As a final follow-up from my pulmonary embolism escapade [click here for the backstory] of August, 2012, I had a stress echocardiogram in March of 2013. Hooked up to EKG leads, I walked for ten minutes at a moderate pace and then had a sonar exam of my heart. Easy-peasy. A week later, the results came back- no damage to my heart. Left ventricle is of normal size. I am fine. After a fashion.
I have a slightly irregular “T” wave. I’ve had it all my life. Three years ago, at the time of my PE, I was 54. I had ridden and raced a bike for over 200,000 miles. “T” waves represent the repolarization of the heartbeat. My heart repolarizes just fine – about 176 times per minute when I am racing.
I have an ejection fraction (EF) of 65. EF measures how much blood is ejected from the left (main pumping) ventricle of the heart. On the high end of normal, 65 can mean the heart is overworked; it has to compensate for stenosis (narrowing) of the blood’s passageway. In my case, it means that I’ve been busting my fitness ass for the last forty years, and my left ventricle is plenty strong as a result. That, and my resting pulse of 52.
But if I was a 54 year old with the typical array of middle-aged health issues (high cholesterol, diabetes, obesity, hypertension), a high-normal EF plus the T-wave issue is a cause for concern. I have none of those issues.
The cardiologist’s PA was concerned.
“Doctor will probably want to do an angiogram,” the PA said.
“Shoot some dye into my heart?” I thought. “No freaking way.”
I explained to her that I was active, very active.
I could hear her nodding.
“Well, still…,” she said.
“Let me explain,” I said. “I ride anywhere from 75-150 miles every week. Except when I was younger, when it was 300 miles per week. I lift twice a week, except when I lift 3 times per week. I don’t know that I’ve missed more than a few days in row, except for injury or some such, since about 1975. I’ve had the T-wave thing all my life. We found out about when I had a VO2max test for the Olympic Training Center back in 1983.
“Look at my chart. It’s all there, right? I had a DVT. I had an embolism. Look at the rest of my numbers. Look at my history. Treat your patient, not your numbers. I’m not sick.”
“Ah. Yes,” she said. “I see. You pretty much slay yourself, don’t you?”
She laughed.
I laughed back.
“Yep, pretty much. Started when I was in high school, just never quit.”
“This echo makes a lot more sense, then. Listen, let me double check with the doctor,” she said. “I think you’re fine. If you don’t hear back from me by the end of the day, don’t worry about it. Good? Good.”
What a great phrase – You pretty much slay yourself, don’t you?
This begs the question.
Why do we slay ourselves?
1) It is real. Hard work; on the bike, the weight room, rowing, running – is visceral. Nothing gets me more in touch with my true nature than sprinting right up, and sometimes over, the edge of my perceived physical limits. The Stoics said, “Punish the Body. Purify the Soul.”
2) It feels good. A momentary victory over gravity and blood and breath and anatomy and physics and psyche satisfies the body, soul, and the mind. As ace climber and Gym Jones founder Mark Twight once said “It doesn’t need to be fun to be fun.”
3) Vanity. I like how I look. Simple. It may be the armor that I have chosen to put on in life, but I like it. I earned it. I own it. Said Diana Vreeland, style and fashion’s Grande Dame, “I loathe narcissism, but I approve of vanity.”
4) Because I can. I lost my younger brother Michael to a particularly virulent squamous cell carcinoma of the tongue in December of 2012. For the last two years of Michael’s life, even a one block walk or 20 minutes of PT exhausted him. Had I waited another week, or perhaps another day, my embolism would have killed me. It didn’t. When I set foot in the weight room, when I put a leg over my bike, when I snap into my skis – I do so fully aware that my best friend Michael won’t be joining me in body again. I do so fully aware of how close I came to losing this chance to use this body, fearfully & wonderfully made (Psalm 139), ever again.
Why do we slay ourselves?
How can we not?
A related version of this appeared here on April 26, 2013.
I enjoyed your post and your openness on the topic. Clearly you find your physical conditioning to be important, and it is, and I enjoy how you document your interactions with your doctor. When you mention how we slay ourselves, I think its really important how you identified the good feelings behind working hard for some physical goal, whatever that may be. These types of goals are important and can, perhaps, be tied to achieving other goals in life as well! Slay on!