MarkKO's training log

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BenM
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Re: MarkKO's training log

#921

Post by BenM » Fri Jan 06, 2023 7:24 pm

Yeah I think doctors have a tendency to be REALLY conservative with cardio issues. I would be feeling the same way and probably getting a second opinion, although a GP should probably stay in their lane and say listen to your cardiologist!

Surely if you don't get your heart rate up too much, some light stretching or even body weight stuff would be pretty low risk. But this is not medical advice.... you've only got one heart.

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Re: MarkKO's training log

#922

Post by MarkKO » Fri Jan 06, 2023 7:41 pm

BenM wrote: Fri Jan 06, 2023 7:24 pm Yeah I think doctors have a tendency to be REALLY conservative with cardio issues. I would be feeling the same way and probably getting a second opinion, although a GP should probably stay in their lane and say listen to your cardiologist!

Surely if you don't get your heart rate up too much, some light stretching or even body weight stuff would be pretty low risk. But this is not medical advice.... you've only got one heart.
One doctor did say something that seemed sensible: what is strenuous varies from person to person. I think I have reasonable cardiovascular capacity so I'm leaning towards the possibility that I may have a greater margin to work with in terms of what I can do.

A plan is beginning to coalesce in my mind which is that I'll go for walks daily from today; speak to my GP on Wednesday; then see how I feel on returning to work on Thursday, assuming I'm allowed. If I feel good at the end of Friday I think that would be a very, very strong indication that I can start doing something from the Monday following.

Provisionally, I would start extremely conservative. Something like 5x5 with a plate, and a tiny bit of assistance. The week after add a few pounds. Repeat. If after three weeks I'm still fine then I can start working a little harder.

I kind of would have preferred if the cardiologist had wanted me to go back for an assessment in a week to check my ECG and troponin levels because even if I felt absolutely great but those markers were off I wouldn't even dream of doing anything. I get why they didn't though, because it isn't remotely necessary for my health and would tie up resources needed for sick people.

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Re: MarkKO's training log

#923

Post by MarkKO » Fri Jan 06, 2023 7:48 pm

Renascent wrote: Fri Jan 06, 2023 7:09 pm
MarkKO wrote: Fri Jan 06, 2023 5:12 pm I'm experiencing something of a quandry here.

I feel normal. Maybe a little tired, but barely.

I might go for a walk today to see how I pull up because honestly, if I feel normal it's going to be really GD hard to not do normal shit.

I'll talk to my GP about this when I see them on Wednesday. It isn't my usual GP, because he's away but the practice doctors are all good. We've been going there for years.

I understand why the recommendations are there, because you don't mess with your heart. I'm just trying to reconcile feeling normal with the idea that I'm significantly unwell.

I can get my head around missing the meet. That's a lot of stress on my whole body in the three-odd months leading in. A bummer, but it is what it is.

It's doing nothing for several weeks that I'm having a hard time with, unless of course I suddenly start feeling like garbage.
When do you find out how light exactly is "light training" supposed to be?
Never, TBH. Unless I speak to a cardiologist who lifts I don't think any doctor would be comfortable given a cut and dried answer which is very understandable.

My guess would be RPE < 5; or anything that doesn't increase HR beyond resting and doesn't cause a significant spike in BP nor pressure inside the trunk.

So shit like bracing I would imagine would be risky, or any kind of CAT but I also would imagine tempo work would be OK as long as the RPE was way low. Nothing where you deliberately generate tension and pressure in your trunk.

So as a note to self I would imagine the following would be acceptable:

Pushups with bodyweight for under 10 reps
Pullups under five reps
Belt squats with light weight for under 15 reps
Walking lunges
Cable work with light weight
Light band exercises
Light chest supported rows
Light DB bench

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Re: MarkKO's training log

#924

Post by MarkKO » Fri Jan 06, 2023 8:41 pm

Ok, so I survived a one kilometre walk with an average HR of 100ish. Towards the end I thought I felt some mild discomfort between my shoulderblades but it didn't eventuate into anything. I also don't feel exhausted. Onwards.

Tomorrow I will attempt a longer walk.

