Cardiologist too conservative?

I had to take a treadmill stress test yesterday because I had minor
right-side chest pain a couple weeks after a 40% spontaneous pneumothorax in
my right lung. I suspect the test was overkill but I wasn't going to defy my
doc's advice.

He said he'd calculate 220 minus my age (49) so limited the test to 171 bpm.
I told him that I sometimes approach 180 when exercising and that I'd like
to see if there are any problems when my heart reaches that range. Also said
I'd heard the 220-minus-age formula was arbitrary, He agreed but said it was
a good rule of thumb and summarily dismissed my request by pronouncing I
just shouldn't exercise above my 220-minus-age. I realize that there is some
additional risk by exercising at higher heart rates but I'm willing to take
some measure of risk because I like to push myself and better my
performance. Nonetheless he stopped me right at 171. I feel like the doctor
didn't do me a service because he didn't provide a sufficient reason for
this and it seems his refusing to let me go further may have left him in the
dark about potential problems that could develop in these higher ranges if I
don't follow his advice.

I get the impression this cardiologist knows plenty about counseling and
treating sedentary or ill patients but has no interest in advising fitter
patients who want to push their endurance without undue risk. Has anyone had
experience with cardiologists who are more fitness-friendly? What have they
said about the risks of exercising at or near max HR?

BTW, it took me 15:30 to reach my "max" HR. He said his patients normally
don't last longer than 11 minutes but heard of some accomplished athletes
going over 20 minutes. I might've gone another minute or so but nowhere near
20 (with the speed/incline increases every minute). If you've done this
test, how long did you go?

In article <483ef63e$0$5169$4c368faf@roadrunner.com>,
"Zen Cohen" <aturny@hotmail.com> wrote:

> I had to take a treadmill stress test yesterday because I had minor
> right-side chest pain a couple weeks after a 40% spontaneous pneumothorax in
> my right lung. I suspect the test was overkill but I wasn't going to defy my
> doc's advice.
>
> He said he'd calculate 220 minus my age (49) so limited the test to 171 bpm.
> I told him that I sometimes approach 180 when exercising and that I'd like
> to see if there are any problems when my heart reaches that range. Also said
> I'd heard the 220-minus-age formula was arbitrary, He agreed but said it was
> a good rule of thumb and summarily dismissed my request by pronouncing I
> just shouldn't exercise above my 220-minus-age. I realize that there is some
> additional risk by exercising at higher heart rates but I'm willing to take
> some measure of risk because I like to push myself and better my
> performance. Nonetheless he stopped me right at 171. I feel like the doctor
> didn't do me a service because he didn't provide a sufficient reason for
> this and it seems his refusing to let me go further may have left him in the
> dark about potential problems that could develop in these higher ranges if I
> don't follow his advice.
>
> I get the impression this cardiologist knows plenty about counseling and
> treating sedentary or ill patients but has no interest in advising fitter
> patients who want to push their endurance without undue risk. Has anyone had
> experience with cardiologists who are more fitness-friendly? What have they
> said about the risks of exercising at or near max HR?
>
> BTW, it took me 15:30 to reach my "max" HR. He said his patients normally
> don't last longer than 11 minutes but heard of some accomplished athletes
> going over 20 minutes. I might've gone another minute or so but nowhere near
> 20 (with the speed/incline increases every minute). If you've done this
> test, how long did you go?

Don't know yet. I've got one ordered but won't schedule it until this
damned leg heals.

If he wants me to have a 170 to 180 BPM in no time flat, he oughta just
let me do some heavy deadlifts. <g> It's faster.

To hell with the treadmill!
--
Peace! Om

"Human nature seems to be to control other people
until they put their foot down." -- Stephan Rothstein

Dnia 2008-05-29 Zen Cohen napisa³(a):
> I had to take a treadmill stress test yesterday because I had minor
> right-side chest pain a couple weeks after a 40% spontaneous pneumothorax in
> my right lung. I suspect the test was overkill but I wasn't going to defy my
> doc's advice.
>
> He said he'd calculate 220 minus my age (49) so limited the test to 171 bpm.
> I told him that I sometimes approach 180 when exercising and that I'd like
> to see if there are any problems when my heart reaches that range. Also said
> I'd heard the 220-minus-age formula was arbitrary, He agreed but said it was
> a good rule of thumb and summarily dismissed my request by pronouncing I
> just shouldn't exercise above my 220-minus-age. I realize that there is some
> additional risk by exercising at higher heart rates but I'm willing to take
> some measure of risk because I like to push myself and better my
> performance.

I think the guy was right. If something wrong happened to you, he would
be responsible. You had your pneumosomething already. What if it
happened again? You could sue his pants off, I suppose.

> Nonetheless he stopped me right at 171. I feel like the doctor
> didn't do me a service because he didn't provide a sufficient reason for
> this and it seems his refusing to let me go further may have left him in the
> dark about potential problems that could develop in these higher ranges if I
> don't follow his advice.

I'm not an expert at that, and I really mean it, but as far as I
understand if you have something wrong with your heart it has a fair
chance of showing itself even on a resting test. Taking a treadmill
test gives extra info, but not going several heartbeats higher will not
change much, if anything.

> I get the impression this cardiologist knows plenty about counseling and
> treating sedentary or ill patients but has no interest in advising fitter
> patients who want to push their endurance without undue risk. Has anyone had
> experience with cardiologists who are more fitness-friendly? What have they
> said about the risks of exercising at or near max HR?

