Sunday, November 24, 2013

At The Heart of it All – Crushing the Mechanical Bull of Medicine

“Chris, you are going to die…….if you don’t make some serious changes to your life immediately!”  Those were the words that my doctor said to me four years ago with conviction, confidence and the assurance a grade school teach has when proudly proclaiming there will be a test tomorrow.  He looked me straight in the eye and putting his arm on my shoulder also said, “I don’t want that to happen on my watch and you can avoid this but it is up to you!”
Well what do you say to that?  What can you say to that? “Oh he is just getting paid to say that” or “it’s not really that bad, after all I am only 43, how can that be?” For those that know me, I lost my dad to a massive and sudden heart attack when I was 16 and he was 47.  One minute we were laughing and talking and the next minute my life was changed forever.
I had been thinking about my journey in life and that significant mile marker “47” was fast approaching and I could not help but wonder what it had in store for me. Would I out live my father? Would we have an unceremonious tie or would I fall short? Two of the three options were not attractive and the pressure was mounting.
While many may think that this was an easy decision to make, it was and it was not.  I had heard these words before but had safely secured them to a place in the back of my mind for processing for a later date – translation – put them on the shelf and forget about them but this time was different.
I had a wonderful wife whom I loved very much and were trying to get pregnant and I could not help but think why God would give us a precious life to take care of when I was blatantly not taking care of my own?  Ouch!  Sometimes God nudges me; sometimes he gives me a gentle pat on the back then other times he hits me over the head with a Louisville Slugger to get my attention.  This time he used the bat and it worked.
I won’t bore you with the details here on my getting into shape as I have shared that already (you can read that story here in my post “Sometimes Life Has a Strange Way of Getting Your Attention”) but I do want to share with you a rewarding experience that has come out of this process.  I share this with you because if I can do this, you can to. It boils down to How Bad Do You Want It and trusting God to guide you in the process.

Having made the decision to reclaim my health, the first order of business was to do a stress test to see what type of shape I was in and to see if there were any issues with blood flow or oxygen getting to my heart.  If you are not familiar with this process, they hook you up to an EKG and put you on a treadmill that starts at a 4% incline and increases in speed and incline every four minutes to put stress on your heart. Sounds easy enough, right? Ha!

That first test was horrible. I lasted just short of six minutes as was gasping and standing in a puddle of my own sweat. Ouch, what a horrible experience. That “wild bull” (Ok it was a treadmill but it felt like a wild animal) had bucked me off no sooner than I had gotten on it. We both came to the rodeo, one left a champion and I left defeated and realizing how much work I had ahead of me. “Well Chris” I thought, “You got yourself into this mess, what are you going to do about it?  Looks like you have some work to do.” I did not relish a second date with that contraption but first things first, I wanted those test results.

