Why I Check my Oxygen Levels When I Ride

I have been trying to get ready for a the Avenue of the Oaks Century on May 1 and my training has been inconsistent at best….insert excuses here. Today I was able to spend 2 hours on a ride and I wanted to push a bit harder that normal.

SInce I no longer go to cardiac rehab. I try to mirror what the “maintenance” program I was on did when it comes to protocol. Each time I went to rehab the workout started with the following:

  1. Weigh myself.
  2. Relax and sit in a chair (of my own choice I closed my eyes and relaxed my whole body durigng the next steps).
  3. They would hook up the blood pressure cuff, and oxygen monitor.
  4. Then take the reading for my BP, resting HR & Oxygen level.

I do my best to do  all of the above things before I do any type of workout or riding (I’m in the market for a new blood pressure monitor as the electric one I had been using was not accurate when I brought with me to an appointment with my doctor and compared it with hers). Now during the cardiac rehab sessions they would check my oxygen levels 2-3 times, more if I was trying something new or pushing up a level of intensity. At home I only check it before I workout and occasionally after my cool down and when I push myself (now getting to the point of this entry) like I did today. Since I was heading out to ride twice as long as had I the past weeks I decided to take my Nonin Onyx Fingertip Oximeter with me to check throughout my ride. I want to point out at this point that this is same monitor 1 of my doctors uses, and 2 of my rehabs use so that is how I qualified it’s purchase. (one other point it is a nice way to check the accuracy of my heart rate monitor as well).

Today I used at the first sign of feeling like the ride should have been a bit easier and I didn’t believe my HRM, it was correct the oximeter read 138bpm and 98%O2. The next time was after a moderate climb and I hit 164 bpm (my doc say to stay under 160) Oximeter read 161bpm ( it took a few seconds to stop and put it on my finger) and 96% O2. It is also a good thing to have when I’m sucking wind and I can be sure it’s just from being out of shape vs a true loss of O2. I used it one more time when I started to feel tired and then after my cool down. I probably won’t bring it with me on a ride again until I do the century on May 1.

It is a useful tool to have if you work out on your own. It provides me with 2 things, 1: Ability to let me doctor know more information about my health & 2. Oxygen content of your blood is only a small factor when determining your risk for a cardiac event but it does provide me with a bit of assurance that my heart is doing O.K.

KEEPriding,

Eric

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Riding Ave of The Oaks Century after Heart Attack

This Saturday is the Ave of the Oaks metric century ride. I choose this one because while riding 63 miles is not that hard for me at this point, doing it and 6000′ plus of climbing is. I’d say that’s a pretty decent climb for someone without a heart attack so it would be a good goal for me. I try just to be happy that I can ride at all but it’s hard not to compare myself with someone who has no heart problems and I love riding up hills, always have, even though I’m not good at it I’m just persistent that way. Below is the elevation chart.

Ave of the Oaks Century elevation chart.

Ave of the Oaks Century elevation chart.

I’ll be riding it with my PT from my old cardiac rehab program and one of my cardiologist. Which makes my wife extremely happy, even though she wishes I didn’t do it at all. I think I’m ready. While I haven’t ridden that distance in a while I have been riding lots of hills and doing 3,000′ climbs in 28-30 miles rides and some hill repeats so I feel ready and the best riding shape since my heart attack.

I’ll do my best to keep track of my ride and bring you a crank by crank report.

Eric

My 3rd Cardiac Rehab Program

Below is a chart (click on it to view it larger)showing my routine during phase 3 & maintinence of my cardiac rehab at Scripps Integrative Medicine.

After 30 minutes of either stationary cycling or running on the treadmill or track I would perform the following pictured workout. While cycling or running I was allowed to maintain a heart rate of 140-145 maximum. On the stationary bike I would usually do a 3 minute warmup, 3x 8 minute intervals then a 3 minute cool down before starting the rest of the work out. The intervals might be 120-125bpm then 125-135 bpm and finish with 135-145bpm.  I would up my heart rate by either a low cadence hard gear or just by me regulating high cadence efforts and the occasional standing up to peddle. The runs were on their outdoor track (still monitored). It was a mix of walking fast, no lower than 125bpm and a slow jog which I would be able to hold 145-150bpm without a problem. My treadmill work was also done as intervals. Again, a 3 minute warm up then 3x 8 minute jog and 3 minute cool down.

