In the winter of 2021, myself, a former competitive Olympic lifter and consistent weight trainer for more than 50 years; experienced swelling in the feet and ankles. My personal physician of some 20 years had gotten into trouble from prescribing excessive opioids. He had been my primary care physician for some 20 years. Over that span, I was essentially a healthy person with at best a few minor health issues; with no history of chronic disease. For instance, an infection in one elbow ‘pushed into the joint’ from a long trip overseas; severe food poising while visiting in Santa Domingo, Dominican Republic, i.e., self inflicted wounds.
I went to see his replacement at the same office. I was prescribed furosemide. He sent me to a hospital to conduct ultra – sound of the vessels in both legs; to check for blood clots. Results of the tests were negative.
I had begun drinking a lot of water when the swelling appeared; because I read that it is good for excessive fluid retention. It didn’t help. Relatively soon my body – weight ballooned up to 111 kgs. My normal weight was in the 103 – 105 kg range. The replacement doctor referred me to a cardiologist. The swelling began to run up past my knees. Since my appointment with the referred cardiologist was not for several weeks; I panicked and went to see another cardiologist within one day’s notice. This was a mistake.
At this time I was essentially crippled with severe arthritis in both hips. I could barely walk. When I hobbled into the cardiologist’s office he decided I had congestive heart failure and was in serious distress. He didn’t see the arthritis and must have assumed my heart was so weak I could not walk; this despite what should have been a sign of my fitness from my visibly larger than normal muscle mass from twice daily training.
That same day I was sent for an echo cardiogram. According to what and how it is measured the cardiologist decided I had suffered congestive failure. He assured me my time above ground could end at any moment. I had no classic symptoms of shortness of breath, angina, or weakness; and, other than the severe discomfort of my arthritis; I felt fine.
I was admitted to hospital that day. After two nights of torture at the hands of an assortment of staff I went home with multiple prescriptions including one drug which artificially slowed my heart beat. This particular drug had a terrible effect. I felt fatigued. I would have to sleep for up to two hours after taking one of the twice daily pills. The effect of this drug was particularly debilitating when I went to exercise with weights. I could not exercise at the same intensity.
The cardiologist decided I should have a procedure to shock my heart from arrhythmia, the ‘afib’ disease. This procedure was performed in an out – patient setting. In the interim I had a stress test and numerous blood and EKG tests; none of which were outside a normal range. I had quit taking the furosemide – the swelling quickly went away. After the arrhythmia procedure the doctor planned an implant to monitor my heart. All this time, other than the near debilitating effect of the heart slowing drug; I felt fine; exercised twice daily; lost the excess weight and regained my old bodyweight.
I decided to get another opinion. I collected all the records and brought them to another cardiologist. That was a mistake. For some weeks he just went along with the original diagnosis and continued prescribing heart medications. Finally, after I had insisted repeatedly I felt fine, he ordered another Echo.
There was a substantial; and, to him a surprising difference from what my medical records reported after this Echo test.
All this time I felt as Dorothy in the Wizard of Oz; who said “I kept telling everyone I want to go home”. I kept insisting to family, friends, doctor: I feel fine I am not sick. Yet everyone insisted I was sick without so much as taking my pulse, i.e., knowledge based in ignorance.
Some weeks later when I next saw my cardiologist; I coerced him to order another Echo. Right after this Echo in December 2021 I went to Uzbekistan for two weeks; without knowledge of the results; as my next appointment was not until January 2022. I was more than 24 hours in transit; arriving at 2:00 AM local time; sans any physical distress; not even jet lag. Over the course of my stay I even tried to give myself a coronary in the pool I used daily; by pumping legs and arms as hard as possible; to no avail.
By the way the heart has to work harder for upper extremity exercise than for lower. The reason is unknown; but, this additional stress is hypothesized as the reason why people get heart attack shoveling snow in the winter; due to the stress of lifting snow on the shovel with the arms.
