Radio Frequency Catheter Ablation

I have arrhythmia, called atrial flutter, which can cause me to feel miserable and dictates that I take a rather nasty drug called cordarone/amiodarone. The drug potentially has numerous side effects including lung problems, eye trouble (not related to CSR), skin problems and digestive trouble. The catheter ablation was done to permanently repair my flutter, which would mean I could get off amiodarone, not to mention warfarin.

I've had the same procedure before, in about 2003 at Groote Schuur Hospital in Cape Town. At that time it was unsuccessful as the electrical wiring of my heart was very very messy, and the doctor who did the procedure, Prof Okgreglicki who unfortunately passed away recently, doubted any further surgery would be any more successful. However the electro-physiologist I saw in Pretoria recently, convinced me that the technology had moved on significantly and considering my age, it was definitely worth a try.

So I went along on September 3rd and had the operation, no sweat. So what do they actually do? They make some incisions in your groin to gain access to your femoral artery, which supplies the most direct route to your heart. It is the same procedure they do for an angiogram. They then push a catheter up the artery into the heart, all the while viewing what's going on using radioactive dyes and a mobile Xray machine, which rotates around your chest. But I didn't see any of that this time as I was under general anaesthetic.
Then once they have an idea of what's going on in the heart, by doing stuff like giving you little shocks to pace your heart externally, they then burn the faulty neural pathways so that the spurious beats don't happen. One that was done I woke up talking nonsense to the doctors and nurses.

What the doctor said was that my wiring was still very bad, he said, electrically degenerate...heehee...crocodile clips anyone?Aand that while he knows he has fixed my rhythm at the moment, he thinks the chances are good the arrhythmia will return. Also he said that I have previously unreported calcification of my pericardium, the heart sack. This is usually indicative of a past infection of of TB. I don't remember having a previous infection, but perhaps my university days count. The doctor said that this problem is for the plumbers, he called himself an electrician, and that I should speak to my regular cardiologist in this regard, I have an appointment when someone else cancels, or else next year.

I think the most uncomfortable bit of my time in hospital was lying in bed without moving my legs. It was terrible.I kept the operation quiet, having lots of people coming to visit me in hospital is not my idea of fun, so only my family and Renalda knew I was there. She had to be kicked out by the night nurse :P The next worse thing was that I couldn't sleep, it was a mixed ward and on of the ladies was a HUGE snorer! I only got some rest after 4am when they started waking people up again!

I'd driven myself there stupidly, not remembering that even after a night in hospital, I would not be able to drive. So Renalda's folks kindly came to fetch me and drove me and my car home.

I'd been rather slack about keeping track of my INR and it was 1.2 when I had the operation. They were worried about clotting so I had to take some Clexane. I found out how much of a woes I am and how hardcore Renalda is. I held the injection to my belly for hours, but couldn't do it!! I'm not scared of needles, I just can't put one into my own skin. Renalda had to come do it for me.

It's taken me most of the month to recover fully. There was significant internal bleeding in my right leg and I still have a bruise. But I'm fine now, I went for a hike two weekends ago and played volleyball last Wednesday. Follow up appointment with the electrician later this month. 

Cardiologist visit

I went to the cardiologist yesterday after feeling relatively crap for the passed few weeks. My heartrate went through the roof when I went for a run a few days ago, 200bpm through the roof. I thought that meant that my heartrate monitor was wrong, but yesterday I did a stress ecg on a treadmill and there it was 200bpm.

The doc has changed my meds, I'm now on 4mg coversyl daily, 5mg concor twice daily and 125mg digoxin daily... not to mention the ubiquitous warfarin.

It's such a pity because a month ago I was really feeling very strong, and was losing weight pretty steadily.

On the road again

So the new drugs seem to have taken effect. I can have a half decent workout session without feeling like I'm going to faint. As for the push-ups... perhaps I should leave that goal for a little while and work on my waistline. I think I'm getting a little tubby, the lack of exercise and winter food has gotten to me. Perhaps if I lose a few pounds those push ups won't be as difficult to do.

