‘Fast forward’ to a time many months after my surgery had been done. I was prescribed one of the best cardiac medications ever, or so it was told to me by my cardiologist at the time. I remember even months later a ‘family medicine’ doctor acquaintance of mine asked me, “What cardiac medication are you on?” He was simply curious after hearing my story. I told him the name of the medication and to my surprise, my having not realized the high regard attributed to my particular cardiac medication by fellow practitioners, he blurted out, “Well...you’re on a really good medication. One of the best!” He continued to ask me about the dosage I was taking and advised me that I could, or even should, actually be taking a higher dosage. I wasted no time, approached my cardiologist, and mentioned the increased dosage. He complied, and Voila!...I felt quite secure with the increased dosage and confident that my medication was indeed among the best of any current day cardiac medication I could possibly ever take.
As a medical doctor I knew there were quite a number of categories or groups of cardiac medications in general, from what are generally categorized as ACE Inhibitors, Calcium Channel Blockers, Beta Blockers, and so on. Sometimes new categories of cardiac medications would come into existence, but most of the time new medications would simply be claimed to be ‘improvements’ over existing cardiac medications...and they would usually fit within one of the already existing categories. And this particular ‘best’ medication that I was taking was no different: an improved medication fitting within one of the existing categories, and which categories by the way generally encompassed medications with similar side effects or other effects.
For example, this ‘best’ medication of mine, and others like it, tend to slow down the heart rate as one of their effects. Generally speaking, the slowing down of the heart rate is supposed to be beneficial to the heart. It is often said that slowing down the rate at which the heart beats (the heart rate) gives the heart a rest. When we think of ‘resting,’ however, we often think of lying down and doing nothing. With the heart, on the other hand, which is always beating, the fact is, by simply slowing down the rate at which the heart beats, that indeed does allow the heart to be rested (simply because the interval of time between beats becomes slightly longer as the rate at which the heart beats slows down and it is during this interval, however short, during which time the heart rests).
The fact is, a considerable number of cardiac medications, besides doing and having the effects they’re supposed to have as well as other effects, are similarly, like mine, often found to slow down the rate at which the heart beats. So you would think this would and should be a really good thing. And many of those cardiac medications that do slow down the heart rate are just that, good medications and quite beneficial to the proper functioning and healing of the heart. So that should be the end of the story. For those taking such medications, be grateful for living in a time wherein such medications are available [I didn’t say affordable!] and for being able to take such medications, and accept any such side effects as slowing down of the heart rate as ‘just one of those things’ which occurs, and beneficial at that
Patients on such medications, if they know how to take their pulse rate (which is usually indicative of their heart rate) often find that upon exercising, their heart rate is a lot slower than it otherwise would normally have been had they not been on such medications. And so, that’s that. With this ‘side effect’ being understood and accepted, all parties involved-- the patient...and doctor...and the pharmaceutical companies that developed the medications--would all accept the slowing down of the heart rate not only as a side effect, but as a welcome side effect since its occurrence affords the the heart a rest and thereby enables ‘sick’ or damaged hearts to become healthier and to heal.
Well, for sure now. Enough said. All parties, all documentation, all experimentation, all testing, and for all that is currently known, the slowing down of the heart rate via these cardiac medications is a good thing. And that’s that...right!
...Perhaps...but then again, perhaps not. Unfortunately upon my having worked with so many people on such medications as both [the key word here is ‘both’] a medical doctor and personal trainer in a gym armed with a stethoscope and blood pressure cuff and checking blood pressures and pulse rates before, during, and after so many hundreds of different kinds of exercise motions and using so many different exercise machines and so on...I’ve discovered that the slowing down of the heart rate, although helpful in one respect, might also be having just the opposite effects...effects that are quite undesirable and even harmful to the heart and cardiovascular system and in turn to the individuals health, and even life.
Now, although I must categorize the ideas I am about to present as theory, you will find them to be quite logical and insightful, and thought provoking enough to recognize that such medications might actually be having deleterious effects which the medical establishment, in large part, has no idea might really be occurring. Just like my doctors said that I was on one of the ‘best’ cardiac medications that has been developed, imagine if in addition to its beneficial effects, the medication was also having heretofore unrecognized harmful effects, and I don’t mean just the harmful side effects that might be reported for any given medication. I am talking here about harmful effects that have never before been reported and which ironically, in the long run, might be harming the proper functioning of the heart even though in the short run the particular medication might be helpful and even life-saving!
