[M_Six]

CT scan for calcium buildup in the arteries. Anything above 400 is bad. My score is 5x that number. I'm stunned. I feel fine and can push my heart rate to 170bpm and keep it there for 20-30 minutes while I ride and still experience no discomfort at all. My cholesterol numbers have always been fine, even a bit too low. BP is under control. I exercise a minimum of an hour every single day and have been doing so for the past 6 years. I thought sure my heart was the last thing I needed to worry about. Apparently that is not the case. Got an appt with my regular doc today and I'm sure he'll be shuffling me off to a cardiologist. Funny how life can dope slap you when you least expect it.

[chassis]

Originally Posted by M_Six

CT scan for calcium buildup in the arteries. Anything above 400 is bad. My score is 5x that number. I'm stunned. I feel fine and can push my heart rate to 170bpm and keep it there for 20-30 minutes while I ride and still experience no discomfort at all. My cholesterol numbers have always been fine, even a bit too low. BP is under control. I exercise a minimum of an hour every single day and have been doing so for the past 6 years. I thought sure my heart was the last thing I needed to worry about. Apparently that is not the case. Got an appt with my regular doc today and I'm sure he'll be shuffling me off to a cardiologist. Funny how life can dope slap you when you least expect it.

Best wishes for success in the journey. I try to read all that I can about tests and what the result mean, and do not mean. nih.gov seems to be an information source with less bias than others. Harvard and Johns Hopkins are other sources to learn more.

[Markr]

Originally Posted by chassis

Best wishes for success in the journey. I try to read all that I can about tests and what the result mean, and do not mean. nih.gov seems to be an information source with less bias than others. Harvard and Johns Hopkins are other sources to learn more.

Here, here - hope everything works out fine for you. I have a Medscape subscription, which is really useful for looking up any drugs and any interactions etc. Also, take a look at Nattokinase and Serrapeptase - they purport to break down clots and plaque, but don’t take alongside any blood thinners. They are showing lots of promise to treat micro clots in Long Covid and ME/CFS.

On a more positive note, weather here is good again today and just managed to knock out 21 miles with 781ft of climb. So hot, I came home and drank a litre of milk straight off, on top of c. 1.6 litres of water whilst I was out.

[M_Six]

Originally Posted by chassis

Best wishes for success in the journey. I try to read all that I can about tests and what the result mean, and do not mean. nih.gov seems to be an information source with less bias than others. Harvard and Johns Hopkins are other sources to learn more.

Originally Posted by Markr

Here, here - hope everything works out fine for you. I have a Medscape subscription, which is really useful for looking up any drugs and any interactions etc. Also, take a look at Nattokinase and Serrapeptase - they purport to break down clots and plaque, but don’t take alongside any blood thinners. They are showing lots of promise to treat micro clots in Long Covid and ME/CFS.

On a more positive note, weather here is good again today and just managed to knock out 21 miles with 781ft of climb. So hot, I came home and drank a litre of milk straight off, on top of c. 1.6 litres of water whilst I was out.

Thanks, guys. Got an appt with my doc shortly, so maybe some answers. I have still been riding, but just taking it easy and keeping my heart rate low(ish). Did 25 miles yesterday and today. It's been nice and cool here, so that helps with the HR. I've always pushed myself to improve my times and surpass my efforts week to week. That may have to change. Getting exercise without hitting high HRs may be the better option going forward.

[chassis]

Another test to ask the physician about is an angiogram, either CT or traditional (with catheter). The reason for the angiogram is to confirm or dispel the cardiac calcium test.

[M_Six]

Originally Posted by chassis

Another test to ask the physician about is an angiogram, either CT or traditional (with catheter). The reason for the angiogram is to confirm or dispel the cardiac calcium test.

Pretty much what my regular doc told me today. He said they'd either do another CT scan with dye (contrast) or an angiogram. I'm waiting to hear back about an appointment with the cardiologist. Hopefully that won't take too long. Although apparently I've been living with this issue for quite some time. I wish I'd known about this CT scan test earlier. They drive you nuts pushing a colonoscopy every 10 years or so, but no one has ever suggested this test until now. This test was 1000x easier and faster than a colonoscopy and, from what I understand, relatively inexpensive to run. Why is it not more widely encouraged?

