Then, somehow, from a place beyond sense or strategy, she breaks forward, unpinned from her body’s flaws and marvels. It’s only courage that takes her the final distance. Only grit. ~Paula McLain
As I was struggling through a 4-mile run last week, I was listening to Circling the Sun by Paula McLain. Horse racing is one of the main topics of the book, and the protagonist, a rare female trainer in the 1920s, needed her horse to win. The horse had started out strong, but was not in the lead as the end of the race approached. The passage above describes how the horse found her reserves and transcended what she was physically capable of in order to win. She became unpinned from her body’s flaws and marvels, buoyed by courage and grit.
My body’s flaws are winning over courage and grit, and I am trying to figure out how to get them all to make peace with each other.
Since April 2015, when I had an electrophysiology study after which my physician decided he could not do an ablation, the plan to deal with my multifocal atrial tachycardia has been to take a beta blocker a half hour before each run.
After having my procedure on April 6, 2015, I went on my first mile run on April 14. It took 14:06 to run 1.06 miles (13:17 pace). My average heart rate was 143 and my max heart rate was 153. On June 4, 2016, about 14 months later, it took 57:42 to run 3.16 miles (18:16 pace). My average heart rate was 138 and my max heart rate was 197. Both times (all times between now and then), I had taken my beta blocker a half hour before starting the run.
Although there have been a few brief visits to the sub-13:00 per mile speed over the past 14 months, it has been far more typical for my average pace to be in the 14’s, 15’s, or 16’s. For me, running on beta blockers is like running through mud.
I suppose my hope after the electrophysiology study, once I knew there had been no ablation and the ongoing plan involved medication before every run, that I could reach some consistent “status quo.” It has taken me the whole 14 months to begin to let go of my years-old goal of running a sub-30 5K, but as time passes the question becomes “where does running fit for me at all?”.
Is running still good for me physically?
Although I am fortunate to have an electrophysiologist with a great way of explaining things and a respect for the sport of running, he also says, “you know it’s not necessary to get your HR up to 160 (or whatever…) for it to be a workout,” right?
He’s right – I can get a good workout in a multitude of ways that don’t escalate my heart rate like running does.
But they are not running!
Nothing I have read online, no doctor I have spoken to, no one I know who has tried to combine running with an arrhythmia situation really has the clear answer.
Probably the best summary is: running while experiencing tachycardia is not generally as dangerous as it sometimes feels. BUT given that my EP thinks mine is likely to convert into atrial fibrillation (which increases stroke risk) over time, and the fact that I usually run alone, and the fact that I have to err on the conservative side because I want to be around to see my kids grow up, I think I have to assume that running to the point of abnormally high heart rate is not necessarily the healthiest choice for me. (Ironically, if it DOES turn into AF, I will be a candidate for an ablation again, and it is likely to work, but I can’t engineer that situation into being.)
What do people think?
If I had a dime for every time I have said, in all sincerity, to another runner or prospective runner, “you’re only competing against yourself,” “every mile matters,” or “you’re lapping the person on the couch,” I would be wealthy.
However, I would be totally lying if I didn’t say these are the thoughts that have dogged me over the past few months. At first, after the EP study, I thought I would reach that comfortable status quo, and just blend into the scenery at races, just log my usual refreshing and energizing training miles, just keep doing something good for my body (and mind) out on the roads and trails.
But that little “how can you still call yourself a runner?” voice in the back of my head will not stop its incessant pestering.
- When I post my times to DailyMile and people see it took me 18 minutes to run a mile.
- When I stop right before the finish line as I did at Gate to Gate and walk little circles off to the side while doing a Vagal maneuver to try to get my HR down from 197 so I am not running the risk of passing out in public as finish line adrenaline kicks in.
- As I tell people “really, no, don’t wait for me. I’m going to take FOREVER.”
- As I participate in races, trying to keep my feet running without my heart noticing they are while my head tries to mediate between the two
- As I stopped logging my food and gained back 25 pounds I lost while training for a half marathon (and obviously my cookies-every-day habit has nothing to do with my tachycardia except for the fact that I know my mindset and my eating choices are inextricably intertwined right now).
You Can’t Trust Technology Blindly Without Listening to Your Body Too
Even when you have the best technology, you still have to pay attention to your body. Back in November-December of 2015, I was seeing “high” readings on my Garmin. These readings, for example, led me to run/walk the Turkey Trot rather than solely running it at a moderate pace. I decided maybe the batch of metoprolol I had recently been given was “bad.” I called the Publix pharmacy which had dispensed it, which said it was fine. I called my EP’s office, which confirmed the readings from my loop recorder were fine. It turns out my receiver on my Garmin chest strap was bad (oops!). I ordered a new one and the problem was solved. Now I follow the care instructions for my chest strap to the letter (it has to be cleaned often to prevent salt buildup).
How do I still contribute to the running community?
Running pervades every single aspect of my life. If I’m not dressed up, I’m almost always in a race shirt. If I am packing for a trip, the running shoes go in first. If it’s a weekend, my review of possible activities always involves which races are being run. I am a running groupie, and running people are my favorite people.
I have commitments as a Fitfluential Ambassador, a Charity Miles All-Star, and as a runner for Gareth through I Run for Michael. I know Gareth’s family “gets it” because he also has an invisible condition (a mitochondrial disorder). I know Charity Miles has my back – I can walk/bike and/or keep running 18 minute miles and #everymilematters still applies because the causes we love benefit. Fitfluential is a bit more challenging. I can only hope that my choices during this frustrating interim period help someone else who is struggling know they are not at all alone and you can have a love of fitness without looking like a fitness magazine model.
While I suppose it would be an easier thing to discuss if I had a cast on my leg or some other outward physical sign of a health challenge, an invisible condition like a cardiac arrhythmia with questionable impact plays a different role in the multi-act play that is my running life.
I suppose I am at the intermission and the second act of this play has not been written nor rehearsed yet.