New Drugs

I thought drugs were supposed to make you feel better. Today I've been pretty drowsy, and considering I slept for...10 hours...last night, I don't think it's lack of sleep! The doctor has put me on Carvetrend, which has the active ingredient carvedilol in it, which I'm pretty sure I've been on before. Probably when I was in worse shape... this is worrying. I think I took the trade name Dilatrend for some time. It is a beta/alpha blocker... don't ask me what that means, although I'll probably look it up soon anyway.

He's also put me on Vectoryl, which is an ACE (Angiotensin Converting Enzyme) inhibitor.

Eish

I decided to go to the Cardiologist on Friday...well at least to phone him. He asked me to come in immediately. Did a quick ECG and echo, apparently I am in sinus rythm but have an ectopic. However I know that I definitely have palpitations regularly, when exerting myself.

He said that my heart looks a little more lazy than it had in Feb. He's trying me on some new drugs, I don't know the names off hand, but will add them in my next post. I also had a ProBNP and Magnesium blood test which just came back favourably, but he wants to put me on Amiodarone (Arycor) for the next 6 months. There after there should be a new chronic drug which doesn't have the side effects associated with arycor.

Hopefully this rythm thing can get kicked in the butt this time.

Sigh

If you're wondering why I haven't continued, it's not because I'm lazy or chicken. I think the world cup took its toll on me. Late nights, more drinking that I should do. Anyway, three weeks ago I noticed that I had a lot less capacity and that I was palpitating. Since then I've had a bout of flu too, so I did my first real exercise since then last night, salsa dancing. And it wasn't encouraging. Anyway, I've dealt with this before and I will again. Gym next week to see how everything goes and if there is no improvement then I'll make a cardiologist app.

Come to think of it

I was at the cardiologist in Feb and the news was fantastic, I just forgot completely to post about it. My EF is something crazy like 45% and the size of my heart is within normal limits. I still have the odd bought of arrythmia, but on the whole it seems the ticker ticks pretty regularly. Still need to watch myself, but I think I'm well out of the woods, as long as I'm sensible, keep exercising and eat relatively healthy.

More good news

I thought I'd take some liberties with my work time and write a quick post. I went to the cardiologist again today for a follow up appointment after my abortive cardioversion two months back and a month of amiodarone.

It was more of the same with an ECG and echo, I didn't even see the ECG but I assume it was fine, the echo concluded that my heart was of a normal size and my Ejection Fraction was 50% which is fantastic! So now it seems that my only real problem is my heart rythm which misbehaves from time to time, and still doesn't allow me to have full capacity while exerting myself.

I was however able to get hold of the report for the cardioablation that my previous cardiologist performed in 2004. Dr Guerra is going to contact an electrophysiologist and we will consider another ablation as the technology has improved greatly in the passed few years, but only if the other doctor thinks its worth the effort.

So perhaps there is some more hospital time in my near future, but if it is successful then I will feel a lot better ALL the time!

As for my MSc, it's pogressing slowly, but progressing, I had to take a bit of a break to catch up on the reading that I should have done, thats pretty much done now and I should be able to continue writing, and hopefully be finished by the end of the year latest.

All said the news is encouraging, I'm not going to say I'll write more often again, cause I probably won't but I'll try :)

Somewhat wasted day

I got to Dr Guerra's rooms at 7:20 this morning, the expected traffic did not materialise. It was a day of waiting. Good thing I took my book, and a new one just incase I finished that one! Had an early ECG that showed I was in arrythmia, so we went ahead and I was admitted for the day. This time instead of spending hours waiting in the reception while they found me a bed I was sent straight up to the ward... it looked like this might be a quick one.

I got my own room which was and wasn't cool, atleast when there are nurses rushing around you feel like you can't be forgotten. Every now and then someone would traipse in and do and ECG or take blood or put a drip in. But mostly I lay back and read my book, napped, read some more. Finished my book, started the new one. I watched 10 o'clock go by then 11, then 12 at 1pm I got up and went to find out what was going on.

Apparently i was in a general ward and for the procedure I needed to be in the high care ward, but there weren't any beds there currently so I waited and waited while they juggled patients around to find me a bed. Finally at about 2:30 I walked into the high care ward, much to the disgust of the other patients who were variously wired up or being beaten by physio's. I was soon to be wired up myself, but mercifully there was no physio to beat me... or perhaps...