[chassis]

Great questions that patients should ask. Before agreeing to any treatment, I would write down:

cardiac calcium score
angiogram results (non-invasive CT with contrast or catheter)
EKG read by a cardiologist (either using a personal $129 6-lead Kardia device or done at a lab/clinic)
BP
resting heart rate
BMI
waist/abdomen circumference
blood lab numbers (trig, total chol, hdl, ldl, chol ratios, glucose)
hs-CRP inflammation

With all of this in front of you and the physician, red flags can be specifically identified with yellow highlighter. I would reject any statement generalizing the results to put you into a box or category, with a corresponding treatment, without detailed explanation of the entire picture.

I think of this as multivariate calculus, and I hold the view that treatments are prescribed based on too little data/too few parameters. Getting more data and understanding it takes time. Chris Columbus proved that if you get more data, the decision changes.

The patient has lots of time - the rest of his/her life. The physician has 20 minutes until the next patient...

[M_Six]

Originally Posted by chassis

Great questions that patients should ask. Before agreeing to any treatment, I would write down:

cardiac calcium score
angiogram results (non-invasive CT with contrast or catheter)
EKG read by a cardiologist (either using a personal $129 6-lead Kardia device or done at a lab/clinic)
BP
resting heart rate
BMI
waist/abdomen circumference
blood lab numbers (trig, total chol, hdl, ldl, chol ratios, glucose)
hs-CRP inflammation

With all of this in front of you and the physician, red flags can be specifically identified with yellow highlighter. I would reject any statement generalizing the results to put you into a box or category, with a corresponding treatment, without detailed explanation of the entire picture.

I think of this as multivariate calculus, and I hold the view that treatments are prescribed based on too little data/too few parameters. Getting more data and understanding it takes time. Chris Columbus proved that if you get more data, the decision changes.

The patient has lots of time - the rest of his/her life. The physician has 20 minutes until the next patient...

Thanks for this. I have all this info except for the angiogram, which I've been told is the next step. Aside from the calcium score, I'm pretty much in the normal range for someone my age. Yeah, I could stand to lose 25lbs and I've been working on that. But otherwise I'm not looking bad. My hs-CRP is 1.43, which is average. It'd be nice if that was in the 0.0-.90, range, but it is what it is. I guess it's just a matter of waiting for the angiogram now.

[chassis]

14 miles, perfect weather conditions. Started the ride with a sweater and 60 deg F, ended in a t-shirt and 65 deg F. High broken clouds and no wind, great day. Low traffic on the trail, pretty nice ride. MCL is appreciating the once-per-week ride cadence.

[M_Six]

Perfect here, too. Sunny, clear sky, very light breeze from the north. And so cool. Mid-60s now and maybe low-70s later. I'm going out for an easy spin in an hour or so.

[M_Six]

Nice and easy 25 miler today. Average HR was 138 with a high of 150. Both about 30BPM below my previous numbers. This may be the new reality, though. I have to say, the lazy man in me likes this new relaxed riding. But I can't help feeling like it's not doing me as much good as more strenuous riding.

[chassis]

Today on the 14 mile ride over 1.5 hrs (took a water break) my average HR was 99 and peak was 142. I have never enjoyed HIT with extended high or max heart rate.

If by "good" you mean calorie burn, you are correct that a lower average HR burns fewer calories than a higher average HR. But time in the saddle, literally, also plays a role. Was your average speed slower, in line with the lower HR? I use a Fitbit and consider the calorie burn data to be directionally informative. I don't expect it to be precise to the calorie, but for comparison purposes it is good.

Diverging a bit, take hiking for example. I am usually the slowest person in my family of 20-somethings and my wife who has run 56 marathons. I often feel my self nutrient-depleted at the end of a hike, partly because I am on the trail for a longer time than the rest of my crew. I do not "pre-fuel" because in my view it defeats the purpose of exercise. I do consume calories on the trail (trail mix: nuts, raisins, chocolate) but tend to hit bottom calorically-speaking after long hikes.

The point being made is time + intensity = calorie burn. I tend toward longer time and lower intensity. My family is the opposite.

For me, fitness is a slow-and-steady thing, combined with diet/weight maintenance.

