General fitness, health and nutrition · Public discussion

Lopressor vs Exercise

Started by Howard Slomer · · Last activity · 16 posts · 922 views

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General fitness, health and nutrition
Published
23 May 2004
Last activity
27 May 2004
Original author
Howard Slomer
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  1. I've been taking 50mg of Lopressor twice a day since my
    heart attack in December 2002. The Lopressor apparently
    prevents my heart rate from exceeding 125 bpm, even during a
    stress test. Since my heart attack I have been doing a lot
    of biking to try to strengthen my heart but my fitness level
    doesn't seem to improve much no matter how many hours I
    spend biking,

    Is it possible that the Lopressor is preventing me
    from improving my fitness level? Are the benefits of
    taking the Lopressor outweighed by it's effect on my
    heart rate?

    Th-
    an-
    ks
    in
    ad-
    va-
    nc-
    e,
    Ho-
    wa-
    rd

  2. Howard Slomer said:


    I've been taking 50mg of Lopressor twice a day
    since my heart attack in December 2002. The
    Lopressor apparently prevents my heart rate from
    exceeding 125 bpm, even during a stress test.
    Since my heart attack I have been doing a lot of
    biking to try to strengthen my heart but my
    fitness level doesn't seem to improve much no
    matter how many hours I spend biking,

    Is it possible that the Lopressor is preventing me
    from improving my fitness level?

    Yes.

    Quoted message said:

    Are the benefits of taking the Lopressor outweighed by
    it's effect on my heart rate?

    Typically not for someone who has had a heart attack.

    Quoted message said:

    T
    h
    a
    n
    k
    s
    i
    n
    a
    d
    v
    a
    n
    c
    e
    ,

    You are welcome, Howard.

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    heartmdphd.comheartmdphd.com

    **
    Who is the humblest person in the universe?
    makeashorterlink.commakeashorterlink.com

    What is all this about?
    makeashorterlink.commakeashorterlink.com

    Is this spam?
    makeashorterlink.commakeashorterlink.com

  3. Cyclist here, not a medical professional any more,....

    I take blood pressure medicine and ride 200-300 miles per
    week.

    At one point when I was able to use selective beta blockers,
    I even raced for a team.

    What "elements" is it that is making you feel your are not
    improving your fitness level,...??

    "Howard Slomer" <[email hidden]> wrote in message
    "]news:[email hidden]...

    Quoted message said:


    I've been taking 50mg of Lopressor twice a day
    since my heart


    attack

    Quoted message said:

    in December 2002. The Lopressor apparently prevents my
    heart rate from exceeding 125 bpm, even during a stress
    test. Since my heart attack I have been doing a lot of
    biking to try to strengthen my heart but my


    fitness

    Quoted message said:

    level doesn't seem to improve much no matter how many
    hours I spend


    biking,

    Quoted message said:


    Is it possible that the Lopressor is preventing me
    from improving


    my

    Quoted message said:

    fitness level? Are the benefits of taking the Lopressor
    outweighed by


    it's

    Quoted message said:

    effect on my heart rate?

    T
    h
    a
    n
    k
    s
    i
    n


    advance,

    Quoted message said:

    H
    o
    w
    a
    r
    d

  4. Dr. Chung, Roadcyclist,

    Thanks you for your quick replies!

    "roadcyclist" <[email hidden]> wrote in message
    "]news:[email hidden]...

    Quoted message said:

    Cyclist here, not a medical professional any more,....

    I take blood pressure medicine and ride 200-300 miles
    per week.

    At one point when I was able to use selective beta
    blockers, I even raced for a team.

    What "elements" is it that is making you feel your are not
    improving your fitness level,...??

    I had a heart attack (LAD blocked 100%) in December
    2002. Last year I biked about 1800 miles and walked
    several hundred miles during the summer months. The
    hills were almost as difficult to pull at the end of
    the summer as they were at the beginning. Based on
    previous my biking experience I expected steady
    improvement during the season.

    During this winter I worked out daily on a bike
    trainer or treadmill for an hour or more a day and
    so far I biked about 300 miles this year. Again I've
    seen no real improvement. During the longest climbs
    and fastest sprints I have been unable to raise my
    pulse rate above 125. Most of my bikeing is done in
    a fairly hilly area.

    Since the heart attack I've had several stress and
    echo tests. My heart function had been above average
    on all but the first echo test which was done
    shortly after the heart attack. During the stress
    tests I've have been unable to raise my pulse rate
    above 125. My doctor and the folks at the heart
    hospital attributed this to the Lopressor (50mg
    twice a day).

    I believe I will be taking Lopressor for the rest
    of my life because of the good effect it has in
    preventing additional heart attacks. At the same
    time I have been told to exercise vigorously to
    prevent additional heart attacks. The two seem to
    be at odds with each other. The Lopressor "seems"
    to be preventing me from increasing my fitness
    level. Maybe this is ok if the Lopressor is
    protecting my heart in a way that is more important
    than being fitter?

    I had a pacemaker installed in February 2003. Except
    for a brief interruption to my exercise program the
    pacemaker has not affected my maximum heart rate.

