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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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so are you on maintenance roids? sounds like you are (40 vs 80). if you're not on maintenance, you might find your "flares/attacks" will become much, much less about 1-2 weeks after starting the maintenance (LABA and others_) roids.

also, if you are still suffering with albuterol costs, i am pretty sure i pay WAY under $10USD for mine. i can pick some up for you and have them sent to you if you want. so glad you updated us! thanks so much!

http://harvestmoon6.blogspot.com


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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [kathy_caribe] [ In reply to ]
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kathy_caribe wrote:
ericmulk wrote:
justarunner wrote:
Steroid inhalers are localized to the lungs, they don't really operate outside of that realm. So performance enhancement isn't what the drug is about. It essentially reduces inflammation in the lungs to allow you to breath better if your airways are inflamed for whatever reason.
Having said that, I do believe USADA/WADA ban their use outright. However, if you need one for medical use, they will give you a TUE (Therapeutic Use Exemption) good for a certain duration. Galen Rupp has had like 1-2 TUEs for steroid inhalers in his career as has a variety of breathing afflictions.
And it's a shame they don't help performance, cause I stunk up the track tonight with my awful workout lol!


Ah, i see, thanks for the explain. Asthma inhaler use is very high in the competitive swimming world, with something like 30% or so of all swimmers at national meets using an inhaler. I don't know if these are "steroid inhalers" or some other type but, apparently lots of top swimmers have asthma and get a TUE for an inhaler. In fact, it is so prevalent that some people have questioned whether the inhalers are giving these swimmers some sort of advantage. I haven't read much about it lately but it has been a hot topic off and on over at least the past 7-8 yrs or so.


there is a study somewhere with a correlation between chlorine swimming and asthma. FWIW. as for steroid inhalers, they are not required for a TUE. systemic steroids are but not inhaled unless you're taking in nebs and i did the calculations once - i think it was 5-6 nebs a day. when i'm doing that much i'm not even able to get out of bed so no worries on needing to be drug tested.

Ummm, what exactly is a "neb"??? You've lost me here and even Google doesn't know:)


"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [ericmulk] [ In reply to ]
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nebs = nebulizer

Justarunner -> suggest you move outside the bowl so you can eventually/hopefully wean off the meds!
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [buddyblanke] [ In reply to ]
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buddyblanke wrote:
neb = nebulizer
Justarunner -> suggest you move outside the bowl so you can eventually/hopefully wean off the meds!

OK, thanks. Upon a further reading i see that a nebulizer is actually a "drug delivery device used to administer medication in the form of a mist inhaled into the lungs". Anyway, thanks for spelling out the word:)




"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [ericmulk] [ In reply to ]
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fyi, when i'm coming up google empty i just add more context http://lmgtfy.com/?q=asthma+neb

http://harvestmoon6.blogspot.com


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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [kathy_caribe] [ In reply to ]
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kathy_caribe wrote:
fyi, when i'm coming up google empty i just add more context http://lmgtfy.com/?q=asthma+neb

Sure, i could've searched more and figured it out but the way you used "neb" made it sound like you were taking some sort of pill, as in "i'm taking 5-6 nebs a day". I just think your using "neb" in this manner is kinda sorta off base, at least for people with no background in this area:)


"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [ericmulk] [ In reply to ]
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ah. sorry about that.

for me neb is both noun and verb. "i need a neb" "are you going to neb yourself now or do you want to wait?" and there are nebs (plural noun form). :) consider yourself among the lucky that you aren't so well versed nebs. :)

http://harvestmoon6.blogspot.com


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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [kathy_caribe] [ In reply to ]
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kathy_caribe wrote:
ah. sorry about that.
for me neb is both noun and verb. "i need a neb" "are you going to neb yourself now or do you want to wait?" and there are nebs (plural noun form). :) consider yourself among the lucky that you aren't so well versed nebs. :)

Well, thanks for understanding my point of view, and i do consider myself lucky in never needing to use the "nebulizer". Your use of "neb" reminds me of the F-bomb: can be used as noun, verb, adjective, adverb, gerund, etc:)


"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [ericmulk] [ In reply to ]
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i think fuck has to be one of the most versatile words in teh English language. unless you're in Oz. then it's cunt. :)

http://harvestmoon6.blogspot.com


Last edited by: kathy_caribe: Oct 28, 15 8:09
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [kathy_caribe] [ In reply to ]
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kathy_caribe wrote:
i think fuck has to be one of the most versatile words in teh English language. unless you're in Oz. then it's cunt. :)

Ya, the F-bomb is very versatile but can get a person in trouble at work, or even at the pool, if you are not very careful. As a result, i'm trying very hard to say "frig" instead:)


"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [mblocher] [ In reply to ]
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Hello mblocher, Monty, and All,

I just got a pacemaker. For those triathletes that have a pacemaker ..... what adaptations (if any) to your training and racing are required?

My EP doc is also Dr. Navinder Sawhney (who I highly recommend) with Arch Health Partners practicing at the new Palomar Hospital in Escondido.