In other words,while in the short run there might be beneficial, healing, and known health promoting and life-saving effects...
...in the long run there might be deleterious effects, although as yet unknown, and which might even prove to be harmful so as to shorten life! I cannot be sure about this. As I said, it is currently my theory. But I’d say in the long run, once properly studied and sifted through, this theory might well turn out to be true.
I’ll give you my reasoning on these matters, but for educational and informational purposes only. Remember again, what I am about to say is ‘my’ theory only, and might turn out to be wrong...
...but I doubt it highly.
And furthermore, I am so confident that these ‘new realizations’ of mine are true, that they have caused me at least (for the time being ‘not you’ nor anyone else I know) to alter the way I am taking such ‘best medications,’ and even to such extent that I have even seen fit to discontinue them from time to time.
Like I said, I cannot and will not advise you to do the same, not until they (the medications, theses ideas and theory of mine) have been more widely understood, tested, and accepted. But you should at least know about this information for it involves medications that not only I am taking, but many of you who are reading these words. Remember, I am merely introducing these ideas as significant realizations of mine which I have derived upon from having practiced not just as a medical doctor, but also from having combined my medical doctoring with other fields, one of many, and among which is personal fitness training.
Remember, it’s unlikely personal fitness trainers would ‘see’ what ‘I see’ when training individuals because they are usually unlicensed and medically uneducated professionals, hardly versed in the nature of disease let alone its etiology, diagnosis and treatment. In other words, once again it is the combination of these fields that has enabled me to ‘see’ things which the ‘best’ of the medical establishment and fitness persons (and so on) have heretofore been unable to see. And if I’m correct about these theories, a marked number of people on such ‘best’ medications like me (to the tune of tens of thousands and even more perhaps) might actually, in the long run, not only be harmed, but also be found to prematurely shorten their lives!
My Reasoning:
MAXIMUM HEART RATE LESS WITH AGE?
-- Very Important Concept! --
Most fitness professionals know or should know the simple formula for the maximum heart rate for any given individual in any given age range. The way it goes, if you take 220 and subtract the person’s age you get the average maximum heart rate for an individual of that given age.
On the other hand, ideally, in order to more accurately determine the maximum heart rate for a given individual, it is obtained during an exercise stress test. During an exercise stress test the patient is pushed to the maximum level of exercise intensity (within reason), and it is that corresponding elevated heart rate that is considered to be the maximum heart rate for that individual. In other words, with an exercise stress test the maximum heart rate for any given individual can be determined.
...But for any average person who has not had a stress test, the maximum heart rate that that person’s heart is capable of achieving is estimated or approximated (once again, by taking 220 and subtracting the person’s age). Not a very exact or accurate method, but then again, how accurate is the ‘real’ one determined via the exercise stress test?( Not really that accurate either, but more accurate than the ‘220 subtraction estimate,’ granted.)
The point is, what does all this mean? For the fitness trainer it is usually used to approximate the heart rate range and level of intensity of exercise within and at which his or her client would be advised to exercise. Generally speaking, they would tell their clients to exercise at that range or level of intensity of exercise during which their heart rate is being maintained at a rate somewhere between 40 to 60 percent (or more) of their maximum heart rate. Although there is a lot to be said about, and even wrong with how these levels of intensity of exercise are derived upon...well, that’s another story. The point is, the personal fitness trainer ‘sees’ the maximum heart rate along the lines I have just described, and that’s that.
On the other hand, to the medical doctor who is determining the maximum heart rate from the exercise stress test, it’s no surprise for him or her to find (just like the personal fitness trainer) that maximum heart rates during exercise correspond to the patient’s age: the greater the age, the lower the level for that patient’s maximum heart rate!
The Doctor [...not Dr. Alterwein. Perhaps, a cardiologist!]: “Mr. McGillicutty...from your exercise stress test the maximum rate at which your heart can go is 135 beats per minute. Now...since you’re seventy years old, that’s pretty much what we find for most other 70 year old’s, for people who are the same age as you.”
Mr. McGillicutty: “Why is that so doc?”
