20190628 Cardiopulmonary Exercise Test, Part 1
When I started this T2D Be Gone thing, it was, in part, because in the Summer of 2018, my bike riding endurance fell thru the floor. Motivating. My working assumption was that my energy metabolism was busted. Mitochondrial damage, failed ATP production, and all the rest. I was convinced that my issues were biochemical - the meds, bad diet, accumulated damage - and set about to change those things.
That was then. The meds are mostly gone. I have a firm grip on diet. Doing the damage assessment is an ongoing concern. Things like insulin resistance, pancreas performance, fatty liver and fatty pancreas, arterial / CV disease threats are all front and center now. Practically, the causative agents for the damage is excess energy input, excess exposure to glucose and damaged lipids , and subsequently installed damaged cellular lipid use. It takes a while to eliminate excess stored energy ("fat"), and even longer to replace every damaged cell in my body.
Back in the day, VO2Max - the amount of oxygen consumed under maximal physiologic stress - was THE measure of cardiovascular fitness. You can get an idea of the test, and what's what, here. There are many many more modern measurements now, but, one thing at a time. My interest is in debugging my defective energy production systems, so I better consume my own fat self for energy and 'parts'. I admit, I wanted the number to give me something to try to improve. Here's a reference to what 'the number' should be.
I knew I wanted the measure VO2Max, but how to get it? I asked my body composition guy, and he suggested entities to call and ask. I asked a cute lady in my volleyball league, who is a rehab trainer ("I teach people how to breathe.") (yes, I had interesting tangential thoughts. Oh well :-). Nope, not there. She engaged with another PT and Doc in my league. They did due dilly on me (why do you care? what'll you do with the number? have you considered these alternatives?), and told me they didn't know how to get the measure for me. Hard to believe, but I sure sounded like I knew what I was asking for, and why.
At long last, I asked my GP Doc. I told him very specifically what I wanted, after he had done his due dilly on me too. He went back and inquired among the cardiologist heads at Unity Health, and at long last, wrote the order for a Cardiopulmonary Exercise Test, 28 June 2019 at 8am.
My two favorite prep instructions:
And then, we waited for two other people. One, a cardiology nurse, just in case I became a cardiology patient, and one more nurse, to stand by the bike and measure my blood pressure every 2 minutes. I suspect, but do not know, she was also tasked to catch me should I exit the bike fully under the influence of gravity. She taped down all the leads and tubes so they stayed out of everyone's way.
My task was to maintain a 55-65 stroke cadence. Their tasks were to measure everything they could, take care to keep me on task, and not kill me. Missions accomplished.
5 minute warm up, and then the bike resistance started to increase. I believe, but my memory is a bit fuzzy on this, I was holding at 210 systolic. Took about 15 minutes on the bike. At which point the cardiology nurse, for some reason, chose to walk behind me, and dropped a clipboard on a desk. Quite the racket. It blew up my focus, and my cadence dropped to 30ish. At which point, no mas. There's no way I was going to restart at that resistance. Such is life. 3 minute cool down. My final BP was 120/72. Un stick, un tape, remove breathing apparatus. Make sure I could stand and make it to the chair.
More conversation about my results - basically, she told me I did well, but nothing else. She had to review the results, then get a Doc to read the results, then they'll send the results to my GP Doc. And, me, maybe. So, I've asked my GP Doc to send me what they send him.
The exercise bike needs maintenance. The handlebars have a very slight wiggle / free play to them. The resistance on the pedals is inconsistent around the stroke. Both led me to less good form, hence, lesser performance.
When I get actual test results, I'll do another blog post.
Be well.
That was then. The meds are mostly gone. I have a firm grip on diet. Doing the damage assessment is an ongoing concern. Things like insulin resistance, pancreas performance, fatty liver and fatty pancreas, arterial / CV disease threats are all front and center now. Practically, the causative agents for the damage is excess energy input, excess exposure to glucose and damaged lipids , and subsequently installed damaged cellular lipid use. It takes a while to eliminate excess stored energy ("fat"), and even longer to replace every damaged cell in my body.
Back in the day, VO2Max - the amount of oxygen consumed under maximal physiologic stress - was THE measure of cardiovascular fitness. You can get an idea of the test, and what's what, here. There are many many more modern measurements now, but, one thing at a time. My interest is in debugging my defective energy production systems, so I better consume my own fat self for energy and 'parts'. I admit, I wanted the number to give me something to try to improve. Here's a reference to what 'the number' should be.
I knew I wanted the measure VO2Max, but how to get it? I asked my body composition guy, and he suggested entities to call and ask. I asked a cute lady in my volleyball league, who is a rehab trainer ("I teach people how to breathe.") (yes, I had interesting tangential thoughts. Oh well :-). Nope, not there. She engaged with another PT and Doc in my league. They did due dilly on me (why do you care? what'll you do with the number? have you considered these alternatives?), and told me they didn't know how to get the measure for me. Hard to believe, but I sure sounded like I knew what I was asking for, and why.
At long last, I asked my GP Doc. I told him very specifically what I wanted, after he had done his due dilly on me too. He went back and inquired among the cardiologist heads at Unity Health, and at long last, wrote the order for a Cardiopulmonary Exercise Test, 28 June 2019 at 8am.
My two favorite prep instructions:
- Have a light meal 2 hours before the test. I ate 4 ounces of grilled beef and 4 of grilled chicken breast.
- No alcohol, coffee, tea, or carbonated beverages prior to test. Well, prior is a very long time!! And, given an 8am get there time, no coffee was a non-starter. 24 ounces got me going.
And then, we waited for two other people. One, a cardiology nurse, just in case I became a cardiology patient, and one more nurse, to stand by the bike and measure my blood pressure every 2 minutes. I suspect, but do not know, she was also tasked to catch me should I exit the bike fully under the influence of gravity. She taped down all the leads and tubes so they stayed out of everyone's way.
My task was to maintain a 55-65 stroke cadence. Their tasks were to measure everything they could, take care to keep me on task, and not kill me. Missions accomplished.
5 minute warm up, and then the bike resistance started to increase. I believe, but my memory is a bit fuzzy on this, I was holding at 210 systolic. Took about 15 minutes on the bike. At which point the cardiology nurse, for some reason, chose to walk behind me, and dropped a clipboard on a desk. Quite the racket. It blew up my focus, and my cadence dropped to 30ish. At which point, no mas. There's no way I was going to restart at that resistance. Such is life. 3 minute cool down. My final BP was 120/72. Un stick, un tape, remove breathing apparatus. Make sure I could stand and make it to the chair.
More conversation about my results - basically, she told me I did well, but nothing else. She had to review the results, then get a Doc to read the results, then they'll send the results to my GP Doc. And, me, maybe. So, I've asked my GP Doc to send me what they send him.
The exercise bike needs maintenance. The handlebars have a very slight wiggle / free play to them. The resistance on the pedals is inconsistent around the stroke. Both led me to less good form, hence, lesser performance.
When I get actual test results, I'll do another blog post.
Be well.
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