All of this overlies the heart problem that was diagnosed back in 2021 and which I am still waiting for a proper explanation of. The HIT session was intended to get my heart rate up since personally I think that is a problem, and while last year my heart rate had been dropping below 30BPM every night and the smart watch stopped recording, this year things seem a lot better and I've only had a very few days with 30 in the spreadsheet from the watch, which the finger probe backed up with 26 and 27's.

The latest session I managed to hit 149 during the first two 30 second sections of the hit, but then it dropped back to around the 100 mark so most of the rest of that section was 'zone 1' level. The exercises don't change, but the results vary hugely day on day. I am planning to have a proper discussion with my GP when she as the latest results in, although I am still waiting on an appointment with the hospital physio team to assess the current state of may knee. That and the cardiac consultant should be seeing me for an annual review. As always ... we just wait ...

Sugar content can be a problem, but most of what puts me over on that guide is down to the natural sugars in the fruit element, which I try to make two of my five a day. It would be nice if the health application on my Samsung phone did a much better job of tracking five a day amongst other things. The nutritional data it uses is very hit and miss on some key elements, such as fibre and with the newer drive for 30 plant different elements a week is just another area that needs addressing. Adding fruit like bananas gives a big hit on sugar and calories which means cutting down elsewhere which can be difficult.

Returning to the ongoing problem with my arm. The lack of help from the GP's physio in providing useful exercises has meant I've been browsing online and have added my own steps to the morning physio which seem to be having an effect. It even begs the question about the level of Naproxen I need to take. I've dropped to a single tablet this morning and while my arm is uncomfortable, with tingling in my fingers, it is not the eye watering pain that I was fighting 10 days ago. One of the arm exercises does prompt movement pain, so I am happy that I know where I am and while the mobility in my left hand is still limited, I can at least use it better for things like wringing out the flannel while washing. The videos point out that the nerve paths need exercise to help reopen the tight areas and perhaps that is something that my NHS physio should have been helping with?

Sleep is still erratic, and I have had a few spikes in my HRV over the last few weeks. Of cause staying awake to watch the snooker last night did not help ... and the watch is still struggling to record blood pressure, but things seem to be trending back to an HRV in the 'normal' range which I had not been for most of last year, but had hit nicely prior to the arm problem. I'm still fighting problems that could be called stressful, but despite the watches insistence that I need to reduce my stress, I am comfortable that stress is not a problem. Being able to think through things is perhaps something I need to reduce over night, and 'meditation' exercises could help with that, but the question really is if the high HRV is down to over thinking in bed, or triggering those though processes. Which comes first and if I solve the problem will my sleep improve more?

After three weeks and with my GP saying she had run out of options that I could take due to my heart problem, I ended up in A&E again on Tuesday. Had to get myself over there and did not consider the bus vibrations would be a problem, so I ended up getting off as soon as we hit Worcester. As it turned out, there is a footpath from the bus stop through the wood at the back of A&E. Little over a mile, but I still needed to get my steps in so worked nicely. Fun getting back through the wood in the dark after 6 hours inside, but fortunate that the Evesham bus was running late as it turned up 3 minutes after I got back to the bus stop.

Got triaged very quickly when I went in and when offered 'pain relief', the triage nurse ignored my point that it had not been working, and put me into the 'minor injuries' queue. After waiting 2 hours I chased to see what was going on, and was then seen by a 'nurse practitioner', who put me back on the main list and finally pushing me in for an ECG and bloods which should have happened when I arrived given my heart medication. The doctor then saw me quite quickly after the ECG had been completed and sorted an dose of Naproxen to address the pain. ECG was messier than it has been but in line with what I was seeing caused by the Nefopam. We had to wait on the blood results even though they would probably be clear given the ECG, and by the time those came through I was the most comfortable I'd been in the previous 4 weeks! Had to wait a little longer for tablets to take home but those were not long. As I said the walk back through the wood was more fun, but only about 400mts without any lights, then on light paths.