I also will be posting notes and comments on 2 other programs I participated in over the next few months.

If you have any questions please feel free to post them here. I’d be glad to pass on my experiences.

scripps_cardiac_rehab_worko

This was my personal program reviewed by my doctor, nurses and exercise physiologist based on my health. DO NOT COPY this program with out first consulting your doctor(s).

My best riding since my heart attack…

YTD Riding Total- 576.93 miles / 38,524′

  • Road – Geared: 440.55mi / 34,363′ 
  • Road – Fixie: 136.38mi / 4,161′ )    
  • Dirt: 0

Not that any workout I do is worthy of publishing, bragging about or keeping track of but, I think it might be of help to some. Plus, it helps motivate me. Those of you who have had heart surgery and want to know what someone else is doing who has had 7 stents and 2 heart attack (5 years ago+ as of this posting) is doing. 

So. I’ll post what workout. I do, riding or otherwise, with pertinent info; heart rates, blood oxygen etc…

February has me out more so far but it has been tough with our new baby to get more than 2 hours in.

Goals for the year:

1. Feb 14, Palm Springs Century, full length – bailed out due to rain interrupting training and new baby duties.

2. April 4, Avenue of the Oaks Century (metric)

3. Sept 12, Amtrak Century, full length

4. Ride a BMX race again…..TBD

5. Ride 100 miles on my fixed gear….TBD

6. Do 10,000′ climbing in 1 day….

7. End the year with 150,000′ feet.

Riding Log- As of 04.1.09

04.01.09:  Road Ride-Fixed

  • 1:35 min  
  • 19.52 miles 
  • 875′ climbing 
  • 129 ave BPM / 156 max BPM (ave)

03.30.09:  Road Ride-Fixed+ Rehab work out

Warm up/(5)x 2.15sec effort at 8 out of 10, 145bpm-155bpm  & 4min recovery inbetween/ recovery home/cardiac rehab leg and weight program

  • 51.20 min  
  • 10.59 miles 
  • 260′ climbing 
  • 120 ave BPM / 154 max BPM (ave)

03.29.09:  Road Ride-

Felt amazing. My best ride since my heart attack. Climbed ober 2000′ in first 18 miles. My highest ave heart rate to date.

  • 2:38 
  • 32.63 miles 
  • 3047′ climbing 
  • 141 ave BPM / 160 max BPM (ave)
  • Blood oxygen levels: Before ride 78/98%. After ride 109/98%
  • BP after stretch and cool down-111/74/86bpm

03.26.09:  Road Ride-

  • 2:22 
  • 39.50miles 
  • 3049′ climbing 
  • 139 ave BPM / 157 max BPM (ave)
  • BP after stretch and cool down-119/79/90bpm

03.23.09:  Road Ride-Fixed+ Rehab work out

Warm up/(5)x 2.30sec effort at 8 out of 10, 145bpm-155bpm  & 4min recovery inbetween/ recovery home/cardiac rehab leg and weight program

  • 55.42 min  
  • 11.57 miles 
  • 358′ climbing 
  • 126 ave BPM / 148 max BPM (ave)

03.21.09:  Road Ride-

  • 2:43 
  • 35.02 miles 
  • 2513′ climbing 
  • 134 ave BPM / 158 max BPM (ave)

03.20.09:  Road Ride

Hill repeats- 30 min warm up/(8) x 6.30min x0.7mi hill with 2.30-45min recover in between and recovery home.