The Doctor: “Well, Mr. McGillicutty. You’re getting older. You’re not a young man anymore. You’re seventy years old. Young people...let’s say like around 30 years old. When I take an exercise stress test on them their maximum heart rate can usually go up to approach as high as 190. Now, we don’t usually push people to exercise to such extents that their heart rates actually go that high. So of course, at the age of 70, to have a maximum heart rate of 135...like you...that’s great. But even so, your heart is not going to be able to beat as fast as a person who is younger. So, the way it is, face it Mr. McGillicutty...you’re getting older...and the ability of your heart to beat fast is going to slow down a little with age!”
Interesting...especially because, as you might already have guessed...I see things differently. Very differently...having combined both, medical doctoring and personal fitness training.
The Doctor: “Of course your heart is going to slow down a little with age.”
Hmmmm...Now let’s see. Let’s think a little...
...The personal fitness trainer uses the maximum heart rate to help determine the level of intensity of exercise for his or her client, and he approximates it (the maximum heart rate) from the 220 formula (minus the person’s age).
...On the other hand, the medical doctor, usually a cardiologist, simply determines the maximum heart rate (as well as a whole bunch of other parameters) via actually taking an exercise stress test And then he, the doctor, judges, “Well...that’s good. Your maximum heart rate, sir...it corresponds quite well with your age. The greater your age, I find, the lower the maximum heart rate.” And that’s that.
The reasoning and interpretation as to the maximum heart rate usually stops there. In other words, we toss the maximum heart rate up to ‘age’ and leave it at that, as ‘just one of those things that normally occurs with age,’ that we cannot really do anything about, that occurs along with the inevitability of ‘age.’ And that’s that.
[What does this have to do with medications?...Everything!]
Well, as you might have again guessed...I shake my head in pity and shame for man...that man has not taken the reasoning behind that maximum heart rate further. But sadly, apparently, man has not yet (done so).
The Doctor: “Mr. McGillicutty. Your exercise stress test, and other tests we’ve taken, have some changes that I don’t like, even though your maximum heart rate is pretty good. There are some other changes which suggest that your heart might not be working as well as it could. So I’m going to put you on this really good medication to help make your heart function better. But don’t be concerned. Although there are some side effects to the medication, they’re nothing we can’t handle. Why, even people having only high blood pressure...they take similar medications...and they too experience similar side effects, like the slowing down of their pulse rate. (the doctor shaking his head) And when is the last time you took your pulse rate Mr. McGillicutty? I’ll bet you don’t even know how to take it. And even if you do...you will not even notice that your pulse is going so much slower!”
Okay, great! Concisely put...summarizing what I’ve said thus far: we, the medical establishment, routinely give medications for cardiac and other cardiovascular diseases, and high blood pressure, (and other diseases) which merely have the effect, as one of their side effects, to lower the rate at which the heart beats, and in turn the pulse rate (which is often a reflection of the heart rate).
The Doctor: “Mr. McGillicutty. Once you’re on the medication, if we took another exercise stress test...we might find that your maximum heart rate is no longer 135 beats per minute...and it might actually be as low as 120 bets per minute.”
Now, let’s stop here for a moment. Let’s think. Think along with me. When I first thought about this somewhat, I said to myself, “A heart rate of 120 (or pulse rate)...that’s sort of like having the maximum heart rate for a person who might be 100 years old (or thereabouts).
[Remember, 220 minus a person’s age of 100 equals a maximum heart rate (or pulse rate) of 120 beats per minute. It’s bad enough that the heart slows down to 120 beats per minute if you get to be 100 years old, but why push the process? Why give someone younger the pulse rate of a person 100 years old? That’s sort of like pushing the heart into the status as of an older heart of an older age! A cardiologist, at this point, might think this reasoning to be nonsense, but that would just indicate a lack of vision and insight toward a more realistic way of looking at the way the human body, or living tissue for that matter, works. Of course, I might excuse such shortsightedness for lack of knowing about progressive adaptation and progressive de-adaptation (theories I’ve developed, embellished upon and advanced from simple body building principles, and believe it or not from the lacklustre bodybuilder’s known truism: “Use it or lose it!” which is part and parcel of progressive adaptation [elsewhere discussed in this web sit.])
