Five Magical Motivations to RUN

So many conversations I have had about running over the past few months as I have made modifications to deal with my tachycardia issues have ended (on my part) with some variation of “but I am still grateful.”

My goal of running a 5K in less than 30 minutes is almost certainly not attainable at this point. Maybe if I checked in to a fitness retreat, ate 100% clean for an extended period of time, trained intensively, put my life on hold and went without the medication that slows my heart rate down and makes it feel like I’m running through mud long enough to pull it off it would happen. It’s not realistic, though, time-wise or budget-wise to put my life on hold. I’m doubtful it would be a good choice for my overall health, and the mere fact that cupcakes exist in this world is some type of evidence that it is possible to deny yourself too much!

Motivations For Running

Enjoying Baked by Melissa “Snowstorm” cupcakes after a run!

Jane Mahoney, a runner in the Kerri On: I Run for Remembrance group, a companion group to I Run for Michael in which members run in memory of people’s loved ones, said this today, after describing a run she and some friends had done in memory of a fellow runner and friend who had died of cancer:

Running is a magical thing, giving solitude, peace, friendship, honor and joy to life. ~ Jane Mahoney

In that one sentence, Jane captured the assets of running which have enabled me, one by one, to put a knot in the rope and hang on when I was almost at the end of my rope with running the last few months.

The Solitude of Running

I won’t lie. Despite the social benefits (discussed below), I still love running by myself. Especially since I am a primary caregiver for my father-in-law and almost never have the house to myself, I love being alone. The repetitive footsteps are like meditation for me; my thoughts have a chance to unfurl and wander, and the fresh air is rejuvenating. I also have the pleasure of listening to various Rock My Run mixes (read here for how you can benefit the Leukemia and Lymphoma Society by downloading this free app!).

Peace

We have a number of scenic running trails here in Tallahassee. A few weeks ago, I went out by myself and ran the Swamp Forest trail in preparation for last weekend’s Swamp Forest Quarter Marathon. It was just me, the trees, gorgeous views of streams, streaming sunlight; and a few animals skittering and fro. No screens to be stared at, no one who needed anything, just peace.

Motivations For Running

The Swamp Forest Trail. Photo courtesy of Robin Bennett.

Friendship

Everyone who knows me knows I am a sucker for working toward a measurable goal. Even though I had heard about groups running from a local running store every Monday and Thursday night, I had declined to join for several reasons. Once a member told me the group was trying to get to 2016 miles in 2016, though, I was in! I joined them this past Thursday night, and Chris (the leader) said “I’ll stay with you.” Now, I have been told “I’ll stay with you” before and many times that commitment, which was sincerely meant at the time, goes out the window when the individual realizes how slow I am relative to them. Not this time. Chris stayed with me every step of the way, and the miles flew by. Three miles later I had a friend and a reminder of why the running community is second to none.

Motivations For Running

The Capital City Runners 2016 or Bust Group.

Honor

I didn’t attend the Gulf Winds Track Club awards ceremony last night, but as the names of the awardees (which are kept a secret until the ceremony) started rolling in on social media, I was thrilled for so many runners I respect who were recognized for their achievements. Although I am happy for everyone, I am exceedingly happy for my friend Maria Matheu, 2015 Female Runner of the Year. Maria worked so hard this year as she ran every race in the Gulf Winds Track Club Extreme Challenge series. Six of the hard miles were the ones she ran for me smack in the middle of a scorchingly hot Tallahassee summer when we ran from Madison Social to Capital City Runners and back, all for a free beer (okay, it was for more than a free beer but still….). She’s another one who said, “I’ll stay with you” and actually did stay with me. She had already run 8 miles that day, and only someone with a bit of a crazy streak would have headed out in the 100 degree heat index day, much less with someone who is going to take FOREVER to get it done. Maria proved (to me) who she was that day. She was (is) a friend. She honored her commitment. No one in our club deserves this award more than she does.