    Howard

    Quoted message said:

    "Howard Slomer" <[email hidden]> wrote in
    message "]news:[email hidden]...

    Quoted message said:


    I've been taking 50mg of Lopressor twice a day
    since my heart


    attack

    Quoted message said:

    in December 2002. The Lopressor apparently prevents my
    heart rate from exceeding 125 bpm, even during a stress
    test. Since my heart attack I have been doing a lot of
    biking to try to strengthen my heart but my


    fitness

    Quoted message said:

    level doesn't seem to improve much no matter how many
    hours I spend


    biking,

    Quoted message said:


    Is it possible that the Lopressor is preventing
    me from


    improving

    Quoted message said:

    my

    Quoted message said:

    fitness level? Are the benefits of taking the Lopressor
    outweighed by


    it's

    Quoted message said:

    effect on my heart rate?


    Thanks in

    Quoted message said:

    advance,

    Quoted message said:


    Howard

    Quoted message said:
    Quoted message said:


  5. Quoted message said:

    I had a heart attack (LAD blocked 100%) in December
    2002.

    Wow, I just dissected mine during a race in Apr,
    aint that a pill,..!!!

    Quoted message said:

    During the longest climbs and fastest sprints I have been
    unable to raise my pulse rate above 125. Most of my
    bikeing is done in a fairly hilly area.

    Maybe you are concentrating too much on the HR and not
    seeing what's happening to you in other areas.

    Just some food for thought here,..

    - Bet your legs do not "load" lactic acid hardly at all
    though do they,..??
    - Run out of "breath" before you run out of
    anything else,..??
    - Able to ride "farther" without the same "pain" as the
    rest of the group,..??
    - Becoming more of a "cruncher" than a "spinner"
    now,..?? ( Hit that
    53/11 !! )
    - Maybe those TT, crits, and RR don't look as good as
    those brevets do now,..huh,..??

    With my dissected LAD, the DO told me I would never race
    again, period.

    I first I was beat down, but now I realize how close I
    came to tearing it all the way though, and never
    "breathin" again,...so all of a sudden, never racing
    again did not sound so bad. I mean after all, I'm 42, I
    am not Lance Armstrong, never rode anything
    professional, and never would. But, I did come from
    where Lance is from DFW, Texas. So I'm hard headed, and
    hard to convince of anything.

    So when I really thought about it, racing was not paying
    any bills, so for the most part it did not really
    matter. My teammates, however noticed a *lot*. They
    noticed how much "power" I was able to ride with, and
    how much "more" they had to put out doing the same route
    than I did.

    I'm kinda like Jan Ulrich,,....a diesel. Slow to start,
    but when I get up to speed I can hold it there,...for a
    long, long, long time. Can't sprint anymore, but can be
    something of a steady "monster".

    My heartrate, *always* at least 20-30 point lower than
    everyone else's. They jealous, mainly because they are
    in pain, and I am not.

    Quoted message said:

    I believe I will be taking Lopressor for the rest
    of my life


    because

    Quoted message said:

    of the good effect it has in preventing additional heart
    attacks.

    I know what you mean. I was on beta-1 and beta-2
    blockers for a while. *Always* ran of out breath FIRST.
    Never loaded, never had a heart rate above 140-150.

    I asked the Dr about it, he said the aerobic blocker was
    really unecessary, and took it away and gave me a more
    selective blocker that let me elevate my HR, and man,
    did it. I regularly saw 170-180's, but man, could I
    sprint. I really put the hurt on them all. They just
    hated to see me stand, cause they knew what was
    coming,....

    *BUT*, man could I load, and man did I tear my LAD
    20mm,...and man, I did not know it was coming,....

    So now, I'm back on beta-1 and beta-2 blockers, and like
    you will be for rest of my life.

    Quoted message said:

    At the same time I have been told to exercise vigorously to
    prevent additional heart attacks. The two seem to be at
    odds with each other. The


    Lopressor

    Quoted message said:

    "seems" to be preventing me from increasing my fitness
    level. Maybe this is ok if the Lopressor is protecting my
    heart in a way that is more important than being fitter?

    No doubt. A catch-22 if all you are measuring your
    fitness level with is HR.

    There are many others way to measure your fitness, and
    they are just as easy to find if you just notice them.

    I have actually started "recording" my rides with a
    Specialized P-Brain computer. It has all the normal
    cycling stuff, but also has a heart rate monitor
    built in and records the whole ride and lets me
    download it to the PC afterward. The best one out
    there is the Cyclimiso HAC4 if you are interested,
    even USPS used them,...

    Quoted message said:

    I had a pacemaker installed in February 2003.
    Except for a brief interruption to my exercise
    program the pacemaker has not affected my maximum
    heart rate.

    I would not expect it to, after all, all it replaced was
    your sino-atrial-node (sp) right,..??

    Doc Chung could address that much better than I
    could,...but I would expect that the device delivering
    the "electrical discharge" would not effect the heart
    rate at all, it either provides a rate or not, and not
    the regulation of it, again, ask the DO,...

