How To (Almost) Kill Yourself (Really) On a Smart Trainer

How To (Almost) Kill Yourself (Really) On a Smart Trainer

“The CT scan indicates you have…”

What?  Seriously?  That can’t be…I’m a cyclist!  Well, I didn’t actually say those things when the doctor conveyed the news.  But I did think them, along with Samuel Johnson’s famous line about how news of one’s upcoming execution concentrates the mind rather wonderfully.

A Little Background….

I’m a lifelong cyclist living in the cycling paradise of Victoria, Canada.  Never a competitor, just another person who loves the freedom of two quiet wheels and a long road on a sunny morning.  That pretty much described me until almost 13 years ago when neighbour Dave invited me out on a group ride with his club, Tripleshot Cycling. Tagline: Pre-dawn café destination cycling. 

One exhilarating ride with these fun people was all it took.  After that, it was the usual progression:  first nice carbon road bike, then a winter training bike, Bike Shed 1.0, wife tired of being a cycling widow and gets nice road bike(s) too, son gets into serious cycling, along with his buddies, daughters join the peloton, N+1 additional bikes, Bike Shed 2.0, family reunions built around cycling, vacations the same. 

And lots of Tripleshot rides.  The club started over 20 years ago as a group of cycling physicians called the Spin Doctors.  One enduring benefit of this origin is that there’s usually a doc or two on most rides: when I got sloppy in 2015 on a fast Friday ride, overlapped wheels and went down hard, I had a couple of ER docs checking me over in less than two minutes.

In the first two months of 2020 my wife and I did a home exchange/cycling holiday to Tucson – our first time in Arizona.  We fell in love with the Sonoran desert, the welcoming bike clubs, and the seeming endless mixed-used trails and exciting mountain climbs including the legendary Mt. Lemmon. 

All of this is to say that the past 12 years featured a lot of cycling, and that doesn’t include winter spin classes and workouts at the local Y.  I had done Maui’s Mt. Haleakala four times (never quickly, I might add), Gran Fondos and “Big Rides” (275 kms/day) so I thought I was in good shape.  And I was.  But I had no idea about a quiet, patient assassin lurking in the shadows (cue ominous music).

COVID + Cycling = Zwift

With COVID came the early 2020 border shutdowns;  we drove home from Arizona just under the wire in the first few days of March.   When it became obvious that the Canada/US border would remain closed for at least 2020 (no return to Arizona!) and the infection risk would be high, my wife had an idea.  “You have a hard time with Victoria winters (winter darkness, grey skies, rain, occasional snowfall), so why don’t you get one of those smart trainers?”  “I’m on it.  Consider it done”, I replied. 

My wise wife also suggested this in the middle of summer, which gave me time to order equipment before the mad global scramble in the fall.  I managed to assemble the entire Wahoo trainer ecosystem, along with a nice 4K video unit to stare at (the tv was the least expensive component).

My Zwift setup

Then came the Zwift subscription.  I loved it.  Every ride was a learning experience – and remains so now.  My avatar is a much better bike handler than I’ll ever be, taking steep hairpin turns at 80 kph.  My job is to manage my limited energy in the face of the “Zwift Effect” where (almost) every ride is a race.  I quickly realized that I was a tiny fish in a very big pond:  although I rode B1 with Tripleshot – a brisk, respectable pace – Zwift was different.   With a global talent pool, trying to hang with the leaders on any Zwift ride for more than a few minutes was like trying to win the Friday A group road ride at home.  Not happening. 

Building Me Up

But I could at least try to build my watts/kg with Zwift’s training programs… and what better program than “Build Me Up”?  These rides produced results, although they did feel fairly punishing, (Dylan Johnson has some insightful thoughts on Zwift training plans; his video is worth a watch) and even in an unheated Canadian bike shed the sweat was prodigious. 

I now had something to challenge me from November to March.  That, and of course the pleasant distractions like FOCUS: Colors of Pari, Tour of New York, and the Black Celebration Series.

