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?

Wife of one, Mom of two, Friend of many.

Boston 13.1

A week has gone by since I ran my first half marathon, the Allstate Boston 13.1 for Autism Speaks. Whereas I usually feel like I could write hundreds of words about pretty much any workout, that has not been the case with this event. I can’t decide whether to start with the people who motivated me to do the race in the first place; the coach and fellow runners who supported me through the eight months of training, the families for whom autism is a part of each and every day who were among my biggest incentives, or the race day itself, a day that was so autumnally perfect that it almost defied belief.

This experience started on February 14, 2012, when I was the first person to comment on this post by Luau:

In retrospect, there was zero doubt that I would participate in this race from 10:15 a.m. on 2/14/12 when I made this first comment to 7:00 a.m. on 9/16/12 when I started the race. But there were steps along the way …… talking it over with my spouse since there would be a commitment of time (to train) and finances (to travel to Boston). Fortunately, the timing was in my favor because it was Valentine’s Day and I asked for his support of this effort as my gift. (It worked!). There were fundraising steps (as a member of the Autism Speaks team I agreed to raise at least $500), including the comment contest that brought in 278 comments (there were two winners and I came in third, but I really appreciated everyone’s willingness to help me out!). There were also literal steps – thousands of them as my training progressed. My training was transformed in April when I began training with Jeff Kline (Coach PRS) of PRS Fit. Along the way, there was one truly awful run but that was outweighed by progressively stronger and longer training runs the last six weeks that helped me feel utterly prepared for my race.

As race weekend approached, I ran the last of my long runs (14 miles) and started tapering. I flew in to JFK Airport on the Friday prior to the race, spent Friday evening in Connecticut with my good friend Audrey, and drove up to Boston on Saturday, September 15.  I got all my gear (my Autism Speaks team tank, a tech shirt, a dri-fit hat, and my all-important race number) and returned to my room to organize myself prior to the team dinner.

As the dinner approached, I found myself feeling inexplicably anxious about meeting the people who I felt I had come to know relatively well via social media. Up until this weekend, I had been batting 1000 for meeting people in real life who I had first met on social media — in that the “IRL” meeting confirmed all the warm, fuzzy, and our-senses-of-humor-match intuitions that led me to invest in a social media relationship. To go back to my husband’s first reaction (remember Valentine’s Day 2/14/12?) of “but you can run 13.1 miles right here in Tallahassee,” I felt more like a 6th grader attending a new middle school after just having moved to the town; I was nervous. Which led me to procrastinate going down to the dinner and (I thought) miss an opportunity to mingle with all the people who I wanted to match a twitter handle to a real face and voice. When I was in line for my food (pasta, of course), I did find/meet Luau, Jess, and “Jersey” and ended up joining them at their table. That was a real blessing because race day flew by with less opportunity to chat. I also met Ann Marie, another twitter acquaintance, and Beth Clark, who I had just started interacting with on social media but turns out to have a love of things Bronx and NY Theater (and autism support) so that was pretty darn fabulous too. (And thanks to Jess for the best compliment of the weekend which may sound completely wrong out of context but I think we were talking about my theater choices when I ended up in New York after the race and we were talking about Avenue Q, which has “racy” content. Someone said, “If you’re easily offended, it’s not for you,” to which Jess said, “if she were easily offended she wouldn’t be here.” (For someone (me) who spends a lot of time feeling very thin-skinned, that was the ultimate pat on the thick-skinned back!).

Equipped with the all-important cow bell,

I returned to my room and met up with my friend Jacqui, who had driven down from New Hampshire to do the race with me. It definitely helped to have someone along for the experience who had run a marathon before (Boston, actually) and was able to keep the tone light. We both turned in pretty early since the race started at 7 a.m. and we had to drive to Suffolk Downs.

The race started at 7 a.m., and we took off through the horse gates. I remember Jacqui saying “Lucky Seven” as she went through Gate 7 and saying about my gate (8) “Eight is Enough.”