I've got a physio appointment later at which I hope to address the restricted movement that I've got in my left arm, which is still not 'pain free', but is manageable. I have a 20 minute physio routine for my back and leg problem, but need to add some shoulder and hand exercises to that, and today's walk was more comfortable than I have had for a while and I could even swing my left arm rather than supporting it in my pocket.

Fingures cross things are moveing the right way ...

Something else that I have realised is that the problem I had with my breathing while talking had returned while I was taking the Bisoprolol Fumarate again, and since that tablet had been in my cocktail since day one, it probably explains why I was having that problem long before the actual heart condition had been diagnosed. With a cocktail of drugs, just how does one ascertain which side effect is caused by which drug? I am still trying to get a proper meds review and a discussion on the other drugs such as the statin which I think is the source of the elevated liver function results. That is not needed to control my cholesterol so just what is the point of taking it. The doctor who insisted that I needed it admitted THAT fact at least, but never gave an alternate reason other than some government target!

Still having trouble getting my elevated heart rate exercise target back where it was before the month on Bisoprolol Fumarate but it seems if I take my walk later in the day I get better results, so again, is the morning cocktail of drugs wearing off by then? Lets see if I can actually get back to 150 minutes over a full week by walking later.

After Xrays on left hand and right knee no breaks were obvious, so just muscular problems which has been the problem with my knee since it became a major problem in January 2024. The morning physio keeps it moving and also keeps my old back problem under control, but that was difficult to handle this morning with both left hand and right shoulder complaining at some of the exercises. I did not manage to get my pulse rate up either which was the problem that having restarted the Bisoprolol was aggravating. At least the emergency doctor did an ECG and that was similar to the one done last time I was in A&E so he was not concerned and confirmed that stopping the Bisoprolol again WAS the right step. He had also got a previous ECG which showed a clean sinus rhythm, and was asking what had changed, to which the response as always is 'nothing'. He has put some notes on my records to poke cardiology to take another look ...

Today my left hand is obviously swollen, and after my exercises my shoulder is also uncomfortable, yet my knee seems to be back to it's normal level of discomfort. Time for my hair-wash and then I'll get out for my daily walk and see how that goes. Need to get my pulse rate up to help keep my weight down. It's jumped a kilo since yesterday morning which is an irritation, but I did not get all of my exercise in yesterday which would not help. That and I pigged out a bit on a nice tea which was too many calories :)

So I've been given the OK to stop the Bisoprolol Fumarate again, and it will take a few days to get out of my system, so lets see how I'm feeling over the weekend. At least I've got the distraction of the Midland's Model Engineering Exhibition to attend, even if there is no money in the kitty to buy anything to add to the projects. Some more parts have already turned up so I don't really need anything else, but it would be nice to work out what holes I need to plug in relation to the projects already 'in stock'.

I would like to start cutting back on a few of the rest of the cocktail of drugs, such as the statin and some of the blood pressure/diabetes ones since I'm no longer classified as diabetic and my blood pressure has been well under control since loosing all the weight. The Samsung Watch8 has been struggling monitor many of the things it was bought to track and blood pressure is one of the things it fails with along with tracking my sleeping heart rate to monitor sleep patterns ... which it also fails on when my pulse drops below its 30BPM lower limit! So while it was not much better before the drug change it will hopefully at least know that I AM sleep which it has failed to do several days in recent weeks. So much for 'Artificial Intelligence', when it can't spot simple patterns and keeps push for things that I don't think *I* have any control over. At least I have a spreadsheet against which to compare the next 4 weeks observations ...

That was yesterday. Having had another interrupted nights sleep, I was awake at 5AM reading. The continual push by the Samsung health apps that this must be down to stress perhaps does not help along with it's insistence that I need to go to bed and wake up consistently! I am happy with my nighttime routine and have been going to bed at 9PM for the last year. I then get comfortable with a book and put some music on, classical at the moment, and read. Over the last week I've been putting the book down at 10PM despite the fact that I am getting near the end of the latest McCaffrey Pern one. One of Todd's additional works to Anne's excellent collection. Wanting to finish is perhaps a little stress that woke me up this morning? But it's the idea that I have some control over WHEN I wake up that irritates.

