Doctor Why

I have been trying for a solid 5 minutes to think of a good Dr pun to title this post with. I have to say I haven't been that successful. Anyway, moving on.

So today I had my follow up appointment with Dr Stobie. It was an interesting morning.

The upshot of this morning is that he doesn't know what is causing my ventricular arrhythmia, but he and his colleagues have a couple of theories.

Theory number 1 is that I have a genetic condition called right ventricular dysplasia. You might want to Google it. Basically it is the number 1 cause of sudden cardia death in young people. Unfortunately dysplasia is quite hard to diagnose. From what I understood today it is one of those things that they narrow down my observation. There is a checklist of major and minor observations and symptoms that go though and the more you tick off the more likely it is that you may have dysplasia and the more warranted further testing is. Before my previous ablation I ticked off a couple of the criteria which is enough to raise concern. Now I only tick off one of the criteria, which means it is less likely, but still something worth eliminating. If those tests do come back indicating dysplasia, well that is a conversation for another day and is one that involves pace makers, significant lifestyle changes and probably thanks to the almighty that I survived 20+ Half Ironman and 2 x Ironman with the condition. As I have said though, this isn't the expected diagnosis.

The other theory is that what I am experiencing is somehow related to Athlete's Heart (probably worth Googling it again). If you do Google Athlete's Heart you will probably read something that says it is the condition in which an athlete's heart grows significantly and while it used to be considered dangerous, these days it is considered benign.

According to Dr Stobie the view that Athlete's Heart is benign is now itself a bit outdated and the current view is that while it is not that dangerous, it is also not harmless. How harmful it is Doctor's  currently aren't sure, but the spike in endurance event related cardiac problems that they are seeing makes them think it isn't benign.

And really that is the problem with the athlete's heart theory, the Doctors really just aren't sure. While they are comfortable saying, what you are seeing is dangerous, they don't really know what about Athlete's Heart would cause what I am getting. From what I hear though all the cardiologists are very interested to see what is going on. A very fit and healthy, youngish person with no history of cardiac problems suddenly develops them, a cardiologists dream. So I guess that is an upside...

So, what happens now?

Well, funnily enough, whatever the condition, the next step is much the same. Wait. And take it easy.

With dysplasia the waiting is because I need to get some testing done and these tests some time. Probably going to be a few months before I get results.

With Athlete's Heart studies have shown that if I properly decondition, it should ease off. I should be able to get back into exercise afterwards, but I need to properly let my fitness go and my heart shrink before I do. That will obviously take time, about 6 months or so I gather. Since the whole point will be to lose fitness I will obviously need to take it easy in that time.

If I get the testing done and it is clear of dysplasia and I lose all my fitness and I still have issues? Well I am not actually sure what happens then. That is a conversation for another day. In the meantime I have some solid sitting around to get done.

So that is that. Upsides from today is that I don't need further surgery unless I want it. The surgery could possibly remove the symptoms, but not the underlying risk. To be honest the symptoms aren't that big a problem for me. When the syptoms do occur they are uncomfortable, but not terrible, that is partly why it has taken me so long to act on them. Plus, my symptoms only occur during exercise and so if I am not exercising, I have no symptoms to remove. If I am exercising I kind of like having the symptoms to remind me to take it a bit easier.

I really wasn't looking forward to another ablation, so not having one is another win.

So that is that. Not particularly happy about not exercising, but to be honest I am coming to terms with it. One thing I have learnt over the years is that you can make a positive out of almost anything if you put your mind to it. For me the obvious positive I am looking forward to is potentially having this issue sorted. The less obvious positive I am looking forward to is the challenge of rebuilding a bit fitness once I am completely deconditioned. I always quite enjoy the process of building fitness and so given that, it sounds like this I could be in for a real blast of a time in the first part of next year.