Re: Cardiologist too conservative?

It seems to me I heard somewhere that Zen Cohen wrote in article
<483ef63e$0$5169$4c368faf@xxxxxxxxxxxxxx>:

I had to take a treadmill stress test yesterday because I had minor
right-side chest pain a couple weeks after a 40% spontaneous pneumothorax in
my right lung. I suspect the test was overkill but I wasn't going to defy my
doc's advice.

He said he'd calculate 220 minus my age (49) so limited the test to 171 bpm.
I told him that I sometimes approach 180 when exercising and that I'd like
to see if there are any problems when my heart reaches that range. Also said
I'd heard the 220-minus-age formula was arbitrary, He agreed but said it was
a good rule of thumb and summarily dismissed my request by pronouncing I
just shouldn't exercise above my 220-minus-age. I realize that there is some
additional risk by exercising at higher heart rates but I'm willing to take
some measure of risk because I like to push myself and better my
performance. Nonetheless he stopped me right at 171. I feel like the doctor
didn't do me a service because he didn't provide a sufficient reason for
this and it seems his refusing to let me go further may have left him in the
dark about potential problems that could develop in these higher ranges if I
don't follow his advice.

I get the impression this cardiologist knows plenty about counseling and
treating sedentary or ill patients but has no interest in advising fitter
patients who want to push their endurance without undue risk. Has anyone had
experience with cardiologists who are more fitness-friendly? What have they
said about the risks of exercising at or near max HR?

BTW, it took me 15:30 to reach my "max" HR. He said his patients normally
don't last longer than 11 minutes but heard of some accomplished athletes
going over 20 minutes. I might've gone another minute or so but nowhere near
20 (with the speed/incline increases every minute). If you've done this
test, how long did you go?

Very few cardiologists seem up to date on the normal reading for athletically
fit heart patients and prefer to use routine information, even arbitrary ideas
handed around the profession like the "220-age", than to really listen to the
experience of the patient himself. I think most of have exceeded our "maximum"
heart rate in routine training sessions, and have pulse rates slower than our
cardiologist "experts" say is safe. It's been a long time ago but I think I was
somewhere close to 13 minutes on my most strictly-controlled treadmill test.

Couldn't do it now, but it ain't the heart that's slowing down. :-)
.

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