with the clinic at the Running Room on Bank Street. It was a lively crew and I was joined by alumni Mireille and we were able to speak about our experiences and pass on any tips that we had and basically just encouraged them to follow us and keep doing what they are doing.
I always feel a sense of accomplishment that I get to do this and help give back to the run community. I hope to inspire these runners when I get back on track.