How CPR Saved My Life


[NOTE: Here's a post from my archives that's been updated. Despite what happened to me, I continue to train and compete…]

Race Season 2009

Okay. So I haven't posted for a while. Not because I've got nothing to say. Far from it. I just don't know quite where to begin...

My 2009 race season hasn't gone as planned. Pre-season training was good and consistent right through from October '08 to April '09. I capped off the pre-season by logging a massive week of hours and miles at the ABA Spring Bike Camp in Penticton, BC.

I don't want to sound immodest, but for where I'm heading with this post you must understand: I'm a fit guy.

I've been racing on the road and track for about the past 10 years. I can hold my own against many riders 20 years younger than me. I can consistently ride 40km time trials in under an hour. My resting heart rate is in the high 40's. I have a body-fat-percentage in the 6% range.

So what gives?

On May 9, an hour into the first race of my season, I got taken out by a crash right in front of me. At 50+kph I had no where to hide and down I went too. I expected to have some road rash, but not much else.

When I stood up all seemed okay, but my bite was all wrong. Later in the ER I'd learn I broke my jaw. I was "looking forward" to a liquid diet for just over 4 weeks. That sucked - pun intended!

The same crash posted a bruise on my left leg, just above my ankle. I didn't think too much of it at the time.

But then after 4 weeks of limping and painful plyometics, I learned I had broken my fibula! (the smaller bone in your lower leg). At least it was well aligned, and I didn't need any further medical work.

As you can imagine, my training got a bit goofed up. But I managed to stay almost on schedule. Power levels were increasing. I competed in another road race and didn't crash — though I did have to avoid a crash that slid across the pavement at 60+kph. I also rode a track meet and finished 6th in the omnium.

I was starting to think my season wasn't going to be too bad after all.

Then the bombshell dropped...

I was all tapered and set to ride in the Banff Bike Fest Stage Race. But then, at about 4:30am on the morning I was to drive to Banff, I awoke with a sharp pain in my chest. It centered on my solar plexus, radiating outwards to both sides. I thought it might be indigestion, but it didn't have the burn of acid reflux.

I stood up, thinking the pain might subside if I changed body position. I managed to walk around my bed. Then I collapsed.

All I can say about what happened next is I'm damn lucky my wife is an intensive care physician. And she was right there by my side. Many times in the ICU Dr. Ella has seen fainting and cardiac arrests. She knows the difference. She's sure my heart had stopped.

I was rigid. My eyes were wide open and staring straight out. She could find no pulse. At first she felt utter disbelief. This couldn't have been happening… But she kept her wits, switched into physician mode and immediately began CPR on me.

One big thump and many chest compressions later I regained consciousness. My first memories were like trying to force my mind awake, like I was deep asleep but knew I had to wake up. And I heard Dr. Ella on the phone to 911. "Why's she calling 911?" I thought.

Quickly I realized something bad had just happened to me.

Now you know why I wanted to tell you a bit in the beginning about the shape I was in. I spent the next 48 hours in the hospital, hooked to a heart monitor, thinking, "What the F... ??" It didn't make sense.

After the continuous monitoring, 3 blood tests (and enough needle tracks to make me look like a heroin junkie), a chest x-ray, an enhanced CT scan, a cardiac ultrasound, a treadmill stress-test and finally a cardiac MRI, we found nothing remarkable.

We proved I was an extremely fit middle-aged man

I had healthy blood pressure, healthy cholesterol levels, and a normal "athlete's heart", i.e., an enlarged but dilated  left ventricle. You see, the left ventricle does all the work pumping blood to your body, so it grows a bit like any other muscle tissue that gets a good workout.

So why the cardiac arrest?

It's important to distinguish that I didn't have a heart attack. That implies a blockage in an artery of the heart leading to death of some heart muscle tissue. My heart is still completely intact with no indications of arterial blockages. But it did stop - hence the term "cardiac arrest".

My recent broken bones could have led to a blood clot thrown into my lungs or heart, but the blood work and many scans ruled that out.

At this point we can only say it was some kind of arrhythmia - an unusual sequence of heart beats leading to stoppage.

Why did it happen? Perhaps this electrical engineer has an electrical problem in his heart. More tests by an electro-physiologist might point in that direction. And there may be a few other genetic scenarios that could explain things. Some genetic testing might provide those answers.

On the one hand it's great to know I'm "healthy". But really, WTF? Something happened and I don't want it to happen again. I don't seem to have an issue while I exert myself, so perhaps my training can remain intact.

