Stress Tests, Rat Poison and Cardioversion

Today ended, hopefully, the saga that began back in August when my annual physical showed an atrial flutter.  That prompted the stress test that I wrote about.  After the stress test the cardiologist determined I need cardioversion, which is just an electric shock to the heart to get the two chambers back in sync with each other.  The biggest problem is that my blood has to be thin enough for the procedure; otherwise there is a risk of a stroke, especially with the blood in the atrium, which has just been pooling there.  So I went on blood thinner, the main ingredient of which is warfarin.  Warfarin is the active ingredient in rat poison.

Anyway, after six weeks of rat poison therapy, today was the big day.  It was an outpatient procedure.  I checked in, got prepped with the IV and electrodes, they ran some anesthesia which got me to that delightful state just where you are almost asleep but barely conscious and the next thing I knew they were asking me how I felt.  My heart is back in a normal rhythm and hopefully this is the last I will need of cardioversion.

I'm hopeful this will take care of the lack of energy I've felt since summer began.  I attributed my lack of desire for exercise to a number of things:  My dad's death, going to Logan almost every week, not having time to exercise regularly and turning 60, which was the worst because there is nothing I can do if my lack of interest is due to age.  But when I learned that my low energy could be due to the fact that my heart was pumping only 75%-80% of the normal amount of blood, it got me excited that this might change things.  I'm cautiously looking forward to being able to ride the Bear Lake Monster century ride next June.

Veterans Day

Another thing that is unique to November is Veterans Day, or Armistice Day as it was originally called.  Armistice Day was created to celebrate the cessation of hostilities in World War I, the Great War as it was termed before another Great War came along and they had to start numbering the world wars.


At the eleventh hour of the eleventh day of the eleventh month in 1918 a cease fire went into effect between Germany and the Allied forces fighting in France.  Armistice Day was changed to Veterans Day after World War II in the United States and to Remembrance Day in the countries of the British Commonwealth, including Canada.  A famous poem written by Canadian physician and lieutenant colonel John McRae in 1915 after he witnessed the death of his friend the day before is called In Flanders Fields.  Flanders, France, was the scene of much of the worst fighting of World War I.  The poem is here:


In Flanders fields the poppies blow
      Between the crosses, row on row,
   That mark our place; and in the sky
   The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
   Loved and were loved, and now we lie,
         In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
   The torch; be yours to hold it high.
   If ye break faith with us who die
We shall not sleep, though poppies grow
         In Flanders fields.


In many countries, especially those of the British Commonwealth, there is a moment of silence at 11:00 a.m. on November 11.  In the United States a wreath is commonly placed on the Tomb of the Unknowns (or Tomb of the Unknown Soldier) in Arlington National Cemetery.   Also on Veterans Day the mat on which the Tomb Guards walk sentinel duty, 24 hours a day, seven days a week without exception, is replaced, as it is on Memorial Day in May.


The Tomb of the Unknowns received the unknown soldier who had been killed in France in World War I on November 21, 1921.

The Forgotten Month

November is the forgotten month.  Sandwiched between Halloween and Christmas, November exists mainly to torment those of us who don't want to rush the Christmas season and who object to hearing Christmas music beginning November 1.

It's time we stood up for the Pilgrims and turkeys.  This is a downtrodden, discriminated-against group being squeezed on both sides.  Witches and goblins on one end, elves and reindeer on the other, both trying to force the Pilgrims and turkeys from their ancestral homeland, November.  When I was in grade school, our bulletin board reflected the seasons.  October had jack-o-lanterns, ghosts, goblins and witches.  When November came, the yellow and black of Halloween were muted to oranges and browns, reds and dull green, to reflect what November is.  Turkeys, horns of plenty, pumpkins without grinning faces and the Pilgrims, in long dresses, buckle shoes and hats stood watch over our classroom.  Maybe, somewhere, a few teachers still do this, but try finding a Pilgrim among the red and green and glitter in almost any store.

So let's OCCUPY NOVEMBER!  Let's take November back and enjoy it for its own sake, not as a prelude to Santa.  Let's do it for the Pilgrims and turkeys.

Stress tests and cardiologists

The fact that my blood work was great at my last physical last month was overshadowed by what my doctor called an atrial flutter, an abnormality in my heart.  Anytime someone says "heart" and "abnormality" in the same sentence it gets my attention.  So I had to see a cardiologist and have a stress echo test.  I had heard about these, and what I heard didn't induce a lot of comfort.  Basically I was told it involves walking on a treadmill at increasing effort (the stress part) until you reach "maximum effort."  Nowhere could I find what "maximum effort" meant, so I was left to imagine walking until I puked, fainted or died, whichever came first.