Motivations For Running

2015 Gulf Winds Track Club Female Runner of the Year, Maria Matheu

Joy

So much of 2015  has been spent staring at the screen of my Garmin, trying to figure out if my heart rate was going to behave or not. Over the past two months, it was reading exceptionally high. Skipping past the frantic calls I made to the pharmacist (is this batch of beta blockers bad?) and my electrophysiologist (WHAT IS WRONG WITH ME?!), it turns out my Garmin sensor needed to be replaced. Everything is still not perfect, but the malfunctioning electronics had me in a misguided  mental (and emotional) spiral of “this is never going to get resolved.” I have a new strap/sensor which seems to be recording correctly. When I ran with Chris Thursday night, I didn’t look at my Garmin for the whole run. Not fixating on my HR allowed me to be more open to the whole reason we do this: JOY.

Lastly, in addition to those five reasons, my son has started joining me at running events again. This may be pushing me even farther away from a sub-30 finish than my medical issues have, but it has me speeding toward something much more important: miles, memories, and, like Jane, a magical thing.

Motivations For Running

Billy Bowlegs 5K. Photo courtesy of Fred Deckert.

Inspire-Me-Monday-2-graphic

From Human Microchip to EP Study and Beyond

In the 24 hours leading up to my EP Study on Monday, I asked myself quite a few times if it made sense to go through with the procedure, especially since my high heart rate episodes only occurred when I was running. In other words, even though the risks are minimal, is it worth having a doctor thread a catheter up through my groin into my heart in order to figure out what was going on in there and to possibly “ablate” any problem areas?

For a recap of the history leading up to Monday, click here.

Now let's talk about EP studies.

Now let’s talk about EP studies.

To get to the point of today’s blog, we will fast forward past the referral process to get to the electrophysiologist, the initial appointment with the electrophysiologist, the implantation of my loop recorder, appointment number one with the electrophysiologist’s nurse, a between-appointments phone call with the nurse where I was instructed to begin taking two baby aspirin every night (I was already taking one) and appointment number two with the electrophysiologist’s Physician Assistant (PA), where I was given the choice of medication or an EP Study with Ablation. Because I was hesitant to settle for a medication-only option (I was concerned medication would make me more tired than I already am all the time and would not yield any answers), I agreed to proceed with the EP Study and Ablation on the premise that a) at least I would have answers and b) if I did get an ablation, I would be able to return to running with a likelihood of less risk, more satisfaction, and a relieved mind.

I reported to the hospital at 7 a.m. on Monday, and did a combination of laying around, prepping (there is some cleaning with grown up baby wipes to be done), having a baseline EKG taken, having baseline vitals taken, chatting with the anesthesiologist, a visit from the PA, and a final visit from the electrophysiologist before the process began.

From an anesthesiology perspective, the goal with an EP study (at least with this team) was not to keep the patient completely “out.” I did have them promise not to share any crazy tequila stories I told while I was in and out (apparently either I didn’t give them anything to work with or they are very discreet people!). I was given oxygen. I remember nothing of the actual insertion of the catheter. I remember significant parts of them manipulating my HR to try to replicate the issues I have been having. One of the cool parts of an EP study is that they essentially “GPS” your heart. I had stickers all over my chest that were a part of the mapping process (and is it a good thing when they say they don’t have much real estate to work with?!). The anesthesiologist told me that he could tell at a certain point that I was really getting anxious (and I was trying to stay calm but I guess “trying” is a relative thing in that situation) so he put me farther out.

Fast forward to the recovery room. and beyond. I remembered how still Wayne (my husband) had to be after his catheterization, and how we had to bring Wayne’s dad back to the hospital when he began bleeding from his insertion site after a catheterization so I was determined to be the perfect patient on that front. But I think the process and technology have both improved. Although you are told to remain very still, there wasn’t a nurse yelling at me when I moved my head a millimeter (as one did with Wayne).

All of that to get to this answer:

I do not have Atrial Fibrillation (this is mostly a good thing!). My issue involves SupraventricularTachydardia (SVTs). The good news is that SVTs, even though they feel totally bizarre and abnormal, do not usually lead to adverse cardiac events or fatalities.