Anyway as I lay there on the monitors one of the sisters came and asked what the problem was, I dutifully answered the usual questions, and then she said, "But you're in sinus rhythm", which was kindof what I though from my appointment on Wednesday morning. Anyway they were most puzzled and said you couldn't cardiovert someone in sinus rhythm blah blah blah. Eventually the doctor came and was a little puzzled himself, but a few minutes he returned and concurred that he thought I was in sinus and could go home. At first I thought he was joking, but apparently not!

Seems the amiodarone has done the trick for now, and I should keep taking 1 of these nasty tablets for the next month! But the proof of the pudding is in the eating and I will only know for certain whether his call is right once I go for a test drive so to speak. I'm gonna give the drug some more time to do it's work and only go for a walk on Monday, then I should know the true verdict.

Another visit to the doc

The past few weeks haven't seen me improve much, infact nothing has changed, I can't run and when I walk fast uphill my heart goes ballistic. I decided perhaps it was time to go see the doctor again. So I phoned up early on Monday morning and had an appointment for just an ECG this morning. The ordinary ECG didn't show much, just that I had an eptopic (unusual/unexpected) beat every now and then, well probably every 5 beats actually.

Fact is, day to day I feel fine, it's just when I exert myself that I feel shody. So they put the ECG cables back on and put me on a treadmill. After 3/4mins I was walking fast at a relatively steep gradient and I could see the ECG measuring between 180 and 210 beats per minute. My heart should never go that fast! Anyway, I think what happens then is my blood pressure drops and I start to feel terrible. So once I'd cooled off I went to speak to the doc again and he said he thinks the bad signals are originating in one of my pulmonary veins and that I should go see an electrophysiologist (I think) to talk about a possible PVI (Pulmonary Vein Isolation). Another option however is a drug which I mentioned in an earlier post which modifies heart rythm but is only available in SA towards the end of the year, not too long to wait I guess...BUT if I'm on those drugs I'm on them for life, if I have a successful PVI then I won't need those specific drugs.

Decisions decisions. Whats happening in the meantime is I am already preparing for ANOTHER cardioversion on Friday. I'm taking amiodarone which is the nasty brother of the other drug coming onto the market. So hopefully things will be better again by the weekend. Whats more I seem to have picked up another cold which is getting me down a bit. Oh well, I think I'll get into bed and try write some software, or some thesis.

29 days... and back in business i think

Before I go have a badly needed nap, I thought I'd get some thoughts down. Or rather a description of how this morning went.

I woke up this morning with a really slow seemingly regular heartbeat and I thought perhaps I wouldn't need to go for a cardioversion. However when I went for my ecg later it was apparent that although my arrythmia was slower, it was still there. If you look at a normal ecg nothing much happens between the big peaks, well mine had a whole lot of little blips inbetween indicating atrial fibrillation, so unfortunately the cardioversion was on.

So I walked down to the hospital admissions where I waited for a bed to be freed for me in one of the cardiac wards. I don't think it was where he wanted me but I ended up in the cardiothoracic (pronounced thorasick) ward, with people recovering from bypass surgery, but thats beside the point. I then had an ecg done, they use the conductive pads with the goo that takes days to remove. I also had a set of bloods taken, I have no idea why, and a failed attempt to put a drip into the back of my right hand, which was rather painful and will nodoubt result in a huge bruise. When the second attempt was successful they finally got me all tubed up and wired up. It was about 10:30 and I was starving, having not eaten since supper the night before.

Anyway Dr Guerra arrived and put some huge electrodes on my right shoulder and low down on my right side. Then they administered the anaesthetic and I was gone, waking up a few minutes later a lot more alert than I ever remember after being under. No dry mouth no nausea, no wanting to ask the nurse for water but not quite getting your tongue to behave enough to get a syllable out. As operations go it was quite pleasant! :P The nurse, Ude, informed me that everything went well and I only got one shock! Straight back into that magical sinus rythm!! :D

I sat there for 30mins before they brought me the tastiest plate of toasted cheese, tomato and ham sarmies I've had in a long time. It was only when I got out of bed that I noticed how sore my shoulder and side were, no doubt from the masses of energy that had flowed through them not an hour earlier. Nothing a good nights rest wont fix.

