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Survival of the fittest

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Dave Wolfe
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Nick Morris
Tom H
mountandog
Mark B
nkrichards
Michele "1L" Keane
Jim Lentz
Alex Kubacki
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Post  ounce Mon Apr 20, 2015 4:20 pm

WOOHOO!!!!!!!  Way to go, NANCY!!!!!

cheers cheers cheers cheers cheers cheers cheers cheers cheers cheers cheers cheers 
Shots 
Sweaty 
Ride Ride Ride
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Post  Mark B Tue Apr 21, 2015 10:45 am

Couldn't hope to top Ounce's post, but...

Congratulations, Nancy! Hope Boston was a great experience for you. Great job managing those less-than-ideal conditions.
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Post  ounce Tue Apr 21, 2015 11:20 am

Mark B wrote:Couldn't hope to top Ounce's post, but...

Congratulations, Nancy! Hope Boston was a great experience for you. Great job managing those less-than-ideal conditions.
Sure you could, Mark.  You just have to be-like-Jerry.
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Post  Julie Tue Apr 21, 2015 12:17 pm

Congrats Nancy! I can't wait to hear about it!
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Post  nkrichards Thu Apr 23, 2015 5:20 pm

Very disappointed...what can I say. My marathon really did start in the Newton Hills and we (doctors) are still trying to figure out how I finished. The finish line became the half way point for me and although the worst is behind me I have a long way to go.

Dr. Baggish was the doctor who took over my care in the medical tent. He's good. I'm honored to say the least. He then turned me over to Dr. Rosenfield in the cath lab. Equally impressive. And they both hooked me up with cardiologists in Oregon that I would not have access to without their help.

So...not one to waste time I did 5 x 200 feet in the hospital this morning at a HR of 77. Good enough to get me out...at least to the hotel next door.

Anyone else realize the irony of the title of this blog? Named because I was running to relieve stress in my life. I had always intended to change the name once I started Boston training but never really felt ready to make that change. Dr. Baggish said he didn't think I would have survived this incident had I not been as physically fit as I was.
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Post  Mark B Thu Apr 23, 2015 5:29 pm

nkrichards wrote:Very disappointed...what can I say.  My marathon really did start in the Newton Hills and we (doctors) are still trying to  figure out how I finished.  The finish line became the half way point for me and although the worst is behind me I have a long way to go.

Dr. Baggish was the doctor who took over my care in the medical tent.  He's good.  I'm honored to say the least.  He then turned me over to Dr. Rosenfield in the cath lab.  Equally impressive.  And they both hooked me up with cardiologists in Oregon that I would not have access to without their help.

So...not one to waste time I did 5 x 200 feet in the hospital this morning at a HR of 77.  Good enough to get me out...at least to the hotel next door.

Anyone else realize the irony of the title of this blog?  Named because I was running to relieve stress in my life.  I had always intended to change the name once I started Boston training but never really felt ready to make that change.  Dr. Baggish said he didn't think I would have survived this incident had I not been as physically fit as I was.

Glad to hear from you, Nancy, but even happier to still have you around.

If you don't mind my asking, what exactly happened to you?
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Post  nkrichards Thu Apr 23, 2015 9:26 pm

I don't mind at all Mark...especially if it helps someone else realize sooner than I did what was happening. I will admit that a lot of the details are pretty fuzzy.
The crowd was moving slowly toward the start line and I was frustrated because I couldn't find Michele's friend Joe. We started before I found him. 9:43 a bit fast but not terrible. 9:11, 9:03, 9:11, oops slow down! 9:31, 9:15, 9:19, 9:35, 9:38, 9:29,9:44, 9:35, that's better. 9:57 half way. 9:59, 10:12, 10:13, 10:45 don't be too cautious....let's get back to some goal MP miles. This is when all he'll broke loose. I got in a nice half mile and then felt like crap. I remember my left shoulder hurting and my chest feeling tight. I assumed Marty's chest cold had finally caught up with me. 11:45, 11:54, 12:43, 14:11 panic setting in. I felt awful and could not understand what was happening. I hadn't gone out that fast or arrived that unprepared. 13:05, 12:52, still struggling but not giving up. 15:18, starting to stumble and afraid I would get pulled from the course. My arms and legs were numb and tingling 17:48 I couldn't figure out where I was on the course. I ran (?) the next half mile @ 18:15 and then pushed the lap button with one mile left. I can't describe how disappointed and confused I was. I was determined to finish that last mile fast enough to finish in under 5 hours but could not feel my legs let alone make them move. I think this is where I tried to walk but I stumbled so much I went back to jogging(?). 17:19. I collapsed in the arms of a volunteer before I completely crossed the mats. I remember them asking my name. I remember a few bits and pieces of the next hour but not much.