They say, that if you need to take your drug, you will take it anyway,
no matter what. ;-)

> BTW, it took me 15:30 to reach my "max" HR. He said his patients normally
> don't last longer than 11 minutes but heard of some accomplished athletes
> going over 20 minutes. I might've gone another minute or so but nowhere near
> 20 (with the speed/incline increases every minute). If you've done this
> test, how long did you go?

I know my mother did pretty miserable, but I don't know her numbers. You
beat her blue anyway. ;-)

--
Andrzej Rosa 1127R

On May 30, 9:03 am, Andrzej Rosa <bakt...@yahoo.com> wrote:
[snip]
> I think the guy was right. If something wrong happened to
> you, he would be responsible. [snip] You could sue his
> pants off

Indeed: he was not looking out for Cohen's best interests - he was
looking out for his.
And charging Cohen for it.

"Andrzej Rosa" <bakters@yahoo.com> wrote in message
news:mai3h5-nm.ln1@bakters.bandit.home...
> Dnia 2008-05-29 Zen Cohen napisa³(a):
>> I had to take a treadmill stress test yesterday because I had minor
>> right-side chest pain a couple weeks after a 40% spontaneous pneumothorax
>> in
>> my right lung. I suspect the test was overkill but I wasn't going to defy
>> my
>> doc's advice.
>>
>> He said he'd calculate 220 minus my age (49) so limited the test to 171
>> bpm.
>> I told him that I sometimes approach 180 when exercising and that I'd
>> like
>> to see if there are any problems when my heart reaches that range. Also
>> said
>> I'd heard the 220-minus-age formula was arbitrary, He agreed but said it
>> was
>> a good rule of thumb and summarily dismissed my request by pronouncing I
>> just shouldn't exercise above my 220-minus-age. I realize that there is
>> some
>> additional risk by exercising at higher heart rates but I'm willing to
>> take
>> some measure of risk because I like to push myself and better my
>> performance.
>
> I think the guy was right. If something wrong happened to you, he would
> be responsible. You had your pneumosomething already. What if it
> happened again? You could sue his pants off, I suppose.
>

He's not a guarantor of my health; he just has to act prudently. I had
already signed a pretty comprehensive informed consent document, and his
warning me of any additional risk, with my knowing acceptance of it would
seemingly negate any malpractice. Seems that if I'm telling him I'm
regularly exceeding those maximums and he fails to test me under those
conditions when he had the opportunity to do so under medical
supervisiocould expose him to liability more than actually testing me with
informed consent.

......

"Zen Cohen"
>
> He's not a guarantor of my health; he just has to act prudently. I had
> already signed a pretty comprehensive informed consent document, and his
> warning me of any additional risk, with my knowing acceptance of it would
> seemingly negate any malpractice. Seems that if I'm telling him I'm
> regularly exceeding those maximums and he fails to test me under those
> conditions when he had the opportunity to do so under medical
> supervisiocould expose him to liability more than actually testing me with
> informed consent.
>
> .....
>

Poor doctor, having to work on a "lawyer"!!!!!!

Burr

"Zen Cohen" <aturny@hotmail.com> wrote in message
news:483ef63e$0$5169$4c368faf@roadrunner.com...
>I had to take a treadmill stress test yesterday because I had minor
>right-side chest pain a couple weeks after a 40% spontaneous pneumothorax
>in my right lung. I suspect the test was overkill but I wasn't going to
>defy my doc's advice.
>
> He said he'd calculate 220 minus my age (49) so limited the test to 171
> bpm. I told him that I sometimes approach 180 when exercising and that I'd
> like to see if there are any problems when my heart reaches that range.
> Also said I'd heard the 220-minus-age formula was arbitrary, He agreed but
> said it was a good rule of thumb and summarily dismissed my request by
> pronouncing I just shouldn't exercise above my 220-minus-age. I realize
> that there is some additional risk by exercising at higher heart rates but
> I'm willing to take some measure of risk because I like to push myself and
> better my performance. Nonetheless he stopped me right at 171. I feel like
> the doctor didn't do me a service because he didn't provide a sufficient
> reason for this and it seems his refusing to let me go further may have
> left him in the dark about potential problems that could develop in these
> higher ranges if I don't follow his advice.
>
> I get the impression this cardiologist knows plenty about counseling and
> treating sedentary or ill patients but has no interest in advising fitter
> patients who want to push their endurance without undue risk. Has anyone
> had experience with cardiologists who are more fitness-friendly? What have
> they said about the risks of exercising at or near max HR?
>
> BTW, it took me 15:30 to reach my "max" HR. He said his patients normally
> don't last longer than 11 minutes but heard of some accomplished athletes
> going over 20 minutes. I might've gone another minute or so but nowhere
> near 20 (with the speed/incline increases every minute). If you've done
> this test, how long did you go?
>

You sound like a "lawyers dream" (ya you) if you went down at over there 171
then you could have sued!!

I know, not you "good lawyer" but some other "normal" lawyer.

Here things are so tight in LA you had your hand in your own pocket!