Ude insisted that I take a wheelchair back to Dr Guerra's rooms where he informed me that all had gone well and that I was in sinus rythm. That I should take my old dosage of meds and no mention was made of the amiodarone... I wasn't quite alert enough to ask him about it but his silence implies I don't have to take any more. So thats that, no worse for wear, except for a few missing chest hairs, a sore hand, shoulder and side. I'll be back at work tomorrow and I think I'll go for a walk in the afternoon and maybe a 10km on Saturday!

I said it would be some interesting data!

Today's run was interesting, although I didn't feel as bad as Monday or as good as a few weeks ago, I did feel a little better. I was 400mg of Amiodarone up, so I assume it is taking some effect. You can see from the graph that my heart was behaving even more unpredicatably! Hopefully by tomorrow it will have taken enough effect to either have slipped me back into sinus rythm or help the cardioversion force me into sinus rythm


It was hills again, this time run by the whole club. It was sobering knowing that a few weeks ago I was running up that hill as fast if not faster than everyone and now I couldn't keep running for the 200m hill. Anyway I ran 45 seconds of the hill and then walked the rest, resulting in the uphill taking me 2min instead of just over 1min. Amazing what the rythm of the heart does! It's a huge difference. In all we did 6km with 6 hills, which was more than I intended to do, but I'll sleep well tonight and be ready for tomorrow's procedure.

I've been thinking about what might happen after tomorrow. I think, whether I'm in sinus or not, Dr Guerra will probably suggest that I stay on the amiodarone for a few more days and perhaps try another cardioversion. Whatever happens I'm still not convinced that I should shift this goal out yet. I want to do the 2 Oceans in a month and if I'm feeling well enought to continue training I will. I think whatever happens tomorrow I'll take it a little more easy than before. I'll concentrate on getting the distance done and anything faster than 7:30 per km will be too fast. Afterall the goal was alway just to finish! I got so caught up with this new found strength that I forgot that. I have a bad heart, I should never let myself forget that, I think for the most part I have learned to live well within that, but the passed few months just allowed me to forget for a while. I won't make that mistake again.

30 days and a little ray of hope

I phoned my cardiologist at 7:30 this morning and after talking to me for a minute he suggested I come in for and ecg immediately, which I did after a bite to eat. As I suspected the ecg showed atrial fibriallation, the reason for me feeling so lousy while exercising the passed few days.

He has put me on amiodarone immediately, which is a heart rythm modifying drug. It's quite nasty, if it's used chronically and thats why I'm not on it, but for acute use I guess it can be quite handy. Search in google images for amiodarone and you'll see some of the side effects. He just wants me on a high dose until tomorrow morning, perhaps it just helps my heart slip back into rythm. If not he will try a cardioversion, which entails a mild anaesthetic and a high voltage shock to the chest. Fun :P

If that doesn't work then he has told me that there is a new drug recently released on the US market that has the same rythm modifying effects as amiodarone, but none of the nasty side effects. In a year or two it should be available in SA and I could take it as a chronic medication to keep my heart in rythm.

What he said about the 2 Oceans is that if I'm feeling good about it I should do it. If not then I shouldn't. Well at the moment I'm not feeling that good about it, but I'll keep training gently and see what tomorrow holds. I'm still gonna go for a run this evening and it'll be interesting to see what my HR monitor does.

32 days to go

I tried to get hold of my cardiologist today, unfortunately I was too late to get him on the phone and will have to wait till Wednesday. Although it's urgent I don't think it's life threatening, only goal threatening. Hopefully I can speak to him on Wednesday and perhaps get an emergency appointment. Maybe he'll agree to give me a cardioversion.

I still ran today but it really does feel like I'm worse off at the moment than I was before New Year. I just have less capacity to go faster, especially uphill, even up mild hills. Compared to a few weeks earlier, it really makes me sad.

