Measuring progress

With many medical conditions, measuring progress during treatment is not always easy. In my
case I used my performance on my bicycle as measure, riding a given route so I could
compare. It's the same route I always do even before I started this and I limit my maximum
heart rate to no more than 165 on the climbs.

While it is true that this showed very rapid progress I needed something more tangible and
thus ordered a six-lead portable EGT recorder I could take with me on the bicycle from
Amazon. This device allows me to view the recordings afterwards and process them in a
variety of ways. I was mostly interested in the V5 ST depression as this was the most visible
sign of my problems. The recorder does V1, V3 and V5. Both V1 and V3 do not show much of
an issue and are close to normal and I thus ignore them.

Here is my starting condition: A 4 mm depression. This lead to me failing to renew my pilots
flight medical.

The software that came with my EGT recorder allows the display of the V5 trend over the
exercise period against heart rate. This is quite usefull and has been my main method of
comparison. It cuts out the subjective picking out of individual wave forms that you may like of
not like at the case may be and gives a more balanced view.
In these graphs you will notice an apparent reduction of the ST depression with increase of
heart rate – that is not really the case but related to the setup on the measuring points of the
waveform and with higher heart rate the points start to look at different instances of the wave.
In reality the depression seems little changed – I am more interested in duration of the
recovery once on top of the hill. As you can see – quite rapid. That's good.

It took 6 weeks for my recorder to arrive so I was well into the protocol when this first
recording shown here conformed a substantial improvement. Depression on average about
1.5mm with some peaks approaching 2mm.

The route consists of two uphills and a bit of flat and downhill. The first uphill is quite steep
and I max out at about 160 or so in this image. The second uphill is much longer but not that

This next image shows the same route about 4 months into the protocol.

As you can see – the V5 depression is now around 1mm with some small excursions.
Interesting is that the depression during normal activity as in walking around is about 0.5mm.
This is getting close to what would be considered “normal”.

A month or so later and it's improved even more but now getting quite stable. This is more or
less my “normal” that I can maintain. I am quite happy with this result.

Here is an interesting one. You may recall I mentioned that you can expect some “setbacks”
in particular during the first few months. This case occurred some 12 weeks into the protocol.
You can see it starts really great – excellent in fact. But after completing the second hill and
now actually starting to relax a sharp increase in the V5 ST depression.

Here is the V5 recording from the moment the recorder flags the problem. This is not looking
good. I have had a (very minor) heart attack – most likely a lesion bursting or a bit of debris
causing a small down stream blockage.

I did not actually notice anything while riding the bicycle but only about two hours later where
a bit of pressure on my chest after climbing a flight of stairs told me the recorder was not

Recordings done after this event showed it took some two weeks to clear up to get back to
my normal wave forms during exercise.

These little ECG recorders are quite inexpensive and easy to use – but buy the stickers from
a hospital and make sure you get good quality types. They need to stay on during a workout
and you need a good electrical connection to get a good, clean recording without much noise
and rubbish. I find I need to shave the spots where the stickers go and also rub with a fine
sand paper just a bit to get rid of any dead skin. The recorder has a preview screen so use
that to ensure the readings are stable and do not change if you move the leads.