My body temp was 92 and they apparently thought I was just cold. I remember feeling worse and worse and mentioning my chest hurting. I remember them telling me they were taking me to the hospital. I remember crying. I remember hearing people talk but not understanding everything.

Apparently they checked my heart and Dr. Baggish showed up at some point. By the time they got me to the cath lab one of my main arteries was essentially blocked. They sucked out the blockage and determined the artery was to large to insert a normal heart stent. I was stable by then. They had called Katie and she was there when they moved me to ICU.

They went back in and took a better look on Wednesday. It was healing nicely so they decided not to put a stent in that was designed for larger leg arteries. The artery was clear and flowing well. The other arteries all looked great.

The theory is that somewhere in the Newton Hills a small bit of plaque broke loose and clotting started. Because I continued to run and because the artery was so large the blood continued to flow but was severely restricted and not getting to my arms and legs. Dr. Baggish indicated that the artery was large because I was physically fit. He also indicated that had I stopped. Before reaching the tent at the finish line it most likely would have ended differently.

It never once crossed my mind that I was having a heart attack! I just could not understand what was happening.

I do have some heart muscle damage but it should repair itself if I give it time and do things right. I' m hooked up with a cardiologist in Oregon that works with athletes. Dr. Baggish has run 30 marathons and stressed over and over that the best thing for me in the long run was to remain active as long as I do it safely.

I'm on several meds to prevent problems especially since they didn't put a stent in. Activity is severely restricted...very slow walking for now and no lifting.

Happy to share my progress as I recover if there is interest.
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Post  ounce Thu Apr 23, 2015 10:30 pm

First off, glad you're on the mend.  very glad.

Now, the questions.  The working theory is that a bit of plaque broke loose and that as a result of your running, the heart arteries were larger than normal (and probably other arteries and veins, too), so it would've been a different outcome as a couch potato.

How long have you been running?
Were you ever very overweight prior to running?
Any family cardiac history?
Any atherosclerosis for you or family history?
Did they happen to explain how the plaque could have broken loose?  I imagine the 'where it came from' is anybody's guess?
Did the 92 degree body temp help or hurt the cardiac situation?


Sorry, I try to learn all that I can about any medical stuff.  It can help, when a situation arises.  I'm interested in the patient's recovery.
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Post  Mark B Thu Apr 23, 2015 11:32 pm

Holy jumping catfish.

You had a heart attack during the Boston Marathon -- and finished the race.

Not only that, but the fact that you finished the race (while having a heart attack) actually helped you survive it.

Simply amazing. I'm in awe. They make 'em tough in Central Oregon! So glad you're recovering so well.

Please keep us updated!

(Ounce: If I read what Nancy wrote correctly, I believe that her continuing to run while having the blockage was critical to her surviving this incident... it was forcing blood around/through the blockage. Had she stopped, the extra force of the heartbeat would have eased, the bloodflow would have slowed, the clotting would have become far worse, and that would have been catastrophically bad.)
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Post  ounce Fri Apr 24, 2015 9:58 am

Mark B wrote:Holy jumping catfish.

You had a heart attack during the Boston Marathon -- and finished the race.

Not only that, but the fact that you finished the race (while having a heart attack) actually helped you survive it.

Simply amazing. I'm in awe. They make 'em tough in Central Oregon! So glad you're recovering so well.

Please keep us updated!

(Ounce: If I read what Nancy wrote correctly, I believe that her continuing to run while having the blockage was critical to her surviving this incident... it was forcing blood around/through the blockage. Had she stopped, the extra force of the heartbeat would have eased, the bloodflow would have slowed, the clotting would have become far worse, and that would have been catastrophically bad.)
I agree.  She had noted the doctors commented the size of her cardiac arteries were larger than normal which allowed the flow to continue around the plaque.  Her determination for a sub-5 hour time actually kept her alive.

What I'm trying to put away in the back of my mind is that if I'm in the same situation, that I get the course CPR/AED bikers to stage an ambulance up ahead to where I can hop right in and we can go off to the hospital.  I also know from years and years of experience that the ambulance will sit still and establish an IV line, then speed off.

Nancy's event is a teachable moment for all of us.
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Post  mountandog Fri Apr 24, 2015 10:12 am

so happy you're with us.  I'm sharing your story with others so we can all learn.
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Post  mountandog Fri Apr 24, 2015 10:19 am

by the way I couldn't help but note the irony of your blog title.  It's eerie in a "predestined" type of way.  I'm not a person who believes in fate, but this is pretty coincidental.  you truly are a "survivor of the fittest".
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Post  Michele "1L" Keane Fri Apr 24, 2015 3:28 pm

Wow, Nancy - you are one tough cookie.  Maybe it was best that you didn't find Joe, and I know he looked for you as he might have made you stop running.  I'm glad that you shared the details with us as it is something that I think we all need to take in and process so as to be awares.  They say that women have different symptoms, and what you describe is what I've been led to believe are the things to look for.  I hope that you do not mind that I share this experience with many of my running friends here and Joe is sharing in Atlanta.  

