Why I Agreed to the “Human Microchip”

I have been doing heart rate-based (HRT) training since April 2012. HRT focuses on the athlete training to certain heart rate zones rather than focusing on pace, speed, distance, or perceived effort. Read this post from RunRunLive for a great basic explanation.

Setting your heart rate zones involves a max HR test and threshold testing (at least the way I have done it). Mine have been revised since I started, but they currently are:

HR Zones

Signs of an Issue

From April 2012 through February 2013, my HRT was going just fine. The first sign of any issue was the Flash 12K on February 16, 2013, when my Max HR was 229, well above my aerobic capacity of 186. I sort of wrote that incident off as a fluke.

I became less able to call my HR issues a fluke during the Summer Trail series of 2014. Granted, running in Tallahassee in the middle of the summer is an invite to strenuous running, but it did not feel right. I had to stop and walk several times to allow my HR to come down when it climbed above 200.

As I wrote in my Turkey Trot 2014 Race Report, the HR issues became more pronounced and more frequent, especially at the Boston Mini Marathon and the Turkey Trot (then at the Swamp Forest Race on January 3, 2015).

The Process of Finding an Answer

Right before the Boston Mini Marathon, I had been cleared by a cardiologist after a ten-minute stress test and a cardiac echocardiogram. After the Boston Mini Marathon, I called him back and asked to reassess. That is when he referred me to an electrophysiologist.

Twice (at least) the first cardiologist said “at some point you may have to get a loop recorder.” Twice (at least) I said “oh if it comes to that I won’t go as far as to have something implanted under my skin.”

When I met with the Dr. Silberman, the electrophysiologist, he reminded me that “you can still stay fit without running.” (I know, all you runners out there ……. I hear you laughing at the screen!). To his credit, he also recognized that running is quite possibly saving my sanity. (Also, I contend that as a runner I avoid so many health problems that would make me costly to CHP: diabetes, blood pressure issues, problems brought on by unhealthy BMI, etc.)

He explained that the implantable loop recorder really is the best option to help him gather information. One likely diagnosis is Atrial Fibrillation (which is described here).

Since the incidents occur sporadically, some diagnostic procedures will not yield the data he needs. Therefore, I agreed to what my teammates and I have come to fondly refer to as “my human microchip.” It looks like this:

LINQ

 

(And if you want to see exactly where it is, click this link. I am not a fan of subjecting people to “wounds” or other TMI pictures on social media but by the same token if it helps with education, I don’t mind. (This picture was taken the day after implantation; it is a tiny little scar now.)

So Much Waiting

And now I wait. I wait while my microchip records (and transmits data to my electrophysiologist’s office nightly). I wait for an incident to happen so I can use my handheld “patient assistant” to mark the incident.

 

Next Steps

After sufficient data is collected to give the Dr. Silberman the data he needs, I have a couple of choices:

  • An ablation, in which the short-circuit is corrected via radiofrequency energy
  • Plan B (ps – I don’t know what Plan B is…)

Medication is not an option because my blood pressure is already on the low side, and most medications would exacerbate that. I assume Plan B would involve life style changes, such as less caffeine and less racing. I really don’t know right now.

Putting It All Together

This title may be mislabeled because this situation does not feel “together” yet. I can tell you the questions/concerns swirling through my mind:

  • It is strange when people describe the various heart rhythm disturbances by saying “one kills you instantly and one only heightens your stroke risk.” I simply don’t see the value of that “only” before “heightens your stroke risk.”
  • I have stopped drinking caffeine prior to my runs. In 2005, during a previous set of cardiac evaluations, Dr. Batchelor advised me to stop drinking caffeine. About a thousand gallons of Diet Coke (before I stopped in January 2013) and coffee later, I have to admit that he may not have been making a passing suggestion.
  • I am so grateful for the people who look out for me and who share their stories. For Shannon Sullivan, who was basically going to put me under house arrest until I asked the cardiologist who had just cleared me to refer me on to Dr. Silberman, for Mary Jean Yon, who has been so  helpful by sharing her story (and telling me to not be so conservative that I don’t get data!), and to David Yon who is the best, most supportive researcher you could possibly want on your side. All of them have encouraged me to a) stay healthy and b) not throw the towel in on running.
  • All of the technology involved in this process is simultaneously reassuring and question-raising. When I had my loop recorder implanted, the Medtronic representative was present. When I had my first in-office visit, he was present. What happens if Medtronic changes hands? (I know there will be contingency plans but I have seen a few awkward situations among my relatives who have pacemaker/defibrillators and can’t resist questioning.)
  • I miss running free of worry. I know I am fortunate compared to the challenges many runners face. It is simply not a relaxing or release-filled time for me in my running life.
  • I have to “let go” of so many concerns about what others think. Dr. Silberman advised if I am having an episode to lie down and get in a sit-up position to break the cycle of whatever is going on electrically for me. That just sounds like an attention-getter (but if it saves my life, who cares?). I feel self-conscious about the fact that I represent my incredible team, KR Endurance, but with the fact that my times are getting slower, not faster, what kind of example am I of the incredible work our coaches do?

