The Medical Profession doesn't get (old) athletes

Not in my experience, anyway.

Three years ago I did an early-season 8K running race. I knew the course (The Spring Run-Off in High Park) and had run it a number of times. I wasn't really trained up for it, it was just a way to jump-start duathlon training (back before I figured out that the bike was the part I actually liked). Of course, my plan to just go out and jog it went out the window pretty quickly, and I went way too hard, but I wasn't really suffering.

With about a km to go I'm wondering about how I'm going to deal with the long uphill finish, and I look at my heart rate and it says 230 bpm. Now, I have a somewhat high max heart rate for a guy my age (around 200 bpm), but that was fucking crazy. Either the HRM was screwed up or I was about to become one of those middle-aged guys who mysteriously drops dead on the finishing line. ("Yeah, it was so weird, he seemed healthy.") I immediately slowed down (but not totally, I didn't want to completely wreck my time), but I'm still around 220 bpm when I cross the finish line & stop my timer. But I sat down and in 2 or 3 minutes it was back down to a less frightening 130. And I feel fine. So WTF is going on? Have I got some weird tachycardia? Is this dangerous? And more importantly, what in hell are my HR training zones supposed to be?

Not the heart of an Olympian, apparently.
So I alert my my doctor, who thankfully is not keen on having his otherwise healthy patients stroke out on him, and he sent me to a cardiologist to get checked out. Unfortunately the cardiologist turned out to be a Scottish lady in her sixties who was about 5'1" and clearly knew her way around a haggis.

What's more, she seemed to harbor some bizarre, deeply-rooted animosity towards recreational athletes. When I explained why I was there (to figure out if I have some genuine, life-threatening problem; and if not, what are the implications if any for training) she said to me, "Why would you want to do that?"
"Well, because I want to get faster and do better in races," I replied.
She looked at me like I was some kind of simpleton and said,
"You're not 18, you know; and you're not going to make the Olympics."  I suppose she was so used to focusing on just keeping people with bad hearts alive that she couldn't conceive of somebody with a good one wanting to optimize it. Like I was being greedy, or something.

"Get off ice, bra. And the couch."
And maybe she's right, maybe I shouldn't be bothering her unless I'm willing to spend my whole life doing the sort of shit that's guaranteed to line me up for a slew of interesting cardiovascular dysfunctions that she can treat and bill for. Like, y'know, smoking on the couch all day with bags of Doritos and litre bottles of Coke, watching reruns of Dog The Bounty Hunter.

Or maybe she just didn't know. Doctors hate that. Certainly she didn't tell me anything useful at all. But if that was the case, say so, refer me to someone who does know and don't waste my time.

And as a side note: while you're at it, maybe try not to bring your own issues to the office.

Anyway, in the end that experience is what led me to becoming a cardiovascular lab rat, which was what it took to actually get a confirmation, from a sports-focussed research cardiologist, that I was fine, and didn't have to worry about my heart blowing up in the middle of a tough climb.

But it seems to me that the medical establishment has lagged way behind a large societal shift from people staying walking-the-dog active to accepting the idea of people being seriously athletic much later into their lives. (Holy crap you should have seen the unbelievable folks in the 65+ division of last-year's Grey County UCI World Amateurs qualifier. Why medical science isn't all over these people is a mystery to me.)

For a profession that thrives on heroic measures to keep people alive (if not healthy), you'd think the implications of of all that would be a bit more intriguing.
Apparently not.

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