Doctors for athletes

A couple of months ago I made it in for my annual physical. It's been 2 years...oops. And I have not had any blood tests done in over 2 years....oops again. No, I don't have a needle phobia, or a white coat phobia (I would be out of a job if I had the latter). I am feeling really healthy and I did not see a need for these tests. I eat healthy, I have pretty good genes, I rarely get a cold, I sleep, I exercise. I have tons of energy. Anyhow, I got the blood tests done. Everything was normal, except the liver enzymes, which were higher than the average range. When I got my results letter, the values were listed as abnormal, but there was no explanation. I checked on line and got nervous about potential causes for the abnormality which ranged from Hep B to liver cancer. Then I looked at symptoms and causes, and they did not sounds possible in my case. Then I remembered that I am a runner. And the blood tests were taken the day after Derry, where I worked super hard. So I went on Medline and did a search about running and liver enzymes, and found that, indeed, athletes have high liver enzyme blood test results after strenuous exercise, where there is breakage of muscle fiber. And boy there was breakage of muscle fibers in that race! Bingo! I emailed my doctor about this, and she said I should repeat with 24-48 hours of no exercise. I did (with 24, cause there was no way I would take 48 hours off for a blood test when I feel good), and enzymes were much lower, with 1 unit over the upper limit, which is good enough for me. The funny thing is that the enzyme levels was lower than in 2007 when I had the same test done, and results were deemed normal. Yup, they changed the ranges in the meantime. So my doctor wants another repeat. She also mentioned that if exercise causes this increase, perhaps I am exercising too much. This made me laugh, because, really, I run 40-50miles/week, and swim 2-4 miles. That is NOT that much, compared to what most of you do. And this brings me to a conversation I had with my mom the other day. She mentioned that in Romania there are special sports doctors now that specialize in treating athletes (not to be confused with the sports medicine docs here, which are mostly orthopedists who you see if you are injured, etc). They are basically PCPs for athletes. How cool is that? We know that athletes' bodies and organs change a lot due to exercise - heart gets bigger, hear rates get lower (my resting HR is 40!!!!), blood pressure is lower (90/50 on a good day for me), etc, etc. I have not researched this, but I am sure blood test values change as well, particularly in those who spend most or all of their time training. I would like to see doctors become familiar with these issues and take them into account when treating athletes. I do like my doctor, and I like that she is thorough. But the comment about exercising to0...that made me laugh!