I am thrilled to know that you are fine and that they will let you continue running, biking, etc.  It was wonderful to meet you and Katie, and I'm glad that Katie was there (or I would have stayed being that I have family in Boston).  Take care and I guess you need to keep this blog going so we can all share in your recovery and cheer you on!
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Post  nkrichards Fri Apr 24, 2015 4:09 pm

Mark wrote:
(Ounce: If I read what Nancy wrote correctly, I believe that her continuing to run while having the blockage was critical to her surviving this incident... it was forcing blood around/through the blockage. Had she stopped, the extra force of the heartbeat would have eased, the bloodflow would have slowed, the clotting would have become far worse, and that would have been catastrophically bad.)
 Yes, but the fact that I made it to the medical tent at the finish line which was staffed by one of the top doctors in the country was also a factor.  I don't think they would actually recommend that you continue if you knew you were having a heart attack.
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Post  Dave Wolfe Fri Apr 24, 2015 4:10 pm

Glad you are okay. Recover well and quickly.
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Post  nkrichards Fri Apr 24, 2015 4:29 pm

ounce wrote:First off, glad you're on the mend.  very glad.

Now, the questions.  The working theory is that a bit of plaque broke loose and that as a result of your running, the heart arteries were larger than normal (and probably other arteries and veins, too), so it would've been a different outcome as a couch potato.

How long have you been running?
Were you ever very overweight prior to running?
Any family cardiac history?
Any atherosclerosis for you or family history?
Did they happen to explain how the plaque could have broken loose?  I imagine the 'where it came from' is anybody's guess?
Did the 92 degree body temp help or hurt the cardiac situation?


Sorry, I try to learn all that I can about any medical stuff.  It can help, when a situation arises.  I'm interested in the patient's recovery.
I don't know all the answers to your questions yet but I'll answer what I can now and update later as I learn more.
I started running in 2007 in an effort to become more fit so I could enjoy the grand kids.
I weigh 145-150 now.  My peak weight was 170.
I lost an uncle to a massive heart attack at the age of 58.  Dad had some narrowing but he was 82!  No other heart disease but lots of high blood pressure issues.
FYI my blood pressure is low/ normal.  My cholesterol at admission was 144 with LDL of 70 and I have little to no plaque in any of my other arteries.  Apparently this was just a very small deposit in that main heart artery but once it breaks loose clotting starts and that was the problem.
Dr. Baggish indicated that the marathon effort my have been a factor in breaking the plaque loose but said it was just as likely that it could break loose while watching TV...not sure I would have recognized the symptoms in that case either.
I'm also very curious about both the cause of the low body temp and it's effect on my outcome.  I didn't feel cold during the race so I wonder if the poor circulation was a contributing factor.  I was freezing after entering the medical tent and the initial response was to treat that.  It took a bit to realize that my condition was deteriorating rather than improving so more was going on with me...thank you for being there Dr. Baggish.

I'll share as I learn more.
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Post  nkrichards Fri Apr 24, 2015 4:32 pm

mountandog wrote:by the way I couldn't help but note the irony of your blog title.  It's eerie in a "predestined" type of way.  I'm not a person who believes in fate, but this is pretty coincidental.  you truly are a "survivor of the fittest".
It is a very strange coincidence and I'm convinced it was just that but I will admit I was much more nervous about this run than usual...of course it is Boston
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Post  nkrichards Fri Apr 24, 2015 4:52 pm

Michele \"1L" Keane wrote:Wow, Nancy - you are one tough cookie.  Maybe it was best that you didn't find Joe, and I know he looked for you as he might have made you stop running.  I'm glad that you shared the details with us as it is something that I think we all need to take in and process so as to be awares.  They say that women have different symptoms, and what you describe is what I've been led to believe are the things to look for.  I hope that you do not mind that I share this experience with many of my running friends here and Joe is sharing in Atlanta.  

I am thrilled to know that you are fine and that they will let you continue running, biking, etc.  It was wonderful to meet you and Katie, and I'm glad that Katie was there (or I would have stayed being that I have family in Boston).  Take care and I guess you need to keep this blog going so we can all share in your recovery and cheer you on!
Michelle,  I enjoyed meeting you and Joe and all your running friends.  Katie and I had a lovely visit with Joe at the pasta feed and I was looking forward to meeting up with him at the start line.  We really did appreciate your offers to help and would have accepted if it was needed.  We were given a bit longer leash today so we rented a car and a room on Bearskin Neck for the remainder of our stay.  We both needed to get out of the city.