    Many cyclist *dream* of a low heart rate, when what they
    really should be dreaming of is a "large *range* of
    heart rate to operate in". Sure, Lance's resting is 32.
    But he can also ride at 210+ for hours. ( * Freak * !!!
    ). His lungs hold a 1/3 more than the rest of us,....he
    finishes a climb with a lactic level of 2.4, (most are
    11-14 or so).

    He's just not human.

    Now that you an I are more machine, and meds, we'll just
    have to measure differently. I'm struggling too, but at
    least we're both still here TO struggle. I have too many
    friends that either didn't notice, or chose NOT to
    notice, and now they are not around, period.

    Just damn glad to even get to sit on my Fizik
    Aliante,....

    JG

  6. Howard Slomer said:

    Dr. Chung, Roadcyclist,

    Thanks you for your quick replies!

    "roadcyclist" <[email hidden]> wrote in message
    "]news:[email hidden]...

    Quoted message said:

    Cyclist here, not a medical professional any more,....

    I take blood pressure medicine and ride 200-300 miles
    per week.

    At one point when I was able to use selective beta
    blockers, I even raced for a team.

    What "elements" is it that is making you feel your are
    not improving your fitness level,...??

    I had a heart attack (LAD blocked 100%) in December
    2002. Last year I biked about 1800 miles and walked
    several hundred miles during the summer months. The
    hills were almost as difficult to pull at the end
    of the summer as they were at the beginning. Based
    on previous my biking experience I expected steady
    improvement during the season.

    During this winter I worked out daily on a bike
    trainer or treadmill for an hour or more a day and
    so far I biked about 300 miles this year. Again
    I've seen no real improvement. During the longest
    climbs and fastest sprints I have been unable to
    raise my pulse rate above 125. Most of my bikeing
    is done in a fairly hilly area.

    Since the heart attack I've had several stress and
    echo tests. My heart function had been above
    average on all but the first echo test which was
    done shortly after the heart attack. During the
    stress tests I've have been unable to raise my
    pulse rate above 125. My doctor and the folks at
    the heart hospital attributed this to the
    Lopressor (50mg twice a day).

    I believe I will be taking Lopressor for the rest
    of my life because of the good effect it has in
    preventing additional heart attacks. At the same
    time I have been told to exercise vigorously to
    prevent additional heart attacks. The two seem to
    be at odds with each other. The Lopressor "seems"
    to be preventing me from increasing my fitness
    level. Maybe this is ok if the Lopressor is
    protecting my heart in a way that is more
    important than being fitter?

    I had a pacemaker installed in February 2003.
    Except for a brief interruption to my exercise
    program the pacemaker has not affected my maximum
    heart rate.


    Howard

    Fwiw, a paced heartbeat is a little less efficient than a
    "natural" heatbeat. For the same heart rate, the cardiac
    output may be significantly less for paced heart rhythms
    compared to "natural" heart rhythms. This may be what is
    actually underlying your "fitness level."

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    heartmdphd.comheartmdphd.com

    **
    Who is the humblest person in the universe?
    makeashorterlink.commakeashorterlink.com

    What is all this about?
    makeashorterlink.commakeashorterlink.com

    Is this spam?
    makeashorterlink.commakeashorterlink.com

  7. "roadcyclist" <[email hidden]> wrote in message news:<H6Brc.11101

    Quoted message said:

    Wow, I just dissected mine during a race in Apr,
    aint that a pill,..!!!

    I've never heard of this from exercise, while it is a
    small risk I'm told (<1% ?) during PTCA. Did you require a
    stent or surgery? Did you have undiagnosed hypertension,
    congenital weakness or a previous angioplasty that may
    have weakened your arterial lumina. I rode the Dallas MS-
    150 last May 1-2 and the first day I did 105 miles, mostly
    in rain with 20-27 mph headwind (I only biked 13.1 avg);
    My HR was > 140 (80% for 55) for > 6 hours out of 8
    (resting hr 38-45 depending on BMI). Since many of my bike
    events are > 100 miles I'm worried about exercised induced
    hypertension causing possible major vessel (mostly aortic)
    weakening, but have never heard of such an event till
    yours. Does anyone have a link to a study or article on
    such a phenomenon on normaltensive people?

    Quoted message said:

    did not sound so bad. I mean after all, I'm 42, I am not
    Lance Armstrong, never rode anything professional, and
    never would. But, I did come from where Lance is from
    DFW, Texas

