Each Day Is a Gift

Hubby ran with me to meet Karen for easy recovery run and exchange Garmins at 7am. We were chatting away running easily east to Smith's then down and up trail next to SR 92, turned around to head back west once we reached the top.  With about 0.75 mile left before reaching my home, on 3200N by the Stake Center, my heart suddenly went into tachycardia, beating so fast that it felt like it would jump right out of my throat.  After I rounded the corner onto 600E, told Karen I had to walk because my heart was pounding so fast.  I could feel its rapid pulsating over my chest wall.  It was very scary even though I did not feel dizzy or any shortness of breath.  The strange thing is I was not running fast at all, (no pace because my Garmin is dead), in fact I was talking in full sentences the whole time about our upcoming plans for Fall marathons. 

This is the 3rd time in the last 16 months that I experience this alarming tachycardia.  I went back on my blog and found out that the other two episodes happened on March 29, 2011 and March 15 of this year.  The first episode was at mile 6.5 of a 12 miler on Bull River heading east after just cresting the 1200W hill.  Karen was with me.  The heart rate calmed down after walking a bit.  It was noted that the remaining miles were death march.  I felt drained and fatigued the next day.  Went to doc to get some Symbicort and the receptionist insisted that I had my O2 Sat checked because my breathing was labor, at the time I think I had broncho irritation.  I told the doc. of my tachycardia episode so he got an EKG to make sure there's no arrythmia.  The second episode was nearly a year later running on trail down from Traverse Mountain with Karen and Wendy.  Again the heart suddenly pounding rapidly as if it would jump right of my chest.  I stopped running; but no dizziness or shortness of breath.  However the last mile home felt hard.  Again felt drained during the day.

Today's episode was a bit more worrisome because it lasted much longer.  I walked the last 0.5 home and stood outside talking with Karen for another 5 min.  Upon getting in the house, I sat down petting my cat trying to relax; but the heart kept on pounding away.  Hubby told me to get the blood pressure monitor to check the B/P and HR.  The heart was going so fast that the monitor could not get any readings.  I got my stetascope out to listen to my heart and count the beats.  It reached 150 beats in 30 seconds; that was at least half hour since I stopped running.  I felt ok, no shortness of breath, just an uneasy and queasy feeling, like death-looming-nauscious-scary feeling.  I asked hubby to take me to the ER; but he said I would get better care going to the doctor especially since it's around 8:30am and there'd be no one at the doc's.  Turned out he's right.

On the drive to the doc (about 15-20 min.) I kept trying to take B/P and HR readings with the B/P machine with no success; and listened my heart with the stetascope.  The staff got me in right away and was unsuccessful in getting any B/P HR readings from neither the B/P machine nor the oximeter.  They grabbed the doc who also couldn't get any readings but confirmed that I definitely was experiencing tachycardia.  It took a while to locate the EKG machine and the charger.  As soon as the nurse put the EKG leads on me, my HR dropped.  My EKG result showed normal sinus rhythm with a HR of 66.  The entire tachycardia episode lasted about 90 min.,  clearly much longer than the last two episodes.  It left me feeling completely drained.  After I got home, I tried to do some core exercise while watching the Olympic swimming qualifying events but promptly fell asleep...so weak and fatigued.

The doc. said that he would consult a cardiologist.  Since it happened infrequently for no ryhmn nor reason other than that I was running, a halter monitor would not be useful.  He also doubt that the cardiologist would recommend angiogram since I have no angina nor eschymia nor other symptom such as shortness of breath or chest pain.  The only suggestion he made was that I should always run with someone.  Thankfully all three episodes happened close to home and I was with Karen. 

I think I'll wear my HR monitor which I haven't done the last 4 years.  I'll carry a cell phone when running alone, and resume taking liquid iron. 

Ran with Karen and Wendy on the rail trail Bull River loop.  Slow, conversational run.  Yesterday's tachycardia episode took a lot out of me.  Not going to worry about pace as I'm just trying to build back the base miles.  

My doctor called me, first thing he said was:  "How was your run?" :) :) :)  Then he told me he talked to a cardiologist who said that sometimes marathon runners experience atrial fibulation that resolve itself.  The cardiologist office will call and set up appointment for me to see him and determine what kind of tests/monitoring I'll need. 

**********update*********

Dr. Carter, the cardiologist, called me this afternoon.  He will see me tomorrow at 1pm to get a history and to determine if/what kind of ECG is needed.  He is concerned that there might be myocardial fibrosis in the atrium.  I am not too worried. 

Ran with hubby and Wendy east to Smith, west on Timp Hwy Trail, south onto 600W home for an easy 5 mile loop.  Wore HR monitor average 140.  AP: 11:34.

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Went to see Dr. Eric Carter, the cardiologist.  He took a thorough history of my running, the tachycardia episodes, etc. and listened to my heart, carotid and femoral arteries which are all within normal range.  He said he wish he could've captured the episode with an EKG.  Based on the history he is pretty certain that it is atrial in nature.  There are two possibilities, cardiac fibrosis and atrial fibrillation (AF).  He said that endurance athletes often put so much stress to their hearts that they develop AF.  He wants me to take some diagnostic tests:  cardiac MRI, treadmill stress test, EEG, and last option cardiac holter monitor (not practical based on the infrequency of the arrhythmia episodes that happen mostly while running).  These diagnostic tests will then determine what treatments I will need.  He mentioned surgery and ablation.  We scheduled the cardiac MRI 3 weeks from today, still need to schedule the other tests.  Our insurance does not cover any diagnostic tests...such a bummer!