[M_Six]

Luckily I have a "magic bike." It's a Trek Domane+ LT with pedal assist. It's not full electric. You have to pedal or you go nowhere. But I can set the amount of extra power it gives me. So now I set the power on full and pedal nice and easy. I'm only 1MPH slower than usual, but I'm working way less. My calorie burn over the 1hr-22min ride is about 100-150 less in "easy" mode than when I'm pushing it. That's what, a couple of pieces of cheese? The upside is that I'm not getting tired at all. If I have the time, I can spend 2hrs riding. It's the discomfort in my wrists, shoulders, and butt that limit me more than physical exertion.

The thing I keep wondering about, though, is the effect on my heart as a muscle. Muscles get stronger if you work them hard. I always felt that pushing my heart rate was helping to strengthen my heart. So I'm concerned now that taking it easy is going to have the opposite effect. That my heart won't be getting stronger, but will just maintain a certain stasis.

This whole issue is motivating me to get back to a serious weight loss regimen. I had been down to 200lbs, which at 6'3" is a good weight for me. I slacked off last year and put 40lbs back on. I've whittled that down to 227 now, but I need to work harder and get back to 200 or maybe a tad less.

[chassis]

Agree that a fit muscle needs to keep pushing to get fitter. But my question, for all types of fitness, is how much "fit" is needed?

Extreme examples in any fitness dimension are easy to find. Ultra-low body fat (body builders, performance runners, performance cyclists), ultra-low body weight (anorexics), and at the opposite end, high muscle mass (body builders). I am not aiming for any of these extremes.

I strive for moderation in diet and exercise and target "good" zone BMI. I have been at my target weight for a while, so maintenance or very slight weight loss are my goals.

I have an informal long term weight loss goal of 1 pound every couple of years. This puts a bias into my thinking about diet and exercise, if I am aware of my long term goal to lose a small amount of weight. It's a mental/psychological thing for me.

[M_Six]

True. Constantly trying beat last week's scores is an ultimately self-defeating game. Sooner or later you're going to hit the ceiling. I've been sort of obsessive (in a small way) about raising my fitness level week over week. More mileage, better "Relative Effort" scores (a Strava thing), and Fitness Level scores (also Strava). I know I'll have to settle for a constant level eventually and give up the rising slope. At my age, I'm just not going to get beyond a certain point. It could be that the time to shift into maintenance mode is now or soon.

I've also been thinking it's time to back off the cardio a wee bit and spend more time with resistance training. That is supposed to be more beneficial for aging folks anyway, although I don't enjoy it nearly as much as cycling.

[Markr]

I enjoy cycling more than any other firm of exercise - I can’t do running etc due to a bad teenage ankle sprain.

Didn’t do any cycling this weekend, as we went away on a one night city break to near where we were both born, and had some fab food - which was the objective, a good look around some big city shops and some time away from the usual weekend chores - our daughter came around and looked after the dogs.

Just finished work and been out on the bike for an 1:06hr and cleared 18.18 miles, which I was happy with. Weather was quite warm c. 80F / 27C with a moderate wind, which hit me on the 5 mile leg home.

I have only recently got into Strava, so still learning how it works - I believe I can send routes to my Garmin, but haven’t looked into that yet.

[M_Six]

Another easy 25 miler today. Light west wind, which works well for our trail in one direction anyway. Just started raining lightly as I was finishing up.

[M_Six]

Had an appointment with a cardiologist today. Went very well. I have a stress test scheduled two weeks from now, but he said he expects there won't be any issues since I do my own stress test every day when I ride. But if it does indeed come back with no problems, I can go back to my regular exercising. The treatment for this is basically what I'm already doing, although at a more aggressive level. Statin and low dose aspirin daily and continued exercise and weight reduction. So I'm greatly relieved. Just have to take it easy until that stress test.

[M5Rick]

It's cooling here now from the 30C temps we have had and more pleasant riding without the sweat.

[Markr]

Knocked out 12 miles last night, a bit later than I wanted (due to work), and could have gone further, but light was starting to go. Quite a bit cooler too - starting to think about getting the long bibs out! - but not quite there yet.

[M_Six]

The weather here has definitely turned the Autumn corner. It was 48F this morning when I got up. Just came back from a ride in near perfect mid-70F weather. I felt so good I just kept riding and knocked out 30 miles.

[M5Rick]

Cut short my Sunday ride and turned back before the farm as it started raining with the sky turning a sort of dull pink so I turned on my front LED white light to blink, I took shelter under a tree for a few minutes and dashed home when it died down before it came down heavier again.