When I arrived, I asked what maximum effort meant and was told that it means getting one's heart rate up to 90% of maximum, which the cardiologists define as 220 minus one's age.  In my case, that is 160 beats per minute.  I immediately felt better.  Having done heart rate monitor (HRM) training, I know what 90% of maximum heart rate feels like.  It's work, but not my idea of maximum effort (for that opinion, see above).  The test starts by being attached to a bunch of electrodes and lying on my side while a technician makes an ultrasound of my heart.  This lasted about 20 minutes, during which I nearly fell asleep.  Then the test came.  The treadmill started slowly but every three minutes the incline and speed increased.  Once I hit my maximum, I jumped off the treadmill and back onto the table so the technician could take another ultrasound of my heart under stress.  She had 60 seconds to do this.  The worst part was when they told me to hold my breath.  Imagine being out of breath and being told not to breathe.  After the test was over, they told me I could go and someone would call.  The good news was they didn't look at the results and say, please sit down and the cardiologist will be right in.  Apparently I was healthy enough to leave.

Eventually I met with the cardiologist who confirmed an atrial flutter, meaning the upper chamber of my heart, the atrium, is not pumping regularly; it's just fluttering.  As he put it, I have 25% of my heart not working properly, which could explain my lack of endurance this year.  I attributed it to lack of training.  The cure is to have my heart shocked back into a regular rhythm.  To do that, I first have to thin my blood so a clot doesn't develop, which could lead to all sorts of nasty things.  So I'm on a blood thinner, warfarin, which is the generic for coumadin, a long-used blood thinner to help prevent strokes.  Warfarin is the basic active ingredient in rat poison.  It works by thinning the rat's blood so much that it leaks out of its veins and the rat bleeds to death internally.  So I'm on a prescription of rat poison.

Results are In!

So I had my physical on August 17, then had to wait a week to go back to hear the results.  They are good.  Blood chemistry is right where it should be.  Weight continues to go down (at least it did before this past weekend when I wasn't so good).  I've gotten used to fewer carbs and while I'm hungry I don't crave things.  Friday I hit my lowest weight in a year and that came after two backpacking trips hauling 30 lbs. of pack weight over 9,000 ft. mountain passes and not eating while doing it.

Tonight I made shrimp in garlic cream sauce and put it over pasta, the first pasta I've had in six weeks.  I already notice that I am still grazing around the kitchen.  It's because the pasta (refined carbs) push my blood sugar up, so my body responds with insulin, but overdoes it and then my blood sugar is low so I have cravings.  Even though my stomach is full, I still want to eat.  I contrast that to when I eat a mostly protein meal such as salads, veggies, meat, eggs or dairy.  I am hungry but I don't have cravings.  Overall, I'll take the hunger pangs over the cravings because the pangs are easier to ignore.

Bottom line is I'm pleased with the results and plan to stay on a low carb diet.

Only Two More Days

My annual physical is August 17 -- two days away.  I'm most anxious to see what the low-carb diet has done to my blood chemistry.  Even though we were on vacation last week and ate out a lot, I feel like I did pretty well avoiding carbs, particularly refined flour and sugar.  I did eat a baked potato one night at dinner (along with oven-baked catfish, which I found pretty delicious).  I also splurged at a Steak N Shake hamburger joint and had a hamburger and fries.  But I continue to pass up the rolls and bread (except for the hamburger bun), haven't eaten pasta in nearly a month, limit the servings of potatoes and rice to one occasionally, and make use of salads, meat, cheese, eggs and veggies as the mainstays of my meals.

My weight isn't going down a lot, but this morning I noticed my waist is smaller.  I pulled on my belt to tighten it to where it usually is and found that would put me in the fifth hole, rather than the fourth, where I've been for several months (and on occasion in the third).  I am speculating that the weight training I've been doing as the core of my exercise program is building muscle that is mostly replacing the fat I'm losing from the diet.  Since muscle is denser than fat, I'm losing some inches while maintaining my weight.  My overall weight loss since starting is only about 4 lbs.

Continuing Low Carb Adventures

It's been two weeks tomorrow since I started the low-carb diet.  Last week I wasn't as strict as I was the first week.  I let a few carbs in, especially some mashed potatoes (can't have Dutch oven chicken without them), and on Tuesday I visited my mom.  When mom puts a homemade meat pie in front of you, you have to eat it.  Then on Friday we went out to dinner.  I ordered fajitas.  I used two of the flour tortillas, but had no rice, so the meal was meat, onions, green peppers, guacamole, salsa and sour cream, plus the two tortillas.  On Sunday we had a big family dinner and I had my first slice of bread in nearly two weeks.  Tomorrow morning I'm planning on steel cut oatmeal for breakfast.  After 14 days I'm sick of eggs.

The cravings for refined carbs are almost gone.  My weight has dropped a little, maybe four lbs., hardly the 10-15 touted by the South Beach diet in the first two weeks.  My energy is pretty good; I'm not feeling the blood sugar drop around 10:30 in the morning and 4:00 in the afternoon like I did.  I'm still hungry, but it isn't killing me.  Once again, though, the real test is coming on August 17 when I have blood drawn for my annual physical and we see what cholesterol, triglycerides, fat and the other blood chemistry looks like.