Burr

"Zen Cohen" <aturny@hotmail.com> writes:

> "Andrzej Rosa" <bakters@yahoo.com> wrote in message
> news:mai3h5-nm.ln1@bakters.bandit.home...
>> Dnia 2008-05-29 Zen Cohen napisa³(a):

>>> I had to take a treadmill stress test yesterday because I had minor
>>> right-side chest pain a couple weeks after a 40% spontaneous
>>> pneumothorax in my right lung. I suspect the test was overkill but I
>>> wasn't going to defy my doc's advice.
>>>
>>> He said he'd calculate 220 minus my age (49) so limited the test to
>>> 171 bpm. I told him that I sometimes approach 180 when exercising
>>> and that I'd like to see if there are any problems when my heart
>>> reaches that range. Also said I'd heard the 220-minus-age formula
>>> was arbitrary, He agreed but said it was a good rule of thumb and
>>> summarily dismissed my request by pronouncing I just shouldn't
>>> exercise above my 220-minus-age. I realize that there is some
>>> additional risk by exercising at higher heart rates but I'm willing
>>> to take some measure of risk because I like to push myself and
>>> better my performance.
>>
>> I think the guy was right. If something wrong happened to you, he
>> would be responsible. You had your pneumosomething already. What if
>> it happened again? You could sue his pants off, I suppose.
>>
>
> He's not a guarantor of my health; he just has to act prudently. I had
> already signed a pretty comprehensive informed consent document, and
> his warning me of any additional risk, with my knowing acceptance of
> it would seemingly negate any malpractice. Seems that if I'm telling
> him I'm regularly exceeding those maximums and he fails to test me
> under those conditions when he had the opportunity to do so under
> medical supervisiocould expose him to liability more than actually
> testing me with informed consent.

How old is your doctor? Maybe the real answer is that your doctor
didn't want to see you beat his own time on the stress test so badly .

What's more likely, though, is that your doctor just doesn't care.
Somewhere along the lines he lowered his goals from keeping people
active and healthy to merely keeping people alive.

I suppose that's probably a pragmatic position for a cardiologist to
take, but it certainly doesn't sound very *fun*. If you are going to
take a stress test, you might as well see how well the ticker holds up
when you open things up all of the way.

Jason

On May 29, 11:30 am, "Zen Cohen" <atu...@hotmail.com> wrote:
> I had to take a treadmill stress test yesterday because I had minor
> right-side chest pain a couple weeks after a 40% spontaneous pneumothorax in
> my right lung. I suspect the test was overkill but I wasn't going to defy my
> doc's advice.
>
> He said he'd calculate 220 minus my age (49) so limited the test to 171 bpm.
> I told him that I sometimes approach 180 when exercising and that I'd like
> to see if there are any problems when my heart reaches that range. Also said
> I'd heard the 220-minus-age formula was arbitrary, He agreed but said it was
> a good rule of thumb and summarily dismissed my request by pronouncing I
> just shouldn't exercise above my 220-minus-age. I realize that there is some
> additional risk by exercising at higher heart rates but I'm willing to take
> some measure of risk because I like to push myself and better my
> performance. Nonetheless he stopped me right at 171. I feel like the doctor
> didn't do me a service because he didn't provide a sufficient reason for
> this and it seems his refusing to let me go further may have left him in the
> dark about potential problems that could develop in these higher ranges if I
> don't follow his advice.
>
> I get the impression this cardiologist knows plenty about counseling and
> treating sedentary or ill patients but has no interest in advising fitter
> patients who want to push their endurance without undue risk. Has anyone had
> experience with cardiologists who are more fitness-friendly? What have they
> said about the risks of exercising at or near max HR?
>
> BTW, it took me 15:30 to reach my "max" HR. He said his patients normally
> don't last longer than 11 minutes but heard of some accomplished athletes
> going over 20 minutes. I might've gone another minute or so but nowhere near
> 20 (with the speed/incline increases every minute). If you've done this
> test, how long did you go?

Hi Zen, A couple of years ago I used to do a day of treadmills once a
week. Most of the patients did a standard Bruce protocol which is the
increase grade and speed at intervals. The idea is to complete a
certain amount of stages based on the patient's age. While the patient
is exercising, I am watching the EKG tracing for abnormalities and
watching the patient for signs of discomfort or fatigue.

The results of the exercise treadmill test (ETT) can help to diagnose
causes of chest pain and can help to predict if there are existing,
fixed atherosclerotic narrowing s to the coronary arteries.

In your case, the pretest likelihood of you having coronary artery
disease as a cause of your atypical, right-sided chest pain was small.
It was most likely pleuritic pain due to the pneumothorax. But since
an ETT is an easy to perform, noninvasive test of function it was
worthwhile to order.

I can't tell from your description exactly which protocol was used,
and it doesn't matter. For explanation sake I'll discuss a Bruce
protocol. It consists of four 3-minute stages and involves changes in
both grade of incline and speed of treadmill. Stage 1 is 1.7 mph and
10% grade, stage 2 is 2.5 mph and 12% grade, stage 3 is 3.4 mph and
14% grade and stage 4 is 4.2 mph and 16% grade.

Once you have completed a Bruce protocol, you've completed the ETT.
The heart rate is another parameter that can be monitored. I want to
see a patient get to the minimum predicted exercise heart range. I may
stop the test on a patient who appears fatigued, winded and has
reached higher than the average predicted maximal heart rate.

In your case, if you felt fine I would have let you keep going even if
you had passed the predicted maximal heart rate limit. It's only an
average and a guideline. OTOH, if you had already exercised 15:30
without any worrisome symptoms or changes on your EKG, you had already
passed the test if a Bruce protocol was used. No further information
would be gained by continuing to exercise or pushing your heart rate
higher. The question, "was this atypical right-sided chest pain due to
a fixed blockage of a coronary artery or are there any other
significant existing blockages at this time?" was answered, and the
answer is, "no."

Dnia 2008-05-29 Zen Cohen napisa³(a):
>
> "Andrzej Rosa" <bakters@yahoo.com> wrote in message
> news:mai3h5-nm.ln1@bakters.bandit.home...
>>
>> I think the guy was right. If something wrong happened to you, he would
>> be responsible. You had your pneumosomething already. What if it
>> happened again? You could sue his pants off, I suppose.
>>
>
> He's not a guarantor of my health; he just has to act prudently. I had
> already signed a pretty comprehensive informed consent document, and his
> warning me of any additional risk, with my knowing acceptance of it would
> seemingly negate any malpractice. Seems that if I'm telling him I'm
> regularly exceeding those maximums and he fails to test me under those
> conditions when he had the opportunity to do so under medical
> supervisiocould expose him to liability more than actually testing me with
> informed consent.

