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Old 01-05-09, 08:51 PM   #1
wrobertdavis
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Exercise induced stroke

Ok, the title was to get your attention, not necessarily based on facts.

Here's the deal. I've been riding seriously for three years. I ride 100-150 miles /week. I can ride 18 mph all day long. I can do 20-21 mph for quite a while when I am feeling good. I am 60 years old.

On Saturday, I went on a 50 mile ride on a beautiful day with a large local club. I got caught up riding with the A group. At mile 10, we were running 22+ mph pace line. At mile 15, we were doing 23-24 mph. I could feel myself melting down and dreaded moving into position when I would have to pull the line. That never came. My left side was cramping and I had to back off. I stopped for a rest, then picked up riding with 2 guys at 20 mph. I found myself weaving and having trouble keeping a straight line. I stopped at the 25 mile rest stop and ate a little and drank a little. I was drinking in a rhythm that always worked for me (drink water every 20 min, a Succeed electrolyte tablet every hour in cool weather).

Back on the road at mile 25, I slowed way down as I hit a fierce headwind. My bike mysteriously shifted and I looked down to discover my right hand was "laying there" and forced a shift. This happened three more times, and I knew I was done. I hailed the SAG wagon for the first time ever and asked to be taken in.

Back at the starting point, I found myself weaving around and repeatedly dropped my car keys from my right hand. I managed to get home and my wife demanded we call a doctor when she heard my voice slurring.

After two days of exhaustive tests, we now know I suffered a cerebral hemhorrage caused by blood pressure spike induced by extreme exercise stress.

I am very lucky. I have mild numbness all along my right side but nothing dysfunctional. The doctors believe I will recover completely with no damage and I will be back riding in a month or so. I came home from the hospital today and I am typing this myself (with a mild bit of difficulty).

Lessons I may have learned:

1. Pay attention to your blood pressure medication if you take it and monitor BP regularly.
2. No matter how great you feel, or how young your friends tell you that you are, you just might be a bit more age worn than you think you are. Be careful.

All constructive comments and discussion are welcome.

Bob
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Old 01-05-09, 08:58 PM   #2
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Bob,
Glad you are going to recover completely. This makes me glad I religiously take my 2 BP meds. I see my physician for a follow up visit Wednesday and I think I'll mention my cycling and be sure he is on board with keeping me riding healthy and working with me. I have a family history of heart disease and strokes. My father, paternal uncle and paternal grandmother died from strokes so I tend to watch things carefully.

Thank you for the heads up on something important.

Bill
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Old 01-05-09, 09:08 PM   #3
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Bob,
Glad you are going to recover completely. This makes me glad I religiously take my 2 BP meds. I see my physician for a follow up visit Wednesday and I think I'll mention my cycling and be sure he is on board with keeping me riding healthy and working with me. I have a family history of heart disease and strokes. My father, paternal uncle and paternal grandmother died from strokes so I tend to watch things carefully.

Thank you for the heads up on something important.

Bill
One of the things I would love to be able to do is monitor myself riding. The neurologist told me cardiovascular exercise has more benefits than risks if you don't push it to the limits.

I want to find out if a heart rate monitor and associated alarms would be useful to keep me out of trouble. I am also going to look into stress testing to see if there is a way to reliably determine how my body reacts to stress and avoid detrimental patterns. The doctor was going to let me return to cycling in a few days until my wife insisted "No you don't understand, my husband is crazy".

Bob
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Old 01-05-09, 09:22 PM   #4
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Yes I think SO

Hi,
I have a heart rate monitor and it tells me when I am feeling off, and the most important when I am approaching that max heart rate.
Many times I am tired or feeling a little off and the heart rate monitor will speed up to easily that a sign off fatigue or health problems.
Your on Bp meds cause you have a Blood pressure problems when you exercise to improve your blood flow to your muscles you may forcing your body to increase the blood pressure to keep up so, holding back a little although not very maucho may help your BP and heart to keep up.
There's nothing natural about pushing 100% when you only have 75% available that day.
I hope you recover completly. watch you balance, it may be a little off, some people with problems go to Recumbs if its off.
I have High BP too, and all the problems .
PSPS
Some beta blockers are known to slow your heart rate even when you exercise, I had to drop that med I now only take Lisproniol and a thiazide, both have serious side effects cause thiazides can dump salts, and lisproniol can raise Potassium dangerously, all meds can have side effects and thats if your healthy not fighting a virus or tired..
I found my heart rate monitor At Bike island the most cost effective.
I am 68 My max normal heart rate is 162 it drops 1 number a year, so you can guess your max, and remember 145 isn't bad if your working hard at my current physical condition 130 is crusing 140 and I am starting to breath hard and 118 coasting or recovery...


here a good starting point more or less depending on your health and meds.

http://www.wikihow.com/Calculate-Your-Target-Heart-Rate

Last edited by djnzlab1; 01-06-09 at 04:48 PM.
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Old 01-05-09, 09:51 PM   #5
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I'm glad to hear you will recover from this and glad you shared it with us. A real eye opener!
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Old 01-05-09, 10:15 PM   #6
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Thanks for the heads ups, and glad you are ok.