  • 1:39 min  
  • 15.66 miles 
  • 2,1111′ climbing 
  • 126 ave BPM / 159 max BPM (ave)
  • BP after stretching/cool down 110/77/86bpm

03.11.09-03.19.09

03.17.09:  Road Ride

  • 55.42 min  
  • 11.57 miles 
  • 890′ climbing 
  • 126 ave BPM / 148 max BPM (ave)

03.15.09:  Road Ride

  • 3:53 min  
  • 43.76 miles 
  • 2,212′ climbing 
  • 121 ave BPM / 158 max BPM (ave)

03.11.09:  Road Ride

  • 1:07 min  
  • 14.74 miles 
  • 1,113′ climbing 
  • 131 ave BPM / 147 max BPM (ave)

02.24.09 – 03.10.09

03.04.09:  Road Ride-fixie + Scripps weight program

  • 40.01 min  (5) x .75mi efforts at 145-155bpm with 4 1/2 – 5 min recover spin in between.
  • 9.29miles 
  • 278′ climbing 
  • 130 ave BPM / 155 max BPM (ave)

03.06.09:  Road Ride 

  • 1 hr 49 min. 
  • 23.24 miles 
  • 2125′ climbing 
  • 129 ave BPM / 151 max BPM

03.04.09:  Road Ride-fixie + Scripps weight program

  • 30.37 min 
  • 7.16 miles 
  • 214′ climbing 
  • 138 ave BPM / 155 max BPM

03.01.09:  Road Ride 

  • 2 hr 06 min. 
  • 24.88 miles 
  • 2,233′ climbing 
  • 138 ave BPM / 155 max BPM

02.25.09:  Road Ride 

  • 1 hr 16 min. 
  • 17.41 miles 
  • 867′ climbing 

02.6.09 – 02.23.09

02.23.09:  Road Ride -Fixie 

  • 56.53 min. 
  • 12.74 miles 
  • 400′ climbing 
  • 130 ave BPM / 148 max BPM
  • bp before ride 129/70 71bpm – bp after cool down 114/76 81bpm

02.21.09:  Road Ride 

  • 2:11 min. 
  • 27.47 miles 
  • 2251′ climbing 
  • 137 ave BPM / 150 max BPM

02.19.09:  Road Ride 

  • I felt good but my hr seemed to be 12-15 higher than normal so I cut my ride short.
  • 35.10 min. 
  • 6.90 miles 
  • 597′ climbing
  • 145 ave BPM / 169 max BPM

02.14.09:  Road Ride 

  • 2:09 min. 

  • 25.32 miles 

  • 2325′ climbing 

  • 137 ave BPM / 152 max BPM
  • bp before ride 127/76 75bpm 

02.11.09:  Road Ride 

I had just stared some hill repeats when I flatted and ran out of air and no pump, so I came home and did my Scripps Rehab workout.

  • 24.09 min. 

  • 5.57 miles 

  • 1397′ climbing 

  • 134 ave BPM / 153 max BPM

02.08.09:  Road Ride 

  • 1:13 min. 

  • 14.59 miles 

  • 1274′ climbing

  • 135 ave BPM / 152 max BPM

01.28.09 – 02.05.09

02.05.09:  Road Ride -Fixie (quick one before the rain)

  • 43.44 min. 

  • 9.93 miles 

  • 371′ climbing 

  • 131 ave BPM / 151 max BPM

02.03.09:  Road Ride -Fixie

  • I tired hard to make it 50 miles but my butt got sore and the winds tired out my legs.

  • 2:43 min. 

  • 36.33 miles 

  • 507′ climbing 

  • 125 ave BPM / 150 max BPM

01.28.09:  Road Ride 

  • 1:34 min. 

  • 18.77 miles 

  • 1431′ climbing / 1502′ decend

  •  

    142 ave BPM / 160 max BPM

     
     

01.05.09 – 01.25.09

01.25.09:  Road Ride – Fixie 

  • 1:39 min. 

  • 20.32 miles 

  • 957′ climbing / 962′ decend

  • 130 ave BPM / 141 max BPM

01.22.09:  Road Ride 

  • 1:41:00 min. 

  • 23.07 miles 

  • 1473′ climbing / 1362′ decend

  • 131 ave BPM / 151 max BPM

  • After cool down 115 BPM at 97% oxygen.

01.17.09:  Road Ride 

  • 1:35:00 min. 

  • 21.62 miles 

  • 1150′ climbing / 1267′ decend

  • 137 ave BPM / 154 max BPM

01.13.09:  Road Ride 

  • 1:14:00 min. 