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Re: MarkKO's training log

#925

Post by MarkKO » Sat Jan 07, 2023 3:39 am

Warning: this log is going to get somewhat more tedious while this whole myocarditis BS plays out because it's a convenient place to journal my thoughts.

I made the mistake of googling myocarditis. I kept my reading to reputable sources, like the Mayo Clinic, Cleveland Clinic, Heart Foundation, etc; and whatever peer reviewed research papers I could find.

My findings were as follows:

1. There is very little information about recovery times and what you can/can't do. I suppose that's because it varies significantly from individual to individual, but even under those circumstances I would have expected some broad guidelines along the lines of don't let your HR go beyond x percent of your estimated maximal HR, don't let your BP become elevated for more than x time, etc. About all I could find was that I most likely will recover fully, but I might not which is unhelpful at best.

2. The majority of the non-peer reviewed information is about what myocarditis is, what causes it and how likely it is to kill you, effectively. That last one got me a bit, because apparently while survival rate after a year in 80% (which already is fucking terrible when you think about it); after five years it's 50% and all I have to say to that is FUCK.

3. There is very, VERY little readily available information about the risks to cardiovascular health of lifting weights. Like, almost nothing. There are quite a few peer-reviwed articles talking about the *benefits* of weight training for both prevention and rehabilitation in respect of cardiovascular diseases but nothing I could find about the risks posed by lifting weights. There was thing on a website about 'extreme exercise' giving rise to markers associated with heart attacks but that was about marathon running.

So all in all I would not call it a productive use of my time because it didn't really so anything beyond worry me.

I'm trying to understand exactly how much shit I'm currently in, to be frank, and I'm having a hard time coming up with a conclusion with the information available to me at this point in time.

Instinctively, it makes sense to go with how I feel. I feel ok, so I'm OK. I'm not in pain, I don't feel tired, I have normal energy levels, my appetite is fine, etc.

On a more logical level, it makes sense to go with the information provided by the doctors and peak bodies. That's where it gets murky, because as per above the peak bodies are remarkably unhelpful. The doctors were more helpful, obviously, but not enormously so. In particular, I keep coming back to 'what is strenuous varies from person to person'. I know what strenuous is, training normally. That's the whole point of training. But what about modifying it to not be strenuous? Does that immediately make it not strenuous?

Maybe the heart just takes longer to heal, like a tendon or something. I will have to look into that.

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Re: MarkKO's training log

#926

Post by Hardartery » Sat Jan 07, 2023 9:54 am

MarkKO wrote: Sat Jan 07, 2023 3:39 am Warning: this log is going to get somewhat more tedious while this whole myocarditis BS plays out because it's a convenient place to journal my thoughts.

I made the mistake of googling myocarditis. I kept my reading to reputable sources, like the Mayo Clinic, Cleveland Clinic, Heart Foundation, etc; and whatever peer reviewed research papers I could find.

My findings were as follows:

1. There is very little information about recovery times and what you can/can't do. I suppose that's because it varies significantly from individual to individual, but even under those circumstances I would have expected some broad guidelines along the lines of don't let your HR go beyond x percent of your estimated maximal HR, don't let your BP become elevated for more than x time, etc. About all I could find was that I most likely will recover fully, but I might not which is unhelpful at best.

2. The majority of the non-peer reviewed information is about what myocarditis is, what causes it and how likely it is to kill you, effectively. That last one got me a bit, because apparently while survival rate after a year in 80% (which already is fucking terrible when you think about it); after five years it's 50% and all I have to say to that is FUCK.

3. There is very, VERY little readily available information about the risks to cardiovascular health of lifting weights. Like, almost nothing. There are quite a few peer-reviwed articles talking about the *benefits* of weight training for both prevention and rehabilitation in respect of cardiovascular diseases but nothing I could find about the risks posed by lifting weights. There was thing on a website about 'extreme exercise' giving rise to markers associated with heart attacks but that was about marathon running.

So all in all I would not call it a productive use of my time because it didn't really so anything beyond worry me.

I'm trying to understand exactly how much shit I'm currently in, to be frank, and I'm having a hard time coming up with a conclusion with the information available to me at this point in time.

