Thursday, 19 October 2017

Medical Update Part 2

Yesterday I gave a bit of a medical update about how my heart is doing. If you haven't read it then you really should because it is awesome. If you have read yesterdays blog I suggest you click back and have a look now. It is okay I will wait.....

Okay, good.

Now in yesterday's blog I wrote about having some blood taken last week for genetic testing. Specifically testing to see if there is a chance I have a genetic condition called Arrhythmogenic Right Ventricular Cardiomyopathy or ARVC if you are a cool kid like me. The genetic test won't say for sure one way or another, but it might give the doctors more of an idea.

Now one of the things that has bugged me about this potential diagnosis is that if I a genetic condition, then I have had it all my life, genes don't just develop problems. But I have done intense levels of sport for years without problem, is a genetic problem likely.

To be honest I don't know the answer to that, I think the fact that I have done lots of sports for about 25 years makes me think ARVC probably is a bit unlikely. However, from what I understand it isn't impossible.

Studies have shown that people with ARVC may not have symptoms, or they may not have many symptoms. So having ARVC doesn't necessary mean you have heart issues or are even aware of having anything wrong.

Some studies have also seemed to indicate that if you get a person with confirmed ARVC and no symptoms and then put them through a regime of intense exercise regimes their symptoms seem to get worse. Now I am not sure how widely confirmed that finding is, but it has been tested at least once I gather.

So, theoretically I could have had ARVC all my life and only just been getting symptoms because I have finally pushed my heart too far.

Once again I am not so sure about that as I have been pushing my heart pretty hard for a very long time and so I would have thought these symptoms might have shown up earlier, but I guess it can't be ruled out, hence the test.

However, given that other studies seem to have found that long term endurance athletes sometimes develop ARVC type symptoms without having the underlying genetic condition seems to make more sense to me.

I guess we shall see, a few months time and we should have a better idea one way or another.

Interesting stuff though.

Wednesday, 18 October 2017

Medical Update

Okay, made it. Here I am. 

Sorry for the lack of blog yesterday, as I said on Monday I am up in Darwin for work at the moment, and sometimes getting online to post a blog is just a little bit tough. So it was yesterday. But never fear, today I have found time. 

Way back on Monday I mentioned that I have some health updates and that it felt like a Wednesday sort of blog. Well it still does and so here we are.

There hasn't been a lot of progress with my heart, however, but there have been a few developments with respect to tests etc. 

I think I wrote a while ago about having a signal average ECG, which is a bit like an uber ECG where they do about 120 ECGs and then overlay them to cancel out noise and see if any patterns emerge (at least I think that is what it does, after all I am not a doctor). I haven't heard anything from Dr Stobie regarding that test, which I am choosing to interpret as good news, or at least the absence of bad news. 

Then last week I had some genetic testing done. Or more accurately I had some blood taken with which they are going to do the genetic testing. As the Doctor doing the testing explained, the testing bit is quick, but the analysis afterwards can take months. So last week I started that process. I am not expecting results anytime soon. 

The reason for the genetic testing is they are trying to get an idea of whether or not I might, perhaps, maybe have a genetic conditions called Arrhythmogenic Right Ventricular Cardiomyopathy (say that 10 times fast) or ARVC to its friends. The reason I say they are trying to get an idea of if I might, perhaps, maybe is because genetic testing is far from certain. It can help give an idea of whether it is likely or not but not a concrete diagnosis.

Why test for ARVC? Well, the symptoms I have sort of fit the diagnosis. I am not a doctor (obviously) but this is my understanding. Diagnosing ARVC is very difficult (even with genetic testing) so they tend to do it based on symptoms. More recently (2010 I think) there has been a check list developed that indicates whether or not ARVC is likely. Using this checklist they can diagnose ARVC whether the genetic markers are there or not. I don't tick many of the items on the ARVC checklist, but I tick more than none. Enough to make it worth checking. 

Again, Why?

Well, whether or not they think I have ARVC or not dictates the forward treatment. If they come out and say odds on you have ARVC then I need to avoid competitive sport going forward. In fact I need to pretty much limit myself to 30 minutes of moderate exercise 5 times a week for the rest of my life. Not ideal, but to be honest at this point I have sort of come to terms with that. Doing competitive sport puts me at risk of sudden cardiac death, which is an option that I feel is worse than not doing exercise. Might just be me.

If the diagnosis comes back and says you look like you probably don't have ARVC then that is different. Studies are showing that as the popularity of endurance sports increases there seems to be an increase in the number of people displaying ARVC type symptoms but who don't have the genetic markers. There seems to be a bit of uncertainty about it in the medical world, but people are thinking there could be a link. Once again, I am not a doctor so I am far from an expert on these things.

Following on from that, some studies seem to indicate that in cases on non genetic ARVC if people detrain the symptoms seem to subside. This is exactly why I am currently detraining. Besides I need to wait several months to get the results of the genetic testing and so that is going to force me to detrain anyway. Kills two birds with one stone really, potentially getting a diagnosis and working on a solution at the same time.  

Anyway, so that is about that. There is of course another question about, if I have a genetic condition why was I able to train for years without problems before they flared up this year, and there is potentially some answers around that. But I think that might be a blog for another day. 

Monday, 16 October 2017

A bit of a lie down

Just a quick blog today. After the epic day that was Kona, we can probably all do with a bit of a lie down anyway.

The reason for the short blog is because I am currently up in Darwin. Yep Darwin. Being in Darwin usually means one thing busy, busy, busy and this visit is no difference. As a result I am a bit unsure what my blog update schedule will look like. If I am a bit haphazard with the blogs this week then I apologise in advance.

This visit is all about work. rather than for seeing family or training or any of the other many reasons that I usually come up to Darwin. Rather boring, but still a nice excuse to be up here seeing all the usual suspects, including my parents. So while I am up here for work, it should be a pretty fun trip.

Tomorrow I am really looking forward to my old coach Daryl and his wife Robyn, the people who formed my view and approach to Triathlon more than any other people. Always great to catch up with them and I am really looking forward to seeing them tomorrow.

Beyond all that I don't have a lot to write about today, unless people want to hear about a very congested unfun flight between Perth and Darwin. No.... Oh well then.

I do have some recent health updates etc to write about, but I think I will keep them for another day. Nothing earth shattering, just the latest in the saga. That feels like more of a Wednesday post I think.

Anyway, I have just been told I have 15 minute to vacate the building and so I think that is as good as an excuse as any to get out of here.

More interesting blogs to come I promise.

Watch this space.