Oh, my. There is nothing more terrifying than a patient who can speak
legalese. Your doc has some balls to let you close to the treadmill at
all. ;-) Anyway, I doubt that any possible problems could hide itself
in those several BPM above the arbitrary cutoff. Tired engine sounds
tired at tickover, gets worse at hinger rpm and there is a chance it
will throw a rod through a crankcase if pushed to the redline at full
throttle. Before the test you don't know if you have a tired engine or
a healthy one with plenty of miles still in it. Or at least your doc
doesn't.

--
Andrzej Rosa 1127R

"Zen Cohen" <aturny@hotmail.com> wrote in message
news:483ef63e$0$5169$4c368faf@roadrunner.com...
>I had to take a treadmill stress test yesterday because I had minor
>right-side chest pain a couple weeks after a 40% spontaneous
>pneumothorax in my right lung. I suspect the test was overkill but I
>wasn't going to defy my doc's advice.
>
> He said he'd calculate 220 minus my age (49) so limited the test to
> 171 bpm. I told him that I sometimes approach 180 when exercising and
> that I'd like to see if there are any problems when my heart reaches
> that range. Also said I'd heard the 220-minus-age formula was
> arbitrary, He agreed but said it was a good rule of thumb and
> summarily dismissed my request by pronouncing I just shouldn't
> exercise above my 220-minus-age. I realize that there is some
> additional risk by exercising at higher heart rates but I'm willing to
> take some measure of risk because I like to push myself and better my
> performance. Nonetheless he stopped me right at 171. I feel like the
> doctor didn't do me a service because he didn't provide a sufficient
> reason for this and it seems his refusing to let me go further may
> have left him in the dark about potential problems that could develop
> in these higher ranges if I don't follow his advice.
>
> I get the impression this cardiologist knows plenty about counseling
> and treating sedentary or ill patients but has no interest in advising
> fitter patients who want to push their endurance without undue risk.
> Has anyone had experience with cardiologists who are more
> fitness-friendly? What have they said about the risks of exercising at
> or near max HR?
>
> BTW, it took me 15:30 to reach my "max" HR. He said his patients
> normally don't last longer than 11 minutes but heard of some
> accomplished athletes going over 20 minutes. I might've gone another
> minute or so but nowhere near 20 (with the speed/incline increases
> every minute). If you've done this test, how long did you go?

I will repeat what I've said before - you need a sports medicine doctor,
and to go from there. At the very least, that formula has been
discredited for active adults, and there are several alternatives out
there, one of which suggests subtracting _half_ your age from 220.

You need a different doctor. You might try asking at a local running
club for recommendations.

You need a different doctor right now.

-S-
http://www.kbnj.com

Steve Freides wrote:
> "Zen Cohen" <aturny@hotmail.com> wrote in message
> news:483ef63e$0$5169$4c368faf@roadrunner.com...
>> I had to take a treadmill stress test yesterday because I had minor
>> right-side chest pain a couple weeks after a 40% spontaneous
>> pneumothorax in my right lung. I suspect the test was overkill but I
>> wasn't going to defy my doc's advice.
>>
>> He said he'd calculate 220 minus my age (49) so limited the test to
>> 171 bpm. I told him that I sometimes approach 180 when exercising and
>> that I'd like to see if there are any problems when my heart reaches
>> that range. Also said I'd heard the 220-minus-age formula was
>> arbitrary, He agreed but said it was a good rule of thumb and
>> summarily dismissed my request by pronouncing I just shouldn't
>> exercise above my 220-minus-age. I realize that there is some
>> additional risk by exercising at higher heart rates but I'm willing to
>> take some measure of risk because I like to push myself and better my
>> performance. Nonetheless he stopped me right at 171. I feel like the
>> doctor didn't do me a service because he didn't provide a sufficient
>> reason for this and it seems his refusing to let me go further may
>> have left him in the dark about potential problems that could develop
>> in these higher ranges if I don't follow his advice.
>>
>> I get the impression this cardiologist knows plenty about counseling
>> and treating sedentary or ill patients but has no interest in advising
>> fitter patients who want to push their endurance without undue risk.
>> Has anyone had experience with cardiologists who are more
>> fitness-friendly? What have they said about the risks of exercising at
>> or near max HR?
>>
>> BTW, it took me 15:30 to reach my "max" HR. He said his patients
>> normally don't last longer than 11 minutes but heard of some
>> accomplished athletes going over 20 minutes. I might've gone another
>> minute or so but nowhere near 20 (with the speed/incline increases
>> every minute). If you've done this test, how long did you go?
>
> I will repeat what I've said before - you need a sports medicine doctor,
> and to go from there. At the very least, that formula has been
> discredited for active adults, and there are several alternatives out
> there, one of which suggests subtracting _half_ your age from 220.
>
> You need a different doctor. You might try asking at a local running
> club for recommendations.
>
> You need a different doctor right now.
>
> -S-
> http://www.kbnj.com
>
>
Maybe this is a better test. http://www.tocal.com/homestead/vandv/vv26.htm

Note well the 1st hand account at the bottom - interval training

Bob

Zen Cohen expressed whined in need and complained precisely :

> I had to take a treadmill stress test yesterday because I had minor
> right-side chest pain a couple weeks after a 40% spontaneous pneumothorax in
> my right lung. I suspect the test was overkill but I wasn't going to defy my
> doc's advice.

