I simply cannot be this unfit (not as in the she is “unfit to be a mother” category). My endurance compared to little, old (emphasis on both) women and men is shameful. 85 pounds lighter should have me breezing through my treadmill/bike routine. Nope. Instead of just breaking the mirrored walls around me, I decided to analyze why the heck I am performing at lower levels than my personal trainer thinks I should be, based on her fitness assessment. Finally, it hit – the damn beta blocker that I have been taking for about 7 years is the most likely culprit.
Back when I was probably weighing more than 300 pounds, I kept having “asthma” attacks, which my primary care doc thought was a strange resurrection of a childhood condition. After a particularly devastating event during a viral infection when my lips turned blue (even my anesthesiologist-sweetie was horrified) followed by a few episodes of chest pain, I referred myself to a cardiologist. I failed an exercise stress test – gasping for air (turns out I had gone in to pulmonary edema and had acute heart failure) my ECG looked as if I had coronary artery disease. Not asthma at all! Given my family history and weight, not a big surprise but scary. (Have I mentioned docs are weenies when it comes to their own health?)
Next up, a cardiac catheterization. I was relieved to find that my coronary arteries were “clean” but was diagnosed with a condition called “diastolic dysfunction” that could cause acute heart failure during heavy exertion or stress, such as with the the viral infection. This type of heart failure is often seen in women of a certain age (cough), and is associated with high blood pressure (not me), diabetes (nope), coronary artery disease (nuh-uh), and diseases of the heart muscle (no). Obesity can certainly be a contributing factor. My inquiring mind and the outstanding cardiologist reviewed all the available research on appropriate treatment. Given that this is primarily a condition of women, not surprisingly there were few quality studies to guide the choice of medications (do not get me started on the bias in medical research against women as participants in studies). We seriously discussed weight loss surgery, which I dismissed after meeting with the head of the WLS program. A beta-blocker was chosen, and my symptoms improved remarkably with about a 30-pound weight loss and the medication. Beta-blockers are also good for my migraines and an anxiety disorder (sigh, starting to reveal more than anticipated), so the drug has been a good one for me.
Fast forward to today. Not only can I not get my heart rate above 80 with vigorous exercise (read that as sweating profusely and a beet-red face), but I poop out waaay too early. The last time I saw a cardiologist was about 1 year ago. My diastolic dysfunction had completely resolved even with minimal weight loss, and she suggested that I could try to slowly wean off the medication, as one cannot stop beta-blockers abruptly. Given that I get other benefits from the drug, I was not keen on this. The obvious solution right now – march myself back to Dr. Bates (who is a fitness fiend), get kudos for my weight loss, and discuss the pros and cons of quitting and continuing my good ol’ beta-blocker. Gah, I hate going to docs, but she is too cool, her office is a fun place to visit, and it’s always fun having people react (positively) to my new body. Appointment made for 9/20. Guess I’ll just have to modify my exercise expectations until then.