As February approached I did my best to keep up with the training program but found that the most I could manage were the 90 minute sessions, and those were tough.  I didn’t even try the handful of pre-graduation 2-hour sessions with their extreme demands.  The fact that I could for the most part hit the watts/cadence numbers with my KICKR in erg mode made me think the training was working and I was getting fitter (a dangerous assumption).  I was pushing myself hard.

Course “Graduation day” approached in early February, with the FTP test that would show exactly how much my Functional Threshold Power had increased since early November.  I focused on getting some extra rest and good nutrition before the session.  During the test it felt like whatever power I generated was just moving my legs rather than making watts.  Try as I might, with a herculean effort I couldn’t hit my November FTP number. 

That didn’t seem right – why was I going backwards?

What’s Happening?

When you’re confronted with screens of data – Zwift is good at that – the tendency is to go into analysis mode if things don’t go as planned.  Perhaps it was technique:  maybe I went too hard too soon? Have I overtrained?  Looks like I need to carry on and get some more data!

So, more rides – get some rest and push hard again!  Except that an 80 minute ride ridden at a Zwift C to C+ pace left me feeling more dragged out than ever, with a week (rather than the usual day) of recovery time needed before I wanted to go anywhere near the bike shed [CLUE].  After several of these experiences I was dragging myself around the house, feeling progressively more exhausted [CLUE].  Cycling indoors or out held no attraction. [CLUE]

With this deteriorating condition, my thoughts turned to the most high-profile suspect:  I had somehow contracted COVID-19.  While the numbers on Vancouver Island have always been low relative to the rest of Canada (being on an island helps), we still have daily infections and the occasional death.  I seemed to meet the symptom criteria for testing so booked the drive-through gargle test (much nicer, I’m told, than having your brain flossed).  The results were online that same afternoon:  Negative.   

Ok, what now?  That night, around 3 am, I told my wife that with the heaviness in my chest I was convinced I had pneumonia (self-diagnosis.  I studied law, not medicine).  The way I was feeling, I thought staying in bed wouldn’t help much – it would be just as good sitting in emergency where someone could have a listen to my chest.  (My first good idea so far!)

A Hospital Visit

3am was a great time to avoid the usual lineups at Royal Jubilee Hospital emergency department a few minutes up the road.  The triage nurse took a quick listen to my chest then said, “Follow me.”  What happened after that was a rapid succession of chest x-ray, ECG, blood samples, more examinations, insertion of an IV connector (good to have it should the need arise suddenly). 

It was clear to the staff: I had a heart issue.  Heart?  Not even on my radar.  The following day came an ultrasound echocardiogram (fascinating to see my heart valves flapping) and a CT scan where I got the fateful news: 100% blockage in the right coronary artery. 

Terrifying information, yet the docs felt I probably had no permanent heart damage given my general fitness level and “athletic heart” from cycling (45 bpm resting rate that set off the “Low HR” monitor alarm beside my bed) that likely also developed a robust collateral circulation system.  A similar blockage in the left coronary artery  – called the widowmaker, if it’s at the junction where the left artery splits into two branches – might have meant I wouldn’t have been here to write this. 

Perhaps the most important factor in avoiding serious heart damage was the fact that I had not tried to “tough it out” – getting out of bed and coming in was the right call.  (Although some would question the wisdom of driving myself to Emergency; then again, I did think it was a respiratory infection.) 

Two days later came the angioplasty:  an assembly-line procedure with dozens just like me waiting their turn.  Local anaesthetic at the wrist, insertion of a guide and probe directed by real-time X-ray in the radial artery snaking through the arm and shoulder to the heart, inflation of a balloon catheter at the blockage followed immediately by implanting a tubular drug-coated wire stent to hold the artery open and keep that blood flowing.  In 30 minutes, the lower half of my right coronary artery went from a dry riverbed to a fully flowing river of pulsing life.  

The doc had made an interesting observation before the procedure:  “This blockage has probably been developing for the last several decades.”  And all this time I thought my lungs were my weak point. 