Oh, of course you won't. Now here you are, scared shitless, on Usenet,
which has been your consistent playground to abuse. Posting to the
worthless misc.x groups and hoping that a cardiologist will come along
in SMC to calm your potentially dying heart and soul.

Excuse me if I smile at your vulnerabilities.

> <snipped death knoll> I feel like the doctor didn't do me a
> service because he didn't provide a sufficient reason for this and it seems
> his refusing to let me go further may have left him in the dark about
> potential problems that could develop in these higher ranges if I don't
> follow his advice.

Imagie that. You abuse Chung, then post to make sure he sees your gasps
and fears, then you second uess your Urban Cardiologist. Hmmmm, where
did you learn to second guess traditional, managed-care medicine. Why
right here on the Usenet you so freely abuse, now may not LIVE without.

> I get the impression this cardiologist knows plenty about counseling and
> treating sedentary or ill patients but has no interest in advising fitter
> patients who want to push their endurance without undue risk.

You're fit? No, delusional, you're NOT fit and you could be dead in a
very short time.

> Has anyone had
> experience with cardiologists who are more fitness-friendly? What have they
> said about the risks of exercising at or near max HR?

Oh, several, dozens, grovel some more. Ask me specifically so I will
know you are serious.

> BTW, it took me 15:30 to reach my "max" HR. He said his patients normally
> don't last longer than 11 minutes but heard of some accomplished athletes
> going over 20 minutes. I might've gone another minute or so but nowhere near
> 20 (with the speed/incline increases every minute). If you've done this test,
> how long did you go?

35 but, hey, I follow the 2PD, must be an anomaly, right?

Steve Freides was thinking very hard :
> I will repeat what I've said before - you need a sports medicine doctor, and
> to go from there. At the very least, that formula has been discredited for
> active adults, and there are several alternatives out there, one of which
> suggests subtracting _half_ your age from 220.

> You need a different doctor. You might try asking at a local running club
> for recommendations.

> You need a different doctor right now.

> -S-
> http://www.kbnj.com

Do you know what a sports medicine doctor is? I do having trained
athletes for years and dealing with "sports medicine doctors". They are
doctors who wil take any patient but advertise their "sports medicine"
proficiencies.

And most sports med docs are not cardiologically trained, they are
orthopods.

Omelet has brought this to us :
> If he wants me to have a 170 to 180 BPM in no time flat, he oughta just
> let me do some heavy deadlifts. <g> It's faster.

> To hell with the treadmill!

Right on! Let's rally around the moron and his advice!

DUDE,

Just do what the doctor tells you!!

As you lawyers say the man who has himself for an Attorney has a fool
for a client!



Maybe it's the same for doctors



Burr

on 5/29/2008, Zen Cohen blithered like the half-dead idiot he is:

> He's not a guarantor of my health; he just has to act prudently. I had
> already signed a pretty comprehensive informed consent document, and his
> warning me of any additional risk, with my knowing acceptance of it would
> seemingly negate any malpractice.

You don't know the legal and medical ramifications of what you signed?
Yet for over four years you have posted to sci.med.cardiology
pontificating how you are such an expert on all things
medical/cardiological?

You several times daily abuse Andrew Chung, M.D. Cardiologist now you
come forwartd to admit that you are nothing more than a Usenet bully,
so full of shit it makes cows rething dung?

HAHHAHAHHAHAHAHAHAHHA

You're a fraud, you always have been and now, as you die right in front
of us...

Oh, you don't think you're dying? Let me put you to "rest".

With your symptoms, your lucky to be typing on Usenet, acting out like
the asshole you are. You haven't a real clue how badly you are
physiologically. You are screwed, buddy boi.

> Seems that if I'm telling him I'm regularly
> exceeding those maximums and he fails to test me under those conditions when
> he had the opportunity to do so under medical supervisiocould expose him to
> liability more than actually testing me with informed consent.

He sees you as someone who he is not worth putting his $$ in jeopardy.
Why?

Let me guess. You shot your mouth off about what you know and he saw
the fear in your eyes and the potential for...exactly what you are
doing here. Jumping AROUND SCARED LIKE A MEXICAN BEAN IN THE HOT SUN
who is going to run off and find sources, which you have ZERO
caopability to understand, then come back and make his life miserable
all tthe while you fear drives your insanity.

oOther than that, why in the world would you be posing this to misc.*
groups..

....and, most importantly, to sci.med.cardiology?

Buddy boi, you don't believe in Christ, in God, in Heaven and your body
is failing you fast. Best start believing in Hell, it's all you got
left.

Before you go off on a "Mu is a hateful Xristian" line, I'll save you
the time.

I watched Bob Pastorio ruin his life on Usenet and in his real life. I
warned him, Andrew warned him, we told him he was killing himself, no
avail.

You, Sir, have been warned more times than Pastorio. You're beyond
help, as he was.

I am hopeful that those who come along when you croak will learn, from
you, and this dialogue, what you did not. That, Sir, is love and IMO
the true meaning of Christianitiy. Speaking the blunt Truth.

Mu

Jason Earl submitted this idea :
> What's more likely, though, is that your doctor just doesn't care.
> Somewhere along the lines he lowered his goals from keeping people
> active and healthy to merely keeping people alive.

Lowered goal? Let's see, two choices, healthy or alive. Hmmmmmm.

Tell me, do want to be, today, known to have been healthy or alive?

> I suppose that's probably a pragmatic position for a cardiologist to
> take, but it certainly doesn't sound very *fun*. If you are going to
> take a stress test, you might as well see how well the ticker holds up
> when you open things up all of the way.