  • 17.39 miles 

  • 824′ climbing / 898′ decend

  • 142 ave BPM / 161 max BPM

01.12.09:  Random at home workout 

12×16 stairs / Medicine Ball 200 ( did most of it) / 3×8 8# chest flys / 3×8 8# standing flys / 1×12 stationary lunge per leg
no hr monitor on

01.08.09:  Road Ride 

  • 49.37 min.

  • 10.49 miles  

  • 854′ climbing

  • 138 ave BPM / 161 max BPM 

01.06.09:  Walking / Hill Repeats

  • 50 min. 

  • 5 hills with park bench work out in between-3x 10 steps ups / 3x 10 push ups / 3x 10 tricep dips

  • 50 crunches on a stability ball.

01.01.09 – 01.04.09

01.03.09:  Road Ride 

  •  8.41 miles 

  •  34.47 min. 

  • 630′ climbing

  • 139 ave BPM / 161 max BPM 

  • (2x) 45sec with 60sec rest between -full body plank,  back plank ( I forget what it is called but pretend your Superman), (2x) 15  slow girlie pushups , 10 minutes of strecthing.

Listening to your body not your imagination.

It now gets dark at the home of the HAR around 5:30. I’ve been anxious to get back on the bike since I have only gotten 2 rides after my sinusitis left a week ago. I put on some “cold” weather gear (62deg. brrrr!:)) strapped on the Garmin monitor and rigged up the DiNotte. At night I just ride through my neighborhood.I love the anonymity, isolation and introspective thoughts that riding at night gives me. Since I live in a Southern California suburbia style planned community(no, I’m not a republican) most people are home eating dinner, so cars are hardly ever an issue.  I have not been out riding much and I expected my HR to be higher than normal. I did my usual 10 minutes warm up and thought about doing a short loop of 40 minutes or so. I felt good, maybe even strong for the first mile. The first hill is easy I usually am in the 140bpm area. This time my Garmin sounded the beeping alarm to tell me” Your in the the 90% range!”, I was at 157 bpm. ? O.K. no big deal. A short down hill then I stood up for a 30 sec effort up the next hill……161bpm ? ! Now my max is supposed to be in the 177bpm range. My last cardiolite test the docs maxed me out at 162-165bpm so that is up there for me. Hmm this is unusual even for me. I kept going 1/2 mile straight then another roller to get out of the saddle on…….again 160 quickly….hmm. I was always told by my doctors that if I feel fine it’s O.K.* and that I’m free to exercise at that heart rate. I coast down a small false flat then swing a U turn and go for another out of the saddle effort to that far away light post then a high rpm effort to the stoplight…about 1/2mile in all. As I almost got to to the street light a bit of chest pain, specifically it was sort of sharp 7 dead center radiating. I coasted down a steep hill then tried another good pace on the flat…still not feeling great. This is when I started to worry. “Not another problem?”, “Do I have to tell my doctor about this?”, “Is it just the cold air?” or “Maybe it’s the Tofurky from lunch?” I was almost done so back up the first little hill from the beginning of the ride then home. Back to 156-160bpm, arrrrgh and a diff location of discomfort, more in my upper chest. O.K. so I’ll just stand up for 1/2 a block hill and head home I thought. As I turned the corner I got in a good cadence but was more nervous than in discomfort. Whenever I get these types of pains and thoughts I try to slow down and ride through them before I make any real decisions to stop or grab a Nitro hit or pop some baby aspirin. I have a 75 yard 60 vertical feet climb back to my street after my cool down. When in shape I hit 125+bpm or 140bpm other times, tonight 156bpm….more food for my thoughts. I then spin in the easiest gear home, 3-4 minutes until my HR goes down. No problem there, same as always 115bpm in the garage and 98% oxygen on my meter. I still feel something that isn’t indigestion and isn’t chest pain either, it’s making me nervous. Not enough to go to the hospital.