I'm crowd'n 60, just getting back into riding, I raced roads and crits 30 yrs ago. I'm the classic "the older I get the faster I was". I tend to push everything related to exercise so your post is a good warning for me. I have kept in shape with other sports over those years, running and swimming, but cycling is the only one that makes me push way beyond my limits. I will just about kill myself to not lose or to stay up with a group.

Your reminder, and the HM I got from my kids for my birthday yesterday (are they trying to tell me something), my help keep me out of the the emergency room.

Thanks and recover soon.
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Old 01-05-09, 10:16 PM   #7
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What a scare! I'm glad you got the good news that you should completely recover. I ponder on your #2 lesson quite frequently.... it's a sobering thought when you feel 25 but you're heading toward 60.
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Old 01-05-09, 10:58 PM   #8
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Eek

Glad you're going to come out of it okay.

This raises a question for me. I'm not aware of any heart or stroke issues. However, it's high summer here (ie, flamin' hot) and my commute home, just after the hottest part of the day, includes a 15 minute climb up a hill that's always pushed my heart to the max ... literally - it's the hill I discovered my max hr on two years ago. I haven't been wearing my HRM when commuting (just something else to pfaff about with), but maybe it'd be a good idea, at least while the heat is on, just to keep me this side of the red line - any thoughts? (note, I've already got the HRM, not talking about buying one). I guess if I feel the need to ask the question I've already answered it haven't I.

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Old 01-05-09, 10:59 PM   #9
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Nothing like a warning . . . you'll be fine, but learn to listen to your body.
Have pedaled over 300,000 miles and am 76 years old. No longer can I keep up with the A group . . . been there and done all of that.
Got in over 5,000 miles in 2008. No, am not as fast as I used to be; no, can't ride as far as I used
to; no longer get in 10+K a year either.
But can hardly wait 'til I get older!
So get better and get back on the bike . . . and listen to what your body is tellin' you!
Pedal on!
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Old 01-05-09, 11:08 PM   #10
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First off, congrats on going to the doc's and congrats on the prognosis.
Given my condition, this is a scary-a**ed story; I know I might push harder than I should.
Then, I do see my cardiologist 4 times a year and have had an annual stress test two years running.
Two years ago I was given the order: Never get your HR over 165bpm.
I set the alarm on my HR monitor for 165.
It beeped, I stopped and rested until it came down to 130 or so. Mostly...
I'd go over a little...166... 167 but, more, I would hit 165 and hold it. Sometimes for 10-15 minutes.
My cardio couldn't believe the improvement in my fitness when I went back for this year's stress test.
His order now? Keep doing what you've been doing.
I still feel like I'm dodging bullets sometimes, though...
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Old 01-05-09, 11:24 PM   #11
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Wow! What a frightening experience!

Like others have said I'm glad you sought medical help right away and are going to make a full recovery.

I don't take BP meds and although my mother had hypertension, I'm otherwise not at risk.

I regularly work close to my field-tested max HR. The other day cgallagh and I contacted a coach to have a VO2 max test done. We want scientific data, so we don't overload (his dad has had heart issues and so Chris has several risk factors. I just want to know because I'm obsessed with my numbers and limits).

As Yen said, point #2 is very sobering. It's hard to behave my chronological age when my mental age is half that.

Best wishes for a full recovery.
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Old 01-05-09, 11:39 PM   #12
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This is a good place to share this warning. Thanks. I knew there was a reason I don't push myself.
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Old 01-06-09, 05:35 AM   #13
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glad you are ok and it was not much worse.

As i have gotten older i am 57. i have found i just cannot keep up with the A group everytime i ride,sometimes yes,sometimes no. i take 3 different B.P meds a day and once my heart rare hits 166-172,that is it just like hitting a wall. Even though I push myself i have also adusted too the fact that I need to ride within my own limitations,not someone else's.
I still hammer hard,but also the biggest factor i have learned is more recovery rides and just keeping a fast good temp type ride works wonders also.
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Old 01-06-09, 03:40 PM   #14
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I know it is easier said than done, but LISTEN to your body, it was trying to tell you something long before you called for the wagon. I am sixty as well and if I could do 18mph all day I would be quite happy. You are lucky on a lot of fronts. Slow down and enjoy it.

