Wednesday, September 22, 2010

Training Setback...ticker trouble (part 2)

When I last left you, dear reader - I had just received a diagnosis of atrial flutter, and was about to schedule a procedure to correct it. After numerous phone calls with the medical office, and hours of frustration and waiting, I was finally given an appointment for my procedure - September 26th.

I arrived at the hospital bright and early (as instructed) having neither eaten nor drank since midnight the night before. My clothing and belongings were taken from me, and I was given a pair of surgical scrubs to wear. I waited in the surgical waiting area from 10am until almost 7:30pm, still not allowed to eat or drink. I was finally brought into the cardiac cath lab, and a team of surgical staff descended on me, to prep me for the procedure. Electrodes were placed all over my body, wires connected, needles inserted, various body parts shaven - my last memory was the anesthesiologist promising me a cocktail that I would enjoy.

I woke up in recovery some 4.5 hours later, my first vague memory being one of physically fighting with the nursing staff, and having to be restrained. I am told (I don't actually remember this) that I repeatedly told the nursing staff that I was "So sad" and that I felt like I had been hit by a truck. I also recall begging for ice chips, receiving them, and then vomiting uproariously. I have vague memories of being transferred to a room on the cardiology floor, and given instructions not to get up or move for 6 hours.

The following morning, I was met by the surgical team, who informed me that the procedure was not successful. They wanted to try again, a week later - and prepared to discharge me with several prescriptions - and a plan to return in one week's time.

The second procedure went a lot smoother from a logistics perspective. I was admitted at 7am, and promptly brought into the surgical theater. The procedure took around 4 hours again, and I woke up in recovery, feeling a lot better than the previous time. This time, I was told that the procedure was successful and I was transferred back to the cardiology floor for bedrest and observation.

Several hours after the procedure, I was told that while the arrythmia they had set out to treat had been fixed, this time I had developed a second arryhtmia, called atrial fibrilation. I was warned that this was a possible outcome - and that the plan was to treat this arrhythmia using drugs, and allow the heart 30 days to recover from surgery, in hopes that it would naturally return to normal rhythm.

My 30 day recovery has almost ended. I am pleased to note that the arrhythmia has been kept under control with medication, however, it also makes running very challenging. One of the effects of the heart meds is to slow my heart rate - so when I am running at a pace where my heart rate should be 160, it is actually 130. The effect of this is that my body doesn't actually receive enough oxygen, and my muscles start to feel like dead weight.

I have recently returned to running, with the limitation that I must run at a pace that is appropriate for my new, lower, chemically induced maximum heart rate. It's a tough pill to swallow (ha) - but I'd rather be able to run slowly than not at all. I completed my most recent 18 mile training run, at approximately a 12 min pace (I would have normally run at a 9:30 - 10:00 pace for this distance), so I plan to move forward with my training for the marathon.

I have a pretty full calendar of long runs between now and the race, and I am optimistic about what will happen between now and then.

If you read this far, I appreciate your caring - and will keep you informed on how I progress.

Tuesday, September 21, 2010

Go Joe!


Inspired by my last blog post, my friend Neil made this for me. I love it!

Sunday, September 19, 2010

NYC Marathon Tuneup

Today was the NYC Marathon Tuneup, an 18 mile NYRR Training run. This was an important run for me, because I decided that if I can complete the run today (regardless of the pace), I'll continue training to run the marathon. Conversely, if I didn't finish, I would officially drop out of the marathon.

For those that had been following along at home, I'm currently on a bunch of heart meds, following a catheter ablation procedure that I had about a month ago. The effect of all these meds is that they keep my heart rate low, which is a bit of a problem when running. Generally, my heart is in the 150 -160 bpm range when doing long runs. Under these heart meds, my heart doesn't go much faster than 130 bpm no matter how fast I go. The net effect is that my muscles don't get enough oxygen, and start to feel like dead weight. If I wanted to succeed on this long run, I was going to have to take it slow, and just hope for the best.

I headed down to the race with Sharon, my old training buddy. She had her own plans for the day, but was going to join me for the first 6 miles. We ran into Josh at the race, and we headed for the corrals. We started off at around a 10 min/mile pace, which is a bit fast for me under the current circumstances. I let Josh and Sharon go at Mile 3, and settled in for what was going to be a long day.