Dr. Silberman chose not to ablate – he found two “hot spots” that activate at around 160 bpm, but they return to normal as my HR rate escalates and several other spots activate. It was taking so much medication (isuprel) to get my HR up enough to replicate the issue that they were afraid they would run out mid-procedure and apparently there is a manufacturers’ shortage of it so they couldn’t get more. One option is a different (more involved) procedure with a balloon that can discover/ablate more surfaces at once, but that is not necessarily that obvious route to go. For now, the recommendation is that I take a beta blocker before running and keep my HR to below my zone 4.

Here are the takeaways for now:

Technology is pretty awesome

I am still in awe at what medical professionals can find out via technology. From my Garmin which provided preliminary data about the patterns of my heart rate issues, to the loop recorder that provided more specific information, to the map of my heart and its electrical patterns, we have access to so much data.

Physicians with good bedside manner are pretty awesome

I am grateful for the way in which Dr. Silberman has explained everything at each step of the way. I appreciate the fact that he respects the role of running in my sanity (even though he does say, repeatedly, “you know, you don’t have to exercise at 170 bpm to be fit”).

dr-silberman-rotated

Good nurses are pretty awesome

I am a little fuzzy on my ability to evaluate the performance of some of the nurses, but all the ones I was “with it” for were great. They were patient, answered my questions, and provided plenty of attention (along with a nifty “discharge note” (below) and a follow-up phone call the evening I was discharged. My last nurse had an interesting mantra — “be assertive” — she said it ten times if she said it once. She’s right of course but it still struck me as interesting.

cardiac-nurses-rotated

 

Remember that post I wrote about how hard it is to get a wheelchair at TMH?

I have to admit, when I remembered (duh) that I would need one of those very same wheelchairs to transport me out of my room and down to my car, I was a little afraid the staff would see my name and all of a sudden develop a very lengthy d e l a y! But my complaint was never about the transportation staff themselves, just the challenging process of getting a wheelchair for my father-in-law, and I am happy to report my chariot arrived to sweep me away from the hospital relatively promptly.

Frequent naps and permission to “take it easy” are awesome

I was told to avoid running/exercise (sigh) and not lift anything heavier than ten pounds for a week. As much as I have missed my usual high-intensity, rapid-fire life, I have to admit having permission to take it easy has its bonuses too. I have probably taken more naps in the past week than I have in the past year (or five…). I think I needed the rest.

Not running is not awesome

Double negative that may be … but if you know me, or if you have had your own period of enforced non-running, you know what I mean. All of a sudden everyone’s off-hand remarks on social media about their “quick three-milers,” “couldn’t help signing up for another race,” and “awful run but I am glad I did it” seem like they are coming from a completely different universe. My paper workout chart, my Training Peaks, and my Daily Mile are all completely blank this week. So is my endorphin quota. It’s odd and not awesome.

So much of your running mojo is in your head

This has messed with my mental status. As much as I have advocated endlessly for the power of the back of the pack, for the fact that every mile matters, for the fact that runners should all support one another, the truth is that I have felt very close to the edge of being excommunicated from the runner fraternity (and I know if anyone else said all that to me I would immediately jump on them and tell them the thousand reasons why they still belong). I’m just keeping it real here. I have finally gotten a little tiny bit of traction and credibility as a Fitfluential Ambassador and am having to work hard to convince myself I still belong.

Not running messes with your nutrition

One beautiful thing about running combined with relatively clean eating habits was that I had a little wiggle room to treat myself to “fun food” occasionally. A few weeks prior to the procedure I announced to my coach that I was “tired of logging.” although I knew what to do to maintain my weight, I also know how easy it is to wander once you are no longer making yourself accountable. Logging and reporting my food logs to my coach every night incentivized me to, for example, have salads on hand for lunches, to skip bread in the evenings, and to keep the long-term goal in mind.

And I think that’s the rub now: there is no long term goal now that I have ditched the sub-30 5K. The things I run for still exist: Gareth, Charity Miles, my team at KR Endurance, my running friends, my health and my sanity.

