A Coffee Story

One of my long term training patients had a very instructive heart related experience. Some of you may know this man from Tempus. Polar Heart Rate data saved this guy from winding up in permanent Atrial Fibrillation and thus multiple drugs and a decreased quality of life.

So…he is Italian; turns out he loves coffee but not quite as much as life. While coffee is wonderful and generally healthy, my morning coffee ritual is one of the highlights of my day, for some it can be a problem. Multiple well done studies have shown reproducible health benefits across large populations and interestingly enough the benefits have been shown with caffeinated coffee but not with decaf. So this is not an anti-coffee screed. And it is not about populations; it is about an individual and how all medical and health related issues need to be addressed: one individual at a time.

While how this young man, 68, went from needing bypass surgery 10 years ago to being an indefatigable athlete in amazing shape and health without that surgery is an amazing story, the story recently took a new turn worth telling. Many of you know he never had that bypass by the way. He avoided that surgery the Tempus Way.

OK, what’s new? His hill sprints for several years now have been built around a maximum heart rate of over 170 beats per minute (bpm).  Well, when Tempus closed and in the light of our long, very long standing knowledge of his heart rate response to exercise we, OK I, got a little sloppy about always wearing his heart rate monitor. He finally started wearing his watch again and I noticed his heart rate during recovery, which had previously been spectacular, would hang up at around 150. In fact it would skip back up to the high 150’s and then down to high 140’s and so on. Hmmm. Got my attention. Next point; we noticed his previously very low resting heart rate had taken a 20 beat jump. Now this all unfolded over several training days. I would take his pulse by hand and watch the watch and so on and it became clear that at around a heart rate of 150 he would flip into Atrial Fibrillation. Not good. So with that information I restricted his heart rate to below 150 for each repeat hill interval and at this level he did not trigger his A Fib. Good but still something wrong with this story. Perhaps his coronary artery disease had returned. On questioning it turned out he was drinking a lot more coffee. Not a lot by most people’s standards but more than we, several years before, had found ideal for his insulin resistance and heart rate response to exercise. OK guy, stop drinking coffee.

Within two weeks his resting heart rate had returned to its previous low value and more importantly his A Fib is no longer triggered. Again this morning, Thursday the 6th of August, I let him off the leash a little bit and ran him till his heart rate was 160; no problem, no more A Fib with a great and smooth recovery heart rate. This is the 3rd training day with this beautiful result! Gradually I will work him back up to the 170 bpm range and beyond should he and his heart want to do that. Very cool. Now there is some detail in this story about safety issues and procedures but this outline leaves none of the salient points out of the story. The take home? Never train without your heart rate monitor. If you are training in such a way that the monitor is not a safety issue then you are not training in a range that will have the desired effect on heath.

So what to think about coffee? For most people, most of the time it is just fine. If, however, like the man in this story, you discover a problem consider whether coffee is the culprit as it certainly can be. For example if you note palpitations, poor sleep, decreased urinary stream,  hand tremor, irritability, the list is long, try a two or three week period of abstinence and see if the symptom(s) goes away.

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