Had heart attack whilst on bike - advice on getting back on the saddle

Damo78
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Had heart attack whilst on bike - advice on getting back on the saddle

Postby Damo78 » 13 Sep 2018, 2:13pm

Hi All,

Almost 2 weeks ago I went to go on an early morning hill training session with a mate. I'm signed up for a 100 mile sportive in the Lake District next week, and am not great at hills so needed to do as much as possible.

I do a lot of riding, including hills, and that week had clocked up about 120 miles in commuting and one other (very hilly) ride. Had no problems at all, felt like I was getting fitter, was starting to really enjoy (most of) the hills, and was getting fairly quick.

Got up on the Saturday, felt fine, usual really. Had some porridge for breakfast, drove to my mates house, and set off on our bikes. However, we climbed the first hill after less than 1/2 mile (out of Cotgrave in Nottinghamshire, a hill that the Tour of Britain went up last week), and found it took a lot more out of me than usual. I was out of breath, which is usual, but also got a pain in the middle of my chest, just above the stomach. I assumed it was asthma, or bad indigestion/stitch, so carried on riding. Got a few miles down the road and just could not catch my breath, despite using my inhaler, and still had this pain. I shouted to my mate to pull over so I could see if I could catch my breath and get rid of the pain. It worked, and we set off again, but the pain and breathlessness soon returned. I did consider at times whether it might be my heart, but the pain wasn't radiating, and I wasn't sweating (no more than usual), it just felt like a cramp I've had in my stomach a few times when riding but one which wouldn't go away.

We ended up cutting the ride short, though still did 42 miles (very stupid). I got back to my mates, and sat and started watching the football. However, part way through the first half I started feeling ill again, the pain had returned (though not as bad), I felt really uncomfortable, and it had started to move into my throat. I tossed a virtual coin in my head - tell my mate to call 999, or go home and see if it got better. Chose the wrong option again, went home, grabbing some Gaviscon tablets on the way, and it seemed to clear up. Felt fine for the rest of the weekend, but made an appointment at my doctors Monday afternoon just to be checked out - especially with the Lakes ride coming up.

My doctor took one look at my blood pressure (180/something) and sent me to the local hospital, where I have spent the last week. Had an Angiogram on Monday this week, and a stent was inserted into a narrowed artery. It would appear I did in fact ride 42 miles whilst having a heart/angina attack, managing several PR's up hills somehow. Very, very stupid, I ignored all the advice that said "if you get chest pains, don't feel stupid about dialling 999", and just carried on riding thinking it would go at some point.

I'm now back at home and can't wait to get back on the bike, though a walk to the school and back to get the kids (a few hundred yards) takes it out of me at the moment so I won't be doing it just yet.

But I'm just wondering if anyone here has had a similar experience, and how they went about getting back on the bike. Obviously I won't be doing the Lakes ride next Saturday :) However, I'm assuming I'll need to start steady without hills. If you have been through this experience, how long did it take to get back into normal riding (so 30+ miles with hills) (though I'm aware it might differ depending on the situation).

I'm delighted to have come out of hospital having lost 1/2 stone in a week - I want to keep this going as I had started dieting properly in the weeks leading up to this episode in an attempt to lose several stone. But I also don't want to push it too soon.

I'd appreciate any advice.

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al_yrpal
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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby al_yrpal » 13 Sep 2018, 2:53pm

You are so lucky on two counts…

1. To survive

2. To get a stent so quick, it took a mate 6 months!

Dont be an idiot by asking for advice here, we arent doctors! Slow down, take it easy and think of your family. Follow the docs advice.

Al
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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby mjr » 13 Sep 2018, 3:26pm

Yep, ask the medics. Hopefully, you've got easy access to them for a while, so use it. I'd ask them about how to use a Heart Rate Monitor to keep an eye on your cycling. Yours is one situation where I might consider putting a computer screen back on the bike.
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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby Damo78 » 13 Sep 2018, 3:58pm

al_yrpal wrote:You are so lucky on two counts…

1. To survive

2. To get a stent so quick, it took a mate 6 months!

Dont be an idiot by asking for advice here, we arent doctors! Slow down, take it easy and think of your family. Follow the docs advice.

Al


Thanks.

Yes, I do feel very lucky (and stupid), especially when told what it was.

I must admit I was getting a bit frustrated and impatient waiting for the Angiogram - I was in hospital, feeling fine (no pains, breathlessness or anything), just waiting for the test so I could go home (especially due to the fact the hospital is 10 minutes from home, virtually at the end of our road). They'd even taken the heart monitor away within a few days and were just checking my blood pressure morning and night. However, I also knew it was the medication I was on that was keeping me that way, and I was being monitored so was in the best place had I had another attack. I quickly realised how big the queue actually was for an Angiogram, so although still frustrated at the wait I could understand it more. They then did the stent at the same time of the angiogram.