The race is 3 laps around Central Park, for a total of 18 miles. I had to do some walking in the later parts of lap one, and started to have doubts about the rest of the day. Right around Mile 4, a runner (who looked a lot like Howie Mandel) came up from behind, and yelled "Go Joe" (it was written on the back of my shirt). We stayed together for a few minutes, and I mentioned that I had just gone through heart surgery 18 days ago. Suitably impressed, he wished me luck in the run - gave me some much needed encouragement, and kept moving. I did my thing for the remaining miles of loop 1. Fortunately, I ran into Mark (my training buddy from Phila, and fellow Flyer) right around mile 6. He was gracious enough to keep me company for the second loop, and entertain me with stories from his recent trip to Thailand. We stayed together through lap 2, and the first mile of lap 3. At this point, the wheels were definitely starting to come off - so I let Mark go ahead, promising him that I'd finish the run today.

Loop 3 was a tough loop for me, as I went through the gamut of emotions: anger for being limited in what I can do, fear about not finishing, hope, you name it. At this point, I really started to get strength from the other runners out on the course. I chatted with an attorney who was training for his first marathon, a PR guru who was training for his first Ironman, and a bunch of other people along the way. I really got the feeling that we were all in this together - and that we would do what it took to encourage each other to keep moving.

Around mile 17, I ran into Howie Mandel again - he was on his 4th loop of the park. I picked it up, and ran with him for a bit (only to realize that I had more in the tank than I really thought), and coasted it in for a 3:37:09 finish. Obviously, these are not the numbers I was hoping for 6 months ago - but under the circumstances, I feel fortunate to be able to run - and grateful to my fellow runners for keeping out there and enjoying it today.

Tuesday, September 7, 2010

Training Setback...ticker trouble (part 1)

I realize that I did a somewhat half-assed job at letting people know about my most recent training setback, so I thought I'd take a bit of time to tell the whole story. My apologies to the folks that I have been unduly alarmed by all of this.

As many of you already know - I am currently in training for the NYC Marathon, which will hopefully be my third marathon. On July 13th, I was attending speedwork with my usual Tuesday night group - when I realized that something wasn't right. I wasn't able to complete our assigned workout without stopping to walk several times (which has never happened before). I definitely felt as though something was wrong, I just didn't know what. I happened to have been wearing a heart rate monitor, so I knew that my heart race was excessively high (greater than 200 bpm), also something that has never happened before.

Thoroughly spooked by the experience, I promptly made an appointment with my physician. He took an EKG, which registered completely normally - but encouraged me to follow up with a cardiologist. I was given the green light to continue running, and two days later, I raced a 5k with my co-workers. While I didn't PR at the race - I felt that I was able to run comfortably, at a pace that was just right for me.

The next few weeks brought very inconsistent workouts. Some days, I could run for miles and miles without issue, other days, I could barely keep a pace for one or two miles without having my heart go crazy. Additionally, I started having what I believed were palpitations, where my heart started beating very quickly and felt like it was going to leap out of my chest, even while at rest.

My first visit to the cardiologist was uneventful - I brought a stack of printouts from my Garmin, showing the different types of workouts I had been running, and showing concrete evidence of my exceptionally high heart rate. Unfortunately, an EKG yielded a similar, completely normal heart rhythm - which didn't give the doctor much to work with. We scheduled a stress test for the following week as a follow up.

Finally, at the stress test, the doctors were able to trigger the heart rhythm that I had been experiencing, which was promptly diagnosed as atrial flutter. Atrial flutter is a "short circuit" of the heart's electrical conductivity, which causes the upper chambers of the heart to contract very rapidly, often between 200 and 300 bpm. A follow up visit to discuss the results of the stress test was scheduled for the following week. At the follow up, I was experiencing flutter (while at rest), which was subsequently captured on another EKG. This prompted a referral to an electrophysiologist, a doctor specializing in treating electrical abnormalities of the heart.

I went to see the electrophysiologist the next day. She confirmed the existence of the flutter, and recommended a surgical procedure called RF Ablation to correct it. Given the fact that my episodes of atrial flutter had been occurring with greater frequency, and while at rest, it was recommended that I schedule the procedure as soon as possible. I left the office, and set off to schedule the procedure for the following week...