When he asked if we have any questions....hubby immediately asked about curtailing my running.  Thankfully the doctor said because I did not experience syncope, I could "party on".  :)   However on the way home, hubby said I'm just too stubborn and would not limit my marathons to "normal" amount.  He said he wants me around and to watch our grandkids grow up.  I sat in silence and felt "heart broken" on the way home.  I am going to "sleep" on this.  I have registered for PCM, TOU, SGM and a Dec marathon...I really would like to finish these marathons. 

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Some articles on AF in endurance athletes:

http://www.sciencedaily.com/releases/2009/06/090621143221.htm

http://www.ncbi.nlm.nih.gov/pubmed/19654095

http://www.runnersworld.com/community/forums/runner-communities/masters/atrial-fibrillation-running-performance

http://europace.oxfordjournals.org/content/6/3/222.full

Ran to Mt. Ridge Jr High with Wendy via SR92.  We stopped at the park to refill my water bottle.  Walked the uphill and stopped running once we reached 8 miles.  AP: 11:28  AHR: 145.  We started at 6:30am and it got pretty warm quickly.

It was so good to pour my heart out to my best friend.  She understands how much I love running and feels my anguish over the past year with my struggle with asthma, 2 stress fractures and now the tachycardia issue.  I so appreciate her listening ears and she is always there when I need her.  She is so Christlike.  I am so grateful to have her as my neighbor and best friend.  I am a better person because of her goodness and love!  :)

Need to go shopping as company is coming tonight and I will be at Girls Camp this afternoon and evening.  So no running tomorrow morning.  It'll be good to save my body for Saturday's 18 miler, longest run since April 28, 14 weeks ago...hope I can do it.  I have come to appreciate all that God has given me.  I am treasuring and enjoying each run as a gift.  I ask myself this question almost daily:  what can I offer, how can I love more sincerely and deeply and what ways can I serve God better?!!! 

Slept in 'till 7.  Had a wonderful day/evening at Girls Camp yesterday.  Got home around 10pm to watch the Women's Individual Gymnastics with Jeff, Jenn,  and our house guests.  I already knew the Olympic results...tried hard not to spoil it for Jenn.  I think it's more exciting to watch it without knowing the results before hand.  That cute little Gabby reminds me so much of Livvy, not enough face for those big eyes and huge smile! :) :) :)  Was so happy for Phelps too!

As a result of the late night "Olympic Party",  I slept in this morning 'till 7.  Hubby went for a quick run while I made a scrumptious breakfast of omlet, pancake, mini crescant, Greek yogurt topped with strawberries, raspberries and blue berries for our guests.

Went to the temple with hubby....thought a lot about a friend, her husband and their five children...actually it has occupied my mind over the last 7 months! 

Plan was to meet my running buddies at 6:30.  John and Wendy slept thru their alarm. :) Karen was punctual even though she was up late from going to "Wicket".  Anyhow, it was almost 7 by the time we got going. 

Karen and I ran up to Alpine.  About 3.5 miles into the run, saw a cute happy smiling girl running westbound on the other side of the road.   I yelled at her back after she's already over 100m away:  "Is that you Carina?"  Always make me happy to have a Carina-sighting!  :) 

At the Alpine park while Karen used the restroom, I drank from the ever-flowing fountain and ate some gel-chews.  Then we head south to North County Rd and turned east on SR92 to the mouth of AF Canyon where we jumped on the golf course trail west to Lone Peak HS to Van Dyke Park (refill water bottle and ate remaining of the chews) south to 700 N to 200 E AF.  Thought about Toby and her special day of her triplets' baptism.  Then we continued westward back to Lehi via Cedar Hollow.  We walked the steepest parts of Center St. (mile 17).  I commented that this is what Deer Valley loop (also mile 17) is going to feel like in two weeks.  Karen replied:  "The thought of running Park City right now sounds awful to me!"  Yep, it is going to be a death march for me.  Once we reached 2600N.  I was done running, but we weren't done talking; so we walked to Karen's where I got some ice water.  It was so hot that Karen refused to let me walk home so she drove me back in her daughter's convertible that she just got done washing/cleaning! :)

I would not have been able to finish this 19 miler without Karen.  (We ran thru 5 cities: Lehi, Alpine, Cedar Hills, Highland, American Fork).  I talked her ears off.  It was a slow painful run with an embarrassingly AP of 11:26 for 18 miles (turned off the Garmin during the last walking mile).  Good thing Karen didn't have her Garmin or she'd be aghast at how slow we were.  Average heart rate 158 with the last 3 miles reaching above 160.   I must've been a bit dehydrated...did not go to the bathroom until 3pm and the color was pretty dark.   There was noticeable salt residue on my shirt.  Left quad and lower legs very sore.  Right foot achy but not painful.