My advice to be honest is more about how others have recovered from it and the plan (if any) they followed. All the doctor has told me is that I can ride as soon as I feel ready, but should really leave it 2 weeks (which I will be). After that it's just going to be a case of building up slowly, but I'm interested to know how long it took others to get back on it.

mjr wrote:Yep, ask the medics. Hopefully, you've got easy access to them for a while, so use it. I'd ask them about how to use a Heart Rate Monitor to keep an eye on your cycling. Yours is one situation where I might consider putting a computer screen back on the bike.


My watch does tell me my heart rate, though I wasn't sure how accurate it was. Whilst having the pain, and having just rode up a hill, I checked this and it was about 120bpm, which seemed about right (usual for me during a ride, maybe a little bit lower than usual), but again, I was never sure of accuracy. However, when I was in hospital, each time they took my blood pressure and heart rate, I'd then check my watch and it was usually either spot on, or a maximum of 1 bpm out. Saying all that, I wouldn't know what is good and bad in certain situations, so agree it's worth me speaking to an expert to find out what to watch out for.

I was considering buying a chest strap that will communicate with my Garmin (there is one at Halfords for £20), but not convinced it's worth it if my watch is accurate enough.

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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby hondated » 13 Sep 2018, 6:04pm

Damo78 wrote:Hi All,

Almost 2 weeks ago I went to go on an early morning hill training session with a mate. I'm signed up for a 100 mile sportive in the Lake District next week, and am not great at hills so needed to do as much as possible.

I do a lot of riding, including hills, and that week had clocked up about 120 miles in commuting and one other (very hilly) ride. Had no problems at all, felt like I was getting fitter, was starting to really enjoy (most of) the hills, and was getting fairly quick.

Got up on the Saturday, felt fine, usual really. Had some porridge for breakfast, drove to my mates house, and set off on our bikes. However, we climbed the first hill after less than 1/2 mile (out of Cotgrave in Nottinghamshire, a hill that the Tour of Britain went up last week), and found it took a lot more out of me than usual. I was out of breath, which is usual, but also got a pain in the middle of my chest, just above the stomach. I assumed it was asthma, or bad indigestion/stitch, so carried on riding. Got a few miles down the road and just could not catch my breath, despite using my inhaler, and still had this pain. I shouted to my mate to pull over so I could see if I could catch my breath and get rid of the pain. It worked, and we set off again, but the pain and breathlessness soon returned. I did consider at times whether it might be my heart, but the pain wasn't radiating, and I wasn't sweating (no more than usual), it just felt like a cramp I've had in my stomach a few times when riding but one which wouldn't go away.

We ended up cutting the ride short, though still did 42 miles (very stupid). I got back to my mates, and sat and started watching the football. However, part way through the first half I started feeling ill again, the pain had returned (though not as bad), I felt really uncomfortable, and it had started to move into my throat. I tossed a virtual coin in my head - tell my mate to call 999, or go home and see if it got better. Chose the wrong option again, went home, grabbing some Gaviscon tablets on the way, and it seemed to clear up. Felt fine for the rest of the weekend, but made an appointment at my doctors Monday afternoon just to be checked out - especially with the Lakes ride coming up.

Only want to say that I am sorry to read this and wish you all the best for the future.

My doctor took one look at my blood pressure (180/something) and sent me to the local hospital, where I have spent the last week. Had an Angiogram on Monday this week, and a stent was inserted into a narrowed artery. It would appear I did in fact ride 42 miles whilst having a heart/angina attack, managing several PR's up hills somehow. Very, very stupid, I ignored all the advice that said "if you get chest pains, don't feel stupid about dialling 999", and just carried on riding thinking it would go at some point.

I'm now back at home and can't wait to get back on the bike, though a walk to the school and back to get the kids (a few hundred yards) takes it out of me at the moment so I won't be doing it just yet.

But I'm just wondering if anyone here has had a similar experience, and how they went about getting back on the bike. Obviously I won't be doing the Lakes ride next Saturday :) However, I'm assuming I'll need to start steady without hills. If you have been through this experience, how long did it take to get back into normal riding (so 30+ miles with hills) (though I'm aware it might differ depending on the situation).

I'm delighted to have come out of hospital having lost 1/2 stone in a week - I want to keep this going as I had started dieting properly in the weeks leading up to this episode in an attempt to lose several stone. But I also don't want to push it too soon.

I'd appreciate any advice.


