Medical
Racquetball may have Saved my Life
by Richard Bruns

This unpublished "extra" is available exclusively online. All ideas expressed via RACQUETBALL Online [www.racqmag.com] are those of the authors and do not necessarily reflect the official position of the USRA.

A few years ago, as I was undergoing the annual, inquisition-like ritual of my physical examination, I startled my primary care physician with a question. "Doc, when I first came to you more than twelve years ago I had high blood pressure, high cholesterol and a depressed ST cardiac wave. If I hadn't come to you with these symptoms at that time, and we had not addressed them, would I still be alive today?"

I was looking at fifty-five years the very next month, and I had been thinking of this significant milestone for several weeks. My physician, Dr. Thomas Suard, is one of the finest and most humane doctors in Napa, California. He is always calm (although he says his son would disagree with him), asks pertinent questions, and most importantly listens to what you tell him; and equally important to me, he has a sense of humor, however dry. He doesn't, as seems so true of many physicians, broadcast the screaming attitude, "I'm the doctor; you're the patient. I'll tell you what's wrong with you because you don't know what you're talking about."

I have not, in my years of being his patient, seen him taken aback. Now I'm not suggesting that he fell over in a dead faint when I asked what, was for me, a poignant question -- but he did raise his eyebrows a couple of millimeters and seemed to metaphorically step back a couple of centimeters before he said -- "Now that's a really interesting question." 

Of course, there is no real answer to such a question without the opportunity to run statistical, long-term, blind-study experiments with a several dozen identical clones the same age as I -- and that's not likely to happen.

He did respond with sound layman-level logic. "Well, given your family history" (my father died at 39 of a massive heart attack, and his father at 60, also of a heart attack), "and given the symptoms you exhibited when you first came in, let's just say I am really glad that you did come in!" Enough said.

So how did I happen to come in to see my doctor, since my lifestyle and health was built into and around playing, teaching and living racquetball? I was completely symptomatic. I was playing five to ten tournaments a year, teaching four racquetball classes at Napa Valley College, beginning and advanced clinics at the local private club, conducting regular juniors programs, and teaching about five private lessons a week.

The truth is, I blame it on racquetball. I have been playing racquetball since 1977. I have been teaching racquetball at Napa Valley College since 1978, and teaching as a private pro since 1980. This odd game, involving two to four people swinging racquets at a ball in a large and otherwise empty room, has dominated my social and professional life for nearly twenty-five years, starting when I was thirty-two. 

In the mid-eighties I decided to return to Sonoma State University for graduate work in physical education to expand my knowledge and understanding of the biomechanics of racquetball to improve my teaching and coaching. To further feed my passion.

Since my B.A. was in English, I had to take a number of lower division prerequisite classes for the grad program. One of the prerequisite classes was Human Physiology wherein we all experienced the joy of learning to take blood pressures by practicing on each other. Let me set the scene. There were about twenty-five students ranging from eighteen to twenty-two in this class -- and me, in my mid-forties. Talk about culture shock.

Anyway, I accurately measured the BP of my lab partner, and then he, bless his heart, said, "I'd better try that over again." And he did. He measured it at 180 over 125. We fetched the instructor, and he measured it and said, "I suggest you check with our first-aid department where there is a nurse."

So I did. She confirmed the high reading at just a little lower than in class, but was adamant about seeing my doctor. I had just signed up on a medical plan and so I chose my primary physician, and he confirmed officially my high blood pressure. He added the bonus information, after a basic physical exam, that my cholesterol reading was nearly 200, and the bad cholesterol level was way way too high. Looking seriously at me, he said "We've got to get this under control." And thankfully, today, combined with a better diet and better living through chemistry to help counter the genetic disposition towards these problems my mostly deceased family passed on to me, these issues are under control.

But I have had to ask myself the question, what if I hadn't returned to school? What if I had somehow listened to the numerous people who questioned the wisdom of school at the ripe old age of forty-five. "What're you going to with school at your age?"