The challenge is getting my head (and my heart) back in it.

EP Studies

****NOTE: I really hate talking endlessly about myself like I have ended up doing throughout this cardiac health  journey. I continue because I know it has helped me to read of other people’s experiences. It’s a scary and lonely feeling to feel like “the only one” facing this type of issue. A lot of people have helped me, especially Mary Jean Yon. While I don’t feel ready to be anyone’s lifeline yet, it is important to know you are not alone, and to be your own most assertive advocate when it comes to your health. That’s why I keep talking about it. Maybe next week I’ll post about dancing unicorn kittens or something lighter!

Turkey Trot Race Report 2014

I love the Tallahassee Turkey Trot. I mean, love, bolded, in RED, italicizedunderlined love the Turkey Trot. I love the Turkey Trot so much that when my husband suggested I go to New York for my 50th birthday (which fell the day after the Turkey Trot this year), I refused to even think about it (and trust me, me turning down any hint of going to New York is big!).

"Tuning Up" with the Cycling Turkey four days before the race!

“Tuning Up” with the Cycling Turkey four days before the race!

Before talking about Thursday’s 10K race, I have to add a caveat. I wrote this post about finding “ands” instead of “buts” in your running and am the most ardent of believers in the fact that every runner matters, and that the joy of running can be found at the front of the pack, the back of the back, and everywhere in between.

Post-Turkey Trot Questions

But Thursday was a day that shook me up a little bit, and it will most likely be a milestone in my running journey. Around the 5.5 mile mark, and right at the moment a runner came up to me and said, “your pace has been great; I have been trying to catch up to you to tell you that,” my pace immediately became a walk as this happened:

Turkey Trot HR Chart

“This” is my heart rate going a little bit wildly off the charts of what is normal for me. (My normal is 143-186 (with 143 being where I could converse with you while running and 186 being my “sprinting as if my life depended on it” pace). There’s a good basic explanation of heart rate training from Chris Russell of Run Run Live here.

I have been training by heart rate (under a coach’s supervision) since April 2012. As far back as February 2013, when I ran the Flash 12K race, I have had odd HR spikes. I remember the “angel” runner who ran through the finish line with me saying, “we’ll do this together.” The issue started cropping up again this summer, at the Pot Luck Bash and each of the summer trail series runs. I sort of chalked that up to the heat and race adrenaline. I had a racing HR issue during one training run this summer but again … Florida is hot in the summer (mild understatement).

I finally decided to discuss this (and a few other “small” issues) with my primary care physician. He did an in office EKG (fine) but decided to go ahead and refer me to our health plan’s staff cardiologist (props to the health plan for having a staff cardiologist). He had me do a stress test (thanks for the mile, doc!) (fine) and went ahead and had me to a cardiac echocardiogram (fine).

Feeling relieved, I thought “I can put all of this cardiac worry behind me since I checked out okay.”

When My Gut Said “WALK”

I arrived at the Boston Mini Marathon on October 25, my second half-marathon, feeling great. Although it was cold outside, the weather was perfect for running. I felt so good about my weight loss, my improved nutrition, and the cause I was running for (Miles 2 End Prostate Cancer). I felt confident that I would shatter my previous half marathon time and at least finish in less than three hours. I was well on target to do that until around mile 5 when my heart rate started going a little nuts. I kept running, thinking I could run through it. When it refused to settle down, I started walking. I kept moving forward, and turned around at the half way point of the out and back race. I decided to try running again, remembering the cardiologist asking me “does it just feel like your heart is racing or do you feel loss of power, like you’re going to pass out, etc.?” Since it had “just” felt like my heart was racing, I decided to run again. That’s when it felt “not right” (I know, not a medical term but ….). I spent the last six miles of the race run-walking. The good news about the run/walk approach is that my HR stayed down. The bad news it took longer to finish the Boston Mini-Marathon than it had taken to finish the Boston 13.1 in September 2012, when I was definitely in relatively inferior shape.