My sis and brother in law come over to help me move some furniture, again just keep going and didn’t think about it and see if the pain goes away. It didn’t and I probably should not have moved that bookcase. I need to go to the market now and as I always do I grab my wallet, cell phone and nitro/aspirin bag. I take a hit of Nitro as I get in the car. Now this is NOT RECOMENDED. I have taken Nitro many times and know how it effects me so I feel safe driving having taken it. I’m in the market 7 or 8 minutes later looking at the magazines and feeling a little dizzy (probably the Nitro, but not sure) and my chest is still feeling “funky”. To be on the safe side I pop 2 baby asprin and continue shopping. As I call Mrs. HAR to make sure what flavor of juice she is craving (she’s 8+ months pregnant), reading labels and deciding if the the broccoli I’m holding is too wilted or worth buying if I eat it tomorrow I notice that I no longer feel any pains, dizzy or anything I would consider cardiac related.

Enjoying the seat warmers on the drive home (remember, it’s really cold here) I think about how often I have let my mind over take my knowledge. Knowledge only I can understand because I have lived through any pain I could ever get from a cardiac issue be it immediate emergency care or the “MAN! I can’t believe I need to tell my Dr. about this and need another test” pain. SInce I had my heart attacks I have tried to keep a mental spreadsheet or chart of pains, feelings and emotions. I believe, and have been told,  my body will tell me almost all of things I need to know. If I can learn what it’s saying and how it’s saying it then retain that information to recall when these “episodes” arrive it will help me enjoy my rides more often.

* After annual cardiolites every year since my heart attack, many ultrasounds, cameras in my veins, and continually discussing my physical activities my doctors came to this conclusion.

* Never try anything I do or base your actions on mine without consulting you doctor(s). I have had clearance & or testing done to determine if what I’m doing is reasonable/safe for me to try. This website is not meant as any substitute or suggestion of medical advice, It is mearly a documentation of my experience(s).

Cardiac Rehab “The role of exercise after a heart attack”

Below is a transcript from the Mayoclinic.com website To view the podcast or see more of their website click this link

“Podcast: Cardiac rehabilitation — The role of exercise after a heart attack”

Welcome to Mayo Clinic’s podcast. Our topic today is the role of exercise in recovering from a heart attack. I’m your host, Rich Dietman.

In today’s podcast we’re talking about cardiac rehabilitation; specifically, how exercise can help you as you recover from a heart attack. My guest is Dr. Ray Squires, a professor of medicine in the Mayo Clinic College of Medicine and program director of Cardiovascular Health and Rehabilitation at Mayo Clinic. Dr. Squires, thanks for being with us today.

Dr. Squires: Thank you, Rich.

Rich Dietman: Let’s start by defining cardiac rehabilitation, just exactly what’s meant by that term?

Dr. Squires: The discipline of cardiac rehabilitation is a longitudinal form of care provided to patients who have cardiovascular disease. It entails exercise, and that’s what we’re going to talk about today. But it’s much more broad in its application than that. It really is a combination of reducing risk factors for heart disease, such as cholesterol, blood pressure, smoking, stress, excess body weight, excess blood sugar, taking proper medications that can prolong life and make patients feel better, and helping them to adjust to their life with heart disease. The ultimate goal of cardiac rehabilitation is to improve both the quality of life as well as the quantity of life.

Rich Dietman: We know that exercise is important for preventing heart attacks, but what role does it play in adults who’ve already had a heart attack? What’s the benefit?

Dr. Squires: Exercise has many benefits for patients with cardiovascular disease. It has an immediate impact on risk factors, such as the cholesterol and triglycerides in the blood; it actually makes the blood vessels more healthy. The inner lining of the blood vessels is called the endothelium. And it’s not very healthy in patients that have cardiovascular disease, and it does things that it really shouldn’t. And exercise helps to normalize the function of that important system in the body. Exercise helps patients lose weight, it helps them lower their blood pressure, helps them to prove their physical capacity so they can do things that they would like to do. But probably most important, patients that exercise live longer.

Rich Dietman: For a long time, people who’d had heart attacks were advised not to exercise; the doctors thought that the stress would cause further problems and damage to the heart. What’s changed about that?

Dr. Squires: What’s changed, Rich, is there’s been much research performed in the last 25 years that has demonstrated that the stress of exercise — and it is a stress, heart rate increases, blood pressure increases, breathing increases. But in proper amounts it’s a good stress, and the cardiovascular system adapts to that and actually becomes stronger. So it’s wrong to tell patients with cardiovascular disease that they should perform no exercise. Now, some patients have very severe heart disease and they really are not candidates for exercise, but that’s a very, very small percentage of the patients that we see.