My Takeaways from this Experience

#1: Assumptions are Dangerous

Athletes may be the last to realize they have heart disease or recognize their symptoms (says T. Jared Bunch, MD,  who directs heart rhythm research at the University of Utah). 

This truth is worth one more anecdote to prove Dr. Bunch’s point: a recently-retired doc buddy of mine has a brother who is by all accounts an elite amateur cyclist:  25,000 km/yr average (that’s 15,000+ USA miles!), ultra-endurance races, you know the type.  Lives on the bike.  This fellow calls up his doc brother and says, “I’m just not getting much out of my workouts.  Like I have no energy.  I’ve got this heavy pressure in my chest, and weird stuff like pain in my jaw when I’m going up stairs.  What’s going on?” To which my doc friend replied (I’m paraphrasing): “Dude, do you want to call 911, or should I?  Get your ass to emergency RIGHT NOW!” 

This athlete is a highly intelligent fellow (practicing lawyer) but, like the probable majority of extremely fit individuals, had a blind spot when it came to acknowledging his own symptoms.  Yes, he had a significant coronary blockage.

#2: Pay attention when something out of the ordinary happens

Unexpected lingering exhaustion, unusually long recovery times, etc should be red flags. Consider following this up with your doctor.  In a data-rich environment like Zwift, performance numbers that are in decline or going in reverse (combined with a physical feeling that’s “something’s not quite right”) may be a clue.  Listen to your body and don’t rationalize the matter away like a typical cyclist!

#3: Learn the signs of cardiac issues

Again, don’t self-diagnose like I did!  And it’s worth noting that for women, these signs can be more subtle and difficult to analyze.  But you don’t have to take my word for it:  take a few minutes to digest the summary that follows. 

And with this new awareness (and maybe an overdue medical checkup?)… Ride On!   

Warning signs of a heart attack 

(source: secondscount.org)

Many heart attacks involve discomfort in the center of the chest that lasts longer than a few minutes or that goes away and comes back. It can feel like:

  • Uncomfortable pressure
  • Squeezing
  • Fullness
  • Stabbing pain

However, not all heart attacks are proceeded by chest pain.

 Heart attack symptoms include:

  • Chest discomfort
  • Discomfort in other areas of the upper body:  one or both arms, the back, neck, jaw, or stomach
  • Shortness of breath with or without chest discomfort
  • Pounding heart or changes in heart rhythm
  • Heartburn, nausea, vomiting, abdominal pain
  • Breaking out in a cold sweat
  • Dizziness or lightheadedness

Warning signs of heart attacks in women

These heart attack symptoms are more common in women. They may occur without chest pain. 

  • Sudden onset of weakness
  • Shortness of breath
  • Nausea, vomiting, indigestion
  • Body aches
  • Overall feeling of illness
  • Unusual feeling or mild discomfort in the back, chest, arm, neck, or jaw (Remember, these may occur without chest pain and still be a heart attack)
  • Sleep disturbance

People who have diabetes or are elderly may also experience atypical heart attack symptoms.

About The Author

Michael Skinner

Michael is a semi-retired administrative law specialist who would rather Zwift than ride in the rain, hence his Tripleshot handle, “FairweatherMike”. Living in Victoria, British Columbia, he also uses that other human-powered transport, his kayak.

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Harry Roberts
Harry Roberts (@harryroberts)
2 months ago

Would love to hear the “After” story. How did/have things gone since then?

Peter Josefchak
Peter Josefchak
2 months ago

I’ve been in marathoning since 1983. My sense has been that athletes feel
that as long as they can perform then everything MUST be fine. Wrong! Annual
medicals, stress tests, blood tests etc etc are not on most training plans. You can be
fit and/or healthy but the first does not imply the other. People do the
annual checkups and DO NOT rely on fitness as the yard stick…IMHO…I have many
stories but I’ll leave them alone….Be safe and well….

Peter Higgins
Peter Higgins
2 months ago

Definitely worth watching your performance. Watts and FTP will suffer in workouts long before you are symptomatic climbing a single flight of stairs. The data don’t lie, and in this case, detected a problem early enough to be easily fixed. Most people don’t have the data for this kind of early detection system, but this can be really helpful.