Two years later, in Advanced Exercise Physiology, a graduate class, we were all having a wonderful time learning how to perform stress tests. A stress test, if you are too young to need one, or have avoided them because you're afraid of the possible results (and boy howdy, is that a mistake!), and therefore may be unfamiliar with them, is a kind of institutionalized form of torture. Once again, we're back at the Inquisition.

You are wired up with several electronic leads which are connected to an EKG (electrocardiogram) machine to measure the heart's work load against its complex rhythm. The volunteer (or victim in the lab; patient at the hospital) starts by walking on a heavy-duty tread mill connected to a computer with a software program that (1) quickly increases the speed you must walk, then run, in timed intervals, and (2) at the same time increases the angle up which you are running. This procedure causes physical stress -- and distress -- very quickly.

These measurements tell experts many things, one of which is a telltale from a portion of the cardiac mapping called the ST Wave. If an ST Wave has a depression in it, it suggests that there may be cardiac (heart) arteries which may have some blockage (arteriosclerosis). This is not a good thing. Arteriosclerosis leads to heart attacks and strokes.

Being the noble fellow that I am, I volunteered to be the 'subject', a.k.a. victim, for the lab session. After it was over some twenty minutes later, my instructor, and one of my colleague students working on a Master's Degree in exercise physiology and who happened to also be an ICU nurse, pulled me aside and said, "We think you should see your doctor. We think you should see your doctor immediately." Deja vu all over again. 

They pointed to my EKG printout, and said, "This is the ST Wave signature. Right about there, at about two thirds the way to your maximum exercise level, it starts to depress to a significant degree."

When a scientific person says "significant," they frequently mean "Yikes!" So off to my good doctor I go to relate this latest chapter in my second SSU career. He quickly arranged another, 'real' stress test with a cardiologist, which proved to be even a worse experience than the first one. The administrator of the test insisted on shaving five patches off of my somewhat furry chest "to insure that the leads have good contacts." My wife said I came home looking moth eaten.

"That's a significant ST depression showing there," the cardiologist told me.
Yikes!

Because of the yikes factor, I was immediately set up with an angiogram -- a cardiac picture taking process. This is another really fun procedure where they put you on a nifty substance called Valium (or something similar) sending a quantified relaxation through a tube straight into your circulatory system through an Intravenous drip, which quickly relaxes you into a state resembling a warm fuzzy dishrag. 

The members of this green-pajama clad inquisition then give you a local anesthetic and stick a pointy thing into the major vein of one leg. This delightful item is run up through that vein into the area of your heart where it releases a dye enabling high tech equipment to display the flow of blood through your heart on a TV monitor with no commercials. I seem to remember someone saying, "Oh, look. There's the source of that nagging depressed ST Wave -- two partly blocked cardiac arteries." 

So changes were made, attitudes adjusted, and by golly - life goes on! 

None of the procedures were actually bad; it was the fear, my fear, of what they would find that made it all seem like Torquemada was after me. 

Since that time, I have had three former students, still regular players, who have had major heart attacks from previously undiagnosed heart conditions. One was younger than me; the other two about five and ten years older. They all survived, and to a man, each said that a major factor in their surviving their respective episode, was the strength of their heart. Strength built through a life-long love of the game of racquetball.

My own cardiac-rooter procedure may one day come, but it hasn't yet, and I'm doing what I can to stave it off. So, what if I hadn't returned to school? You could make yourself crazy with such questions. So, really, I don't ask them often -- Because I did make that choice. And the words of Robert Frost, "That has made all the difference."

Racquetball is more than just a game to me. I, and people I know, have taught and with whom I continue to play racquetball, are alive today because of it. 

My professional teaching advice: Don't you wait for symptoms to appear. If you are 40 or older, and/or have family history of heart problems, check with your physician soon. Have the blood pressure checked. Get your cholesterol checked. It just might save your life.

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