A moment of peace amongst the trees. On my way to the top of biggest climb in Berkshire
The Wonky Ticker
For a moment there the wind stopped blowing. I was in clean air. Momentarily free of medical professionals prodding my spine, all clear to resume riding and free to dream again. I even had a notion that Butch Wall and The Comeback Kid riding may ride an Etape Du Tour together one more time!
November 2018 - The Midlife Cyclist Series II - Phil interviews Dr Nigel Stephens on the subject of "Crashing and Health Worries"
It is very reassuring if you need to see a Consultant Cardiologist that they do this in their spare time - to a very high level!
"I even had a notion of Butch Wall and The Comeback Kid riding riding an Etape Du Tour together one more time!"
Exquisite Irony
And then, with exquisite irony - straight after Midlife Cyclist Series II ended - where we focussed a great deal on middle-aged athlete cardiac health - I started to feel a bit weird. Skipped heart-beats and slowing heart rates and a strange loss of pressure feeling in my chest. I did what most blokes do at this point – totally ignored it - self-diagnosed - unspecified chest weirdness - that would almost certainly resolve itself, never to return if I didn’t give it anymore head-space. I tried that for a week, but one evening the symptoms were so marked that displacement and distraction failed to yield the same satisfactory results.
I gave up and went to see my GP. An ECG yielded ‘significant’ timing issues. A 72 hour ECG flagged up even more worrying funkiness (sinus rhythm, branch-block, 1st & 2nd degree AV block - in case you want the detail). My GP put through an urgent referral through to our local cardiology unit who came back with an appointment six weeks out. Lovely people doing their straight best over-stressed and I guess under-resourced.
"I did what most blokes do at this point – totally ignored it - self-diagnosed - unspecified chest weirdness - that would almost certainly resolve itself"
Bring on the backless gown. Again.
Luckily, I had already contacted Dr Nigel Stephens – who has generously contributed to every lecture series we have ever run at Cyclefit. After being friends and having collaborated for ten years or more, I was now his patient. A further irony being, that a year previously I was part of his core rehab team after his own major hip surgery, following a horrible crash on his bike whilst training for the Worlds Pursuit Championships. Being middle-aged gives us the intellectual suppleness and humility to readily accept these different dynamics I think.
It was hugely reassuring to have Nigel at the helm, anchoring my care – to mix my nautical metaphors. He was incredibly calm but also took great pains to communicate clearly and thoroughly. The big risk, Nigel, pointed out, was that my sarcoid, an auto-immune condition, that appeared straight after my first (failed) spinal-fusion surgery, in 2013, was now attacking my heart. I assumed that this was not a ‘good’ thing but resisted the urge to google what it meant and concomitant prognosis/treatment ramifications. What was the point? I trust Nigel explicitly and completely. If I have learnt anything from my back surgeries, it is to put your trust in your consultant and be constructive and compliant in your own treatment. It is not a passive relationship exactly, but it is broadly a pedagogical one. Their job is diagnostic followed by treatment recommendation. Your job is to listen, learn, attend, respond, stay calm and follow advice to the letter. Mrs Cavell, however, did a bit of googling and went a bit pale for a few days.
MRI's and claustrophobia
The gold-standard test for cardiac sarcoid is a specialist heart MRI. Now I am an MRI pro – by that I mean a borderline claustrophobic who has developed coping strategies that just about last the requisite 30 minutes needed for a spinal MRI. This one was to be very different. Undertaken at a very welcoming and professional Paul Strickland Centre in North London. It requires one to be strapped down onto the scanner with a tray of equipment strapped to your chest and an IV line of different dyes being shot into your arm. It lasts for 90 minutes and one is required to undertake continuous breathing exercises. The only way I got through it without completely embarrassing myself and self-soiling was the obvious humour and downright humanity of the technicians in my ear-piece. And one of them gave me a pair of glasses that converted my upward vision into an image of my feet. An hour and a half happily wiggling my feet around was immensely reassuring and took me out of my body into another foot-based reality. If you have to have an MRI and are a little claustrophobic, then I recommend asking for these clever glasses.
Nigel pulled all the results together of all the tests he had commissioned in a meeting very soon after. It was a relief that I showed no evidence of cardiac sarcoid. His understated and quiet summary of being ‘relieved’ at this finding was enough for me to reliase I had dodged a bullet. Mrs Cavell recovered some colour.
The conclusion is that none of the symptoms is currently considered to especially worrying in a middle-aged man with an athletic history. But I have one final hurdle to clear before Nigel will clear me for highly exertive training.
He is putting me through a ramp test at Northwick Park this week to monitor what happens to my heart rhythms at upper heart-rates. Currently I can potter around at a lower level, but can’t think of anything more ambitious until I pass this last test. I will let you know how it goes.
And Gravel Riding
Landrace was conceived to roll up and down the Chiltern hills and get lost in the back-woods
Carpenter's Wood. A Halifax from 578 Squadron crashed here - 1944
Landrace Update
In the context of the wonky ticker, riding has necessarily been gentle and short. Which has bought into sharp focus the most spirit-cleansing bicycle-based satiation one can have in about an hour and a quarter. For me that means 70% trail and 30% road, as far away from civilisation I can get.
Landrace V's Open UP?
We are frequently questioned about the difference in ethos between our Landrace and an Open UP, and when would you choose one over the other? In technical terms the Open is lighter, stiffer (the product of hi-modulus carbon), has a higher bottom-bracket and clearances for 650b x 2.1 MTB wheels/tyres. The Landrace is designed to take a maximum 700x35c gravel/cross tyres, has mudguard eyeletts, a lower bottom-bracket (to lower overall rider centre of gravity).
The Open is better for outright performance and for the versatility of switching to 650b wheels if the fancy takes you. Jules road-raced, cyclo-x and MTB raced his Open UP, simply changing tyres and wheels! But the UP is not a good winter bike (because it has no mudguard braze-ons) and will not last a lifetime, because no carbon bike ever will or should.
The Landrace is a fine gravel/trail bike that is more comfortable off-road than the Open with a 700c wheel because the titanium is inherently more springy. Its designed-in alter ego is that of an extraordinarily fine winter bike. It has clearances for a generous 28c tubeless road tyre and full mudguards, but still retains a comparatively short 420mm chainstay to keep power-transference on point. One of our pet-hates is gravel bikes that feel vague and sloppy on the road. Landrace truly feels composed and efficient sliding along the tarmac lanes on 35mm Panararacer Gravel Kings and an almost invisible segue onto a jeep-track or bridle-way. The Gravel King's are not my favourite wet-weather or mud tyre however. Actually how would I know, I avoid such weather. Love hard-pack, hate mud. It's a metaphor for life.