Peter Josefchak
Peter Josefchak
2 months ago
Reply to  Peter Higgins

I agree. The data arising from the Zwift platform can be considered like stress test
indications (Watts, HR, endurance etc) as values change with no apparent reason, Good metrics to document and then get checked out…

Dan
Dan
2 months ago

Very similar story for me. I have been a cyclist for nearly a decade. 2 years ago this month, I was out on a ride, and it felt like someone was pulling on my seat belt. Pressure across the chest, and discomfort across the shoulder blades. It seemed like I was putting in a hard effort, but I wasn’t. Felt dragged down. I cut my ride short, went home, took a shower and a nap. That afternoon, I still felt run down, so I drove myself to the local Emergency Room, where they did the tests. An ER doc came… Read more »

ShakeNBakeUK
ShakeNBakeUK (@bakeuk_2)
2 months ago

the reason that athletes have a “blind spot” when it comes to assessing their own health is that they spend the vast majority of their life ignoring/blocking out what their body is telling them and powering on through the pain, which is very good for being competitive but very bad for detecting issues such as heart problems. always worth speaking to a medical professional if anything doesn’t seem right. hopefully in the future we will all be weaing uber-smart watches which monitor heart activity/rhythm 24/7 and can provide early warning alerts for certain conditions (Apple Watch ECG’s are already capable… Read more »

rdcyclist (Mark Crane)
rdcyclist (Mark Crane) (@rdcyclist)
2 months ago

I too had a very similar story: Lifelong cyclist (I’ve been riding seriously for more than 50 years), fairly competitive racer at one time, 5 hour century rider, etc. Six months after I turned 60, I noticed my HR ceiling dropping and some chest discomfort. As a typical white American male, I figured taking it easy for a month or so would do the trick. It didn’t so I went to the Cardiologist. EKG looked good, stress test EKG looked good, bloodwork looked good so the doc signed me up for a CT Calcium Test Score inspection. There was more… Read more »

PRSboy
PRSboy
2 months ago

Fascinating article- thanks for sharing your story, which contains excellent advice for all of us!

Robert Munro
Robert Munro
2 months ago

I go well over the rule of thumb max HR every time I ride. It doesn’t cause me any discomfort so should I worry?

Peter Josefchak
Peter Josefchak
2 months ago
Reply to  Robert Munro

The person to ask would be your doctor. He/she knows you best…IMHO

Crankenstein
Crankenstein
2 months ago
Reply to  Robert Munro

Those rule of thumb formulas for max heart rate work for most people but when they are off they can be off by quite a bit (as in 10 to 20 bpm). If you are not experiencing any other symptoms you probably have nothing to worry about. But. If you haven’t had a checkup recently or discussed this with your doctor now would be the time to do so. Elevated heart rates under stress in general can sometimes indicate other underlying issues. It wouldn’t hurt to mention that and/or ask for a blood workup or monitored stress test next time… Read more »

Ralph H
Ralph H
2 months ago

So…I am the brother of the doctor mentioned. From childhood until the day I retired, (read terminated), I rode my bike to work every day, rain, snow, sleet, dead of night, no exceptions. (Well, if there was too much snow my gear cluster froze and I stopped if the portages over snow drifts were too long because my shoes got wrecked and I am a cheapskate, always road a road bike, no snow tires as I figured the skinny tire cuts through snow better.) My first symptom was doing a 5 hour ride on Zwift just after I got it,… Read more »

Alastair G Cooper
Alastair G Cooper
2 months ago

Beta blockers require a TUE so it might not be them!

Phil
Phil
2 months ago

I’ve been cycling and racing (Time Trials) for over 40yrs, I have lost count of the number of friends with a similar history who have a heart problem of one sort or another, and to everyone of them it came as a shock – take care everyone and if something seems wrong GET IT CHECKED OUT

Dan Kapsak
2 months ago

Sounds familiar! thanks to cycling, a heart attack in March 2019, further catheterization in May, and then September 2020–a six-pack in my heart, but still being seen and not viewed, and still riding (aiming at 4k miles this year).

