Happy Father’s Day! I’ve had a lovely day: bike ride and some yoga with my daughter, a few holes of golf with my son (who bought be some personalised golf balls with instructions not to lose them!) and will be having a bbq in the sunshine then watching the football. Pretty much a perfect day.
The most interesting consultation I had this week was with a patient of a similar age to me, who was extra-ordinarily fit. Top 1% type fit. Made me look sedentary! Tragically, a new heart condition means exercise is now to be discouraged. There are very few instances where that is the case, but this is one of them: arrhythmogenic cardiomyopathy – literally – a heart muscle disease which is characterised by arrhythmia, and in this case often serious heart rhythm disturbances which can be fatal.
It is a condition where heart muscle cells become replaced by fat and fibrous tissue. It is inherited, although in this case there was no family history at all so it is quite likely they have what we call a ‘de novo’ or ‘new’ genetic mutation in their family line. It often affects young adults, but there is a huge spectrum. At one end patients have few if any symptoms and are very well, at the other patients may need a heart transplant or it can be fatal. Quite often an implantable cardioverter defibrillator (ICD) is indicated.
I have written before about how I try to personalise exercise recommendations for the specific heart condition a person has, and the latest guidelines very much favour individual ‘prescriptions’ of exercise. Cardiologists used to be far too restrictive in their advice for exercise in cardiomyopathy, but this is changing. However in this case, where someone was so very fit, it really is challenging.
There are some general principles though – steady state exercise is less risky than high intensity stuff. Replacing lost electrolytes during sweating. Warming up and down.
Nevertheless, I felt really bad delivering the advice about this specific condition. I was taken aback by how well it was received though. My patient was really accepting of the situation, I’m sure far more so than I would have been. Far worse things they could have had was their feeling.
Sitting here today and reflecting on this, my overwhelming feeling is gratitude. On what has been such a special day with my children, I’m grateful for my own father and the help and support he has given me over the years. I’m grateful for my body and its ability to work and the sports which I love. I’m grateful for my own children and the joy they bring. It has been well proven that practising feeling gratitude is a really helpful part of maintaining good mental health. It certainly makes me put things in perspective. The ancient Stoics knew all about this, and it’s something we could all learn from.
Try it now. Just stop for 2 minutes and think what you’re grateful for. We all have 2 minutes to spare, and I guarantee you will feel better for it.
I just hope my last bit of gratitude today is after an England win in the Euros!!