> Jason

"The ticker" "Fun"

OK, I got it, you're under 30.

"MU"

>
> I watched Bob Pastorio ruin his life on Usenet and in his real life. I
> warned him, Andrew warned him, we told him he was killing himself, no
> avail.
>
> You, Sir, have been warned more times than Pastorio. You're beyond help,
> as he was.
>
> I am hopeful that those who come along when you croak will learn, from
> you, and this dialogue, what you did not. That, Sir, is love and IMO the
> true meaning of Christianitiy. Speaking the blunt Truth.
>
> Mu
>
>

Mu,
You talking about Bob the cook?

I knew him years ago when he first started writing and I think the TV show.

That the same Bob that passed last year?

Burr

"MU" <danmc51@gmail.com> wrote in message
news:483f7b1b$0$25950$6e1ede2f@read.cnntp.org...
[snip ravings of a delusional assclown]
> I am hopeful that those who come along when you croak will learn, from
> you, and this dialogue, what you did not. That, Sir, is love and IMO the
> true meaning of Christianitiy. Speaking the blunt Truth.
>
> Mu
>

Mu, sorry to tell you that contrary to your expert medical opinion, my doc
says I'm in great shape. Funny that you preach christian love while gloating
over the (perceived) misfortune of others. Still, as vile a piece of shit
you are, I could never actually be happy over your misfortune or the fact
that you're so plainly a loser. As always, thanks for the irony and comic
relief.

"Steve Freides" <steve@fridayscomputer.com> wrote in message
.....
>
> I will repeat what I've said before - you need a sports medicine doctor,
> and to go from there. At the very least, that formula has been
> discredited for active adults, and there are several alternatives out
> there, one of which suggests subtracting _half_ your age from 220.
>
> You need a different doctor. You might try asking at a local running club
> for recommendations.
>
> You need a different doctor right now.

Well, I definitely need a different doctor if I want to get cleared to get
back to back to lifting weights more quickly. That said, I do plan to look
for a doc who's better versed in sports medicine. I had switched
primary-care docs to a guy who advertised himself as a sports doc but he
seems to hold to some antiquated ideas of fitness, too. He's switching to a
"concierge" practice and I don't want to pay $1500/yr to be a part of that
so I'll be looking for a new primary care dr soon.

In article <483f736c$0$25949$6e1ede2f@read.cnntp.org>,
MU <danmc51@gmail.com> wrote:

> Omelet has brought this to us :
> > If he wants me to have a 170 to 180 BPM in no time flat, he oughta just
> > let me do some heavy deadlifts. <g> It's faster.
>
> > To hell with the treadmill!
>
> Right on! Let's rally around the moron and his advice!

No sense of humor?

Whatever...
I wasn't being serious. I have an injured leg right now so cannot do a
stress test, but that's not keeping me totally out of the gym.
--
Peace! Om

"Human nature seems to be to control other people
until they put their foot down." -- Stephan Rothstein

MU <danmc51@gmail.com> writes:

> Jason Earl submitted this idea :
>> What's more likely, though, is that your doctor just doesn't care.
>> Somewhere along the lines he lowered his goals from keeping people
>> active and healthy to merely keeping people alive.
>
> Lowered goal? Let's see, two choices, healthy or alive. Hmmmmmm.
>
> Tell me, do want to be, today, known to have been healthy or alive?

For the logic-impaired among us, an ASCII Venn diagram:


+-----------------------+
| +--------+ |
| | | |
| | alive | |
| | | |
| +--------+ |
| |
| active and healthy |
| |
+-----------------------+


--
Jim Janney

Truth <yamantaka@aol.com> writes:

> On May 29, 11:30 am, "Zen Cohen" <atu...@hotmail.com> wrote:
>> I had to take a treadmill stress test yesterday because I had minor
>> right-side chest pain a couple weeks after a 40% spontaneous pneumothorax in
>> my right lung. I suspect the test was overkill but I wasn't going to defy my
>> doc's advice.
>>
>> He said he'd calculate 220 minus my age (49) so limited the test to 171 bpm.
>> I told him that I sometimes approach 180 when exercising and that I'd like
>> to see if there are any problems when my heart reaches that range. Also said
>> I'd heard the 220-minus-age formula was arbitrary, He agreed but said it was
>> a good rule of thumb and summarily dismissed my request by pronouncing I
>> just shouldn't exercise above my 220-minus-age. I realize that there is some
>> additional risk by exercising at higher heart rates but I'm willing to take
>> some measure of risk because I like to push myself and better my
>> performance. Nonetheless he stopped me right at 171. I feel like the doctor
>> didn't do me a service because he didn't provide a sufficient reason for
>> this and it seems his refusing to let me go further may have left him in the
>> dark about potential problems that could develop in these higher ranges if I
>> don't follow his advice.
>>
>> I get the impression this cardiologist knows plenty about counseling and
>> treating sedentary or ill patients but has no interest in advising fitter
>> patients who want to push their endurance without undue risk. Has anyone had
>> experience with cardiologists who are more fitness-friendly? What have they
>> said about the risks of exercising at or near max HR?
>>
>> BTW, it took me 15:30 to reach my "max" HR. He said his patients normally
>> don't last longer than 11 minutes but heard of some accomplished athletes
>> going over 20 minutes. I might've gone another minute or so but nowhere near
>> 20 (with the speed/incline increases every minute). If you've done this
>> test, how long did you go?
>
> Hi Zen, A couple of years ago I used to do a day of treadmills once a
> week. Most of the patients did a standard Bruce protocol which is the
> increase grade and speed at intervals. The idea is to complete a
> certain amount of stages based on the patient's age. While the patient
> is exercising, I am watching the EKG tracing for abnormalities and
> watching the patient for signs of discomfort or fatigue.
>
> The results of the exercise treadmill test (ETT) can help to diagnose
> causes of chest pain and can help to predict if there are existing,
> fixed atherosclerotic narrowing s to the coronary arteries.
>
> In your case, the pretest likelihood of you having coronary artery
> disease as a cause of your atypical, right-sided chest pain was small.
> It was most likely pleuritic pain due to the pneumothorax. But since
> an ETT is an easy to perform, noninvasive test of function it was
> worthwhile to order.
>
> I can't tell from your description exactly which protocol was used,
> and it doesn't matter. For explanation sake I'll discuss a Bruce
> protocol. It consists of four 3-minute stages and involves changes in
> both grade of incline and speed of treadmill. Stage 1 is 1.7 mph and
> 10% grade, stage 2 is 2.5 mph and 12% grade, stage 3 is 3.4 mph and
> 14% grade and stage 4 is 4.2 mph and 16% grade.
>
> Once you have completed a Bruce protocol, you've completed the ETT.
> The heart rate is another parameter that can be monitored. I want to
> see a patient get to the minimum predicted exercise heart range. I may
> stop the test on a patient who appears fatigued, winded and has
> reached higher than the average predicted maximal heart rate.
>
> In your case, if you felt fine I would have let you keep going even if
> you had passed the predicted maximal heart rate limit. It's only an
> average and a guideline. OTOH, if you had already exercised 15:30
> without any worrisome symptoms or changes on your EKG, you had already
> passed the test if a Bruce protocol was used. No further information
> would be gained by continuing to exercise or pushing your heart rate
> higher. The question, "was this atypical right-sided chest pain due to
> a fixed blockage of a coronary artery or are there any other
> significant existing blockages at this time?" was answered, and the
> answer is, "no."