Please feel free to share my story.  The reason I'm sharing it here is in hopes that it can help someone else.  I have a lot to learn and will continue to share as I progress back to an active lifestyle.  One of Dr. Baggish's biggest concerns...after I was stable...was that I would let this incident scare me...and others around me...into becoming less active.  He assured me that part of my care once I got back to Oregon would include making sure my family understood that I could and should exercise safely. 

Will share as I learn more...
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Post  Michele "1L" Keane Fri Apr 24, 2015 5:10 pm

So no more marathons, but plenty of runs, bike rides and swims.  Guess you can do those short triathlons!
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Post  Mark B Fri Apr 24, 2015 7:02 pm

Dr. Baggish sounds like one heck of a doctor. Glad he was there.

Question: Have you considered sharing this story? It's likely to be of interest to the local folks in Boston, but also to the folks in Oregon, as well as runners in general. The doctors can't share due to medical privacy laws, but you could let the PR folks at the hospital know that you'd be interested in talking and they'll take care of the rest.
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Post  nkrichards Fri Apr 24, 2015 7:13 pm

Mark B wrote:Dr. Baggish sounds like one heck of a doctor. Glad he was there.

Question: Have you considered sharing this story? It's likely to be of interest to the local folks in Boston, but also to the folks in Oregon, as well as runners in general. The doctors can't share due to medical privacy laws, but you could let the PR folks at the hospital know that you'd be interested in talking and they'll take care of the rest.
Yes, at some point this may come up.  My family has asked me to keep things a bit quiet until I get home but I figured I was safe to share here.  Once things settle down I'll make that offer to Dr. Baggish.  He specializes in working with athletes as does his friend who now works in Portland.  Marty said I have a message on the phone from BAA but I don't know the details yet.  As long as the story is about the benefits of exercising safely and not about me I'd be happy to cooperate.
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Post  Michele "1L" Keane Sat Apr 25, 2015 11:08 am

Maybe we cano ne of our budding journalists - Mark or Seth - to write a positive article.  I'm sure the BAA is checking up as they do that.
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Post  Mark B Sat Apr 25, 2015 2:16 pm

Fair warning: Your case is so unusual that it'd be next to impossible to not make it about you, Nancy.

"Farm woman from Madras, Oregon finishes Boston Marathon while having a heart attack... but she'll be fine because she's made of tough pioneer stock!"

"Five training secrets that kept hardy farm woman moving despite a coronary artery blockage!"

"Should she have stopped? Doctors debate whether continuing to run during a heart attack is a bad - or very good - idea."

"Her heart gave out on Heartbreak Hill, but her will carried her to the finish. Her amazing story of survival, next time on Oprah!"

Okay, maybe it wouldn't be that bad, but actually... it could be. Yours is a compelling story, and if you decide to allow it to go public, it's possible that you might end up getting a LOT of attention. Once it gets out, you won't have any control over how its covered.

Consider if that's something you want.
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Post  nkrichards Sat Apr 25, 2015 5:05 pm

Mark B wrote:Fair warning: Your case is so unusual that it'd be next to impossible to not make it about you, Nancy.

"Farm woman from Madras, Oregon finishes Boston Marathon while having a heart attack... but she'll be fine because she's made of tough pioneer stock!"

"Five training secrets that kept hardy farm woman moving despite a coronary artery blockage!"

"Should she have stopped? Doctors debate whether continuing to run during a heart attack is a bad - or very good - idea."

"Her heart gave out on Heartbreak Hill, but her will carried her to the finish. Her amazing story of survival, next time on Oprah!"

Okay, maybe it wouldn't be that bad, but actually... it could be. Yours is a compelling story, and if you decide to allow it to go public, it's possible that you might end up getting a LOT of attention. Once it gets out, you won't have any control over how its covered.

Consider if that's something you want.
Quite funny but you do have a very good point.  I'll think long and hard before I let it go public.  My concern is that the right message get out there but if my story is not told correctly it may do more harm than good...and I may not be able to control the message.

We took a short scenic drive up the coast today and had a seafood lunch before returning to our room.  We're in a little old place but can see and hear the ocean ...I enjoyed Boston but we needed a change of scenery!  Early to bed tonight.  Everything takes twice as long as it should and it's going to be a very long day tomorrow.  Can't wait to get home!!!
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Post  ounce Sat Apr 25, 2015 6:48 pm

Have an efficient flight home.
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