I can't expect Dr. Ella to be by my side every moment for the rest of my life. So is there a preventive solution? Sure. An Implanted Cardiac Defibrillator. Stay tuned… I might become the Bionic Bicycling Blogger...

Does this mean anything to you?

Damn right it does. Two things.

First, being an athlete doesn't guarantee you a long, healthy life. A high degree of physical fitness should give you a high quality of life while you're here. But high fitness levels can mask underlying health issues. You might have issues that could have grabbed you from the face of the Earth sooner if you hadn't been athletic.

Don't neglect to get annual physical checkups and blood tests. Work with your family doctor to maintain your health. If you've got small problems that don't seem too bad but don't fully correct themselves, don't ignore them. Keep an open discussion going with your family doctor. As athletes we tend to think we're invincible, that a little rest is all that's needed to get better. That's not always the case.

Second and more important, learn CPR if you haven't already. Dr. Ella is the director of CPR training at the hospital where she works. Until you take a course yourself, she has these pointers to keep in mind. What they teach now is a little different from before:

How To Perform CPR
  1. Make sure the person is lying on their back on hard ground.
  2. Check and double-check that there is no pulse and no breathing. The best place to look for the pulse is to first position the person on their back. Find the point on their jawbone just beneath their ear (it doesn't matter which side, left or right). Then slide your fingers - not your thumb - down onto their neck.
  3. If there is no pulse, then find the bottom of the sternum, i.e. the bottom point where the ribs meet in the middle of the chest. Measure up 1 hand width from the bottom of the sternum. This point will become the focal point of your compressions.
  4. Begin with 1 solid hard fist-blow to the focal point. Really hard!
  5. Start chest compressions on the focal point. Put one palm on top of the back of your other hand and interlace your fingers. Get yourself directly above the person's chest (not reaching towards them at an angle). Begin direct downward chest compressions. Keep your arms firm, and don't let them flex during a compression. Try to compress the chest about 2 inches with each press. Keep a tempo of about 1 compression per second, or slightly faster. Think "1 and 2 and 3 and 4..."
  6. Now here's the BIG difference from what you might have learned in the past: do not stop to administer any mouth-to-mouth breaths. Just keep on compressing.
  7. Call for help and get someone else to dial 911 if at all possible.
  8. After about 1 minute of chest compressions check again for a pulse. If you're still alone at this point, call 911. If you still didn't find a pulse, don't waste too much time on the 911 call. Get back to the chest compressions and just keep going until help arrives or the person starts to come around.
The key difference of not stopping to apply mouth-to-mouth is much like pumping up a bike tire. When you pump a tire it takes many pump-strokes before enough pressure builds to break the valve seal and start getting air into the tire.

With CPR, the concept is similar. It takes many compressions to build up enough blood pressure to get some blood flowing.

The most important thing you're trying to do with CPR is to keep blood flowing through the brain to preserve as much of it as possible. Any time you stop CPR compressions it's like taking that pump off your bike tire. You lose all the pressure gained and all the flow you started. You open the person up to more possibilities of brain damage if their heart ever starts again.

Back On The Bike

I'm back training, doing my best to be ready for the Canadian National Track Championships at the end of August. I'm spending a lot of time second guessing myself, but I will not be defeated by this. If I'm not back racing this season, I'm certainly going to be back at it in 2010!

What Happened Later in 2009?
Read how my story continued at the end of the season. I bagged a couple of medals at the Canadian National Track Championships. But I also bagged a little extra metal in my chest… Read all about it in this post: Bicycling Blogger Restarts With An ICD

Photo "Heart anatomy" by: Patrick J. Lynch

7 Ways to Become the MacGyver of Off-Season Weight Control

Weight loss is a perennial New Year's Resolution. As cyclists, we need to be mindful of our weight year-round, not just around January 1. After all, the fastest way to improve your power-to-weight ratio (a really raw yardstick to how fast you can go on your bike) is to chop off the weight while maintaining your power.

At this point in your off-season, if you haven't been minding your weight, it's time to start. Here are 7 ways to get control as shared by Tyrone Holmes on Active.com.

