Author + information
- David J. Moliterno, MD, FACC, Editor-in-Chief, JACC: Cardiovascular Interventions∗ ()
- ↵∗Address for correspondence:
Dr. David J. Moliterno, Department of Internal Medicine, University of Kentucky, 900 S. Limestone Avenue, 329 Wethington Building, Lexington, Kentucky 40536-0200.
Maybe you noticed there was not an Editor’s Page in the last issue of JACC: Cardiovascular Interventions. Dr. King did a great job of getting an Editor’s Page into every issue (or nearly every issue) during his tenure. It was surely easier when the journal was published monthly, though even when the journal moved to being published twice monthly, he kept up. As for my inaugural year, I did not plan far enough in advance. So when I took some vacation time recently, there was nothing written in advance to put into press. And on my vacation, there was not the possibility of penning a page. Well I am back, and I hope each of you had some protected time for a vacation during the last weeks of the Northern Hemisphere’s summer.
The older I get and the more endorphins I seemingly need, my hobbies and vacations are becoming more like cardiopulmonary stress tests (and fortunately I keep passing!). I have 2 sons, and as they were growing up, we would try to find time each summer and each winter for an active vacation together. Winters often involved scuba diving trips in a tropical retreat (and my wife loves the beach, so everyone was happy), and summers often included a bicycle trip that involved history, adventure, and great food. Some of our earlier active vacations included bicycling day-trips, in parts of the western United States, eastern Canada, northern Italy, and southern France. As my sons grew older and we all became better conditioned, the cycling distances lengthened. The day trips evolved into multiday trips that had us riding across Vermont and into Canada or across the Czech Republic and into Austria. For each of us the physical challenge was actually part of the fun—and a great excuse to eat more good food along the way.
My sons are now college-aged and busy with life’s happenings, so my riding vacations over the past few years have been without them though with new friends from around the country. The trips continue to be adventurous, and somewhat by selection, progressively more challenging. Whereas the weeklong trips of years past covered long distances with my sons, they were often supported by a taxi shuttling our luggage to the next town’s bed and breakfast or restaurants making sure we had our tanks filled. I then bought a stronger, heavier bike for adventure touring (steel frames can survive better and are more easily repaired than aluminum or carbon) and moved to the next level, so-called self-contained cycling. This involves strapping everything you need or want to your bike—and you learn to decrease both need and want because you have to haul it yourself. My first couple self-contained trips were on paved roads and relatively flat terrain. These were great new explorations learning how to plan and manage for different types of weather, geography, and supplies (and yes food). With a 30-pound bike and another 30 pounds of gear, these pedaling vacations really burn the calories and make for near instant sleep-induction when hitting the pillow. In the quiet of a country road and with a moderate incline, I could sometimes hear my heart pounding, smoothly, steadily, and without complaint for a prolonged enough period of time that I knew all was well. My wife still laughs when I relay some of my bike-camping stories, saying how ironic it is that now I can stay in whatever hotel I might choose, but I am rather content to be in a tent in a field eating a campfire meal.
A few summers back, I ratcheted up the challenge akin to the Bruce protocol. I added incline by heading to the Canadian Rockies. It was, indeed, a calorie-burning marathon with hot days and cool nights. At times it felt like I was topping out the Bruce protocol-equivalent if not in percentage of incline, then in metabolic equivalents achieved. No inappropriate clamoring from the cardiovascular system, though I think my leg muscles wanted an even higher cardiac output once they were maximally vasodilated. Last year, I rode in the same general area, except I traded in the on-road course for an off-road segment of the Continental Great Divide route (from Banff, Alberta, to Whitefish, Montana) complete with a fat-tired bike (Figure 1). And this year I had not necessarily wanted to increase the physical demand over last year’s trip, but I did want to continue the exploration southward along the Great Divide route. So I rode the Alpine Section through Colorado. This was terrific fun with beautiful scenery and more great climbs. The one thing noticeably missing (and for me was another step up in the stress test of bike trekking) was oxygen. Well, oxygen was there, just not as concentrated as my body is accustomed to in Lexington (978 feet above sea level). Climbing Boreas Pass, a gorgeous route out of Breckenridge, Colorado, I repeatedly reached my cardiopulmonary limit. My heart was willing. My legs were willing. I simply could not breathe fast enough. Fortunately, nearer to the summit the percentage of incline leveled out. At 11,482 feet, the barometric pressure there is around 500 mm Hg (instead of 760 mm Hg at sea level) and there is roughly two-thirds of the oxygen (per volume) than at the ocean’s shore. Still, no unexpected symptoms as evidenced by the answer I gave to one onlooker at the base of Boreas Pass when asked why I was riding with all my gear over the pass—“I guess because I still can.”
There is no great moral to this piece of my life’s story, but rather some encouragement to each of us to be sure to regularly protect some off-time, enjoy it with family and friends, pursue a side passion even if it is part vacation and part stress test—because we still can.
- 2017 American College of Cardiology Foundation