The bottom line [Try to understand this paragraph. If you don’t, don’t be concerned. If you do, then I know you really don’t truly understand it.]: The body (living tissue) progressively adapts anatomically and structurally to whatever function is applied to a given structure, or to whatever function has been ‘forced’ upon a physical structure or system of the body. This ‘truism’ is to living tissue and the body...as is ‘gravity’ to the forces of the physical universe. And it is no different for the pulse rate (and heart and cardiovascular system from which the pulse rate is derived). ‘Force’ upon the human body (or living tissue or other living organism) a function (such as an altered or slowed pulse rate, which by the way affects all tissues throughout the entire body, for the circulation pulsates throughout all those tissues and affects all of them to one degree or another)...and in turn, over a period of time, in some corresponding way you will also gradually be changing the actual structure or anatomical variations of that body, its body parts and body systems, both microscopically and eventually even macroscopically [‘microscopic’ you need a microscope; ‘macroscopic’ you can see with your eyes].
In short, and again, if you didn’t fully understand some of the above, I also thought of a related thought, of how we often prescribe and continually renew these ‘best’ medications for various diseases or medical conditions for many years at a time, even decades. Why, the fact is, I’ve seen patients come to me who have been on the same pulse lowering high blood pressure medication and cardiac medication for years...like I said, for decades. And I couldn’t help but realize that that artificially slowed heart rate (via the medication) might in the long run eventually be changing the circulatory system, the heart, the lungs, and even many other parts of the entire body in as yet unknown microscopic and macroscopic ways! I don’t need to prove it. I understand the underlying principle of the way living tissue works...via progressive adaptation and de-adaptation, just like the laws of gravity. Get it?
The more erudite doctor, more open-minded, might now be saying, even somewhat annoyed...challenging my statements: “Okay...what do you mean? Okay...How does the heart...how does the circulatory system change? What are you talking about?” But then again, he hasn’t spent years in a gym with a blood pressure cuff and stethoscope as a medical doctor/personal fitness trainer who happens to have a visionary and creative thought process wherein you eventually not only realize, but also see and feel those changes in yourself, and others you work with and train and treat!
Look...I remember this young lady, about 30 years of age. She was actually quite plump, a little overweight, about 5 feet 4 inches tall. She had no underlying disease process that I could pick out from her history and exams, and after working with her for a few months, I remember one time, I got her to the point wherein she was jogging along on a treadmill at a fast clip, about five miles an hour and up an incline of about 4 or 5 percent. Now, I had gotten her into good cardiovascular shape, at least for that particular type of treadmill exercise, even though she was still somewhat overweight. But at her young age, she was well able, after a few months, to maintain this level of intensity of exercise. She was only slightly out of breath after a few minutes, but nevertheless I was still getting ready to tell her to slow down a little. She was quite a determined young lady, determined to change her body around and make things work. I asked her how she felt. She said fine. No real visible strain. Like I said...just a little breathiness. Then I asked her, curiously, “How about your heart? Do you feel your heart pounding in your chest?”
“Nope,” she said rather flippantly.
“Nothing?” I said curiously again, since I happened to note her heart rate. She had a heart rate monitor on. “Have you looked at your heart rate monitor lately?”
“So what!” she flippantly replied, as if to say ‘no big deal.’
“Do you realize that your heart rate is 195 beats per minute? That’s beyond your maximum heart rate!”
Again, I got from her another: “So what?”
Well, I thought of myself and of other patients and people who I had worked with. With myself, well I don’t have to tell you. At 190 beats per minute my heart would be feeling to me like it was coming out of my chest! And if I took an older person, depending upon how much older of course and depending upon their underlying level of conditioning and medical history...well, I would tell you that a certain number of them, even merely approaching such a high pulse rate, within minutes their hearts might decompensate, develop some type of arrythmia, perhaps go into fibrillation or a very rapid (or very slow) and abnormal heart rate...and in short order, they might drop to the floor and become dead! And why...just from exercising to a level of intensity of exercise enough to make the heart go very much more rapidly than it is used to be going for their age?
Well yes, that’s right. They could drop dead, even for a healthy person...for a heart ‘forced’ to beat much more rapidly than it was used to beating, as toward their maximum heart rate or even beyond (if that were possible for it might give way long before then, more so for older people)...their heart could decompensate and they could rapidly become dead!