Instinctively, it makes sense to go with how I feel. I feel ok, so I'm OK. I'm not in pain, I don't feel tired, I have normal energy levels, my appetite is fine, etc.

On a more logical level, it makes sense to go with the information provided by the doctors and peak bodies. That's where it gets murky, because as per above the peak bodies are remarkably unhelpful. The doctors were more helpful, obviously, but not enormously so. In particular, I keep coming back to 'what is strenuous varies from person to person'. I know what strenuous is, training normally. That's the whole point of training. But what about modifying it to not be strenuous? Does that immediately make it not strenuous?

Maybe the heart just takes longer to heal, like a tendon or something. I will have to look into that.
First I want to say that the percentages don't really apply to you. You have taken pains in your training to care for your cardiovascular health, you aren't in this position because you a slob living on fast food and doughnuts. When they say it varies from person to person, lrt me give you an example. There's you at one end of the spectrum running around with heavy sand bags and watching your diet, then at the other end is my father-in-law whose main exercise is walking to the mailbox once a day at his wife's insistence. Sometimes only walking back from it because they went out and he got out of the car at the foot of the driveway and only walked back to the house. This voyage does him in, he has been known to stand at the mailbox to catch his breath and let things calm down before attempting the harrowing second leg. He is never going to be at risk of pushing anything too hard, ever. He is the reason the survival rate is that low longer term. You will be dandy in short order and move along like nothing happened.

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Re: MarkKO's training log

#927

Post by MarkKO » Sat Jan 07, 2023 3:09 pm

Hardartery wrote: Sat Jan 07, 2023 9:54 am
MarkKO wrote: Sat Jan 07, 2023 3:39 am Warning: this log is going to get somewhat more tedious while this whole myocarditis BS plays out because it's a convenient place to journal my thoughts.

I made the mistake of googling myocarditis. I kept my reading to reputable sources, like the Mayo Clinic, Cleveland Clinic, Heart Foundation, etc; and whatever peer reviewed research papers I could find.

My findings were as follows:

1. There is very little information about recovery times and what you can/can't do. I suppose that's because it varies significantly from individual to individual, but even under those circumstances I would have expected some broad guidelines along the lines of don't let your HR go beyond x percent of your estimated maximal HR, don't let your BP become elevated for more than x time, etc. About all I could find was that I most likely will recover fully, but I might not which is unhelpful at best.

2. The majority of the non-peer reviewed information is about what myocarditis is, what causes it and how likely it is to kill you, effectively. That last one got me a bit, because apparently while survival rate after a year in 80% (which already is fucking terrible when you think about it); after five years it's 50% and all I have to say to that is FUCK.

3. There is very, VERY little readily available information about the risks to cardiovascular health of lifting weights. Like, almost nothing. There are quite a few peer-reviwed articles talking about the *benefits* of weight training for both prevention and rehabilitation in respect of cardiovascular diseases but nothing I could find about the risks posed by lifting weights. There was thing on a website about 'extreme exercise' giving rise to markers associated with heart attacks but that was about marathon running.

So all in all I would not call it a productive use of my time because it didn't really so anything beyond worry me.

I'm trying to understand exactly how much shit I'm currently in, to be frank, and I'm having a hard time coming up with a conclusion with the information available to me at this point in time.

Instinctively, it makes sense to go with how I feel. I feel ok, so I'm OK. I'm not in pain, I don't feel tired, I have normal energy levels, my appetite is fine, etc.

On a more logical level, it makes sense to go with the information provided by the doctors and peak bodies. That's where it gets murky, because as per above the peak bodies are remarkably unhelpful. The doctors were more helpful, obviously, but not enormously so. In particular, I keep coming back to 'what is strenuous varies from person to person'. I know what strenuous is, training normally. That's the whole point of training. But what about modifying it to not be strenuous? Does that immediately make it not strenuous?