    I ride 35(mostly) to 60 miles a day 5-7 Days a week above
    McKinney, mostly in spring and summer (5800 + miles last
    year) and more Precor elliptical hours during winter.
    After stopping 30 + years of jogging > 4 miles QD from hip
    bursitis aggravated from a fall off a roof, I rose to a
    BMI 28 and developed Hypertension (sys > 160 dys > 100)
    after 13 months of moderate HR (<100 BPM) activity (mostly
    light walking). So to reverse my Hypertension I choose the
    following methods:
    1. A Caloric reduction diet, which includes 2 days per
    week of fasting; It is a CRON type diet such as here
    anti-aging-guide.comanti-aging-guide.com which has proven in
    animal studies to increase longevity and decrease
    morbidity for over 90 years.
    2. Exercise (Biking or elliptical) for Max HR > 75% of max
    Q 2 hours a day.
    3. Titrate above two methods for SBP < 120 mmHG and DBP <
    80 mmHG. My personal lab results (walking+low carb diet
    versus 1-1/2 years latter biking+CRON diet) are from
    HDL from 66 to 95(winter with less exercise), Total
    Cholesterol from 235 to 181 (in summer total was 161
    with HDL=85), triglycerides from 32 to 64(up because of
    CRON diet eating high fiber breads). My BMI went from
    28 to 20-21 and body fat to 5-8mm (varies) from unknown
    (no fat calipers at time).

    As a side benefit, I went from agnostic-atheist to semi-
    Christian in my search for strength during fasting new-new-
    life.net/fasting.htm (turn your sound off). It has leaded
    me to pray more, which has improved my personal temper
    and relationships. I need this frequently while biking in
    public as the minor => 1 % of drivers I consider to be
    pathological mortal enemies of us all. MADD needs to have
    a branch like MAID (mothers against incompetent drivers);
    as they will take a felons voting privilege away before
    their driver license! If a person is not fit to fly/drive
    multiple people in a large dangerous vehicle (i.e. plane
    or 18 wheeler), why do we accept an incompetent driver
    because they ONLY kill 1-5 people at a time in a car or
    truck? Here in Texas a law has been passed for motorist
    to reduce their speed by 20mph below the posted speed
    when passing a parked police car; however children and
    bikers receive no such consideration as we are second
    class citizens; People are just too much of a hurry to
    clock in at work from waking up too late from a night of
    late TV and in too big a hurry to get home for food and
    TV. This car idolatry period will be looked back on in
    the future as the Dutch's tulip bulb craze in the 17th
    century investopedia.comcra
    shes2.asp except with much greater personal injury and
    death as in a war or plague. Our children are getting
    obese for fear of their loving mommies SUV running them
    over while backing out and it only gets worst with
    inconsiderate strangers on the road; Inner city children
    are developing COPD and adult obesity-heart risk factors

    in their teens from the pollution. Howard Slomer said:

    I had a pacemaker installed in February 2003. Except for a
    brief interruption to my exercise program the pacemaker
    has not affected my maximum heart rate.

    Your case is much more complex that non-Drs, such as myself
    can help you with. I can only guess that you had significant
    damage to your heart and SA-node or A-V pathways that have
    required a pacemaker? The lopressor may be to also aid in
    abnormal fast heart arrhythmias from your MI? But you are
    doing the best thing by exercising and diet; just increase
    your time to compensate for lower max heart rate if your
    Cardiologist thinks it is wise.

    Safe bicycling to all of you. Mike

  8. Dr. Chung,

    "Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote
    in message "]news:[email hidden]...

    Quoted message said:

    Howard Slomer wrote:

    Quoted message said:
    Quoted message said:

    I had a heart attack (LAD blocked 100%) in
    December 2002. Last


    year

    Quoted message said:
    Quoted message said:

    I biked about 1800 miles and walked several hundred
    miles during the


    summer

    Quoted message said:
    Quoted message said:

    months. The hills were almost as difficult to pull at
    the end of the


    summer

    Quoted message said:
    Quoted message said:

    as they were at the beginning. Based on previous my
    biking experience


    I

    Quoted message said:
    Quoted message said:

    expected steady improvement during the season.

    During this winter I worked out daily on a bike
    trainer or


    treadmill

    Quoted message said:
    Quoted message said:

    for an hour or more a day and so far I biked about 300
    miles this year. Again I've seen no real improvement.
    During the longest climbs and


    fastest

    Quoted message said:
    Quoted message said:

    sprints I have been unable to raise my pulse rate above
    125. Most of my bikeing is done in a fairly hilly area.

    Since the heart attack I've had several stress
    and echo tests.


    My

    Quoted message said:
    Quoted message said:

    heart function had been above average on all but the
    first echo test


    which

    Quoted message said:
    Quoted message said:

    was done shortly after the heart attack. During the
    stress tests I've


    have

    Quoted message said:
    Quoted message said:

    been unable to raise my pulse rate above 125. My doctor
    and the folks


    at

    Quoted message said:
    Quoted message said:

    the heart hospital attributed this to the Lopressor
    (50mg twice a day).

    I believe I will be taking Lopressor for the
    rest of my life


    because

    Quoted message said:
    Quoted message said:

    of the good effect it has in preventing additional heart
    attacks. At


    the

    Quoted message said:
    Quoted message said:

    same time I have been told to exercise vigorously to
    prevent additional heart attacks. The two seem to be at
    odds with each other. The


    Lopressor

    Quoted message said:
    Quoted message said:

    "seems" to be preventing me from increasing my fitness
    level. Maybe


    this

    Quoted message said:
    Quoted message said:

    is ok if the Lopressor is protecting my heart in a way
    that is more important than being fitter?