Sitting in the lobby area collecting myself, it was time to see my doctor.  It’s funny how people are. If you know someone well enough you can read their facial and body expressions and know the entire story or at least the Cliff Notes version without them saying a word. Before Dr. Jani said a word I knew what he was going to say.
“Chris, you have a couple abnormalities that are concerning. I am ordering a Nuclear Stress Test to get a better look at your heart!”  Not surprised but not what I wanted to hear, I asked “Will I have to get on that treadmill again?”  Really, I was just told I could have issues with my heart, self-imposed issues no less and all I could ask was if I had to get on the treadmill again?”  No points awarded for good questioning and the answer was “Yes.”  Just great!  Not only did I get my butt kicked by that “wild bull” just moments ago, I had to get ready to saddle up and do it again in a week. I could almost see it grinning at me in attack mode, like a lion getting ready to devour a helpless rodent.  “So a nuclear stress test” I managed to mutter, “what does that entail?”  Congratulations Chris at least you managed to ask a question with some substance.  He went on to explain…….
A nuclear stress test measures blood flow to your heart muscle both at rest and during stress on the heart. It's performed similarly to a routine exercise stress test, but provides images that can show areas of low blood flow through the heart and areas of damaged heart muscle.
A nuclear stress test usually involves taking two sets of images of your heart — one set during an exercise stress test while you're exercising on a treadmill or stationary bike and another set while you're at rest. A nuclear stress test is used to gather information about how well your heart works during physical activity and at rest.
You may be given a nuclear stress test if your doctor suspects you have coronary artery disease or another heart problem, or if an exercise stress test alone wasn't enough to pinpoint the cause of symptoms such as chest pain or shortness of breath. A nuclear stress test may also be recommended in order to guide your treatment if you've already been diagnosed with a heart condition.
Well there you have it. One week later and I was back on the “wild bull” and this time I was also getting nuclear medicine shot into my veins so they could see the images of my heart.  I looked like a Borg from Star Trek and the medicine felt like freezing lava entering my system. No need for Christmas lights this year, I could just stand in the window with a star on top of my head and May could hang the decorations from my body as I was sure to glow from this injection.
The treadmill still won in convincing fashion but I managed to eke out a couple more seconds so as not to be an utter failure and to preserve some self-esteem. I liken it to scoring a touchdown with two minutes to go in the game when you are behind 70-0. The score does absolutely nothing but keep you from getting shut out. Oh well, I had to take what I could get and at least a few seconds was progress in the right direction.
I was blessed that the nuclear test results were normal and there was no MAJOR issues but I needed a course correction quickly.  “You are fortunate” my doctor said.  “But it’s up to you what you will do going forward.”  Enter the formulation of the title for my blog….”How Bad Do You Want It?”
Those two tests did the trick and with the Lord’s help, I set my life on a course to improve my health.  I lost nearly 40 pounds, took up running, biking and swimming and improved my eating with a more recent improvement by adopting a mostly plan based diet.  I had completed three marathons, countless other races and two half IRONMAN triathlons this past year. I felt great and all was well, or was it?
I turned 47 on March 8 and I couldn’t help but wonder if the Grim Reaper was on my tail.  He can be sneaky and I had done all I could to prevent him from making an early appearance.  My father passed away on November 15 and the closer that date came, the more anxious I got. I know that is ridiculous but it was my reality and I had to live with it.
So what is the purpose of this post? Well I’m glad you asked.  A strange chain of events began that would get my attention. In September a good friend of mine checked himself into the ER with severe chest pain.  Not yet 50, this scared both of us.  Thankfully it did not appear to be anything other than stress but this got me looking ever more closely for the Grimm Reaper. 
Fast forward to October and another good friend of mine in his early 50’s who is active, lean, eats well and an is good physical shape was not feeling well for a couple of weeks as he had been tired and lacked energy. But things got worse. As were talked on day he was complaining of a tingling in his chest and left arm that was radiating up his neck. DANGER WILL ROBINSON.  After much pleading he went to the ER and they discovered he had one artery with 80% blockage!  How can this be?  By God’s grace he is fine and on the road to recovery. Once again I turned my sights on the Grim Reaper, peeking around every corner more carefully than ever before.
Now it’s November 13th and I am on my way to New York City for a business meeting and I brought along the most recent issue of Marathon and Beyond to read on the plane.  Hal Higdon had written an article on the life of Jim Fixx. For those that don’t know Jim Fixx is credited with starting or at a minimum, helping launch the running boom in the 70’s. Having been a smoker and overweight, Fixx took up running and became somewhat of a celebrity.  He wrote the classic book “The Complete Book of Running” and by all accounts was in excellent shaping, having run several sub three hour marathons.  He died of a heart attack at age 52 while on a run. (Fixx had several symptoms of cardiac distress that he ignored and did not have a diet conducive to heart health and he never did a stress test)

How can that be?  Now my concern for my own state of being was escalating. Two friends of mine had cardiac issues, I just read an article about a talented runner in Fixx that died of a heart attack at age 52 and it was only two days to the anniversary of my dad’s passing from the same affliction. Add in I was recovering from a bad virus and still didn’t feel well and had all the makings for one big helping of “Freak out Stew!” Sitting in my hotel room I was scared to answer the door as it may be the Grimm Reaper posing as a house keeper and I was not ready to meet him just yet.
That’s it. I had to do another stress test for my own piece of mind. I called my doctor’s office and asked for an appointment for a stress test.  The young lady put me on hold and next thing I know I have my doctor on the phone.  That is one of many reasons I LOVE Dr. Jani. He is always there to talk when I need him. 
“Chris, he said, you don’t need a stress test. You run, you take your meds, your blood work is good and you eat right.”  “I know that Dr. Jani” I said, “But dad died at 47 and that anniversary is in two days, I have two good friends that are healthy that had cardiac issues and Jim Fixx just scared me to no end.  I need this test to make sure I am OK and for peace of mind.  I have a beautiful wife and a precious two year old, please do this for me. “Ok, you got it.” He said. We will see you at 8:00 am on Wednesday in my office.” Ok, test is on the books, I just needed to avoid the old Reaper until then.