Maybe the heart just takes longer to heal, like a tendon or something. I will have to look into that.
First I want to say that the percentages don't really apply to you. You have taken pains in your training to care for your cardiovascular health, you aren't in this position because you a slob living on fast food and doughnuts. When they say it varies from person to person, lrt me give you an example. There's you at one end of the spectrum running around with heavy sand bags and watching your diet, then at the other end is my father-in-law whose main exercise is walking to the mailbox once a day at his wife's insistence. Sometimes only walking back from it because they went out and he got out of the car at the foot of the driveway and only walked back to the house. This voyage does him in, he has been known to stand at the mailbox to catch his breath and let things calm down before attempting the harrowing second leg. He is never going to be at risk of pushing anything too hard, ever. He is the reason the survival rate is that low longer term. You will be dandy in short order and move along like nothing happened.
Thanks. I was hoping this would be the case, because I thought it might be.

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Re: MarkKO's training log

#928

Post by CheekiBreekiFitness » Sun Jan 08, 2023 1:16 am

Just read through the last few pages of your log. I have no useful advice to offer because I'm not a doctor, but I wish you a swift recovery. Stay strong.

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Re: MarkKO's training log

#929

Post by MarkKO » Sun Jan 08, 2023 1:24 am

CheekiBreekiFitness wrote: Sun Jan 08, 2023 1:16 am Just read through the last few pages of your log. I have no useful advice to offer because I'm not a doctor, but I wish you a swift recovery. Stay strong.
Thanks brother.

Your advice would probably be far from useless, because all I got from the doctors was be sensible and TBH I have no idea what strenuous is for you so you figure it out.

I think it's partly because I am not a candidate for any cardiac issues so they were confused.

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Re: MarkKO's training log

#930

Post by MarkKO » Sun Jan 08, 2023 1:50 am

Upped the walk to two kilometres today, HR was in similar range and yesterday. No ill effects at this stage, so I'll go to three kilometres tomorrow.

I'm going to see if I can get in to my GP earlier too.

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Re: MarkKO's training log

#931

Post by BenM » Sun Jan 08, 2023 3:16 am

Very much hoping Hardartery (ironic username considering what we're discussing) is right. I do think that with being active, exercising regularly (including some cardio) and eating a sensible diet puts you well ahead of the averages in most health related prognoses.

Also, I think myocarditis probably suffers a lot from the COVID effect given that it's one rare side effect of the vaccine.

I don't blame you for doing a ton of research and I would definitely be feeling kinda freaked out by the whole thing but by the same token, given your heart showed no damage after the symptoms went down I'd say you have a better chance than most of going completely back to normal very quickly.

If you want reassurance / advice from qualified people who also lift, it might be worth asking in the Barbell Medicine group for some advice. Could be that @Austin or @JordanFeigenbaum mught have some useful insights.

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Re: MarkKO's training log

#932

Post by MarkKO » Sun Jan 08, 2023 3:43 am

BenM wrote: Sun Jan 08, 2023 3:16 am Very much hoping Hardartery (ironic username considering what we're discussing) is right. I do think that with being active, exercising regularly (including some cardio) and eating a sensible diet puts you well ahead of the averages in most health related prognoses.

Also, I think myocarditis probably suffers a lot from the COVID effect given that it's one rare side effect of the vaccine.

I don't blame you for doing a ton of research and I would definitely be feeling kinda freaked out by the whole thing but by the same token, given your heart showed no damage after the symptoms went down I'd say you have a better chance than most of going completely back to normal very quickly.

If you want reassurance / advice from qualified people who also lift, it might be worth asking in the Barbell Medicine group for some advice. Could be that @Austin or @JordanFeigenbaum mught have some useful insights.
That's one specific thing that I keep coming back to.

I'm going around and around and I keep ending back up at the point where I've been told that my heart wasn't damaged. So, if it isn't damaged, it should be fine? But why the medication I'll be taking for six to 12 weeks?

Initially I thought maybe cardiac muscle recovers more slowly, which would account for the projected recovery time. Yet when I searched for that, all I could find was stuff about heart attack recovery that mentioned scar tissue formation and the heart's inability to regenerate muscle. So not super helpful. Possibly my search terms were wrong, but they were pretty broad.

