How did it go?
What does my future look like?
Read on to find out.
Okay, so elephant in the room. What the future doesn't look like? It doesn't look like racing is what it doesn't look like. I might as well get that out and said with. The advice of Dr Stobie and his colleagues is that I don't race anymore. That was his straight up advice. Hard to ignore when it is given to you straight down the line.
Dr Stobie said that he had no doubt I could find a Doctor that would tell me I was fine to race, but it wasn't his advice. There comes a point where you have to trust you medical practitioners and I am at that point. Watching Dr Stobie work I have absolutely no doubt of his expertise. I trust his advice and so I will be following it. No more racing.
What was his actual advice?
Well, similar to what it was before, but with a more concrete way forward attached to it.
His advice looks a bit like this:
- 6 to 8 weeks of light exercise to let my body continue recovery. Basically I can keep doing what I am now, some riding on the trainer and a bit of light shuffling.
- Holter Monitor for 24 hours on Monday to track what the ectopic beats look like now.
- Stress test the week after next by which time my heart should have recovered enough to go through a stress test. The idea behind the stress test is to see what the ectopic beats look like under stress. Under load is when I had the more dangerous symptoms before surgery and so this will give us some idea whether that has improved. If it has then that may be the start of the conversation around more moderate levels of exercise. Although 6 to 8 weeks of low intensity exercise is still the recommendation.
- Another MRI in 6 months time or so to make sure nothing dangerous had happened structurally.
So that is the diagnosis and the recommendation.
Dr Stobie did say that if I was adamant about going back to training then his recommendation would be that they go back in and do another ablation, this time targeting a large area of my right ventricle. However, he said that in the long run my health would be better if I didn't go with that option. While there are questions about the current health of my heart, it should improve with rest and time. However, if they go in and do more ablating they will be creating more scar tissue, which won't go away. I am very much at the point where long term heart health has to take priority.
So does all this mean that the surgery was a failure?
No, not really. While the Holter Monitor and the stress test will give a better idea, all indications are that I am getting a lot less ectopic beats than I was. Before surgery 25% of my beats were ectopic, now I am getting perhaps one a minute if I am lucky. That is a good improvement and definitely good news. It is unclear whether that improvement has come from the surgery or my decrease in exercise, but the improvement is the important thing in terms of my long term health.
If you are getting less ectopics, why can't you go back to training?
Well, it isn't really the ectopics that are dangerous but more what can follow from them. People talk about ectopic beats being benign and most of the time they are. Most people might get one or two during exercise and that is all normal. When you are getting them all the time though they stop being benign and start being indicative of trouble. That is the case for me.
One of the questions I had for Dr Stobie today is what the progress of a cardiac incident would look like for me. How do I get from ectopic beats to cardiac arrest. It was something I didn't really understand before. I was having trouble equating the cause with the consequence. What Dr Stobie explained today is that it looks like this.
- Regular ectopic beats,
- Non sustained Ventricular Tachycardia during exercise (what showed up on the Holter Monitor before surgery)
- Becomes Sustained Ventricular Tachycardia
- Which becomes Ventricular Fibrillation
- Which becomes Cardiac Arrest
- Which becomes death.
Pretty much as simple as that. What I saw during the last Holter Monitor is the first step of a path that can progress pretty rapidly and without warning. Having something explained to you like that tends to focus the mind on what is really important.
So, how do I feel about all this?
Hmmm, that is a hard one to answer at the moment. It is still pretty fresh news.
During this entire process retirement from racing has been a very real, and very likely outcome. Given that it was the most likely result I thought I had processed it and was okay with it. Talking to Dr Stobie this morning made me realise that I wasn't. I guess deep down I had been holding onto the hope that things will have improved and that I would eventually be getting back to racing. Perhaps I could get things together for Ironman WA 2017. Today really forced me to acknowledge that isn't going to happen. Not going to lie, that hurt, quite a bit. I am still not entirely convinced I have processed it. I suspect it is going to take me a while. To go from finishing the best race of my life to being forced into retirement and not even being able to exercise much is a pretty dramatic shift in events. I think it is going to take me quite a while to know how I am dealing with it.
At the moment though I am going okay. After the Doctor I took a bit of time for myself, just having a quiet coffee, spending a bit of time processing. That seemed to help quite a bit. Since then I have been feeling a bit better. I suspect though that the realities of today haven't really hit me yet. I might be feeling okay now, but I am not sure how I will go when I next have to watch a friend have the race of their life, knowing that I can't do the same, or go for my shuffle and be passed by grandmothers in their active wear. I have had those moments over the last two weeks and they weren't that much fun. How I adjust to them long term is a bit of an unknown.
A big part of how I go long term will come down to how I adjust to life post racing. I have some ideas of what that life might look like, but I am going to give myself time before I commit to anything. I am going to try a few things and dabble in some others to get an idea of what is going to work.
One of those things is going to start tomorrow and just quietly I am kind of excited about it.
If you want to know what it is then you might just have to come back and have a read of the blog tomorrow.
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