I went to my January appointment a few weeks after another 24 plus hours and five airports trip back home from Tashkent. The doctor informed me ECHO results were normal as were every EKG I had taken in his office with each visit. I informed him I had long since stopped all medication. And, repeated to him, family, friends and I had not experienced any classic symptoms.
He said “whatever you have been doing keep doing it”. That is the same as saying it ain’t broke so I won’t try to fix it.
If I wanted, I could come back for a followup in nine months.
I am convinced had I stayed under the care of the first cardiologist I would have faced the rest of my life with an implant and tied to a host of heart drugs – unnecessarily prescribed for a disease I did not have.
Over the course of my travails I did a little research. A book I bought in a bookstore in the USSR in 1979; written by Vorobeyev, a two time Olympic champion, MD and Phd had a chapter about his research of the of the weightlifter’s cardio vascular adaptations to weightlifting training; the effects of straining to lift maximum weights, breath holding, competitions and so forth. His research, I am guessing, was part his profession as a weightlifting sport scientist; and, part a review of the medical literature of the USSR and whatever other sources of European and western origin available on the subject of heart issues; real or imagined with straining; breath holding and weightlifting training in general.
I decided to translate the chapter for my own information. However, making this knowledge, specific to weightlifting, readily available to all in our sport, is a positive. Hopefully, it will serve as a resource of scientific common sense; weightlifting, straining and such provoke adaptations – not aberrations to one’s cardio – vascular system.
From my experiences I am convinced little effort is made or even conceived, in the medical profession to make a distinction between aberration and adaptation; all the more so when doctors rely on machines to make diagnosis. Adding to the ambiguity of machine diagnosis; doctors are always seeing sick people; not healthy people. In fact, a ‘healthy patient’ sounds like an oxymoron. Based on what the machines ‘say’, doctors, in turn, prescribe powerful drugs, implants and such, to treat a disease; which may turn out to be an adaptation specific to not just sport training; but to the specificity of the straining typical of a sport like weightlifting.
Vorobeyev’s chapter on cardio – vascular adaptations of weightlifters can be found in the translations section of the sportivnypress web site. Among other experiments to be found in this chapter, Vorobeyev decided to use himself as subject to study the Valsalva effect – a sometimes loss of consciousness from straining while holding the breath. This had happened to him a number of times in his career he wanted to know why he never passed out in training. A typical Russian; it is not enough what and how something happens they want to know why.
Attached to the end of the chapter from Vorobeyev book is an article published by the USSR Academy of Sciences in 1972. The title of the article is “The inter – muscular peripheral heart”. The basis for this little research project was a Russian scientist’s idea; dating to the 1800s; that the heart cannot be the sole organ pumping blood in the human body. It was very difficult for me to render this Russian; what with cardiac speak and all. It was a language within a language within a language.
The article explores a not too commonly known concept. The idea the human body is full of redundancy. Something few in the medical professional would be cognizant. Let alone, the idea a muscle pump could supercharge the circulation of blood. I have also included a reference from a recent (2018) paper where the researchers compared the cardio – vascular systems of powerlifters to long distance runners. The authors conclusions; their findings; contradict contemporary belief; that says it all:
“Although our findings are comparative and derive from a cross-sectional design, they suggest that high-intensity strength training does not necessarily cause damaging cardiovascular changes as it has been generally believed.”
“Comparison of Cardiac and Vascular Parameters in Powerlifters and Long-Distance Runners: A Comparative Cross-Sectional Study”
Diego Vidaletti Silva,1 Gustavo Waclawovsky,1 Ana Beatriz Kramer,1,2 Cinara Stein,1 Bruna Eibel,1 Guilherme Brasil Grezzana,1 Maximiliano Isoppo Schaun,1 and Alexandre Machado Lehnen1,2Arq Bras Cardiol. 2018 Dec; 111(6): 772–781.doi: 10.5935/abc.20180167PMCID: PMC6263448PMID: 30281689