Coughing Pink Frothy Blood

Last week on Tuesday night I was doing some horizontal exercise and at the end of the exercise session my lungs started to fill up with blood. I could feel my lungs filling with every breath and then I could hear the gurgling coming from my lungs. I coughed then swallowed and tasted blood. I did this a couple times before I coughed into a tissue and could see the pink liquid froth. I immediately got up and started coughing into the sink. After a couple minutes I called the advice nurse at Kaiser Permanente and since the coughing and blood stopped we agreed to monitor the situation until the morning. My primary care doctor did not know exactly what it was and thought maybe it either was a heart condition or was acid reflux and prescribed medication. Since I am an asthmatic I know my lungs and told her no-way- I could feel it filling my lungs and my breathing became difficult until I coughed and cleared them. After researching the web- I thought it was pulmonary edema which can be associated with heart failure or left ventricle congestion. She agreed that it could be transient pulmonary edema that had resolved. This has been reported to occur for unknown reasons during (after) sex or exercise (running without warm-up). More reports have been from triathletes as it is known as SIPE (swimming induced pulmonary edema). The web has been a wonderful tool for investigating this situation. I insisted on seeing a cardiologist to make sure some virus in years past did not cause lasting damage to the left ventricle of my heart. I got a referral to see the cardiologist.

I saw Dr. Ethan Daniels at Kaiser Permanente in Santa Clara CA. It was incredible- I told him about my diet and I thought I was going to have to defend myself. I told him I am doing a low carbohydrate diet. It clicked! He said "That is the best diet out there!" WOW- I found a low-carb Doc! We chatted about different diets and then he threw down the challenge- He set a number much higher than my goal and said I will schedule an appointment in 1 year to make sure you hit this goal and maintain it! He did his normal check up and an EKG and all was fine. Then ordered a Stress-Echo for the next day. I felt really confident in this Doctor- he knows his stuff! I came in for my Stress-Echo and read up about the Bruce Protocol but this lab did it a little different using a higher stress test ramping faster in intensity. I wanted to try to do the full test- but the doctor monitoring the test said even some Navy Seals have trouble with the full test. I am in no condition- since I have not been working out that long- plus I don't run- I ride a bicycle. But the test is a thread mill test. I know I am not a runner- I have asthma and have always had trouble breathing but I gave it my best shot. I told them I was going to finish the test. I think I surprised the technicians and the doctor as I passed stage 4 into stage 5- I had to start running. Instead of pushing me they started to try to talk me into stopping- I am sure I could have went to stage 6 and maybe stage 7...but I was more than half way through stage 5 when they finally got to me and I agreed to stop the test about 15 or 20 seconds short  of stage 6- I was above my maximum calculated heart rate of 175. I hit 190 BPM and was breathing very hard but not wheezing- I think my supplements are working. This test was HARD! I laid down and they did the ultrasound. GREAT NEWS! NO ISSUES FOUND! I think they thought I might collapse or pass out- but it did not matter much since my heart was pretty much maxed out but I thought I had room for more!

Here is the protocol from what I could remember: I was at 18% grade going 5 mph for about 90 seconds about 9.5 minutes of testing. Wow- that was an awesome interval workout- it took me at least 10 minutes to settle down from that stress level and get my breathing back to normal. I felt the stress the next morning as I woke up hungry- which does not happen unless I fast, plus I ate more than I should last night...I will definitely have to try this again in the gym- 10 minutes of exercise and I was hammered!

Modified High Stress Bruce Protocol

Stage	Minutes	% grade		MPH
1	2	10		1.7
2	4	12		2.5
3	6	14		3.4
4	8	16		4.2
5	10	18		5.0
6	12	20		5.5
7	14	22		6.0