Between the Boston Mini Marathon and Thursday’s Turkey Trot, my training runs have been solid (no HR issues) and I had one of my best 5K times ever (sub 34:00) at the Vet Fest on November 11.

The Turkey Trot day dawned perfect from a weather perspective. I felt great (again). Well trained, nutrition dialed in, happy to be running the last race of my 40s with 6000+ of my favorite people.

When my HR spiked at around that 5.5 mile mark, I didn’t bargain with myself as long as I had at the Boston Mini. I stopped to walk (very disappointed but knowing intuitively that it was the best decision). Again, this was more than “feeling a racing sensation.” It wasn’t right.

When I saw my friend Gabrielle close to the finish line, she was so encouraging. I don’t know why I felt compelled to explain (except that I am me, and that is what I do), so I told her I was having HR issues. I did run through over the actual finish mat, and since my friend Adrea was finishing the 15K at the same time, had a chance to hug a friend and celebrate a bit.

THEN I texted my coach, and eventually I just called her because I couldn’t drive home to all the people dying to move on to Thanksgiving dinner and explain my complex feelings via text.

It was during that talk that I first floated the “maybe I need to move to a run-walk for the longer distances idea.”

The important point here is that although I have zero, none, nada issues with run walking, I have always said “it is not for me” (which is why my friends who saw me walking at Boston knew there was an issue). I love the feeling of continuous motion; I love the feeling of speed (even though I know I am a slow runner). Once I move to run/walk there’s one more piece of technology getting between me and my mental bliss.

(I am also hesitant to limit myself to running only when I can find others with whom to run. I love running with others but also love running alone; it’s the most peaceful part of my day.)

The morning I ran the Run for Andy Nichols 5K in Blountstown, October 11, I went into my DailyMile and revised my goal of running a sub 30 5K to something less specific:

dailymile

I know the likelihood of meeting the sub 30 goal is unlikely at this point. I also want to preserve my ability to run longer distances. Since these HR issues don’t seem to occur (yet) at the 5K distance, perhaps there is a middle ground for me in racing 5Ks and participating in 10s and halfs by run walking.

I have chidlren to raise and a second half century of life that just started; I don’t want to jeopardize it all just by being stubborn.

The Medical Part

It bears mentioning that I have done this drill before (in 2005). I was not actively running at the time, and after several EKGs and a nuclear stress test, I was told to drink less caffeine and given a clean bill of health. This time, the cardiologist has given me the same mini-cardiac lecture both times I visited him. He describes the heart’s anatomy and the little electrical bundle that coordinates the entire process. Ultimately, after three EKGs and an echocardiogram all were normal, he said I could wear a holter monitor for 24 hours but it’s really hard to wear a holter monitor and run (because the leads would get sweaty and fail to adhere). The other option is implanting a device that can track HR, and that invasiveness seems illogical in my situation. To his credit, he did refrain from suggesting I stop running until the very end of each conversation, and the gist of that part was, “if it only happens when you are running, you need to consider modifying your activity choices.”

I have asked myself if I am fretting for all the wrong reasons. With a congenital heart arrhythmia on Wayne’s side of the family that has led to the death of one member and life-changing modifications for many members, there’s been more than the usual chit chat about heart issues over the years and I always had the “luxury” of worrying about my kids but not myself (since they shared genetics with the affected person and I didn’t). My friend Lisa, one of the best athletes I know, had a massive heart attack while on a run and was saved because an RN was there. Another friend of a friend collapsed and died in the middle of a day on a regular training run.

I don’t know what the outcome of all this will be. I am going to focus on these four things and pray I’ve chosen the right four:

1) Continuing to work with Coach Kristie of KR Endurance to be the best (and healthiest) runner I can be

2) Knowing that each race is “mine” and no one else’s; I have only myself with whom to compete

3) Supporting causes I love through my activity, especially Charity Miles

4) Being grateful for all that running (and, ahem/sigh/okay I will say it) and run-walking has brought to my life and will continue to bring to my life.

Those four things deserve a big thumbs-up, in my opinion!

Photo Credit: Fred Deckert

Photo Credit: Fred Deckert