    I had a pacemaker installed in February 2003.
    Except for a


    brief

    Quoted message said:
    Quoted message said:

    interruption to my exercise program the pacemaker has
    not affected my maximum heart rate.


    Howard

    Quoted message said:


    Fwiw, a paced heartbeat is a little less efficient than a
    "natural"


    heatbeat.

    Quoted message said:

    For the same heart rate, the cardiac output may be
    significantly less for


    paced

    Quoted message said:

    heart rhythms compared to "natural" heart rhythms. This
    may be what is


    actually

    Quoted message said:

    underlying your "fitness level."

    Servant to the humblest person in the universe,

    Andrew

    My heart attack occurred in December 2002, the
    pacemaker was installed in February 2004 (not 2003 -
    my typo). My fitness concerns occurred between the
    two events and after the second event.. The
    pacemaker implant did not change my fitness problem
    other than to cause a four week layoff from serious
    exercising.

    The pacemaker was installed to correct an autonomic
    neuropathy related (vagal/vagus nervous system)
    problem caused by diabetes. I had an echo test the
    day the pacemaker was installed. The test results
    indicated that my heart function was above average.

    Howard

  9. Mike,

    Thansk for the response.

    Quoted message said:
    Howard Slomer said:

    I had a pacemaker installed in February 2003. Except for
    a brief interruption to my exercise program the
    pacemaker has not affected my maximum heart rate.

    Your case is much more complex that non-Drs, such as
    myself can help you with. I can only guess that you had
    significant damage to your heart and SA-node or A-V
    pathways that have required a pacemaker? The lopressor may
    be to also aid in abnormal fast heart arrhythmias from
    your MI? But you are doing the best thing by exercising
    and diet; just increase your time to compensate for lower
    max heart rate if your Cardiologist thinks it is wise.

    Safe bicycling to all of you. Mike

    My heart attack occurred in December 2002, the
    pacemaker was installed in February 2004 (not 2003 -
    my typo). My fitness concerns occurred between the
    two events and after the second event.. The
    pacemaker implant did not change my fitness problem
    other than to cause a four week layoff from serious
    exercising.

    The pacemaker was installed to correct an autonomic
    neuropathy related (vagal/vagus nervous system)
    problem caused by diabetes. I had an echo test the
    day the pacemaker was installed. The test results
    indicated that my heart function was above average.

    Howard

  10. Howard Slomer said:


    Dr. Chung,

    "Dr. Andrew B. Chung, MD/PhD" <[email hidden]>
    wrote in message "]news:[email hidden]...

    Quoted message said:

    Howard Slomer wrote:

    Quoted message said:
    Quoted message said:

    I had a heart attack (LAD blocked 100%) in
    December 2002. Last


    year

    Quoted message said:
    Quoted message said:

    I biked about 1800 miles and walked several hundred
    miles during the


    summer

    Quoted message said:
    Quoted message said:

    months. The hills were almost as difficult to pull at
    the end of the


    summer

    Quoted message said:
    Quoted message said:

    as they were at the beginning. Based on previous my
    biking experience


    I

    Quoted message said:
    Quoted message said:

    expected steady improvement during the season.

    During this winter I worked out daily on a
    bike trainer or


    treadmill

    Quoted message said:
    Quoted message said:

    for an hour or more a day and so far I biked about 300
    miles this year. Again I've seen no real improvement.
    During the longest climbs and


    fastest

    Quoted message said:
    Quoted message said:

    sprints I have been unable to raise my pulse rate
    above 125. Most of my bikeing is done in a fairly
    hilly area.

    Since the heart attack I've had several stress
    and echo tests.


    My

    Quoted message said:
    Quoted message said:

    heart function had been above average on all but the
    first echo test


    which

    Quoted message said:
    Quoted message said:

    was done shortly after the heart attack. During the
    stress tests I've


    have

    Quoted message said:
    Quoted message said:

    been unable to raise my pulse rate above 125. My
    doctor and the folks


    at

    Quoted message said:
    Quoted message said:

    the heart hospital attributed this to the Lopressor
    (50mg twice a day).

    I believe I will be taking Lopressor for the
    rest of my life


    because

    Quoted message said:
    Quoted message said:

    of the good effect it has in preventing additional
    heart attacks. At


    the

    Quoted message said:
    Quoted message said:

    same time I have been told to exercise vigorously to
    prevent additional heart attacks. The two seem to be
    at odds with each other. The


    Lopressor

    Quoted message said:
    Quoted message said:

    "seems" to be preventing me from increasing my fitness
    level. Maybe


    this

    Quoted message said:
    Quoted message said:

    is ok if the Lopressor is protecting my heart in a way
    that is more important than being fitter?

    I had a pacemaker installed in February 2003.
    Except for a


    brief

    Quoted message said:
    Quoted message said:

    interruption to my exercise program the pacemaker has
    not affected my maximum heart rate.