Rick Dorrington
Rick Dorrington
2 months ago

Thanks for this. As an indestructible 60 year old cyclist doing the regular centuries, it’s a good reminder that sometimes you need to pay attention. Good health to you.

Adam Johnston
Adam Johnston
2 months ago

For those with heart issues, how are your teeth? Any root canals, crowns or aching teeth? Over a year ago, I was suffering with sharp jolts of chest pain during Zwift sessions that would cause me to stop. After finding a really good holistic medical doctor in Mill Valley, CA, it was found that I had a tooth infection that was dragging down my overall health. A dentist removed the molar but the arrhythmias continued. I then saw an oral surgeon, who through a “Cone Beam X-Ray”, found a massive sinus infection right above the extraction site that the dentist… Read more »

Otto
Otto
2 months ago

Well,…2 heart attacks and 5 stents made me jump back on the bike (doctors orders) after 25 years of doing almost nothing. I discoverd Zwift because of it and I just got promoted to C-cat. It made me reconsider what really is important and enjoying life to the fullest now!👍

David White (NZ)
David White (NZ)
2 months ago

Thanks, Michael, for raising this important matter. For variation, here’s my slightly different story… I’ve been mountain-biking about 6 years and Zwifting since 6 months before lockdown. In December 2020 I had 2 occasions when riding that I experienced a “minor ache” in the region of the lower tip of my breastbone (sternum). Once was on Zwift, doing a gentle group ride after a sprint race. The other was during a crosscountry MTB ride. In both cases, the ache went away when I let my HR come down. It took a friend to convince me to see my doc.  A… Read more »

Tom
Tom
2 months ago

I had a similar experience, in January did a long ride on Zwift with two big climbs, there was a sprint towards the end and I normally do not go for the sprints. But for some reason that day I did, and I went all out. After the ride I didn’t feel well, had some light pressure on my chest, but not in the center. Also, sensation up neck towards jaw that came and went quickly. Symptoms all went away after settling down so didn’t do anything. Note, symptoms going away when exercise stops is a warning sign! Rode some… Read more »

Bill
Bill
2 months ago

This sounds like the problem I’ve had for a couple years now–athletes are good at ignoring pain. I’ll be going in tomorrow for an EKG. I think my company would be REALLY disappointed if drop dead while Zwifting! 😅 Thank you for sharing–I am certain you are saving lives… maybe mine.

Josh
Josh
2 months ago

Very interesting. Just did not understand why choose to go to a hospital at 3:00am in order to avoid queues. It might seem like you´re hacking the system but that´s just unnecessary and you might not be attended as well as if you were visiting on normal hours.

Joe
Joe
2 months ago
Reply to  Josh

I think he was just cracking a joke about lines at 3am and not actually choosing to go in at that time to avoid them.

Paul
Paul
2 months ago

Nice story – I had similar – 100% block in artery that serves front of the heart and a 80% lesion in an intermediate artery – only symptom was indigestion (oh and btw I have worked in cardiology for over 20 yrs..) – both arteries open now and fitter than I’ve been in years – zero limitation to my functional ability ! Good luck with your journey

Oliver Radermacher
Oliver Radermacher
2 months ago

Thank you. Great article and great comments below. I think I should really see the doc, no chest pains or something like this, but my breath becomes shorter when exercising since a few months. Always thought this should be caused by my lungs, but now I do think twice. Thanks all fort his great community!!!

Alastair G Cooper
Alastair G Cooper
2 months ago

It’s not always actual heart disease that can do this either. In 2016 age 36 I had a heart attack that was caused by coronary dissection. This means the artery was split and blood was pooling and clotting, squeezing the artery near shut. I was on a vigorous group ride at the time, and I felt like I just had zero power. I was riding so slowly and bring dropped by we kids had passed! kids! I put this down to not being recovered from a serious flu I had about a month earlier, so in the end I told… Read more »

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