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John Lewis
10-31-2012, 05:19 AM
"What is that?" you ask.
They told me it is supra ventricular tachycardia.

I had gone for an echocardiogram and an exercise stress test on a treadmill. I had asked the Dr if I could get one more out of curiosity than anything.

The Echo gram was ok and we proceeded to the stress test. It started at a low level of about 4.5 kmh on a 10% gradient. Strangely by 5 minutes in my pulse rate increased faster than expected. The test was ramped up a bit. 12% grade and 6 kmh. I was chatting away to the doc as I ran. He's a cyclist and we were discussing bikes of course. The other doc walked over, looked at the screen, tapped first doc on the shoulder and pointed to the screen. The test was stopped immediately and back to the echo machine.

So the upshot was: My pulse had got to about 95% of my max for age. My max is supposed to be 149-150 based on the 220 - age formula. Then suddenly it shot to 215 BPM is the space of one beat.

I'd had something similar while riding up a steep hill a few months back. Mentioned it to my GP but he seemed unconcerned.

Now I'm waiting to see a specialist Electro Physiologist (Cardio Electrician as Dr jokingly called it). They will give 30 days notice. I thought that meant I would be seen in the next 30 days. Not so it could be a wait of up to 18 months or more.

Now when I ride I use a HRM and take care. I need to ride in a very low gear so riding my velo with 30 GI minimum is out. I can ride only at 4 to 5 kmh on the flat. Less up hill. My lowest GI is 12 on the trike. That's not much fun and a problem as the bike is my main means of getting around.

When the heart takes off I stop and wait. If it doesn't subside I have to phone for an ambulance. They'd prefer I didn't ride at all but I can't sit at home doing nothing all day long and I have things to attend to.

There seems to be several treatments all of which have ramifications.

1. Do nothing - So, sit around on the beach, watch the seagulls and do nothing the rest of your life.

2. Medication - Can have very undesirable side effects

3. Ablation - May or may not work and has a 1% ish mortality rate according to some references. That's a bit of a worry.

4. Pacemaker or pacemaker defib in combination with meds. - Not great as limited HR range means wouldn't be able to get out and ride group tours etc. Also I've been told no more welding or using power tools. Not an option as far as I'm concerned.

Well, its all moot until I see the specialist. Most of the above is from reading on the net and who knows how accurate it is.

I hope something eventuates soon as I want to get out there and smoke the roadies in the velo.

Keep well everyone,

John

darnthedog
10-31-2012, 06:48 AM
Sorry to here this John- Do take care. As to not using welders that is very sad but allows for opportunity to experiment in Carbon fiber or wood even if the heart can put up with the physical. There is also the opportunity to teach a friend to melt metal together while you direct and walk away while they do it. Totally up to you. Again take care and we well keep you in our minds.

TexasTuff
10-31-2012, 07:47 AM
Sorry to hear of the problems John. Does your heart rate only go up with exercise? Mine would go up to 200 bpm while I was doing nothing or even sleeping. Finally stopped the Afib after 3 ablations and then the PVC's started. Now have a defibralator/pacemaker but the PVC's are not as active as the Afib was, so it has never gone off. I have at least one PVC between each normal heartbeat. This isn't supposed to happen to us athletic types.
I have a great Electro Physiologist. We're still discussing options for me. Right now I'm running on 2 speeds, 45 bpm and 85 bpm. I still ride almost everyday but it does tend to limit my top speed. Another option may be to completely ablate the heart and run totally off a pacemaker. That's what I'm in favor of, but the Dr. is kinda dragging his feet about it.
I don't know how it works over there, but they tend to move you up on the list after a couple of trips to the emergency room.
Hang in there John, you have lots of options working in your favor. PM me if you have questions, I've been through most of the options.

John Lewis
10-31-2012, 09:29 AM
Hi TT,
Yes this seems to be exercise induced. I can't read the Dr's scrawl on the copy he gave me of the ECG printout but I think it says junctional. I have had the odd "skipped beat" for years which I suspect is a PVC.

I have found that two friends have pacemakers. Not the defib sort I don't think. I've been able to quiz the guy nearby and he tells me its not good to even cop a static belt from gliding feet over the carpet or getting a belt as we do getting out of the car on a hot day. With welders I think it may be the proximity of a magnetic pulse that is the problem.

Anyway this chap is on meds to slow his heart way down and then the pacemaker brings it back up to speed.

Another friend told me of someone he knew had a pacemaker that he could control the rate of within limits using a remote control. I don't know if that's right because unfortunately this fellow tends to romance a bit.

I think I'd be worried about relying solely on a pacemaker. I have a bit of a concern about relying totally on electronics.

I know of one lady now 94 or so who is on her 4th pacemaker but don't know how many years that is over.

John

TexasTuff
10-31-2012, 09:49 AM
When I went in last week for a device check (every three months, can be done over the phone) I was told I have 8 years of battery left on this one.
When I talked with the doctor I got the impression that a pacemaker is smarter than the pacemaker in the defibrillator. My understanding is that the pacemaker can sense when the body needs a faster beat better than the defib. My defib only seems to have two speeds and speed is increased by movement of the body. Jump up and down and it speeds up stop jumping and it slows down. There is a little springboard (like a diving board) in the defib that senses the movement. Riding my trike does not sense this movement and I have to bounce up and down in the seat occasionally to get the increased heart rate.
Like the old saying, "it beats the alternative".