Similar to Monty I had some symptoms but passed all the tests .... exercise EKG, nuclear perfusion, sonar, etc. and used a Zio Patch monitor for a couple of weeks with out any data detailing a cause for occasional light headed feeling when at rest with low heart rate. (heart worked fine at higher heart rates)

Early in December 2015 I got a Medtronic LINQ monitor inserted under the skin over my heart:

http://www.medtronic.com/...ors/reveal-linq-icm/

The LINQ saves heart rate data in memory and transmits each night from 2400 to 0600 via bluetooth to a handset unit bedside and then over the cell network to your doctor.

The LINQ has a lifespan of 3 years without charging (and would make a great replacement mode for a chest strap .... no muss, no fuss).

Last week while I was at rest ..... the LINQ recorded some 4 second dropouts at low 30's beat per minute heart rates and that indicated that I needed a pacemaker. I did not want to pass out under water, driving, or just fall over and crack my head ..... so now I am the Biotronik Man.

Yesterday Dr. Sawhney installed my new body part ......... (Biotronik Pacemaker) and removed the LINQ at Palomar Hospital.

My Biotronik Eluna 8 DR-T Pacemaker has 240 days of memory on board and at 0100 each day transmits the previous 24 hour (or longer if traveling) heart data to Dr. Sawhney. (would be nice if I could get the data too and import it into Golden Cheetah or the like.)


https://www.biotronik.com/...r&pw=974&pt=

https://www.biotronik.com/...n&pw=974&pt=

The CLS Closed Loop Stimulation feature that adapts to bodily functions appears to be useful if it functions as advertised.

The Biotronik Rep advised me that the unit adapts the voltage that triggers the heart contraction based on a feed back mechanism that also includes an accelerometer that provides a parameter along with the CLS that increases heart rate with sensed physical motion.

============================================


mblocher wrote:
While I can't say that he specializes in endurance athletes, my EP doc is Navinder Sawhney in San Diego. I REALLY like his calm demeanor, he is very thorough and attentive, unlike other cardio/EPs I've seen. He did my ablation for atrial fibrillation last year and is usually at his Palomar hospital office although he goes to Poway on Mondays. My wife would recommend Dr. Charles Athill with Sharp in San Diego - he is an EP specialist and did her pacemaker implant last year after Stephen Higgins at Scripps La Jolla botched her ablation resulting in complete heart block (so obviously, we'd recommend NOT going to him!). Dr. Athill is super conservative and also extremely thorough (his father died from complications from afib, so he takes it personally). He has also been in practice longer than Dr. Sawhney so has likely seen more cases and more variety.


John Rogers at Scripps Green Hospital is also a great guy (not EP specialty) that you'd probably like. Doug Gibson is the main EP guy at Scripps Green, and is not recommended by my cousin who operated with him on numerous occasions as a cardiac OR nurse.

Hope this helps.



.

Cheers, Neal

+1 mph Faster
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [nealhe] [ In reply to ]
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Neal- if you don;t mind my asking- how old are you? seems like afib and this sort of stuff becomes more of an issue once you hit 50
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [Allezdude] [ In reply to ]
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hi, that EKG from june does shows 3rd degree block in the bottom rhythm strip. ironhono called it as well.
http://lifeinthefastlane.com/...omplete-heart-block/
that ekg should be reviewed again, its not normal
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [Allezdude] [ In reply to ]
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Hello Allezdude and All,

I think you are partially correct ..... some published data agrees ..... arrhythmia prevalence increases 9 to 15% > age 80 .... http://www.ncbi.nlm.nih.gov/pubmed/12766527

I will be race age 83 in a couple of weeks.

http://www.ncbi.nlm.nih.gov/pubmed/1782647

Bradycardia (slow heart rate) is found in young student athletes.

The study below is more on point and affected athletes (in this study) with a mean age of 38 years.

My case was primarily bradycardia with occasional skips and it appears that athletes are more subject to the effects of bradycardia than the general population:

http://www.ncbi.nlm.nih.gov/pubmed/6508966

"One hundred and sixty consecutive patients less than 50 years of age (mean 38 years) referred for long term electrocardiographic recording were evaluated retrospectively. Significant cardiac arrhythmias were detected in 51 of 107 (48%) patients examined because of syncope [fainting] or dizzy spells or both."




.

Cheers, Neal

+1 mph Faster
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [nealhe] [ In reply to ]
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Similar to Monty I had some symptoms but passed all the tests .... exercise EKG, nuclear perfusion, sonar, etc. and used a Zio Patch monitor for a couple of weeks with out any data detailing a cause for occasional light headed feeling when at rest with low heart rate. (heart worked fine at higher heart rates)
---------------------------------------
My I as what symptoms you had?

Was it just light headed at rest?