This is what my heart rate looks like, as you can see there are times when my heart rate jumps to 220 bpm. I don't think it's as bad as it looks, and I've gotten used to this kind of thing happening every now and then. However in this new mode it happens more and more often. Marli left me a comment suggesting that I rest a bit, perhaps that is good advice but I'm so close!! I've booked the tickets entered the race, I'll have gotten the T-Shirt! And I'll be able to say I ENTERED the 2 Oceans in 2009! :(

For now, until I have a proffesional opinion to the contrary, I'm going to keep training gently. Hopefully things come right before the race.

34 days and I must admit I'm feeling rather despondent

I skipped Wednesday's run and tried to rest as much as possible in the hope that maybe my heart rythm would fix itself. Afterall I haven't really changed what I've been doing that seemed to encourage it to do this in the first place. I'm still trying to watch my diet, exercising regularly, trying to sleep lots. So physically/mechanically I can't see that there is much of a difference in my heart from last week to this week. Perhaps a rest would have helped it get back to where it should be.

Last night's run proved otherwise, whats worse, it seems to me that whatever mode my heart is in now, it gives me less capacity to exert myself than I had last year! Yesterday the chosen route for the club was Premier which is very tough, so we decided to do an easier route, Lynwood. It is a gentle downhill and then the same gentle uphill back. I was mostly fin on the way down but my monitor kept registering 220+ on the way back at the end of my running interval. In the end I gave it up as a bad job and walked home.

It is really soul destroying to have something this fantastic dangled in front of you for a few weeks and then just as quickly removed! I'm pretty upset about it, I'm angry with the world, angry with the person I blame for me being in this position in the first place and I guess if I believed in a benevolent god, I'd be angry with he/she/it too. Lucky for me I don't really... but thats a discussion for another day.

For a few days I allowed myself to start believing that I was on the way, if not to a full recovery, then to a state a lot closer to having a normal heart. A place where I wouldn't have to be quite so hard on myself about eating, sleeping, drinking, exercising. But now it feels like I'm not back to square one, I'm back to square -10! Enough lamenting.

I'll just have to work with this again and see what can be done with more regular training. I did go for my long run this morning. 13km in 1hr47, that is too slow 8:20 gets me to 21 in 175 mins which is 2hr55. Thats cutting it a bit fine, and considering this run was on a relatively flat route, I doubt I could keep it up anyway! None-the-less this mornings run wasn't as bad as yesterday's. I guess I'm already adjusting to this new setup and it will just take a little more time to get fully used to it and to see how far I can push myself. You can see from the graph below that i am back to running set intervals, where the times are 45 seconds running and 1:30 walking.

What is curious though is that there were times when I saw my hr go to 220 on my watch, but there is no record of it in the data. Perhaps this is a good sign, but who knows, until I've spoken to the cardiologist on Monday I won't really know what to think. Hopefully he can fit me in somewhere for an emergency appointment. What might really get me down is if he says that he now thinks I SHOULDN'T do the 2 Oceans. That would be heart breaking, excuse the pun. I should stop second guessing, it clearly gets me into trouble!

I suppose for those of you who read my blog, it was becoming a bit of a monotonous happy fest. Nothing like some arythmia to keep the drama going :P Hey look, it seems like I haven't completely lost my sense of humour!

36 days - I think I'll just have to settle back into the old idea

As I said I would I have rested this week. After Monday's dissapointing run, I thought it a good idea to take the week off. So I'll go for a slow run tomorrow and then see how I do on longer run on Saturday. Probably 13/14km. I'll have to go back to running intervals, because as Monday's graph shows I'm back to have very little variability in my heartrate, which is very disappointing.

All this has made me think long and hard about whats been going on in my heart. When it comes to hearts I only have my common sense and a little bit of reading up to count on, but as I lay in bed this morning in that state inbetween waking and sleeping I started thinking of electrical circuits. More than half of my undergrad studies were devoted to electical and electronics engineering, so it is something I know quite well. I also know that a heart is basically an electromechanical system. There are neural pathways which transport electrical signals around the heart causing muscle tissue to contract or relax in time with an electrical pulse generated by the sinus node in the right atrium (top right chamber of the heart).