John Lewis
09-18-2013, 02:34 AM
Well its about a year now since I started this topic so perhaps an update is in order.

I ended up in the catheter lab and they proceeded to do some tests. It's quite interesting as you watch the electrode being manipulated inside the ventricle via the monitor.

I asked how she moved it around and she replied. "With great Skill"
That set me laughing which wasn't a good idea.
No problem was found in the ventricle so the electrode was moved to the atrium and more probing ensued.

Then. " Damn, Its multi focal atrial tachycardia," She says. "There's nothing I can do for you."
This of course was by way of an ablation.

I spent the night in the hospital and next morning the Dr came to discuss the situation.

There were 4 medications that might help. Three of those I could not for various reasons tolerate. One in fact was likely to kill me within two years.

The least effective one was all that I could have so that was it. I was sent home with a script and the admonishment not to ride. When I argued she relented and said no more than 5 minutes per day on an exercise bike at a very low level.

Well I have taken the medication but ignored the warning and continue to ride. Its how I get around and I'm certainly not walking the 6 or 7 km to town.

I've had no real problems and the pulse has stayed down. It hits 120 which is about 80% max and sticks there.
I can't put out the power I once could and have to take it easy but I can still ride.

The pity is I have had this lovely Mango Sport velomobile over a year and have less than 1000 km on it and I can't ride it fast enough to take
advantage of the aerodynamics.

Can't complain I guess as I'm still riding. Haven't built anything in a while either. I really need to get motivated as I'm letting the side down there.

John

TexasTuff
09-18-2013, 09:36 AM
Hi John, sorry to hear they weren't able to do better for you but glad to see your still riding.
I've recently resorted to electric assist. I bought a low power hub motor and a couple of SLA 20 ah batteries just to test the waters. It has worked so well that I've not bothered updating the system. It's a very simple 20" front hub, 2 12v 20ah batteries with an on/off switch. Only $185 invested in the setup. I run about 50% of the time with assist on and 50% just on my own. It is enough to do about 50% of the work to get me over the hills and I have a lot of hills. With my help I easily get 20 miles from the batteries. I went with a hub motor instead of mid-drive because the hub motor will get me to help, if needed, in case the chain or transmission breaks or I'm just not able to pedal.
I don't think I would still be riding without the assist. The electric assist helps me get the distance and speed I need to make it all worthwhile. My pick-up sits for weeks at a time unused. Yesterday I was out on the trike for 4 hours doing things I needed to get done and got back home with battery life to spare.
Best of it to you, John. I always enjoy seeing your post.

darnthedog
09-18-2013, 03:30 PM
John
Glad to hear your still riding. Sorry to hear about your health issue.
I enjoy your insights whether you ever build another bike or not.

Tradetek
09-18-2013, 05:19 PM
My personal experience has always been to figure out what your limitations are and how to work around them. I figure if what I like to do is going to kill me and what I don't want to do is going to help me live a long life, then why not do what makes me happy? I might not live as long but at least I'll be happy.

Bill

tomelect
09-19-2013, 08:09 AM
Sorry to hear that John, glad you can still ride. Hope they can find a better treatment for you without the ramifications.

Tom

Ticktock
09-19-2013, 09:39 AM
A few years back I used to fly radio conrtrolled aircraft, and a friend did all the repairs to the gear we used . His problem was that he had a pacemaker! The gear we used would affect the gear he used to stay alive! He carried a remote control to retune his pace maker at any time--he reckoned he had 2 minutes if we affected him!
Even when doing repairs, he had to re tune himself! He demanded circuit diagrams and full specs for any new pacemakers, and always had a remote to put things right when they went wrong.
He would retune himself if he was doing anything more energetic than normal. We regarded it as normal to see Ray playing with his personal remote .
Should add that doctors told him to stop playing with electronics---you can guess his answer.
Steve G

John Lewis
09-20-2013, 11:22 PM
Thanks for all the replies. Its good to hear different points of view and helps put things in perspective .

Steve G: I didn't get the pacemaker and I'm happy about that. I can still use the welders and stuff. I met another chap who had the problem you mentioned and carried a remote to reset.

Tom: I'd like to think they will but might be too late for me. Just one of the hazards of growing old I think.

Bill: That echos my philosophy too. Rather a short happy life than a long miserable one.

darnthedog: I need to get myself into harness because I still have a Kyoto Cruiser to build so my wife can take some of the disabled people she works with out for a ride.

Texas T: I'd read about your experiments and found them most interesting. Amazing that even with just a simple on/off switch you could get that range.
I have been looking at getting a hub motor for my Wolf too as I enjoy riding it a lot.
The people at Sinner have come up with a nice through the cranks system for the Mango but it is a bit too pricy for me at the moment.
Through the cranks or mid drive is about all that can be fitted to Mango.

John