Re: Cardiologist too conservative?

Dnia 2008-05-29 Zen Cohen napisa³(a):
> I had to take a treadmill stress test yesterday because I had minor 
> right-side chest pain a couple weeks after a 40% spontaneous
pneumothorax in 
> my right lung. I suspect the test was overkill but I wasn't going to
defy my 
> doc's advice.
>
> He said he'd calculate 220 minus my age (49) so limited the test to 171
bpm. 
> I told him that I sometimes approach 180 when exercising and that I'd
like 
> to see if there are any problems when my heart reaches that range. Also
said 
> I'd heard the 220-minus-age formula was arbitrary, He agreed but said it
was 
> a good rule of thumb and summarily dismissed my request by pronouncing I

> just shouldn't exercise above my 220-minus-age. I realize that there is
some 
> additional risk by exercising at higher heart rates but I'm willing to
take 
> some measure of risk because I like to push myself and better my 
> performance. 

I think the guy was right.  If something wrong happened to you, he would
be responsible.  You had your pneumosomething already.  What if it
happened again?  You could sue his pants off, I suppose.

> Nonetheless he stopped me right at 171. I feel like the doctor 
> didn't do me a service because he didn't provide a sufficient reason for

> this and it seems his refusing to let me go further may have left him in
the 
> dark about potential problems that could develop in these higher ranges
if I 
> don't follow his advice.

I'm not an expert at that, and I really mean it, but as far as I
understand if you have something wrong with your heart it has a fair
chance of showing itself even on a resting test.  Taking a treadmill
test gives extra info, but not going several heartbeats higher will not
change much, if anything.   

> I get the impression this cardiologist knows plenty about counseling and

> treating sedentary or ill patients but has no interest in advising
fitter 
> patients who want to push their endurance without undue risk. Has anyone
had 
> experience with cardiologists who are more fitness-friendly? What have
they 
> said about the risks of exercising at or near max HR?

They say, that if you need to take your drug, you will take it anyway,
no matter what.  ;-)

> BTW, it took me 15:30 to reach my "max" HR. He said his patients
normally 
> don't last longer than 11 minutes but heard of some accomplished
athletes 
> going over 20 minutes. I might've gone another minute or so but nowhere
near 
> 20 (with the speed/incline increases every minute). If you've done this 
> test, how long did you go? 

I know my mother did pretty miserable, but I don't know her numbers.  You
beat her blue anyway. ;-)

-- 
Andrzej Rosa 1127R