    Howard

    Quoted message said:
    Quoted message said:


    Fwiw, a paced heartbeat is a little less efficient than
    a "natural"


    heatbeat.

    Quoted message said:

    For the same heart rate, the cardiac output may be
    significantly less for


    paced

    Quoted message said:

    heart rhythms compared to "natural" heart rhythms. This
    may be what is


    actually

    Quoted message said:

    underlying your "fitness level."

    Servant to the humblest person in the universe,

    Andrew

    My heart attack occurred in December 2002, the
    pacemaker was installed in February 2004 (not 2003
    - my typo). My fitness concerns occurred between
    the two events and after the second event.. The
    pacemaker implant did not change my fitness
    problem other than to cause a four week layoff
    from serious exercising.

    Then I would be concerned that your fitness problem is
    coming from progression of your ischemic heart disease.

    Quoted message said:

    The pacemaker was installed to correct an
    autonomic neuropathy related (vagal/vagus nervous
    system) problem caused by diabetes. I had an echo
    test the day the pacemaker was installed. The test
    results indicated that my heart function was above
    average.

    Howard

    How's your HgbA1C been this whole time?

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    heartmdphd.comheartmdphd.com

    **
    Who is the humblest person in the universe?
    makeashorterlink.commakeashorterlink.com

    What is all this about?
    makeashorterlink.commakeashorterlink.com

    Is this spam?
    makeashorterlink.commakeashorterlink.com

  11. Dr. Chung,

    "Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote
    in message "]news:[email hidden]...

    Quoted message said:
    Quoted message said:


    My heart attack occurred in December 2002, the
    pacemaker was installed in February 2004 (not
    2003 - my typo). My fitness concerns occurred
    between the two events and after the second
    event.. The


    pacemaker

    Quoted message said:
    Quoted message said:

    implant did not change my fitness problem other than to
    cause a four


    week

    Quoted message said:
    Quoted message said:

    layoff from serious exercising.

    Then I would be concerned that your fitness problem is
    coming from progression of your ischemic heart disease.

    That is why I am concerned but several Cardiolite
    stress tests and an echocardiogram indicated no
    problem and in fact indicated that my heart
    efficiency is above normal. It is not that I can do
    less but I cannot seem to improve. Much of my bike
    riding is over the same route. From past experience
    I would expect the hills to become easier to climb
    and for my time over the route to drop.

    Since Lopressor decreases the workload on the heart
    by slowing the heart rate and decreasing the force
    of the contraction I thought that this might also
    make it difficult or impossible to improve fitness
    while taken Lopressor,

    Quoted message said:
    Quoted message said:

    The pacemaker was installed to correct an
    autonomic neuropathy related (vagal/vagus
    nervous system) problem caused by diabetes. I
    had


    an

    Quoted message said:
    Quoted message said:

    echo test the day the pacemaker was installed. The test
    results


    indicated

    Quoted message said:
    Quoted message said:

    that my heart function was above average.

    Howard

    How's your HgbA1C been this whole time?

    The results for all HgbA1C tests have been
    between 6 and 7.

    Howard

    Quoted message said:

    Servant to the humblest person in the universe,

    Andrew

  12. Howard Slomer said:

    Dr. Chung,

    "Dr. Andrew B. Chung, MD/PhD" <[email hidden]>
    wrote in message "]news:[email hidden]...

    Quoted message said:
    Quoted message said:


    My heart attack occurred in December 2002, the
    pacemaker was installed in February 2004 (not
    2003 - my typo). My fitness concerns occurred
    between the two events and after the second
    event.. The


    pacemaker

    Quoted message said:
    Quoted message said:

    implant did not change my fitness problem other than
    to cause a four


    week

    Quoted message said:
    Quoted message said:

    layoff from serious exercising.

    Then I would be concerned that your fitness problem is
    coming from progression of your ischemic heart disease.

    That is why I am concerned but several Cardiolite
    stress tests and an echocardiogram indicated no
    problem and in fact indicated that my heart
    efficiency is above normal.

    Stress tests are designed to detect macrovascular (occlusive
    atherosclerosis in the epicardial coronary arteries) but not
    microvascular disease. Moreover, echocardiograms are better
    at detecting and quantifying systolic dysfunction rather
    than diastolic dysfunction. Microvascular disease primarily
    manifests as diastolic dysfunction *before* systolic
    dysfunction develops. Diastolic dysfuntion can impair
    fitness just as easily as systolic dysfunction.

    Quoted message said:

    It is not that I can do less but I cannot seem to
    improve. Much of my bike riding is over the same route.
    From past experience I would expect the hills to become
    easier to climb and for my time over the route to drop.

    Since Lopressor decreases the workload on the
    heart by slowing the heart rate and decreasing the
    force of the contraction I thought that this might
    also make it difficult or impossible to improve
    fitness while taken Lopressor,

    Worsening ischemic heart disease at the level of the smaller
    vessels is equally plausible.