This time I was excited for the rematch with the treadmill.  When David, the Exercise Physiologist who was going to administer the test called me back to the lab, he looked at me and asked “What are you doing here?”  I had to chuckle and proceeded to tell him the story outlined above and he just smiled and said “OK, let’s get started.”
David is an awesome exercise physiologist and was a pleasure to work with. He truly cares about his patients, has a great attitude, is very informative and was a lot of fun to talk with.   Never shy to carry on a conversation about exercise, I learned that David and I had a lot in common with our beliefs on exercise, health, diet and life in general. He is a graduate of the University of South Carolina and had done his graduate work in Texas.
All hooked up to the EKG, it was time to get on the treadmill.  Although the room was not much larger than a small office, I pictured in my mind Rocky entering the Ring for the first time against Apollo Creed. There was music, screaming fans and the adrenaline was pumping.  This was my shot at redemption and I was ready to give this treadmill a beating.
Dave explained the test and that my MAX heart rate for a man my age was 173 and we wanted, if we could, to get my heart rate to 85% of max or in the range of 145. “No sweat” I said, “this may take a while.”  He explained the test would start on a 4% incline and would increase in speed and incline every three minutes. “Let’s get after it” I said.  In my mind I could hear the bell ring and just like that the rematch was on, Treadmill vs. Vokaty, round three! 
David was very encouraging during my test. He kept asking how I was doing and that my test results were amazingly good.  He said I was making his day as he usually doesn’t get to see many healthy people take these tests….and the timer kept running. Four years ago I was not able to make six minutes, this day I was had not even broken a sweat at six minutes and my heart rate was barely above 90. Take that treadmill. I could hear the machine groan as we moved on to level 3, territory it didn’t see very often. “Now who is getting tired” I muttered to my nemesis. “I hope you brought your “A” game today because you are going to need it!”
The longer I went the more encouraging David got and the more excited we both became.  Level 3, level 4, level 5, level 6…..17% inclined and running 7:00 minute miles.  “Are you up for level  7?” David asked.  “Bring it” I said, “let’s do this.”  I could hear the treadmill groan as we moved to a 20% gradient and sub 7:00 minute miles.  I was sweating profusely and pounding out the minutes.  The test was clean and I kept on pushing, 173, 174, 175, my heart rate kept climbing and maxed out at 178.
“What is the next level like?” I managed to ask David. “There isn’t a next level, this is it!”  WOW I had put a beat down on the champion.   How about that!  Yes I was tired, but it was my arms that were the most tired as I had to hang on to keep from being launched off the back of this beast while running up hill at a 20% incline.  I came, I ran, I conquered the test! Ladies and gentlemen there is a new world champion!

As David slowed the machine and I cooled down I think he was as excited as I was. He raved about my test results, my VO2 max and that this made his day actually administering a test to a healthy person. It’s what he said next that made me grin from ear to hear.  “Chris” he said, “while doing my graduate work in Texas one of my professors referred to this test (treadmill) as the “Mechanical Bull” of medicine.”  “You my friend have just CRUSHED the mechanical bull of medicine.  Congratulations.”  “There is absolutely NOTHING preventing blood or oxygen from getting to your hear. Whatever you are doing, keep it up!”
 At that point I thanked God silently for these results and I also thanked him for the “country club” hill.  So adequately named, the country club hill is a steep hill that starts at the country club and has three gradients and is ALWAYS the last mile of all my runs, short or long. I have a love hate relationship with that hill. I HATE it during training but LOVE it when in competition and today I LOVED it as it plays a big role in improving my health. It’s like a mean drill instructor that you can’t stand but admire at the same time. 
At that moment I knew that the Grimm Reaper was nowhere to be found. While I know that there are no guarantees in life, I had some peace of mind that I was on the right track. My test results had improved from the last time; I felt great and was controlling the things that I could control. It goes to show that with the Lord’s help, proper diet and exercise you can reverse your health.  It all boils down to commitment and How Bad Do You Want It. Is it easy? Of course not but nothing good in this world comes easy. If there is no price to pay, then there is no worth. Our salvation is the only free gift but the rest we have to work for. 
Before I could leave David needed to share the test results with Dr. Jani.  We walked to a reception area and he went over to talk to my doctor. I could see them both and hear them so being naturally curious, I just had to eavesdrop, after all it was my test so I felt inclined to listen in.
“You didn’t find anything wrong with him, did you David” doctor Jani stated.  “No, Chris in incredible shape” David said. “Let me look at the test” Dr. Jain asked.  As he looked at the test results, Dr. Jani asked David “He stayed on the treadmill how long?  “20 minutes “David said. “I have never seen anyone do that in all my years of medicine.”  David said “I know, this was a lot of fun. In fact, I have worked with many of the athletes at USC and this is one of the top five tests I have ever seen!”
Dr. Jani walked over to me and gave me a big hug and told me he was proud of me. I am sure it is rewarding for doctors and technicians to see their patients succeed and turn their health around. He told me to keep running, keep eating plants and to enjoy life.
I was ecstatic and relieved.  In four years I went from being in horrible shape and on the road to cardiac ruin to having reversed my health and giving a great big TKO to the Electronic Bull of medicine.  I am not na├»ve enough to think that countless others have had much better results and are in much better shape than me, but for me this was huge. 
I will never compete for a podium spot in a marathon or a 70.3 or 140.6 triathlon but there will be more people behind me than ahead of me when I finish. The sheer fact that I can compete, compete against myself and finish is what is important. I decided to reclaim my life and health and to enjoy the process.

As I left my Dr. Jani’s office I was relieved, happy, thankful and proud. I was experiencing a similar feeling to what I had felt when completing my first half IRONMAN. I set goals for major changes and with God’s help I had done it.  I share it with you because if I can do it, anyone can.  Give it to God and think about How Bad Do You Want It.  The commitment is the hardest part; enjoy the journey and the rewards that follow.