Sorry I cannot offer you any advice and I just want to wish you all the best for the future. Hopefully your get back out on your bike as quickly as possible.

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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby softlips » 13 Sep 2018, 7:58pm

If the doctors have said give it two weeks then one would assume they’re happy you’ve been fully revascularised and have no arrhythmias to be concerned about. Ask if there is a cardiac rehab course at your hospital.

Ensure you take the medication they’ve prescribed, you should be OK to start riding in two weeks. Take it as steady as you feel the need to and slowly increase intensity and distance. Cycling is great excercise!

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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby Damo78 » 13 Sep 2018, 9:29pm

hondated wrote:Sorry I cannot offer you any advice and I just want to wish you all the best for the future. Hopefully your get back out on your bike as quickly as possible.


softlips wrote:If the doctors have said give it two weeks then one would assume they’re happy you’ve been fully revascularised and have no arrhythmias to be concerned about. Ask if there is a cardiac rehab course at your hospital.

Ensure you take the medication they’ve prescribed, you should be OK to start riding in two weeks. Take it as steady as you feel the need to and slowly increase intensity and distance. Cycling is great excercise!


Thanks both.

Unfortunately it seems the medications might be causing me other issues now as I went really light headed earlier this evening, ended up having to go to bed. Decided to call 111 for advice in case it's linked, turns out my blood pressure is low (I have a machine here so did a test before calling), when I listed the medications to the clinician that I spoke to she did say that it seems I've been given several medicines which all lower blood pressure. Possibly lowering it too far. So going in for a check, hopefully it's nothing and will be coming straight back out, don't fancy another stay.

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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby Bobbin » 14 Sep 2018, 12:32am

I had heart attack in November last year,just sitting at home doing nowt ! Missus called 999 and I was whisked off to hospital to have a stent fitted. Less than 3 hrs from dialling 999 to coming out of theatre feeling quite normal !
It was 8 weeks before I started cycling but it took that long for me to feel brave enough to have a go.Cardiologist said only flat work to start and only 2 or 3 miles. I would normally do rides of 35 miles with plenty of hills.
I built up gradually to about 20 miles mostly flat, then started a cardiac rehab course.
Told the physio I was cycling again which was fine,told him how far I was cycling, NO,NO,NO says he !
10 miles max and heart rate average in 80s to 90s ,absolute max 120. That's hills out then.
Anyway, after a bit of a scare when I ended up in A&E with chest pains,(got the all clear on that) I was talking to the doctor ,who does ironman triathlons, and she said I need to get some tailored advice from the cardiologist with regards to cycling given my fitness levels before the 'event' because the advice re exercising is somewhat generic and I 'm not your average 60 year old couch potato ,and unless you happen on a cycling cardiologist they possibly don't appreciate what you can do.
However I haven't followed up on this advice yet as I've had an unrelated op this summer and I am just getting fit again again !
Back up to 25 miles or so but no big hills yet !
Due to see cardiologist soon though so will see what he thinks.
I would definitely speak to cardiac rehab. Even if the advice seems a bit cautious,better to be safe I think.
Rob

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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby Bobbin » 14 Sep 2018, 12:36am

Forgot to say. I get dizzy when I stand up ,usually in evening but sometimes during the day. Down to Meds apparently.
Got used to it now.Hoping I might be able to ditch some tabs next review ! :D

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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby Paulatic » 14 Sep 2018, 8:29am

That's hills out then

Not really, just go quietly up them just because it’s a hill doesn’t mean you’ve to knock your pan out.
My ride up a significant hill yesterday
6B588C0A-42E8-43D0-BE85-96F7BFB5D34D.png
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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby Bobbin » 14 Sep 2018, 2:18pm

If I could ride up hills at 92 bpm I would ! Unfortunately I can't ! 8)

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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby Damo78 » 15 Sep 2018, 4:02pm

Bobbin wrote:I had heart attack in November last year,just sitting at home doing nowt ! Missus called 999 and I was whisked off to hospital to have a stent fitted. Less than 3 hrs from dialling 999 to coming out of theatre feeling quite normal !
It was 8 weeks before I started cycling but it took that long for me to feel brave enough to have a go.Cardiologist said only flat work to start and only 2 or 3 miles. I would normally do rides of 35 miles with plenty of hills.
I built up gradually to about 20 miles mostly flat, then started a cardiac rehab course.
Told the physio I was cycling again which was fine,told him how far I was cycling, NO,NO,NO says he !
10 miles max and heart rate average in 80s to 90s ,absolute max 120. That's hills out then.
Anyway, after a bit of a scare when I ended up in A&E with chest pains,(got the all clear on that) I was talking to the doctor ,who does ironman triathlons, and she said I need to get some tailored advice from the cardiologist with regards to cycling given my fitness levels before the 'event' because the advice re exercising is somewhat generic and I 'm not your average 60 year old couch potato ,and unless you happen on a cycling cardiologist they possibly don't appreciate what you can do.
However I haven't followed up on this advice yet as I've had an unrelated op this summer and I am just getting fit again again !
Back up to 25 miles or so but no big hills yet !
Due to see cardiologist soon though so will see what he thinks.
I would definitely speak to cardiac rehab. Even if the advice seems a bit cautious,better to be safe I think.
Rob

