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Cooper Clinic Finds Clarence Amazingly Resilient—After 29 Years of Evaluation

Testosterone Highest Since Testing Began

“You continue to amaze with your incredible resiliency at age 79 which allowed you to recover remarkably fast from your recent left hip replacement procedure,” Dr. Lynn McFarlin began the latest evaluation in a series which began in 1988. “Less than 24-hours from surgery you were able to walk up and down stairs and despite postoperative blood clot in the left calf…you were able to continue recovering from surgery with rapidly increasing exercise intensity.” 

I was discharged home the day after surgery and began rehab on my own. Gradually increasing intensity, I was soon back to training full tilt (making my surgeon a little nervous along the way).

As in the past, my cholesterol readings were “ideal,” my prostate normal (not enlarged), and my Omega-3 level good at 9.0%. I still have white coat hypertension, but normal reading at home when relaxed. “I see no evidence of true hypertension and medical therapy is not needed,” Dr. McFarlin wrote.

Two things distinguish this visit from the previous 16. The first is that my stress test was done on the Schwinn Airdyne, the stationary bike with push-pull arm action. The other is that my hormone function was the best since testing began 17 years ago, “with a very healthy serum testosterone level of 666.”

Personal Protocol Used

Previous stress EKGs have been on the treadmill and then the stationary bike. In both, load begins low and is then slowly increased until exhaustion. At my request, the test this time was done on the Airdyne, using the 10 minute interval protocol I do at home. After a gradually increasing two minute warm-up and recovery, I do three all-out 30 second reps with 90 second rest periods, and end with a two minute cooldown. Importantly, heart rate maximum occurs during the all-out intervals, rather than in the excruciating final seconds at the end of the test. My protocol is far more user friendly. Challenging but not oppressive. A lot more fun than the dreaded standard protocol. The question to be answered was whether it would illicit a comparable maximum heart rate and other readings necessary to assess the functioning of my heart. It appears to have done that and more. 

I’ve long believed that the standard formula for computing maximum heart rate (220 minus age) doesn't work for athletes. That maximum heart rate won’t slow down if you don’t. That has been my experience.

My maximum heart rate was first measured at Lovelace Foundation for Medical Education and Research in Albuquerque when was 39 years old. My max was 180 beats per minute. That was the last time the standard formula worked for me. Measured repeatedly at the Cooper Clinic, my heart rate maximum hovered around 180 over the next 32 years. The high was 190 in 1992 (age 55) and the low 173 in 2007 (age 69). 

After hitting 181 in 2008 and 2009 (age 70 & 71), my maximum dropped to 164 in 2012 and 2014 (ages 74 & 76). Both readings were on a cycle ergometer.

My current reading, on the Schwinn Airdyne, was 166, still 25 beats above that predicted for my age (220 minus 79 is 141).

While modality (treadmill, cycle, or Airdyne), protocol, and motivation make a difference, I believe it’s fair to say that my example shows that the standard formula doesn’t work for those who continue to challenge their limits.

For the back story on the standard formula, see my FAQ: http://www.cbass.com/FAQ3.htm#Forget

Mystery Heart Rate Spike

My Fitbit has been showing heart rate spikes during periods of low intensity activity. Not a lot, two or three times that I can remember. Made no sense and produced no symptoms. I didn’t feel anything. No stress, nothing to suggest an elevated heart rate. I told Dr. McFarlin about these mystery spikes before my stress test on the Airdyne.

He came in during the cooldown at the end of test. And put two and two together. “That explains it,” he said looking at the EKG readings. “I’ll explain it to you later,” he told me.

“Early in the recovery period,” McFarlin wrote in his evaluation, “a prolonged episode of supraventricular tachycardia developed which resulted in an accelerate heart rate of 210 at which time you had no associated symptoms including no chest pain, lightheadedness or fatigue.” 

He explained to me that SVT is different than atrial fibrillation. Afib stands for irregular heartbeat while SVT stands for rapid heart rate. SVT involves only the upper chambers (atria) of the heart and, for most people, is not dangerous. The heart continues to work normally, pumping blood through the body.

(For the basics on how the heart works: http://www.cbass.com/heartmechanisms.htm )

With no symptoms (I didn’t feel anything) Dr. McFarlin sees no need for additional evaluation at this time. Should symptoms develop, we may need to take another look.

Testosterone and Sleep

The reference range was for 30-year-old men is 240-1035—and typically declines an average of one percent each year. So 666 is pretty good for a guy in his 80th year!

My testosterone was measured for the first time in 2000, when I was 62; it was normal at 483 ng/dl.

My low reading was 326 in 2008, and the previous high was 566 in 2011.

My last test, in 2015, at 78, was 494.

*  * *

Frankly, I don’t know why my testosterone level is the best since testing began 17 years ago. My best guess is that sleep is ta key factor.

Clearly, lifestyle plays a role in keeping testosterone at healthy levels. See: http://www.cbass.com/Testosterone.htm

According to Men’s Fitness, A recent study funded by the National Heart, Lung, and Blood Institute found that testosterone levels dropped significantly in men who don’t get enough sleep—equivalent to aging 10-15 years.

Fitbit once again entered the picture, allowing me to track the length and quality of my sleep for the first time.

The latest stats on sleep from Fitbit were reported by Fox Business News on June 30, 2017:

Fitbit this week released sleep statistics based on aggregated and anonymous data from millions of its users from April 8-17. The average Fitbit user is in bed by 11:36 p.m. and sleeps for 6 hours and 38 minutes. That includes 1 hour, 37 minutes of REM sleep; 3 hours, 55 minutes of light sleep; and 1 hour, 7 minutes of deep sleep. Fitbit users wake up at 7:17 a.m., on average, the company says.

Based on the results of the study, it seems we all need more sleep. The US Centers for Disease Control and Prevention recommends adults get at least seven hours of sleep each night.

If you tend to fall short ... try to bank those extra minutes: Fitbit data confirms that sleeping 7 to 8 hours gives you the highest combined percentage of deep and REM sleep," the company wrote in a blog post.

The first thing I do each morning after walking is to check the length and quality of my sleep on Fitbit.

For perhaps the first time ever, I am averaging eight or more hours of sleep each night.

For more about sleep, see Expanding Role for Sleep: http://www.cbass.com/SleepObesityDiabetes.htm

My thanks once again to Dr. Lynn McFarlin and the Cooper Clinic--The World Leader in Preventive Medicine--for helping to keep me on the health track year after year.  

September 1, 2017

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