Rich Dietman: What are the general exercise guidelines for someone who’s had a heart attack?

Dr. Squires: Well, we would like patients to start out gradually. Patients after a heart attack, many of them have had a procedure called the coronary angiogram, which requires a small incision in the leg, so we don’t want them to drive and we don’t want them to exercise excessively for a few days after that procedure is performed. But in general, we want patients to start with five to 10 minutes of walking or stationary bicycling, gradually building up the duration to as much as 45 to 60 minutes at least four or five days per week. We would like them to perform other forms of exercise, such as strength training, where they’re using hand weights or their own body weight to increase their muscle strength.

Rich Dietman: When can a person begin regular exercise after a heart attack? You sort of alluded to that in your previous answer.

Dr. Squires: When a patient is hospitalized with a heart attack, as soon as they are stabilized medically, we get them out of bed, get them walking around. We’ve learned from our past experience in having people stay in bed too long after a heart attack actually makes things worse. So within 24 hours most patients with a heart attack are up walking around. So we start low level exercise, such as walking, within just a few hours of the heart attack.

Rich Dietman: Are there any activity restrictions as far as what types of exercise I can do following a heart attack, for instance, what about lifting weights?

Dr. Squires: Well, in general, every patient’s different. What is right for one patient may not be exactly right for another patient. In terms of weightlifting, or lifting objects to increase strength, we think for just about all patients that’s a good thing, though oftentimes we’ll wait a few weeks after a heart attack before we’ll allow patients to do that. Now some patients want to do lots and lots of physical activity, and if they’re doing well, if their heart attack did not cause much damage to the heart muscle, then that’s OK. Patients who have had lots of damage to their heart muscle — we would restrict them and tell them they shouldn’t do any heavy lifting that would require straining. We would like them to be more careful in terms of exercising out of doors in either warm or cold weather.

Rich Dietman: What are some symptoms that, as I start exercising after my heart attack, I might want to be on the lookout for that might be considered worrisome?

Dr. Squires: Worrisome symptoms would include any kind of chest discomfort associated with exertion. It could be a pressure, could be a pain, could be a fullness below the breastbone, could radiate into the jaw, into the neck, into the teeth, into the shoulders, into the arms. Sometimes patients have pain in the back, or pain in the abdominal area with exercise. Any of those symptoms would be worrisome. Additionally, any dizziness during exercise, or shortness of breath, or unusual fatigue, should be monitored carefully.

Rich Dietman: What do you tell people who are afraid, after a heart attack, to do any sort of physical activity? I can imagine just hearing you talk about those physical symptoms, that sounds like having another heart attack, for goodness sakes, why would I want to do anything that would risk that?

Dr. Squires: That’s a very good question. There are some people who are a bit gun-shy about physical activity after having a heart attack. A heart attack can be a life-changing experience, so another benefit of a cardiac rehabilitation program is you’ll be exercising with other patients and you’ll watch them and see what they’re doing and gradually your confidence will build.

Rich Dietman: That brings me to this question, and that is, how do I get involved in a cardiac rehabilitation program, how do I go about finding one?

Dr. Squires: If you’ve been hospitalized for your heart attack, the professionals in the hospital, if they did their job properly, would have told you about the availability of a cardiac rehabilitation program, either that hospital or the hospital in your home location. If they did not do that, I would talk with your health care provider and ask about the availability of a program in your area.

Rich Dietman: Thanks very much, Dr. Squires. We’ve been talking to Dr. Ray Squires, professor of medicine at Mayo Clinic College of Medicine and program director of Cardiovascular Health and Rehabilitation at Mayo Clinic. You’ve been listening to Mayo Clinic podcast. I’m Rich Dietman.

Good ride…

On Saturday I was able to ride 36.8mi with over 3790′ of climbing in just under 3 hours. Not that fast but I was happy as my ave heart rate of 142 for those 3 hours and I had a max hr of 165. No chest pain or discomfort. I started taking the smallest dose of Lisinopril(2.5mg) for my blood pressure but felt no issues from it. I’m planning on riding in the Tour De Poway in about a week. Not sure if I’ll do the full century or the metric century.