Train safe & smart
Bob

Last edited by: Longboarder: Dec 19, 15 16:56
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [nealhe] [ In reply to ]
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Hey Neal - I do not have a pacemaker, but Dr. Sawhney did my ablation last October. I've got 0 training or racing limitations. A different doctor did my wife's pacemaker this past Feb. (3rd degree AV block) - she also has few limitations to her workouts (not a triathlete, but a personal trainer and fitness nut). Some overhead exercises are limited, but cardiac-wise she's got no limits. Low rate is set at 50, high at 180. Be sure to take it easy the first couple weeks and let your body adapt to your new parts.
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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This story sounds very familiar. In 2010 I was running a lot of miles, feeling run down, not recovering between workouts, etc. I also noticed my heart skipping beats during runs and while at rest. Really freaked me out. Turns out I have a heart block. I was also overtrained, which caused the block to act up more frequently. The overtraining also caused all the other issues. A couple weeks off with proper hydration and nutrition and I was able to resume normal training. As a 15:xx 5k runner, I'm guessing you probably considered this already, but thought I'd share my experience since it sounds so similar.
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [ericmulk] [ In reply to ]
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ericmulk wrote:
kathy_caribe wrote:
i think fuck has to be one of the most versatile words in teh English language. unless you're in Oz. then it's cunt. :)


Ya, the F-bomb is very versatile but can get a person in trouble at work, or even at the pool, if you are not very careful. As a result, i'm trying very hard to say "frig" instead:)

I get SO excited when I here 'ffffffuuuu' from my Dad. He's so mild mannered and level headed, in language especially.

But it always ends in 'dddddggggeee. Oh Fudge? C'mon Dad. Excite me a little here.
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [JSully] [ In reply to ]
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JSully wrote:
ericmulk wrote:
kathy_caribe wrote:
i think fuck has to be one of the most versatile words in teh English language. unless you're in Oz. then it's cunt. :)


Ya, the F-bomb is very versatile but can get a person in trouble at work, or even at the pool, if you are not very careful. As a result, i'm trying very hard to say "frig" instead:)


I get SO excited when I here 'ffffffuuuu' from my Dad. He's so mild mannered and level headed, in language especially.

But it always ends in 'dddddggggeee. Oh Fudge? C'mon Dad. Excite me a little here.

I wish i had that problem. TBH, I've gotten into varying degrees of hot water for dropping the F-bomb about 4 or 5 times over the past 15 yrs or so. One time i offended a male coworker, one time a dentist, once a lifeguard, etc...:)


"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [mblocher] [ In reply to ]
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Hello mblocher, Longboarder, and All,

Longboarder, my symptoms were primarily being light headed at rest with very low heart rate …. Which I blew off as not a big deal ….. da Nile (a river in Africa).

However I had a wakeup call. After driving to Napa from Escondido for a family wedding …. and getting a bit dehydrated so I would only occasionally have to stop to pee …

...... while attending one of the pre wedding parties I met Bruce Doscher http://brucedoscher.com/cyclingposters/ (he had arrived from New Zealand - prize for longest distance?) who is also a triathlete, and we were standing outside on the patio swapping triathlon stories. (I gave him some View-Speed skewers and he comped me a couple of Tour posters)

I was telling him about the 2010 Kona race when I was at about mile 85 on the bike and tore my adductor muscle …. I said, “it hurt like a son of a bitch” and then said, “I feel dizzy” [for real] and passed out. Bruce was into my story and thought I was acting it out by falling. Fortunately for me, the prospective groom was also listening but not all that interested in the story (or triathlon) …. and caught me to break my fall so I did not crack my head on the concrete steps. I was only out for the time of the fall but was drinking red wine and spilled it on my face so it looked like I had blood on me ….. and after that my wife insisted that I get checked out.

I was fine for the next few days and when I got home I contacted Dr. Sawhney ….. and 3 months later I have a pacemaker.

mblocher, we are just swapped ….. my wife had an ablation (tachycardia), with Dr. Sawhney, and I had the pacemaker. I have to avoid lifting more than 5 lbs for 6 weeks with left arm but can use a bike or trainer at 2 weeks. No lifting left arm above shoulder for 6 weeks to avoid dislodging wires going into heart. After 6 weeks I am good to go for SBR or weight lifting etc. My pacemaker is set at 50 low …. so I think I feel it kick in occasionally when at rest .... like on computer or driving ..... but it may be my imagination. It is set high at 130 but since my heart works OK at higher rates that is not limiting and I can go to about 173 when last checked for a treadmill max.

I have great confidence in Dr. Sawhney and after reviewing the various manufacturers pacemakers I am pleased that he recommended and installed the Biotronik from Germany with its advanced features.

I am being lazy for the first couple of weeks as instructed and as you suggest to let stuff start healing ...... but I feel great and at loose ends ……..



.

Cheers, Neal

+1 mph Faster
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [nealhe] [ In reply to ]
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Neil
Thanks for the reply. My resting HR runs around 40 and has since I took up endurance sports in 2002 at 50. No real symptoms but I do get orthostadic hypotension sometimes. I'm do for a cardio work up its been a few years.

Sounds like you'll be a racing again next year, I hope to be racing at 83 too. Good luck.


Train safe & smart
Bob

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