Bobbin wrote:Forgot to say. I get dizzy when I stand up ,usually in evening but sometimes during the day. Down to Meds apparently.
Got used to it now.Hoping I might be able to ditch some tabs next review ! :D


Thanks Rob.

I keep wanting to just ride a mile up the road and back, totally flat, wide cycle path, to see how I am, but know I need to be patient, way to early. I'm going to ask the doctor/pharmacist if it's possible to have a second bottle (preferably smaller) of GTN spray for when I do start, so I can keep it in my saddle bag and not worry about forgetting to take it (I regularly forget my inhaler).

I went for walk earlier to our local Tesco, about 0.5 miles, felt fine but a bit light headed again walking around there. Got a taxi back though as too much shopping to carry. Not really getting out of breath at all now.

With regards to the meds, I spent the entire night in A&E Thursday/Friday due to the light headedness - saw the out of hours doc who sent me to A&E to have another ECG. That came back clear, as did the blood tests, however they've dropped my dosage of Ramipril from 10mg to 7.5mg as they reckon they've overdone it on the blood pressure tablets, which was possibly causing it (3 different tablets). Not really changed much though, so just need to stand up slower. I'm also feeling asthmatic more than before when sitting/lying around, so having to take my inhaler. I'm wondering if it might be due to the Aspirin - I told them I was allergic to it due to the Asthma (though had never tried), they chose to start me on a tiny dose to see if there were any adverse effects, then upped it to 75mg tablets every morning. I'll have to see the doctor about it.

One of the reasons I asked on here was part to do with the fact that the cardiologists aren't necessary cyclists and do just give general exercising advice, so what you've said here is very useful, thanks. Though saying that, I do happen to know that there is a very well known (for unfortunate reasons) heart surgeon who works at the hospital I was treated in (Glenfield, Leicester), lives in the area, and actually regularly appears on daily tables in Strava having cycled along the same roads as me, so clearly a keen cyclist. Wouldn't be the worst person to be passing by if I did have an attack again ;)

I'm yet to speak to rehabilitation - I got a letter yesterday saying they'd been trying to call me but not got through - strange as I've missed no calls. I called them but not heard back yet. Unfortunately around where I live whichever direction I ride involves hills. Lots of them. And quite nasty ones. So it is going to be a case of riding around the block, or walking up the hills initially.

Paulatic wrote:
That's hills out then

Not really, just go quietly up them just because it’s a hill doesn’t mean you’ve to knock your pan out.
My ride up a significant hill yesterday6B588C0A-42E8-43D0-BE85-96F7BFB5D34D.png


Hills generally take it out of me (anything more than a speed bump), though I was surprised my heart rate was as low as 120 after climbing a hill on my last ride that caused this issue, so maybe as I'm getting fitter its reducing my heart rate. Or maybe it was low due to the heart attack.

My wife ordered me a chest heart monitor yesterday that should work with my Garmin 25, so when I'm back on it I'll have it on my main screen instead of the distance. Because I lost my Garmin at one point, I bought a Cateye computer from a mate, then found the Garmin down the back of a car seat so have 2 - I have both on the bike so I have a backup if one fails, and I can have more data displayed at any one time, so I can stick the distance on the cateye and have the BPM showing all the time on the Garmin - if it goes too high I'll stop and rest to allow it to drop.

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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby Solway1 » 15 Sep 2018, 9:46pm

I had a heart attack in 2013 at 53. I stopped all exertional exercise other than that supervised at the Cardiac Rehab classes - I attended for 10 weeks or so. I had a lot of ups and downs, some hospital readmissions, but eventually was able to ride short distances. Again it was all following advice from Cardiac Rehab and follow-up from my GP (who was very positive about graded exercise and generally encouraging of cycling).
I then developed anxiety/ panic type problems and feel that it took me several months to feel normal out on the bike. You shouldn't underestimate the psychological impact this may have had on you...
I continue to take the usual heart medicines and now, several years on, am able to manage reasonable distance on my bike and that includes hill-climbing. But I never over-do it - I slow down and change gear instead. I'm also less inclined to cycle with groups as I prefer to go at my own steady pace
I hope you continue to progress and get this behind you over time. I am now more interested in cycle touring - and in the years since have cycled unsupported across France, Spain, LEJOG, and this year from Rome back home to Cumbria.
All the best...