The atria and the ventricals are electrically isolated from one another except for the AV (atrioventricular) node, which in a normal heart delays the pulse long enough for the atria to complete there contraction, and then conducts the electrical pulse to the ventricals. It's a fantastically clever system and works very well when things are going right.

In my heart there are some stray electrical signals which I believe cause my atria to beat faster than they should. My doctor attempted to burn some of the pathways a few years ago when I had an angiogram. I think they call it a cardioablation. He described them as little self sustaining circuits which send signals round and round in my atria. They get blocked at the AV node, and more so because of the medication I'm on.

So with all this in mind I was semidreaming this morning and thinking about all the electromagnetic radiation we are exposed to on a daily basis. I know that EM radiation induces voltage in wires that are near it... infact if you go put a coil of wire under a high power transmission line, you can steal power from the electrical company without touching the wires. I started thinking about what all this EM must be doing to a heart that already has a bias towards these stray electrical signals. A heart that is perhaps in every other way getting stronger and healthier because of frequent exercise and relatively healthy living. Well the conclusion I come to is that IF those stray electrical signals were perhaps tending towards fading away then all the EM radiation would just re-excite those signals everytime I used a cellphone or walked close to cellphone tower or under a high power line.

Ok I agree, it sounds a bit looney, but bare with me. The strange thing is that I have no doubt that this change over from arythmia to sinus rythm occured while I was on holiday over December. During that time I didn't do a lot of exercise, I didn't eat particularly healthy and I certainly didn't abstain from alcohol. So why did it happen then? Perhaps it was just ready and the rest I had allowed it to change pace. That may be, but I have a better idea! I spent 4 nights on the Orange river, I had no cellphone with me, no-one did. There are very few cellphone towers in range of that stretch of the river and I saw no lights so there was very little electrical power around.

So maybe my heart was ready because of the work I've done and being away allowed these stray signals to fade away without being re-excited. Sound nuts? I'll never know for certain, this is all supposition. I just know it was fantastic for a few weeks to have a heart that was beating in correct rythm. Maybe a few weeks as far away from civilisation every year wouldn't be a bad plan!

What I do plan to do though is to speak to my cardiologist next week (he said I should phone on Mon/Tues/Wed) and ask if he thinks its worth cardioverting me again considering that I was in sinus rythm last week. Anyway I'll keep posting, maybe it happens again.

The anatomy of a stuff up - 39 days

I kindof new that it was too good to be true. Anyone who knows about heart conditions knows that my arythmia just going away is no small thing. It's huge, it's like putting a V8 in Mini. The difference between the amount of energy and power I have is unbelievable. Well unfortunately last night I notice that my heart rate was fast and irregular, which it typical of my arythmia.

I was trying to deny it and went for a run this afternoon, but I could feel the difference immediately. Not to mention that I could see it im my heart rate. Where when I walked to the school the past few weeks my heart rate rarely went above 90bpm, it was jumping between about 95 and 110. Then on the run I could feel it in the back of my throat, I know that sounds strange, but I get a dryness in the back of my throat which has been completely absent the last few weeks. When I got on the hill, I'd run 100m and my heartrate was up to 220bpm so I stopped, walked to the 4km mark and walked back. Dejected.I wasn't gonna put this up but then I thought I'd better incase some people reading this were thinking I'm being dramatic. Actually the graph looks a lot worse than it should. My watch says my average heart rate was 118 where this graph says 180. It went briefly to 220 and then went back down to 115/116 so don't be alarmed, just see that it stayed pretty stable at 115/6 until I started running up the hill.

Whats more my heart was doing pretty strange things. It would DROP as I ran intervals on the way down. It would drop from about 118 to 112 as I ran. I haven't quite worked out what that means yet. But it doesn't seem right.

Why do I think this has happened? Well I think it's a number of things. Firstly I think it was a huge mistake for me to decrease my meds. I should just have managed my races and training better so that I wasn't running straight after taking meds. I remember when I was last in sinus rythm my cardiologist wanted me to be in that state for a year before he would allow me to come off warfarin. So even though my current cardiologist suggested that I come off some meds I think it was a mistake.

