The heart - your single point of failure. And other pleasant thoughts

I may be slightly obsessed but it is a subject close to my, umm, heart. Yes, it's cardiac function and exercise. If you don't exercise then you don't get the benefits of exercise, right? You get fat, you lose muscle and bone mass, you lose "condition". Yet if you exercise too much, ie too strenuously or for too long, you risk damage. And if you get wrapped up in what is too-often the "boy's club" that is competitive sport then you are often driven to do exactly that - damage.

Basically what you really want to do is moderate exercise within the bounds of your abilities. Alas, that won't win you a bike race, will it? Well, not a big one, anyway. Trouble is, the commitment you need to make to competitive sport is OTT. Everything about it is wrong, yet it's addictive and feels so good. Given that you are probably going to do it anyway, you may as well read up on the downsides - the risks. If you want to "succeed" then at least do it fully informed.

Effects of Intermittent Exercise on Cardiac Troponin I and Creatine Kinase-MB

Strenuous physical activity is destructive for cardiac function causing an increased risk of myocardial infarction during and one hour after the exercise bout.¹ Cardiac fatigue is exercise-induced cardiac dysfunction in the absence of underlying cardiovascular diseases with a large number of symptoms and an unclear etiology.

Reflections on training and aging

Well we all do it - age, I mean.

One moment I'm learning to ride my dad's huge old Alcon and the next I've got 3 kids of my own. Let me reflect on this for a moment.

It was too big for me, the Alcon. It had a fixed sprocket on one side of the back wheel and a single freewheel on the other. Once I figured out that the faster you went, the better, I was OK. And this one idea - go faster - has propelled me throughout my cycling career. Go faster. It's better.

It was at Centennial Park that I found my forte. Laps, lots of them. Each one a fresh challenge. Each lap urging me onward, ever faster. Every rider in front of me a target to be caught. And at Heffron Park it was the same - but better. Wait for the last lap, the bell, and then - just go faster! Catch me if you can!

It seemed that "go faster" was indeed the key to it all. And the maxim held true also at Camperdown, bumpy, steep and forbidding that it was, where going slow was to tempt pedal-clipping fate. Going faster was, once again, the way forward.

Inevitably though life has its rough patches. The big fall. The glandular fever. The heart attack. The lay-offs, the come-backs. It's always the same, but always different. You get older and it all takes a little longer.

The falls took their toll both physically and mentally. I'm still paying for that big one at Heffron in '88. I never quite got back on terms with A-grade after that and never again took the "brave route" through the bunch. I lost trust. I backed off when I sensed trouble. I let others have the win. I lost that "animal" urge, perhaps. I mellowed.

And of course the heart attack was a real surprise. How can I ride every day and still get a blocked artery? Well there you go, you can. And the after effects linger. That question hangs over you, floating at the back of your mind - should I push a bit harder, or back off? How's the heart going?

So here I am, 14 months later. Back to 100kms a week. Well I have been here before, even after the heart attack. But I may have rushed my comeback, as you do. And I fell back into a deep hole. It's been over 6 months since I last rode a 100km week. But I've done it. And the sensations are good, again.

Let me run through the process.

Almost 6 months off the bike and I feel breathless, the quads hurt and sundry bits - like tendons, knees and the contact points - complain for days afterwards. But it was better than I expected. Maybe a comeback is possible?

A few rides later and all hope is lost. I'm not improving. I'm puffing, panting, weak and tired. Finishing is a struggle. Perhaps I should stop?

I persist and after a few weeks I notice that I'm going a bit further and occasionally a bit faster. But still I'm at a loss. It wasn't like this when I was 25. (Yes, well, I'm 57 now.) I'm not exactly jumping out of my skin, I lack zip and I'm wasted after every pathetically short ride. But I can't stop now.

Remembering how I over-did it last year I take it steady and build gradually. I don't want to relapse. I start to feel some good sensations when I hit the 80-km-a-week mark. The legs, heart and lungs occasionally work together. Hope springs eternal.

And cautiously I hit 100km-a-week. Finally the legs have some zip and I can maintain a steady, decent pace throughout the ride. I'm not dying at the half-way point and limping home. Instead I'm accelerating almost - almost - at will over the whole ride. OK, I can't attack a hill like "normal" but I don't think that's too far away. I can see the tunnel now and I suspect there's a light at the end of it. We shall see. 

100km in a single week? Here's the proof:

 Oh well, it's (yet another) start.

Jumping to conclusions about "red running"

There's a link or 2 doing the rounds, basically drawing attention to a sad incident where a young woman was allegedly struck by a cyclist whilst she was crossing at a traffic-light controlled intersection in Enmore, a suburb of Sydney. Allegedly (again, because in truth the "facts" are as yet untested) she had "the green" and thus, by logical extension, the rider was "running the red". Or so we are led to believe, anyway, as the cyclist's POV isn't represented in any story I have seen.

Now it's always unfortunate when people (or animals for that matter) are injured on our roads, and I extend my sympathy to anyone injured in this or any other way, simply "going about their everday lives". I too have been struck by cars, slipped and fallen on oil and grease left by motor vehicles and generally been beaten and battered by the poor state of many roads (as well as the attitudes of many road users). It happens. I've tripped and fallen whilst walking on poorly-maintained footpaths for that matter. So without detracting from the obvious physical pain felt by the young woman mentioned in these articles, for which the media concerned have kindly provided lurid images, I have to agree that life itself carries many risks.