I love running and the running community. Now that I have shared my situation with runner friends, people are coming out of the woodwork to discuss their own experiences. I am not alone in having a health challenge, and I know wherever this process takes me, I am fortunate to have the support of many people.

Now that I have a microchip, anyone want to put a leash on me and take me for a run?

Lisa’s CardioSmart – Let’s Send Her to San Francisco!

Lisa Sutton Cox with her son, Austin, and her daughter, Sara

Lisa Cox has always been one of my running inspirations. She has competed in the Escape from Alcatraz Triathlon, the Boston Marathon, and many other running and multisport competitions. Over the years we have shared stories about the challenges of being working moms, about the heartbreak of losing family members to cancer, and many other things big and little. She doesn’t know this but I used to try to match her cadence at intervals. We are roughly the same height so by some (probably faulty) mental logic I thought if I could turn my feet over as fast as she did, I may be as fast as her. That never happened but she was always a consistent, strong athlete to model myself after.

As a survivor of sudden cardiac arrest brought on by undetected Coronary Artery Disease, she is now giving people in a much wider circle than the one we ran around and around during intervals an opportunity to become educated about this issue, to know how to save lives through CPR, and to know that life with Coronary Artery Disease is a lot more complicated than it is without CAD but can be just as (or more) fulfilling.

Lisa has an opportunity to tell her story in San Francisco as part of the CardioSmart Conference if she is one of six nominees to get the most “likes” or “comments” on her picture. If you don’t have time to read this whole post, please consider going to this link and clicking “like” or leaving a comment.

Voting ends at midnight EST on 12/3/12 so please take a moment to vote now!

If you do have time to keep reading, I think you will be as intrigued and inspired by Lisa’s story as I am. Here it is in her own words:

This past summer, I went for a run with my friends.  I went into sudden cardiac arrest – my heart stopped beating.  My friend, Jamie Harris, immediately began CPR.  Jamie saved my life.  Statistics show that only about 5% of out-of-hospital sudden cardiac arrest victims live through the experience and I am one of them. 

My medical team found that I had 99.9% blockage in a main artery and 80% blockage in a second artery.  I had a double bypass.  Of the 9 risk factors listed by the American Heart Association, only 1 applies to me.  My one risk factor is heredity.  My father had a quadruple bypass at age 67 and 6 of my mother’s siblings had heart disease, for which they had bypass surgeries or died.

I have made changes in my diet, learned CPR and spoke out about my heart disease because I feel it is my responsibility to tell others so that people are aware that you can appear healthy and have undetected heart disease.  I hope that by enrolling in a PRE-DETERMINE study, the medical community can study my case and find information that will help others before they have an event like I did.  I am very grateful to have the love and support of my friends and family and to be here to enjoy more time with them.

Less than two months after her cardiac incident, Lisa (in red) won third place as a walker in the “Critter Run” in Dothan, Alabama. Jamie Harris (in the sunglasses) administered CPR to Lisa when she had Sudden Cardiac Arrest.

Lisa’s support network has grown exponentially since her cardiac incident and subsequent   bypass surgery. Below, she is pictured with her cardiologist, Dr. Wayne Batchelor and Ann Brinkman Carstensen, Executive Director of the Alpha Phi Foundation.

Red Dress Gala 2012

To wrap things up, please take a moment to go to this link and “like,” comment, or share Lisa’s picture. If Lisa gets the most likes/comments/shares, she will have the opportunity to attend CardioSmart’s conference in San Francisco in 2013. Long after the votes have been counted, though, please keep in mind the fact that sometimes heart disease can lie silent. Visit Cardiosmart’s Heart Disease Risk Assessment Tool now to assess your own heart health!