I suppose I could sign up to PubMed but even though I know how to read a scientific article and my BSc means I'll understand most of it I don't have the medical expertise to get too much out of it.

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Re: MarkKO's training log

#933

Post by BenM » Sun Jan 08, 2023 2:55 pm

I am gonna take a guess completely out of my non-medical background non-scientific backside and say that it's purely precautionary to prevent a recurrence while your body is getting over whatever the original cause is (assuming that is the virus/gastro bug you had).

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Re: MarkKO's training log

#934

Post by MarkKO » Sun Jan 08, 2023 3:10 pm

BenM wrote: Sun Jan 08, 2023 2:55 pm I am gonna take a guess completely out of my non-medical background non-scientific backside and say that it's purely precautionary to prevent a recurrence while your body is getting over whatever the original cause is (assuming that is the virus/gastro bug you had).
I think you're probably right. I guess the doctors can't really say that though because if I went and did something stupid and had a heart attack I could turn around and say they effectively told me it was OK.

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Re: MarkKO's training log

#935

Post by BenM » Sun Jan 08, 2023 5:09 pm

MarkKO wrote: Sun Jan 08, 2023 3:10 pm
BenM wrote: Sun Jan 08, 2023 2:55 pm I am gonna take a guess completely out of my non-medical background non-scientific backside and say that it's purely precautionary to prevent a recurrence while your body is getting over whatever the original cause is (assuming that is the virus/gastro bug you had).
I think you're probably right. I guess the doctors can't really say that though because if I went and did something stupid and had a heart attack I could turn around and say they effectively told me it was OK.
Yep. I wouldn't be a doctor for quids these days, basically a lot of people seem to only hear what they want to hear and are constantly looking for someone else to blame. It'd be a tough gig.

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Re: MarkKO's training log

#936

Post by MarkKO » Sun Jan 08, 2023 6:41 pm

I managed to get an appointment with my regular GP who is a legend. He spent an hour with me going through every little detail in every test and scan the hospital did.

My troponin levels were ridiculously high, like stupidly so to the point the practice doctors were all talking about them and apparently the only time anyone had seen similar ones was in a bodybuilder taking clenbuterol. For reference, troponin at 1000 is a sign of a moderately severe heart attack. My levels peaked at 30000. Except they dropped very fast, so apparently that means there is likely no damage anywhere. Win.

My heart isn't just normal, it's in great condition. It is, in fact, more muscular simply because of how hard it works due to my training and as a result I'm not likely to have any kind of heart issues for the foreseeable future.

I'm getting my troponin levels checked, and as soon as they're normal I'm free of any restrictions. In the interim, I'm allowed to train but in a way that doesn't push my heart rate too high as the only restriction.

In even better news, the March meet is still on.

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Re: MarkKO's training log

#937

Post by cgeorg » Mon Jan 09, 2023 5:12 am

That's great news, and having a real end in sight should help you take it a bit easier during the recovery. Any idea how long it could/should take those levels to drop to normal?

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Re: MarkKO's training log

#938

Post by MarkKO » Mon Jan 09, 2023 6:49 am

cgeorg wrote: Mon Jan 09, 2023 5:12 am That's great news, and having a real end in sight should help you take it a bit easier during the recovery. Any idea how long it could/should take those levels to drop to normal?
Nope, and nor does the doctor. He tried finding out but there's very little information about troponin clearance times.

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Re: MarkKO's training log

#939

Post by Hardartery » Mon Jan 09, 2023 7:27 am

MarkKO wrote: Mon Jan 09, 2023 6:49 am
cgeorg wrote: Mon Jan 09, 2023 5:12 am That's great news, and having a real end in sight should help you take it a bit easier during the recovery. Any idea how long it could/should take those levels to drop to normal?
Nope, and nor does the doctor. He tried finding out but there's very little information about troponin clearance times.
Biological half-life of tropnin is 120 minutes, so it drops pretty quickly once your body quits cranking it out supposedly. Google says they normally stay elevated for 1-2 weeks post event.

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Re: MarkKO's training log

#940

Post by slowmotion » Mon Jan 09, 2023 9:22 am

Great news!

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