OK, so that's the basic and largely sympathetic background to the story. But I wish to explore it a bit more. Whilst I have generally given up addressing the trolls who are attracted by such stories, once again I am drawn into the fray by the sheer ignorance of many comments. Essentially the debate becomes anti-cyclist, a blanket approach that life would be somehow transformed if "cyclists" somehow vanished from the planet.  Failing that, let's tax 'em into submission. Right - you've heard it all before.

I myself ride, drive and walk and can see (I think) most, if not all sides of this particular situation. I get delayed, I get endangered in all modes of transport. I even know the intersection involved. I don't know for sure (probably no one person has all of the facts) but I suspect that the traffic signals mentioned here are timed too finely for cars, not bikes. So a rider may enter on green yet still be passing through the intersection when it turns red. It's a fairly large, open intersection with a slight rise on the northern side, leading to a hill. Now I repeat again, I really don't know what happened here, but will conjecture that conceivably a rider could enter on the green yet still strike the woman concerned when they, the pedestrian had right of way. As I say, that's conjecture, and it doesn't erase anyone's responsibility; but I put it forward because we really have been led to believe only one set of "facts" so far.

Legally it's still the rider's responsibility to avoid any collision but it's probably not as clear-cut as a car driver deliberately "running the lights". Perhaps a witness can tell us otherwise, however sometimes bikes (and many other vehicles) just take longer to clear intersections. It's physics, not intent to harm. Coupled with a pedestrian lost in their own thoughts, or simply looking by sheer chance in the wrong direction, you have an accident. To label the cyclist (or pedestrian, motorist, or anyone) as "irresponsible" is moot, especially when we only have one point of view available. The legal situation will be resolved but the moral and ethical dimensions may be left unclear. 

In my experience as a road user, if I didn't think I could make it through safely, especially so when the lights had begun changing then I would take action to avoid hitting anyone, irrespective. However I know that sometimes these are split-second judgements involving braking, swerving, surfaces, speed and timing. Until you find yourself in that situation you can't really be certain how you personally would react.  

Now this matters mostly as an explanation, so we can learn from this, without exploiting the situation for other purposes. Indeed if we step away from the individual case here and think more abstractly about the contributing factors perhaps we can address a bigger set of issues about public safety in, on and around our roads.

One year later and I tempt cycling (and ischaemic) fate...

You may recall that despite having cycled some 300,000 kilometres in this tired old body of mine I still managed to have an ischaemic event (yes, a heart attack) on this very day, New Year's, 2014. As I was doing over 200km a week up to that point it came as something of a surprise to feel a persistent, dull ache that said "stop now" as I crested a familiar hill. Of course being a hardened racing cyclist I pressed on anyway, gasping and yawning, determined to "ride through it".

Until, of course, I just had to stop. I knew, deep down, what it was. Still, I didn't accept it. It seemed so unlikely. So I struck a compromise and turned around, slowly, and crawled - grovelled - home. About 15 minutes after stumbling in the door, I accepted my fate and embarked on a 6 day medical adventure involving 2 hospitals, a late night ambulance ride, 2 cardiologists and 3 stents. A month later I blogged merrily on the topic of not ignoring the bleeding obvious.

So here I am, a year later, still acting the goat. I have just tempted fate and re-lived that epic New Year's Day ride, retracing the exact route and soaking up the pain. Fortunately without the hospitalisation, touch wood. I'd like to say that I've spent the past year steadily recuperating, building up the miles and strengthening my weakened heart. But I haven't. Mind you I started well, with good intentions. I kept to a gentle, progressive plan that got me onto the indoor trainer and then out the door, building gradually. And then the confidence grew. This reconditioned heart actually seemed just as good, if not better than the old one! I set some tougher goals and pressed on. Until I started to tire.

It seemed like I was repeating the very mistake that had got me into this predicament: if in doubt, double the training. Despite the still-fresh memory, I was doing it all again. The training was going up but my form was going down. And then I caught a cold.

Now colds may slow you down but they don't have to stop you, so I backed off and came back. But the cold "freshened up". So I repeated the formula - back off, come back. And the virus came back too. It reminded me of a six-month bout of a "mystery virus" that hit me back in the late 1980s, effectively ending my club-level A-grade racing career. I didn't get a blood test then, sadly, so I'll never know for sure, but a GP reckoned it was mononucleosis. The prescription was "rest". So taking a leaf out of that same book I have had a long, long rest since the end of May.

Which is not to say I haven't ridden. Once a week I've given the bike a spin and tested my form. And mostly my form has been lousy. Given that riding every day is my long-term habit, riding just once a week - and for only 20 minutes or so - hasn't been an easy pill to swallow. And it hasn't been the ideal way to make a post-ischaemic comeback, either.

Which is why re-living my "2014 first-ever heart attack ride" today hasn't been without its measure of risk - or even fear. Sure, I took it easy. Sure, I've done the distance a few times in the lead up. Sure, it's not a century ride. But I'm not nearly as fit as I was then, and the hills are unrelenting. I live on a hill. Getting home is hard enough without worrying about blocked arteries and damaged heart muscle as well.

Anyway, I made it. It could have gone horribly wrong but it didn't. The monkey is off my back (I have avoided riding that route for a full 12 months). Hopefully I will listen to my own advice from here on and build the miles up again - very, very gradually. Fingers crossed.