I looked at my last blog post. It was from June 28, 2021.
I had just met my new primary care physician. Since then we had made slow changes to my health. I tried to eat better and exercise more. It has been a journey of trying to implement what I preach. The progress was slow.
Last year, to help my physical activity endeavors (and because I have a huge interest in martial arts), I decided to start training at a local Karate school. The school I attend teaches Enshin Karate a style that traces it’s roots back through Ashihara and Kyokushin. Shortly after that time I noticed my Apple Watch was notifying me about tachycardia (faster than normal heart rate) when I was at rest. At first it seemed random and I tried increasing my water intake. I noticed that lying down and elevating my legs would help to improve the heart rate so I thought this was the problem.
After a while it bothered me that these warnings continued. And I soon realized that the days I got these warnings were on days I attended Karate class. My heart rate, I concluded, was having a delayed recovery back to a normal rate. But I wasn’t quite sure what to do about it.
So I met with my primary care physician to discuss what was going on and we decided to order a holter monitor and refer me to cardiology. The holter monitor would be worn for two weeks. I hoped it would catch these episodes where my heart rate would race. I hoped that I would be able to use it to a class or two.
When I finally got it I was able to wear in to one class. We concluded the class with three 2-minute rounds of sparring. By the end of those three minute rounds I was gasping for air and totally “gassed.” When I later received the report from the heart monitor I learned that my max heart rate was at 7:28 PM when I was sparring. My max heart rate was 200 beats per minute.
I was kind of worried about that so I backed of training for a while until I could see my the cardiologist. It turned out that I saw someone who I had met and trained under when I was both a medical student and resident. The recommendation I received was to start intense lifestyle modifications and he actually encouraged me to exercise 45-60 minutes per day and to utilize high-intensity interval training (HIIT). He asked me to set a goal of 6-7 days per week of exercise. It hurt to hear that as I was happy with 2-3 days before this. But I knew he was right.
On the one hand I was glad not to need to start medications. On the other hand, it sounded so daunting. I met with the cardiologist in late August. It is now late October. From the August to the present time I have increased my exercise but I also had gaps where I was not feeling well (ill) and other days when the kids weren’t feeling well and the madness of life got in the way of my exercise time.
I have had to accept the fact that I won’t be able to perfectly follow this plan immediately. And no matter what happened yesterday, I can try again today. I don’t have to wait until the next week or the next month to try and do it right. That perspective change has been helpful.
But I also can say that I fully understand the struggle my own patients have when I ask them to push for their own lifestyle changes. It’s hard to do. Maybe we can do it together.