You see, and this is a no-brainer, even if you’re not a cardiologist nor a doctor. Common sense will tell you that if the general ‘rule’ is that the heart tends, for some reason, to slow down with age...as everybody says it does, all science and phsyiology...and if a young person can run along with hardly a visible effect and minimal effort while their heart is pumping very rapidly away (near, at, or even beyond their approximated maximum heart rate), while an older person...(all these people with no disease mind you)...while an older person, who even attempts to reach their maximum heart rate let alone go beyond it, might suddenly decompensate...and die, dead on the spot. Well that tells you something.
Okay doctor...okay doctor cardiologist...okay Mr. Layman who is not a doctor..okay...what does all this tell you? Well, it should tell you the obvious: that younger hearts (whatever ‘younger’ means) can go faster and do higher level of intensity of exercise with hardly any ill effects on the body, while older hearts, even healthy ‘older’ hearts, have in some way changed so that they are not in good shape and cannot handle the stresses of younger hearts...and when you think that all this change with age goes along with the slowing down of the heart...and if that heart is even pushed in some way toward its higher or maximum ranges or beyond...it will not just cause the person to have to stop running, let’s say like for the younger person whose breathiness might stop them from running faster...but for the older persons’ hearts, especially if you try to push them as rapidly as ‘younger’ persons hearts can beat...well the, those older hearts, and older people obviously, might just drop dead!!
So, what does it seem logical to say about all this? That if you put together the medicine, the fitness, the’ 220 Rule business,’ and all this other stuff I’ve pointed out...put them together along with progressive adaptation and progressive de-adaptation...the fact is you most certainly might come to the conclusion (or at least theorize) that if your heart is made to beat more slowly than it’s used to beating for your given age...well then, if you heart is artificially (as with medications) ‘made’ to beat even more slowly than it should be able to beat for your given age, and if this slowing down of your heart rate is continued for any significant length of time, it’s then also likely that your heart will, in time, progressively change or progressively de-adapt (its very microscopic and macroscopic structures) into that of a lower status or level of existence...into a lower status of functionability...more so like an older heart might be (that beats at a slower rate)! And I would also assume that, in a very real sense, you might then be limiting or offsetting the lifespan of your heart...of that heart...and cardiovascular system...for that individual!
[Again...if you don’t understand all this, don’t be concerned. You just need to get an overall idea of what I’m getting at. Besides, I might be wrong. But like I said...I doubt it.]
In other words, to summarize at this point, if appears that these ‘best’ medications, while they might indeed be lifesaving for the immediate or short haul...in lowering the blood pressure, or strengthening the heart, or in taking the heart out of heart failure, or in dilating arteries and lessening angina and other such changes...the fact is, over a longer period of time...these ‘best’ medications might, at the same time, be shortening the lifespan, so to speak, for that person’s heart, circulatory system...andeven life.
So, this is all the more reason to say ‘yes,’ to prescribe these lifesaving medications, yes, but then to institute methods, like lifestyle changes and so on, so as to wean people off these ‘best’ medications after a reasonable period of time, before the longer range and potentially ‘harmful’ effects set in. And, as you might now have guessed, I am referring here not only to potentially harmful long range effects emanating from the lowering of the pulse rate, but also I am referring here to other such physiological changes that these ‘best’ medications might bring about in the long run throughout the body in various and sundry ways, decompensating and in turn being detrimental to life!
In short, summarizing again to this point, it’s almost as if you were told by your doctor: “I’m giving you these ‘best’ medications to get you out of the immediate problem and save your life, but I’m going to keep you on these ‘best’ medications for years so that they’ll kill you off prematurely, years before you otherwise would have died had I taken you off them (the ‘best’ medications) sooner! Now mind you. Do not take these words, out of context. For the person who does not institute lifestyle changes (as I’m talking about upon this web site) their life is, on the average, going to be markedly shortened anyway, and for them taking their medications longer might serve to prolong (somewhat) their already markedly shortened lives.
That’s a short summary...short, blunt and to the point...indeed.
I for one could not go into a gym and exercise and know that my heart was beating so slowly no matter how high the intensity of my exercise. I’ve been on such medications, and cannot function effectively like I normally do without the medications, and without my heart rate slowed down. Yet, I’ve heard doctors say: “Don’t worry. Exercise as usual, at your usual rate. No difference. Your heart is just going to beat more slowly. That’s all. Nothing to be concerned about. You can still exercise just as you would normally.”