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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby Damo78 » 16 Sep 2018, 5:01pm

Solway1 wrote:I had a heart attack in 2013 at 53. I stopped all exertional exercise other than that supervised at the Cardiac Rehab classes - I attended for 10 weeks or so. I had a lot of ups and downs, some hospital readmissions, but eventually was able to ride short distances. Again it was all following advice from Cardiac Rehab and follow-up from my GP (who was very positive about graded exercise and generally encouraging of cycling).
I then developed anxiety/ panic type problems and feel that it took me several months to feel normal out on the bike. You shouldn't underestimate the psychological impact this may have had on you...
I continue to take the usual heart medicines and now, several years on, am able to manage reasonable distance on my bike and that includes hill-climbing. But I never over-do it - I slow down and change gear instead. I'm also less inclined to cycle with groups as I prefer to go at my own steady pace
I hope you continue to progress and get this behind you over time. I am now more interested in cycle touring - and in the years since have cycled unsupported across France, Spain, LEJOG, and this year from Rome back home to Cumbria.
All the best...


Thanks, it's good to hear you're back on the bike and doing distances, so recovered well :) That's fantastic that you're cycling so far, though the mention of Cumbria reminds me of the sportive up there that I was supposed to be doing this upcoming weekend - still gutted to not be doing it, was looking forward to the views more than anything else. I'm still tempted to drive up there with my mate, then follow him in my car heckling him up the hills, might take the pain of missing out away a bit (and I've already paid for a hotel room) :)

As regards the psychological impact, to be honest I don't feel that the seriousness of what has happened has really hit me fully yet. Although as mentioned earlier I do feel lucky, at the same time I keep thinking it can't have been too serious if I managed to keep riding for 42 miles through the heart attack, so tell myself it must have been mild (still a heart attack though!!). I felt fine all the time I was in hospital (and in the 2 days between the attack and me actually going to hospital). I got the occasional shorty sharp stabbing pains which the doctor said I don't need to worry about (just the dull, squeezing pains), but I had to keep reminding myself that it was down to the medication I was on that I was feeling so normal. I'm still the same now, keep thinking I feel fine, could get straight back on the bike for a short slow ride down the road and back, but then start feeling light headed again, or bend over and get a sharp pain in my chest, or go for a walk and start feeling pains (though in my stomach rather than chest strangely), and realise I'm still very much under the weather and not ready. I suppose the best thing for me would be to set a target of getting on the bike when I actually don't look so bad in the cycling gear :lol: It will take me a while to get there, but I am losing weight faster now than I was when I was cycling, so if it takes me a few months that will be a good rest from the bike, and also a great incentive to get me back to fitness :)

I'm going to get back on to rehab tomorrow if I've heard nothing back so that I can arrange a time to go and see them, get some more advice. I'd hoped to start going back to work gradually this week, as although the doctor signed me off for 2 weeks (covering last week and this) I don't want to just go back full time next week and straight into it - I'd prefer this week to start working half days, maybe a couple from home, catch up with emails when I haven't got colleagues constantly standing at my desk rather than trying to juggle everything. The hope is that it will get me back to normality rather than sitting around the house all day. However apparently they won't let me until occupational health have had a chat, determined that the environment etc. is suitable, which I suppose is a good thing. I'm also not allowed to drive until Tuesday (assuming the light headedness has gone away, I won't even try if I'm still suffering), and I won't be commuting by bike for a while, so would have to be the bus, which isn't a massive problem except the walk from the bus station to the office and back.

Bobbin wrote:


Sorry Rob, I meant to say also good luck to you in getting back on the bike after your op, I hope it all goes well, and thanks again for your advice.

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Re: Had heart attack whilst on bike - advice on getting back on the saddle

Postby softlips » 16 Sep 2018, 7:29pm

“One of the reasons I asked on here was part to do with the fact that the cardiologists aren't necessary cyclists and do just give general exercising advice, so what you've said here is very useful, thanks. Though saying that, I do happen to know that there is a very well known (for unfortunate reasons) heart surgeon who works at the hospital I was treated in (Glenfield, Leicester), lives in the area, and actually regularly appears on daily tables in Strava having cycled along the same roads as me, so clearly a keen cyclist. Wouldn't be the worst person to be passing by if I did have an attack again ;)

I work in cardiology and you’d be amazed how many cardiologists cycle.