My experiment is in danger of failing. About 10 minutes from the gym I’m considering turning back. I feel unwell – stomach pains and light-headedness. Something is not right. If I miss the session, I won’t know if exercise affects my arrhythmia. It also strikes me that if I do go to the gym and have another arrhythmia I still won’t know if it’s down to exercise – it could be something to do with whatever’s making me feel unwell (or a combination of that and the exercise). Designing an experiment is hard work; no wonder it took so long to find the Higgs-Boson particle. I ponder on this for a while. In the end I decide to carry on – if I’m going to be unwell while exercising, this gym is a good place to be.
We gather in the foyer while exercise instructions, clipboards and pens are handed out and oxygen stats are taken. My heart rate is 71bpm but my O2 is 88%. This is not good – it should be at least 95%. What on earth is causing this? I know I’m feeling anxious; I have stomach pains and I have my scan tomorrow. The previously discovered abdominal hotspot is weighing heavily on my mind. I just hope it’s not weighing heavily in my stomach.
I’m losing all sense of proportion. Well – to a degree. Life is short, life is precious, don’t waste it. I get that. When I’m at the hospital surrounded by sick people, that message is writ large in the front of my brain in capital letters – my very own personal heads-up display. (This message will also be powerfully reinforced in the gym foyer in a few moments time). But the longer I survive cancer, the easier it becomes to lose sight of the big picture and so get stuck in the trivial. It probably is just stomach-ache.
There should be three staff on duty but two are missing. An announcement – the class will finish early today because of a shortage of staff. One is at a funeral for someone from the Wednesday morning class. The other is at a funeral for someone from the Thursday morning class. This news is greeted with silent acceptance; I’m shocked – and then wonder if someone’s going to make a joke about Friday’s class. But no one does.
I choose the exercise bike to start with. The cardio-nurse is on duty and stops by my machine to ask how I am. I explain about the stomach, the light-headedness, the O2 stats. “Did you eat enough before you came?” Yes, I think so. She’s puzzled and tells me to take it easy. They’ll check my stats at the end of the session.
I ask her about the arrhythmia and explain about last week. “Whenever someone tells me about arrhythmia I always ask what they were doing in the 24 to 48 hours before”. Hmm, interesting. I was gardening the day before. “Doing what?” Moving some pots around. “Heavy pots?” One was very heavy. “The exercise might have put the lid on the tin, but I’ll bet it was the lifting the day before that was the trigger.”
She explains it all in terms of speed limiters; “you know – on lorries.” The bisoprolol sets a steady heart rate (speed limit), which can be over-ridden if necessary (foot down or over-exertion). With the foot off the gas the speed/heart rate falls back down to its previous level. So far, so good. I tell her that this is the first time anyone’s explained the nature of beta-blockers to me in this sort of way. I’ve heard the bio-chemical explanation before (whoosh – sound of adrenoceptor blocking agents going over my head) and I’ve heard about some of the side effects – tiredness, sleeplessness, low blood pressure…. – but no-one’s mentioned HGV engine limiting systems before. She just shrugs; “I’ve been doing this for 25 years”.
I ask why there’s a time gap between the trigger and arrhythmia. She puts it down to the bisoprolol. “It’s a problems with all beta-blockers.” The drug can cause a delay in the transmission of electrical impulses in the heart. So the effects of over-exertion will be felt some time later. I’m still pedalling away as we speak and getting more and more breathless – not ideal for conversing – so leave it at that. But there are questions still to be answered. I don’t pretend to understand all of what she says but I like where it’s going.
After the exercise bike I manage a go on the cross-trainer. I get it right this time (rotate pedals forwards) and as I settle into it I come over all Mo Farrah-ish. I can hear Vangelis¹ in my head – and my own personal chariot is on fire. I could be out in the desert (on a Horse with no name) or loping through the Kenyan highlands (no suitable music comes to mind) and I realise that I really, really, like this. I suddenly get running. I understand human evolution; I’ve come down from the trees and I’m now chasing after food. Or perhaps fleeing a lion. Is it too late, at 66, to take up the marathon? When we finish the class my O2 has risen to 95%. So that’s a relief.
I’m tired when I get home and doss on the sofa with a cup of tea and a flapjack. (By comparison, when I got home last week I was bouncing round the kitchen on an endorphin high). My plans for a light supper are almost scuppered – Annie’s made one of her special (cardio-alert) apple and blackberry crumbles with a frightening amount of butter and sugar in the topping. But it would be churlish to turn it down.
And so to the big question; what happened next?
Nothing. Zilch. Diddly squat. In the context of last week, this is a ‘good thing’. The Gods of Arrhythmia chose not to come. Although if they read the bit about the 24-48 hour delay, they may just decide to put in an appearance tomorrow.
Great that someone’s explained the exercise in a way that helps you get on and do it still, but avoid the gods of arrhythmia. And thank you for publicising that explanation about beta-blockers – I’m on them again after a second relapse of hyperthyroidism, and what you/she said has explained some really weird effects I’ve been getting when I try and exercise (they reckoned I was losing about a pound a day of muscle during the worst bit last time, so this time I was trying to stop that happening by running on our cross trainer. Not one of my best ideas, it turns out, but nice to have some idea why). Oh, and I found going backwards was most natural, at first, too.
Fingers tightly crossed that the abdominal hotspot is just stomach ache.