    Quoted message said:


    Quoted message said:
    Quoted message said:

    The pacemaker was installed to correct an
    autonomic neuropathy related (vagal/vagus
    nervous system) problem caused by diabetes. I
    had


    an

    Quoted message said:
    Quoted message said:

    echo test the day the pacemaker was installed. The
    test results


    indicated

    Quoted message said:
    Quoted message said:

    that my heart function was above average.

    Howard

    How's your HgbA1C been this whole time?

    The results for all HgbA1C tests have been between
    6 and 7.

    Do you have metabolic syndrome (MetS)?

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    heartmdphd.comheartmdphd.com

    **
    Who is the humblest person in the universe?
    makeashorterlink.commakeashorterlink.com

    What is all this about?
    makeashorterlink.commakeashorterlink.com

    Is this spam?
    makeashorterlink.commakeashorterlink.com

  13. "Howard Slomer" <[email hidden]> wrote in message
    "]news:[email hidden]...

    Quoted message said:


    I've been taking 50mg of Lopressor twice a day
    since my heart


    attack

    Quoted message said:

    in December 2002. The Lopressor apparently prevents my
    heart rate from exceeding 125 bpm, even during a stress
    test. Since my heart attack I have been doing a lot of
    biking to try to strengthen my heart but my


    fitness

    Quoted message said:

    level doesn't seem to improve much no matter how many
    hours I spend


    biking,

    Quoted message said:


    Is it possible that the Lopressor is preventing me
    from improving


    my

    Quoted message said:

    fitness level? Are the benefits of taking the Lopressor
    outweighed by


    it's

    Quoted message said:

    effect on my heart rate?

    T
    h
    a
    n
    k
    s
    i
    n


    advance,

    Quoted message said:

    H
    o
    w
    a
    r
    d

    I suffered V-Fib at home back in '90 (age 22) and was
    quickly converted by the Houston FD. Been on beta-blockers
    since and had a ICD implanted 2 years ago. No shocks so far.
    I have been weening myself off of Toprol 50mg/once a day to
    almost not taking it at all now. At first, when I cut back
    to one pill every 3 days I felt a little like I had drank a
    pot of coffee, but that feeling is almost gone now and I
    have not taken it for almost 12 days. I am in decent shape
    and pretty active. I don't want to be on beta-blockers any
    longer and since I have an ICD, I feel ok by doing so.

    I am NOT recommending this for anyone here.

    ~David

  14. Johnny said:

    "Howard Slomer" <[email hidden]> wrote in
    message "]news:[email hidden]...

    Quoted message said:


    I've been taking 50mg of Lopressor twice a day
    since my heart


    attack

    Quoted message said:

    in December 2002. The Lopressor apparently prevents my
    heart rate from exceeding 125 bpm, even during a stress
    test. Since my heart attack I have been doing a lot of
    biking to try to strengthen my heart but my


    fitness

    Quoted message said:

    level doesn't seem to improve much no matter how many
    hours I spend


    biking,

    Quoted message said:


    Is it possible that the Lopressor is preventing
    me from improving


    my

    Quoted message said:

    fitness level? Are the benefits of taking the Lopressor
    outweighed by


    it's

    Quoted message said:

    effect on my heart rate?


    Thanks in

    Quoted message said:

    advance,

    Quoted message said:


    Howard

    Quoted message said:
    Quoted message said:

    I suffered V-Fib at home back in '90 (age 22) and was
    quickly converted by the Houston FD.

    Too young. Did you have a cardiomyopathy?

    Quoted message said:

    Been on beta-blockers since and had a ICD implanted 2
    years ago. No shocks so far. I have been weening myself
    off of Toprol 50mg/once a day to almost not taking it at
    all now. At first, when I cut back to one pill every 3
    days I felt a little like I had drank a pot of coffee, but
    that feeling is almost gone now and I have not taken it
    for almost 12 days. I am in decent shape and pretty
    active. I don't want to be on beta-blockers any longer and
    since I have an ICD, I feel ok by doing so.

    Hopefully, you doctor is both aware and supervising
    you in this.

    Quoted message said:


    I am NOT recommending this for anyone here.

    ~David

    Thanks for sharing, David.

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    heartmdphd.comheartmdphd.com

    **
    Who is the humblest person in the universe?
    makeashorterlink.commakeashorterlink.com

    What is all this about?
    makeashorterlink.commakeashorterlink.com

    Is this spam?
    makeashorterlink.commakeashorterlink.com

  15. Dr. Chung,

    "Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote
    in message "]news:[email hidden]...

    Quoted message said:
    Quoted message said:


    That is why I am concerned but several
    Cardiolite stress tests


    and

    Quoted message said:
    Quoted message said:

    an echocardiogram indicated no problem and in fact
    indicated that my


    heart

    Quoted message said:
    Quoted message said:

    efficiency is above normal.

    Stress tests are designed to detect macrovascular
    (occlusive


    atherosclerosis in

    Quoted message said:

    the epicardial coronary arteries) but not microvascular
    disease.


    Moreover,

    Quoted message said:

    echocardiograms are better at detecting and quantifying
    systolic


    dysfunction

    Quoted message said:

    rather than diastolic dysfunction. Microvascular disease
    primarily


    manifests

    Quoted message said:

    as diastolic dysfunction *before* systolic dysfunction
    develops.


