Originally Posted by
chinarider
I have a problem with this. If they test me with this protocol, they'll only get me to about 77% of my MHR. That may be too low to reveal lurking problems. Conversely, if my MHR was on the low side, they'd be trying to push me to an unattainable figure and might think I have a problem because I can't reach the goal. I just don't see how "standard guidelines" that fail to account for differences in MHR can hold water. Do me a favor. When you discuss the results with your Docs, ask them about this.
I did, and for the same reason. My observed max, 2 years back, is 182 and I was 54 then, so I'm also a rule breaker. Early this spring I felt wasted when I hit 176 on a climb, so MAYBE my max is a little lower this year; when I get a chance I'll do an LT test again.
She said there's loads of history in using this method of cardiac assessment, and to use this test depends on a known method of stressing the patient. They want to get everyone stressed in a known and repeatable way. This is the method in which the test has been established. So my results can only be reasonably assessed if they're made within the methodology. I agree, going up to say 155 for everyone of my age is a different percentage stress, looked at on a chart of actual HRMAX. But to resolve that requires a method of determining every patient's HRMAX. A measurement could be done, but in most cases there's knowledge that the patient comes to the test with potential cardiac risks that are not yet understood. Putting every such patient through a true max test might not be safe. Recall the principle rule in medicine, "First, do no harm." I think they're challenged to make an assessment under stress without doing harm.
Medicine is a pretty soft science in terms of having all the bits of knowledge neatly connected together by comprehensive theory, but they do have good knowledge of how to apply the little bits. I'm an engineer, and I'm always looking for things to connect together systematically. But working closely with docs in dealing with my dad's fatal disease, I learned that they have strong knowledge and follow good logic, but are dealing with a lot more uncertainty than I do in my job. The human animal is a system, but we don't know how everything connects together yet.
If you need more, ask yours. Thanks for listening to all the philosophy, if you've gotten this far. I think your problem is logically valid, but we could just think that because we don't have all the background docs have, i.e. we don't understand their paradigms and the extent of empirical knowledge that exists. In physical sciences we know that the theory is only good until a valid observation is made that contradicts it. I'm ok with not knowing everything, it leaves me time to ride.
My test was just yesterday, I don't have the report-out yet. It WAS a stress, though, I was kinda beat all day!