In other words, the doctor had enough information to due his diagnosis
and he wasn't particularly interested in seeing if Zen could break a new
world record.

I have a question. Are the treadmills that are used for these tests
special? The treadmills that I have access to don't seem to have as
much incline as a Bruce Protocol Test would require.

Jason

MU <danmc51@gmail.com> writes:

> Jason Earl submitted this idea :
>> What's more likely, though, is that your doctor just doesn't care.
>> Somewhere along the lines he lowered his goals from keeping people
>> active and healthy to merely keeping people alive.
>
> Lowered goal? Let's see, two choices, healthy or alive. Hmmmmmm.
>
> Tell me, do want to be, today, known to have been healthy or alive?

I think that I'd rather be healthy rather than just merely alive. I
have things that I want to do with my life that require more fitness
than simply posting to Usenet.

"Alive" might be good enough for you, but I personally don't consider it
much of a goal.

>> I suppose that's probably a pragmatic position for a cardiologist to
>> take, but it certainly doesn't sound very *fun*. If you are going to
>> take a stress test, you might as well see how well the ticker holds up
>> when you open things up all of the way.
>
>> Jason
>
> "The ticker" "Fun"
>
> OK, I got it, you're under 30.

Actually, I am 36. That still seems young enough to me to be interested
in having fun.

Jason

On May 30, 10:01*am, Jason Earl <je...@xmission.com> wrote:
> Truth <yamant...@aol.com> writes:
> > On May 29, 11:30 am, "Zen Cohen" <atu...@hotmail.com> wrote:
> >> I had to take a treadmill stress test yesterday because I had minor
> >> right-side chest pain a couple weeks after a 40% spontaneous pneumothorax in
> >> my right lung. I suspect the test was overkill but I wasn't going to defy my
> >> doc's advice.
>
> >> He said he'd calculate 220 minus my age (49) so limited the test to 171bpm.
> >> I told him that I sometimes approach 180 when exercising and that I'd like
> >> to see if there are any problems when my heart reaches that range. Alsosaid
> >> I'd heard the 220-minus-age formula was arbitrary, He agreed but said it was
> >> a good rule of thumb and summarily dismissed my request by pronouncing I
> >> just shouldn't exercise above my 220-minus-age. I realize that there issome
> >> additional risk by exercising at higher heart rates but I'm willing to take
> >> some measure of risk because I like to push myself and better my
> >> performance. Nonetheless he stopped me right at 171. I feel like the doctor
> >> didn't do me a service because he didn't provide a sufficient reason for
> >> this and it seems his refusing to let me go further may have left him in the
> >> dark about potential problems that could develop in these higher rangesif I
> >> don't follow his advice.
>
> >> I get the impression this cardiologist knows plenty about counseling and
> >> treating sedentary or ill patients but has no interest in advising fitter
> >> patients who want to push their endurance without undue risk. Has anyone had
> >> experience with cardiologists who are more fitness-friendly? What have they
> >> said about the risks of exercising at or near max HR?
>
> >> BTW, it took me 15:30 to reach my "max" HR. He said his patients normally
> >> don't last longer than 11 minutes but heard of some accomplished athletes
> >> going over 20 minutes. I might've gone another minute or so but nowherenear
> >> 20 (with the speed/incline increases every minute). If you've done this
> >> test, how long did you go?
>
> > Hi Zen, A couple of years ago I used to do a day of treadmills once a
> > week. Most of the patients did a standard Bruce protocol which is the
> > increase grade and speed at intervals. The idea is to complete a
> > certain amount of stages based on the patient's age. While the patient
> > is exercising, I am watching the EKG tracing for abnormalities and
> > watching the patient for signs of discomfort or fatigue.
>
> > The results of the exercise treadmill test (ETT) can help to diagnose
> > causes of chest pain and can help to predict if there are existing,
> > fixed atherosclerotic narrowing s to the coronary arteries.
>
> > In your case, the pretest likelihood of you having coronary artery
> > disease as a cause of your atypical, right-sided chest pain was small.
> > It was most likely pleuritic pain due to the pneumothorax. But since
> > an ETT is an easy to perform, noninvasive test of function it was
> > worthwhile to order.
>
> > I can't tell from your description exactly which protocol was used,
> > and it doesn't matter. For explanation sake I'll discuss a Bruce
> > protocol. It consists of four 3-minute stages and involves changes in
> > both grade of incline and speed of treadmill. Stage 1 is 1.7 mph and
> > 10% grade, stage 2 is 2.5 mph and 12% grade, stage 3 is 3.4 mph and
> > 14% grade and stage 4 is 4.2 mph and 16% grade.
>
> > Once you have completed a Bruce protocol, you've completed the ETT.
> > The heart rate is another parameter that can be monitored. I want to
> > see a patient get to the minimum predicted exercise heart range. I may
> > stop the test on a patient who appears fatigued, winded and has
> > reached higher than the average predicted maximal heart rate.
>
> > In your case, if you felt fine I would have let you keep going even if
> > you had passed the predicted maximal heart rate limit. It's only an
> > average and a guideline. OTOH, if you had already exercised 15:30
> > without any worrisome symptoms or changes on your EKG, you had already
> > passed the test if a Bruce protocol was used. No further information
> > would be gained by continuing to exercise or pushing your heart rate
> > higher. The question, "was this atypical right-sided chest pain due to
> > a fixed blockage of a coronary artery or are there any other
> > significant existing blockages at this time?" was answered, and the
> > answer is, "no."
>
> In other words, the doctor had enough information to due his diagnosis
> and he wasn't particularly interested in seeing if Zen could break a new
> world record.
>
> I have a question. *Are the treadmills that are used for these tests
> special? *The treadmills that I have access to don't seem to have as
> much incline as a Bruce Protocol Test would require.
>
> Jason- Hide quoted text -
>
> - Show quoted text -