Secondly perhaps I'm training too hard, it's like someone gave me some extra pocket money and instead of putting it in the bank I went and spent it! As I felt better I pushed harder and harder and because my body stopped telling me to stop I went ahead and to a certain extent threw caution to the wind.

Add to that maybe too little rest, some strong coffee and a draft beer yesterday and viola, by early evening it was overs and I noticed how my heart was beating funny. I don't think I should stop living, I don't do anything in excess...except perhaps exercise. Every now and then, like maybe once a month I like to have a beer, I don't think anyone can fault me for that. Once in a while I like some good coffee, you also can't fault me for that. What I will do is to abstain from strong coffee and any alcohol until after the race.

I'm going to skip Wednesday's training session in the hope that a good rest will give my heart a chance to regain it's magic. Also i'm going to go back onto my old dosage of medication. Maybe, just maybe I'll get it back. Whether it does or not I'm going to train a lot easier in the future. I'm going to concentrate on completing the run and not try for any time. The excitement of getting better just made me get carried away. Sure I'm pretty bummed at the moment, I had something and I lost it, but this is nowhere near being 19 and your doctor telling you your heart is the size of a football and is only working 20%.

I'm still going to do this thing even if I take 2hrs59:59. I've been at this for too long to give up now.

Go ahead!!!

I should be my own cardiologist :P ... everything that I thought about my current state was confirmed. My ejection fraction is up again from 42 - 46, theres no denying it now. My heart is in normal sinus rythm... explains the "normal" reaction to exercise. He thinks I'm now on too much medication because my heartrate when they took my ECG was 46bpm, so he's decreasing my dose of atenelol from 50mg bd to 50mg/d.

Basically all is good and he is happy for me to do the 2 Oceans half marathon as long as I listen to my body and just aim to finish comfortably... nothing more. Which is exactly what I planned to do :) I have entered, now I've gotta complete the next 50 days with enough training and without injury :)

50 days... todays the deciding day!

I'm going to the cardiologist today, I'm pretty sure that he'll be happy for me to continue training. Yesterday was a 30min run, which was 4km on the route I previously dubbed Hell on Tar. Well I didn't go all the way to the top yesterday because I only wanted to do 4km, but it seemed a lot less hellish. I decided to push the last little bit to the turn around point and there were no complaints from my legs. Sure it was probably ill advised but it's really nice to be able to just go faster when I wanted to. Whats more is my heartrate didn't misbehave too badly.


I set the limits up by 10bpm to 130 for my running interval and that seemed to work fine, the problem was more getting it to drop from 95bpm to 93bpm on the recovery, especially when walking uphill so I'll probably increase that a bit aswell. This is all a learning curve for me and as long as my heart remains in it's current state, I suspect I'll be playing around with these values a lot.

Week 31 - Straight after Walk the Talk

To say that 30km was over doing it is an understatement I guess. I was finished! I think that probably contributed wit what happened later in the week. I got to work on Wednesday and all was fine, however by about 10am my hands were really cold. I got a cup of coffee and put my hands under the hot tap, when I got back to my office I put the aircon on hot, which I very seldom do (energy use, carbon footprint etc). Nothing worked and half an hour later I was shivering like I was outside in subzero temperatures in my undies.

Needless to say I went home, which was interesting considering I ride a motorcycle (energy use, carbon footprint, financially sensible). I got home and went to bed. I then sent SA Doc what must have been a really annoying sms, but considering my other close doc friend was in SCOTLAND at the time, she was my only option. She told me my symptoms were pretty broad and that, considering my condition, I should see a doctor. I knew she would say that, so I went to the doctor, because at this stage I was pretty alarmed.

The doctor was unimpressed by my "alarming" symptoms and sent me home with a letter booking me off till the weekend. He said I had "viremia", which is short for "I have no idea what you have but you will live", and told me it would pass in 48 hours, which it did! I had fever and a headache all of Wednesday night, read a book most of Thursday, slept like a log on Thursday night and went back to work on Friday.

Needless to say the only exercise I did was 2.8 VERY slow km's on monday.