Getting to sleep is not too much of a problem when I put the book down but the earlier switch off time just means that I am earlier being woken for a toilet break. It bedtime incontinence down to the diabetes? Well that has recently been crossed of my medical record so there must be some other trigger. The new Watch8 does have more gaps in it's sleep record when it reports 'I should wear my watch all night', but I have been. That it can not cope with my more complex heart rhythm is simply a fact, and it has recorded my pulse rate overnight even when it has no sleep record. The problem seems to be that my rate has dropped below it's 30BMP limit for too long?

Do I get enough sleep? Well I am not tired during the day even after my various exercise sessions. Am I getting a good nights sleep? As I am not sleeping through then the answer has to be no. My short term memory has been a problem for some time, and even with the steps I put in place to ensure things like taking my tablets, I still occasionally miss having them at the normal time. Is part of this down to not getting a good nights sleep is the question. I am fairly sure that for the short times that my heart HAS been in sinus rhythm over night I have slept better, and I think I remember that I have written that before, but I am keeping up these logs because I can't rely on remembering things.

So do I need to reduce my stress with Mindfulness and Meditation? My problem is that I do not feel in any way stressed, although others have commented that what I am dealing with could be considered as stress. The battles with the software running this site is ongoing, and thoughts about the next fixes are certainly in my mind when I wake up. Sleeping on it, taking a break to exercise gives me an opportunity for that massively parallel relational database to connect the right pieces of information, and I will get back to the latest bug in a bit. So I don't see meditation as another useful addition to my routine at the moment.

Just have to wait on the latest test results to see if the statins are still affecting my liver function and I hope get the go ahead to simply drop them. My cholesterol has been classified as 'a little low' for some time now and my diet has little problem fat in it. Then perhaps we can look at the other tablets, but I am not stressing about any of this. Just biding my time once again.

The Watch8 has been less helpful than I had hoped. For one thing it has actioned things like switching the phone to 'Do not disturb' when I was waiting for a call which I missed, and then I lost 20 hours of data as it had switched to power save mode. Problems I never had with the Watch4. I still can't get it to calibrate the blood pressure mode and is't new vascular test has also failed so far to gather 3 nights of data as a base line. I probably do not have grounds to complain as it has been made clear that neither watch can come with erratic pulse rate. None of my monitoring devices produce results that a trust since currently my heart is in it's 2 pulses then baulk mode. My rhythm is actually fairly stable, it's just that the gaps between good pulses varies substantially. The two good pulses are about a second apart, then there is an almost 2 second gap to the next good pulse. The 'pulse' in between is just messy and one can not feel a pulse manually. Using the blood pressure cuff I can feel and see on the display the interrupted pattern. Is it an actual problem? I don't know, but having got use to the discomfort in my chest I just put up with it. It is annoying that I DID sleep better for the couple of weeks that I was in clean sinus rhythm and I just want to get back to that! The one thing that the Watch ECG is consistent with is "You had an irregular heart rhythm other than atrial fibrillation." while my health professionals say I do have atrial fibrillation.

Is the exercise helping? Well I try and complete the same basic patter each day to meet my 'targets', but my body does not help. Yesterday I managed 45 minutes of Raised HR activity, something that the watch IS displaying which the Watch4 did not. 10 minutes of that was during the 20 minutes of physio, but today I barely hit 30 second. Some days even after my 50 or so minutes walk I have hit the 20 minute mark, then on other days doing the same routine I'm lucky to top 10. Over the week I am hitting the recommended 150 minutes added to which while I have averaged the old 10000 steps at times, I have no problem with 8000 a day. I'll get out in a bit and do today's, but waiting on DPD delivering a replacement for the failed TV which is due in the next hour, so I should be out on time.

One thing that has been going right is my weight and I am now down below 71.5kg which I set as the latest target. Have to keep calories below 1700 otherwise it just goes up again and it would be nice if I could reliably exceed the exercise calories target to perhaps let me eat a treat more often, but I will aim to slide below 70Kg before Christmas so I can pig out a bit!