...Like I said...”Wrong”!
I knew that if nature made a healthy young heart to be able to beat faster in order to be able to deliver blood to muscles and other tissues throughout the body, that that was what I wanted to strive for, to have a heart like or close to that of the younger heart, one that is capable of being able to beat more rapidly...even though with continual exercise and ‘conditioning’ it’s commonly known that the heart rate does slow down, but that’s another, although related, matter. ‘Conditioned’ to beat more slowly or not, the ‘conditioned’ younger heart (relative to the ‘conditioned’ older heart) simply has the ability to become ‘conditioned’ at a higher level or pulse range level.
...And I therefore also realized that even though these ‘best’ medications might temporarily be delivering blood at a slower rate, but with a more effective heart beat or whatever at that slower rate (and which would account for their early or immediate beneficial effects), the fact is, in the long run a heart which was always made or artificially ‘forced’ (as via medications) to beat slowly...such a heart will ‘forget’ or ‘unlearn’ the natural abilities that nature gave it, such as being able to beat faster as in younger or more healthful states!
I’ve even been on these medications and they began giving me the symptoms of heart failure, the very thing many people taking thee medications are trying to prevent. And well, doctors might say this can occur, and you might eventually adapt to it. What I say is that sure, you might eventually adapt to it, to the medications, so that the heart failure -like side effects might eventually dissipate, but what is not realized in order to do so, the entire body along with the heart as a unit adapts to the medications, while the heart might all the while de-adapt to a lower level or functional state.
...Now I know, few people will understand this, even doctors...but it takes a lot of experience, a lot of working with people actively exercising with them and along with them, and not just writing a script or telling them to exercise...and it takes a lot of thinking.
You see, again, it’s not even so much that it is ‘age’ that lowers heart rates over time (or that ‘removes’ in a sense the ability of hearts to be able to beat rapidly, as younger hearts can do), but more so in actuality it is the lack of having followed a lifestyle over a lifetime that is conducive to having a healthy heart that really counts.The fact is, in the long run, it is the lifelong improper lifestyle that is what is really responsible in large part for the slowing down of the heart (or of its ability to be able to beat more rapidly). I dare say,and just the opposite, that the heart rates of lifestyle implemented ‘healthy’ hearts would be able to beat much more rapidly (and simply be that much more ‘conditioned’ over a lifetime) than do the older more deteriorated hearts seen throughout our aging population today and which,as we have seen, routinely slow down with age.
Summary till now? Here it is. ‘Lifestyle’...proper and natural lifestyle changes...and which can only truly be accomplished naturally, without the altering effects of medications on the structure and functions of the body...proper and natural lifestyle changes even offset older hearts from slowing down.
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The short of all this. The very fact that a young thirty year old girl ‘s heat can beat at 190 with no untoward effects, and the fact that an older person’s heart would not not only not be able to do so, to beat so rapidly, but if ‘forced’ to go rapidly might likely decompensate and even result in death...well then, all this tells us that we should be maintaining the normal functioning of the heart and cardiovascular system in its normal medication free state as long as we can in life. And if are to be placed on lifesaving medications, we should then be doing everything we can do to wean people off these ‘best’ medications, such as with lifestyle related methods as I speak about on this web site. Medication’s don’t necessarily ‘cure.’ They often temporarily abate...and, as I said, I now realize that this same or similar reasoning applies to many medications for many different medical conditions, and not just to those that help the heart or lower blood pressure, as I’ve pointed out above.
Medications in general, while in the short run they might be lifesaving...in the long run they might be harmful and promote premature death than otherwise might have occurred had they also implemented a proper and healthy lifestyle!
Remember now, as I said...this information isn’t meant for you to discontinue your medications. You’ll also notice now that my ‘best’ medication is actually no different than many other ‘best’ medications, for what I say here applies to a multitude of medications, and medications in general. Over time we’ll find the hidden side effects in a multitude of medications , long range in coming perhaps, but no less harmful nor deadly. And being that for most medications these long range effects are yet to be discovered or uncovered, it stands to reason to treat them ‘all’ accordingly...which means...
...to use them when need be...but discard them as soon as can be.
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