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Old 01-06-09, 04:07 PM   #15
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I appreciate all the great comments and feedback. I am home from the hospital and resting for the week. Its 56 degrees outside with 3 mph wind and crystal clear blue sky. Its killing me to sit on the couch!

I was riding with a new Garmin 705 and figured how to extract the ride stats. Here is my heart rate plot. I am pretty sure the hemhorrage occured between 20 and 30 minutes into the ride.

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Old 01-06-09, 04:09 PM   #16
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I know it is easier said than done, but LISTEN to your body, it was trying to tell you something long before you called for the wagon. I am sixty as well and if I could do 18mph all day I would be quite happy. You are lucky on a lot of fronts. Slow down and enjoy it.

Oh, believe me I was listening, but my hard head was arguing with it instead of making wise decisions.

Bob
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Old 01-06-09, 04:27 PM   #17
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The doctor was going to let me return to cycling in a few days until my wife insisted "No you don't understand, my husband is crazy".
Your wife is a wise woman. We are competitive by nature and may intend to take it easy, but end up pushing ourselves if another cyclist is in the vicinity. At least that is what I do. Can't stand being passed no matter what the age of the passer.
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Old 01-06-09, 04:55 PM   #18
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Interesting story. We all have different mixes of strengths and weaknesses, and there's nothing quite like a rambunctious pack and a dose of will power for a cyclist to discover their own weakest link - the hard way.

I've seen this scenario played out before. There simply is no "good way" to tell what's going on in everyday, real life situations. The older you get, while continuing to "play hard" - the greater the chances of negative physiological events.

Comments abouts using HR monitors as a method of assuring a measure of "safe exercise" are misguided. Heart rate is not a major indicator of stress on blood vessels, although I guess it is good at signaling the rate of diminishing positve-returns on your exercise experience.
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Old 01-06-09, 04:57 PM   #19
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maybe that dotted line should be your new max

HI,
better stay below the dotted line,Max heart rate 148, and remember some days we are a little off, if your not feeling well hold back.
Most sudden death in athelets occurs when they are coming down with a cold and don't feel real good.
Most people who die from heart problems don't have blood clots they have vertricular tachycardia.
or rappid heart rate .
Be sure your Dr knows that your using a salt supplement when you exercise it may be elevating your BP. for me I try and find Locarb energy drinks that have more Potassium than Sodium cause sodium can raise your BP. Most of the training drinks made have 3 x the Sodium to Potassium it should be the other way around for High BP. Salt isn't good for BP..
Thats why they put you on diuretics to lower sodium...
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Old 01-06-09, 05:04 PM   #20
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A fit jogger's risk of death from cardiac arrest jumps from an overall of about 3 per million person-hours of risk while not jogging to about 43 while jogging and recovering. That's a factor of about 14 increase in the risk of death. A sedentary individual has about 18 (from Physical Activity and Health, fig. 19.2)

We are all at greater risk while strenuously exercising, but over all, our rate of death from all causes is far less than than for the sedentary: A factor of 5 less for a very fit individual (fig. 9.5).

It's probably a good idea to build up slowly to a major increase in activity level especially if getting very active is a fairly recent lifestyle change.

Al
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Old 01-06-09, 05:59 PM   #21
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Robert, thanks for your story. When you get back on your R3, stay away from the A group.
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Old 01-06-09, 06:16 PM   #22
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Comments abouts using HR monitors as a method of assuring a measure of "safe exercise" are misguided. Heart rate is not a major indicator of stress on blood vessels, although I guess it is good at signaling the rate of diminishing positve-returns on your exercise experience.
I guess you are correct. Its way too complicated to boil down to simple measurement. I will say that I knew I was over stressing and I did not need any set of measurements to tell me so.

Bob
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Old 01-06-09, 06:18 PM   #23
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Robert, thanks for your story. When you get back on your R3, stay away from the A group.
I think a B+ group will work better for me. :-)

Bob
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Old 01-06-09, 06:26 PM   #24
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Here's a plot of a 27 mile ride from two days before where I was totally sane and felt great the whole time and got a good workout without over extending myself. I'll look at this as my poster child.

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Old 01-06-09, 09:26 PM   #25
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Glad all is well but this can happen without the exercise part of the equation. My brother, age 53, had a stroke while driving to work and was found in a field. A passer by saved him. Had a blockage in the artery in his neck but no other issues. Stent, better diet, regular exercise and all is well right now.
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