  1. Keep Riding - The no-brainer reason: manage the calories-in/calories-out equation. The hidden reason from my perspective? You've created a habit of daily (or almost daily) workouts, so don't break that habit. New habits are hard to establish. Working out is a healthy habit to have. Cherish it.
  2. Ride Long and Hilly - You need some longer moderate intensity riding each week. Plan for one long ride and one hilly ride. If weather prevents these from being rides outside, see the next idea...
  3. Cross Train - This is the winter saviour of icy-weather cyclists like me. Any aerobic activity will do: cross-country skiing, snowshoeing, skating, running, swimming. Even a bout of snow shoveling counts! I've filled many of my winter Sundays with a long cardio-combo session of snowshoeing, followed by classic cross-country skiing, finishing with an hour of clearing my driveway.
  4. Strength Train - Cycling is not a weight-bearing sport. Our bone density will benefit from strength training year-round. Your peak power generation will also benefit. And a strong core provides a stable platform for your legs to push against while riding. Off-season is the best time to begin strength training if you haven't already done so. And when you return to in-season? Keep it up once a week. See the power of habit in idea #1 above...
  5. Stop Eating So Many Carbs - Riding less than 2 hours at a time? You do not need sports drinks or energy bars. Water is good enough. Perhaps in the hour before or after you ride you can have a few higher glycemic index (GI) carbs. Outside those time-windows, keep them low GI, like you get from most vegetables.
  6. Have a Holiday Eating Plan - Set eating rules in your mind before you go to holiday party meals. For example, follow the Michael Pollan Plan: Eat food. Not too much. Mostly plants. Another way to look at it: If vegetarians can define themselves by a rule of never eating flesh - and live every day by that rule - can't you create an equally self-empowering rule (or set of rules) for yourself when you go a-partying?
  7. Do You Know About the 5-Pound Rule? - Don't expect to maintain your race-weight all season long. 5 pounds of weight gain is okay - but no more! When real in-season riding returns, 5 pounds can come off quite easily. But if you've got more than that to lose, an in-season weight loss plan can muddle up your efforts in real power gaining workouts. You won't have the energy in your tank for high-quality workouts. You might also want to read my article about the issues of asymmetric weight loss.
There you have it. 7 solid ways to control your off-season weight. MacGyver would be proud that you've got so many resourceful ideas in your mental toolkit!

The 2013 Festivus For The Cyclists

Festivus is a secular holiday celebrated on December 23 as a way to commemorate the holiday season without participating in its pressures and commercialism. It is usually celebrated with the practices of the "Airing of Grievances", the labeling of easily explainable events as "Festivus Miracles", and concludes with "Feats of Strength". If you are a person of a certain age, you of course remember it was featured on an episode of Seinfeld.

You can read more about the whole celebration of non-celebration here: http://en.wikipedia.org/wiki/Festivus

On BicyclingBlogger, I'd like to take this opportunity to recap the 2013 cycling season in my own Festivus fashion...

Airing of Grievances


Oh man, doping yet again!

Froome crushes the competition at the 2013 Tour de France, beating Quintana by 4:20 mm:ss. And our dear sport is still not in a place where Froome can merely take his spot on the top of the podium and be patted on the back and given a big hand shake for a job very well done. No, the press must still pester him about how it must have been doping. Are we still not in a position to accept that the anti-doping controls work?

Perhaps not... as Danilo di Luca was kicked out of the Giro in its last week for an out-of-competition EPO result from before the Giro even departed on its first day! How was he even allowed to start?

And even our home-country hero now has a taint from the skeleton hanging in his closet - outed by that walking/riding pasty skeleton himself, Michael Rasmussen. Never liked that twit, and was a little - just a little - skeptical with his book revelation of Ryder Hesjedal's "introduction to doping." At least Ryder didn't deny, deny, deny as many others have in the past, and admitted his use of long ago. I was always a bit worried about this, because Ryder did ride/domestique for Discovery in its Armstrong doping hay-days. But I thought it would be Armstrong that might finger Ryder - his bullying being so pervasive/perverse - not Rasmu-sh!#ten.

Let us all just hope that the doping controls of the 2012 Giro were solid enough to allow Ryder's victory to stand the test of time.

Festivus Miracles


A Festivus Miracle is an easily explainable event. Check out these Miracles:

  • Intervals are hard, and make me tired! It's a Festivus Miracle!
  • When I didn't ride for three weeks because I was holiday-ing in Europe, I lost 20W+ from my Threshold Power! It's a Festivus Miracle!

Feats of Strength


It was one of my stronger seasons lately. I had a solid 5th place GC showing in the Bike-On-Broadway Stage Race in Saskatoon back in May. And then in June, I had my best ever showing in the Banff BikeFest, placing an 49th of 81 starters. In the past, I never got an official GC result because I had always DNF'ed in the Road Race stage.

But Festivus isn't finished until my result has been wrestled to the ground. And I don't need to go far for that...

Again this year, like last year, my good friend Peter Toth pins me to the ground with his result at the 2013 UCI World Masters Track Championships with his Bronze medal performance in the Team Pursuit event. Well done Peter!

And now I can officially put the 2013 Festivus For The Cyclists to rest!