    Diastolic

    Quoted message said:

    dysfuntion can impair fitness just as easily as systolic
    dysfunction.

    Do tests exist that can measure and diagnose
    microvascular disease? So far I have avoided
    the typical eye and foot problem associated
    with diabetes.

    Quoted message said:
    Quoted message said:

    It is not that I can do less but I cannot seem to
    improve. Much of my bike riding is over the same route.
    From past experience I would expect the hills to become
    easier to climb and for my time over the route to drop.

    Since Lopressor decreases the workload on the
    heart by slowing


    the

    Quoted message said:
    Quoted message said:

    heart rate and decreasing the force of the contraction I
    thought that


    this

    Quoted message said:
    Quoted message said:

    might also make it difficult or impossible to improve
    fitness while


    taken

    Quoted message said:
    Quoted message said:

    Lopressor,

    Worsening ischemic heart disease at the level of the
    smaller vessels is


    equally

    Quoted message said:

    plausible.

    Quoted message said:


    Quoted message said:


    How's your HgbA1C been this whole time?

    The results for all HgbA1C tests have been
    between 6 and 7.

    Do you have metabolic syndrome (MetS)?

    I don't know. I suspect I had MetS when my diabetes
    was first diagnosed 20 years ago (weight 265, high
    blood pressure, normal LDL, low HDL, insulin
    resistant, no or little exercise). Now my weight is
    185 ( 6'2"😉, low blood pressure (115/65), low LDL
    (50), high HDL (47), low trig
    (45), and I exercise 1.5 hours daily. The changes were
    brought about by a combination of diet changes,
    medication and exercise.

    Howard

    Quoted message said:


    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist
    heartmdphd.comheartmdphd.com

  16. Howard Slomer said:

    Dr. Chung,

    "Dr. Andrew B. Chung, MD/PhD" <[email hidden]>
    wrote in message "]news:[email hidden]...

    Quoted message said:
    Quoted message said:


    That is why I am concerned but several
    Cardiolite stress tests


    and

    Quoted message said:
    Quoted message said:

    an echocardiogram indicated no problem and in fact
    indicated that my


    heart

    Quoted message said:
    Quoted message said:

    efficiency is above normal.

    Stress tests are designed to detect macrovascular
    (occlusive


    atherosclerosis in

    Quoted message said:

    the epicardial coronary arteries) but not microvascular
    disease.


    Moreover,

    Quoted message said:

    echocardiograms are better at detecting and quantifying
    systolic


    dysfunction

    Quoted message said:

    rather than diastolic dysfunction. Microvascular disease
    primarily


    manifests

    Quoted message said:

    as diastolic dysfunction *before* systolic dysfunction
    develops.


    Diastolic

    Quoted message said:

    dysfuntion can impair fitness just as easily as systolic
    dysfunction.

    Do tests exist that can measure and diagnose
    microvascular disease? So far I have avoided the
    typical eye and foot problem associated with
    diabetes.

    Quoted message said:
    Quoted message said:

    It is not that I can do less but I cannot seem to
    improve. Much of my bike riding is over the same
    route. From past experience I would expect the hills
    to become easier to climb and for my time over the
    route to drop.

    Since Lopressor decreases the workload on the
    heart by slowing


    the

    Quoted message said:
    Quoted message said:

    heart rate and decreasing the force of the contraction
    I thought that


    this

    Quoted message said:
    Quoted message said:

    might also make it difficult or impossible to improve
    fitness while


    taken

    Quoted message said:
    Quoted message said:

    Lopressor,

    Worsening ischemic heart disease at the level of the
    smaller vessels is


    equally

    Quoted message said:

    plausible.

    Quoted message said:


    >
    > How's your HgbA1C been this whole time?

    The results for all HgbA1C tests have been
    between 6 and 7.

    Do you have metabolic syndrome (MetS)?

    I don't know. I suspect I had MetS when my
    diabetes was first diagnosed 20 years ago (weight
    265, high blood pressure, normal LDL, low HDL,
    insulin resistant, no or little exercise).

    Very probable.

    Quoted message said:

    Now my weight is 185 ( 6'2"😉,

    Still might be 15 lbs over ideal.

    Quoted message said:

    low blood pressure (115/65),

    Not low but optimal.

    Quoted message said:

    low LDL (50),

    Optimal.

    Quoted message said:

    high HDL (47),

    Near optimal.

    Quoted message said:

    low trig
    (45),

    Optimal.

    Quoted message said:

    and I exercise 1.5 hours daily.

    Optimal.

    Quoted message said:

    The changes were brought about by a combination of diet
    changes, medication and exercise.

    ...and weight loss (which should probably be listed first).

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    heartmdphd.comheartmdphd.com

    **
    Who is the humblest person in the universe?
    makeashorterlink.commakeashorterlink.com

    What is all this about?
    makeashorterlink.commakeashorterlink.com

    Is this spam?
    makeashorterlink.commakeashorterlink.com

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