After the horse gates, we were truly off! I have to hand Luau kudos for his mid-stride photography skills (the blue afro is part of his fundraising approach – read more about the blue afro here (and sign the petition to convince Katy Perry to donate a blue wig for his NYC Marathon run here):

One of my concerns pre-race had been that I had never done a run this long without music (or an audiobook). I almost always listen to something when training, but never listen to anything when racing. I wasn’t sure how I would handle the lack of that electronic/audio security blanket. Turns out there was so much activity along the course (people cheering, other runners approaching due to the out and back (and a little loopy) nature of the course) that the lack of music wasn’t an issue; I really think I would have missed a lot of the race environment if I had been plugged in.

There was also the issue of heart rate. Being a bit anal about all of this, and knowing that my coach wanted me to stay at Zone 2 with 3 minute surges into Zone 3 every fifteen minutes, I had taken the time the night before the race to meticulously write down the time intervals for these surges upside down and big enough to hopefully see without digging my glasses out (they’re right above the QR code):

That part of the plan tanked when a) my Polar stopped recording my heart rate a half hour in (and had to be reset), and b) it was clear that Zone 2 was not happening for any of the 13.1 miles. Adrenaline, a new/different terrain, you name it – I was never going to get down to Zone 2 without crawling or sleeping. But I do know from observing my HR monitor that I stayed pretty consistent the whole race, and hopefully that means something good.

I have always admired runners who write race reports with incredible specificity – identifying particular details at named mile markers, such as what their heart rate was, how their breathing was, what they ate, etc. That’s not me.  If I had to pick five specific things about my experience on the course they would be:

1) The first 5 miles really seemed to fly by (relatively).

2) Although I had my own hydration and nutrition with me, there were a lot of water/gatorade stops. That, and the volunteers handing out strawberries. I didn’t want a strawberry but I think that fragrance will always trigger memories of this 13.1 in my head.

3) There was a neighborhood that started around the 8 mile mark — I could see the 9 mile marker right across from the 8 mile marker so I knew that I would loop around and encounter it in a mile; for some reason that was mentally a relief.

4) My left foot. My left foot has had a very subtle “something” (stiffness?) for a few weeks now. It seemed especially notable on Friday as I was flying up for the race. Maybe my hypersensitivity to it had to do with my nerves about the race. I don’t know. Throughout the whole 13.1, it was always “noticeable” — I just wanted to get through the race without it getting so bad that I could not finish on my own terms (which meant running even if my running is slower than some walkers).

5) My thought process at the Ten Mile Marker. When I got to the Ten Mile Marker, I literally thought, “Oh, all that’s left is a 5K.” That is such a big change in mentality for me. It felt great to know that I had run more than 13.1 miles before, that I would be doing it today, and that I was so close to knocking a goal off of my list.

(I finished in 3:09:03.)

As I was thinking over how to close out this post, which has turned into a novel, I ran  across my horoscope for today. It said:

“You have a talent for choosing the right people to hang out with. That doesn’t mean they are always easy to be around, though. Your friends will be mentors, motivators, and reality checkers.”

(Holiday Mathis)

One thing I did “right” was entering into a coaching relationship with PRS Fit. I had to give up things I enjoyed (like the boot camps that involved stadium climbing) and my “regular” Tuesday night interval group. Early on, Coach Jeff pointed out that “what I had always done clearly had not worked” (as it related to running a faster 5K). Being coached made a huge difference in my conditioning level and my mental preparation.

The other “right people” who were along for this run were the donors who contributed toward my fundraising for Autism Speaks. Over the last few years, I have asked for a lot of support for many causes. I try my best to reciprocate but I am pretty sure in this situation much more was given than I can ever repay. I love this image of a heart held aloft, because everyone who contribute (whose names are incorporated into the image) “held me” financially and morale-wise. I can’t thank them enough.

Wife of one, Mom of two, Friend of many.