Any treadmill that I've ever used for patients' exercise treadmill
testing (ETT or "stress test") is a proprietary one that is attached
to a computer and cardiac monitoring system, and sold/serviced by a
medical device company. The treadmill automatically increases in speed
and grade depending on what protocol I'm using.

But aside from that, they look pretty much like a treadmill one would
find in a health club.

The computer gives a constant, realtime print out of the patient's EKG
tracing and periodically makes a hard copy for the treadmill test
report.

Truth <yamantaka@aol.com> writes:

-snip-

> Any treadmill that I've ever used for patients' exercise treadmill
> testing (ETT or "stress test") is a proprietary one that is attached
> to a computer and cardiac monitoring system, and sold/serviced by a
> medical device company. The treadmill automatically increases in speed
> and grade depending on what protocol I'm using.

Thanks for this response. I haven't had a stress test in years, and I
was interested to see how well I would do on one. Actually, I would
like to be able to do a stress test every few weeks and see how my
regular workouts are effecting my ability to perform this specific test.

Basically, I think that this sort of test sounds like quite a bit of
fun.

The problem is that I don't really want to involve a doctor. Not that I
have anything against doctors. I just don't want to go through the
expense and hassle of going to the doctor just so that I can see how
long I can run on his treadmill. After all, I'm not sick, nor am I some
sort of elite athlete whose continued progress would justify involving
doctors.

That being the case, finding a treadmill that can be programmed to
increase speed and incline at known intervals is easy. Finding one that
has a 20% incline (or more) appears to be another story. Even the fancy
ones at my local fitness club don't do that.

Oh well, I might just have to create my own "Jason" protocol that adds
less incline and more speed.

> But aside from that, they look pretty much like a treadmill one would
> find in a health club.

The treadmill part is probably manufactured by the same people, although
the inclines involved are definitely not standard.

> The computer gives a constant, realtime print out of the patient's EKG
> tracing and periodically makes a hard copy for the treadmill test
> report.

I don't need anything that fancy.

Once again, thank you very much. That was helpful.

Jason

On May 30, 11:33*am, Jason Earl <je...@xmission.com> wrote:
> Truth <yamant...@aol.com> writes:
>
> -snip-
>
> > Any treadmill that I've ever used for patients' exercise treadmill
> > testing (ETT or "stress test") is a proprietary one that is attached
> > to a computer and cardiac monitoring system, and sold/serviced by a
> > medical device company. The treadmill automatically increases in speed
> > and grade depending on what protocol I'm using.
>
> Thanks for this response. *I haven't had a stress test in years, and I
> was interested to see how well I would do on one. *Actually, I would
> like to be able to do a stress test every few weeks and see how my
> regular workouts are effecting my ability to perform this specific test.
>
> Basically, I think that this sort of test sounds like quite a bit of
> fun.
>
> The problem is that I don't really want to involve a doctor. *Not that I
> have anything against doctors. *I just don't want to go through the
> expense and hassle of going to the doctor just so that I can see how
> long I can run on his treadmill. *After all, I'm not sick, nor am I some
> sort of elite athlete whose continued progress would justify involving
> doctors.
>
> That being the case, finding a treadmill that can be programmed to
> increase speed and incline at known intervals is easy. *Finding one that
> has a 20% incline (or more) appears to be another story. *Even the fancy
> ones at my local fitness club don't do that.
>
> Oh well, I might just have to create my own "Jason" protocol that adds
> less incline and more speed.
>
> > But aside from that, they look pretty much like a treadmill one would
> > find in a health club.
>
> The treadmill part is probably manufactured by the same peopl