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Survival of the fittest

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Post  dot520 on Sun Apr 26, 2015 7:25 am

This has been an incredible story thus far, Nancy!  I've shared your report with a close friend of mine that is also a runner and she agrees that it's quite remarkable.  Keep blogging and let us know how your recovery goes.
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Post  nkrichards on Tue Apr 28, 2015 9:39 am

Not much to report other than we traveled home on Sunday.  It was a very long day but I did OK.  Monday was tiring as I had so much to catch up on once I got home...payroll, mail, phone messages etc.  I do tire easily and I do everything at about half speed but I can tell that I am improving each day.  I'm headed up to see my primary care doctor here in Madras today.  I want to make sure they have my records...especially my medication info...in the local system and even though I'm feeling OK I'm going to have them take a listen and check my blood pressure.  Not really worried but I think it will ease my mind.  I don't see the cardiologist in Portland till May 13th and I'm on some pretty hefty medication.

The first race in the local 10K series is this weekend.  I placed 2nd the last two years.  They have expanded it to include a 5K series.  I'll volunteer this weekend...or at least watch and socialize.  Maybe I'll be able to participate in some of the races later in the year.  Swimming is one of the last things I'll be able to do...I hope I can participate in the local triathlon...I haven't missed one yet and I'd like to keep that streak going.

I'm a planner and I need goals.  This rest and recovery stuff is hard.
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Post  jon c on Thu Apr 30, 2015 11:35 am

Thank you for updating about what actually happened to you, and am so glad that you survived it.

Definitely a cautionary tale for all of us. No doubt in my mind that your active lifestyle saved you, along with those skilled physicians and the decisions they made.

I too would be interested in seeing how your recovery goes. My dad recently recovered from a triple bypass (at age 83) and there is a history of heart disease on that side of the family.

Enjoyed meeting and visiting a bit with you at the Prudential food court.

We never know what is around the next bend in life.
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Post  nkrichards on Mon May 04, 2015 8:40 pm

Tough weekend.  I really felt like I was improving each day last week and then on Friday I ended up catching the crud from one of the grandkids.  Even though I had a much milder case than the rest of the family it still ended up knocking me off my feet.  I wasn't sure if I needed to call the cardiologist of just tough it out.  I kept a close eye on my heart rate and oxygen level...I think I may invest in a blood pressure cuff.  I kept a sharp eye out for any of the symptoms I had during the initial attack and didn't notice any of them.  It was mainly nausea and extreme tiredness.  I was feeling well enough by Sunday afternoon to sit outside and watch the girls help with my yard work.  I was still feeling a bit off this morning but I'm much better this afternoon.

My first appointment isn't until May 13th and I already have a very long list of questions...including my race schedule so that he can let me know which ones I may be able to compete in.  I'm hoping he lets me jog the 10K on July 4th but the one I really want to be able to do is the MAC Dash (sprint tri) on Sept. 12th.  The swimming may be the problem there as that's the last thing I'll be allowed to start doing.  I don't mind doing it slowly and if I absolutely have to I can do it as part of a team.  I haven't missed one yet and don't see any reason to miss this year!
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Post  Julie on Mon May 04, 2015 9:21 pm

I hope you feel better soon. I'm sorry you had such an awful thing occur, but also thankful you are doing well and had good help (and a good doctor locally, too).
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Post  Mark B on Mon May 04, 2015 11:17 pm

Ugh. Catching a bug after what you've been through is adding insult to injury.

Here's hoping you get good news from the doctor when you visit later this month. Your physical condition prior to the attack can only help speed your recovery.
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Post  nkrichards on Wed May 13, 2015 9:15 pm

So here is the update after my appointment with the cardiologist today.  I do have some muscle damage but it's limited and may heal.  I'll be on a blood thinner and a beta blocker for at least a year and on a statin and aspirin for the rest of my life.  He say's most people tolerate the medication well and can continue to exercise at a fairly high level but we'll have to wait and see.  The beta blocker is the biggest potential for difficulty but it's important for now.

We're working on getting me started in an official cardiac rehabilitation program in Bend (an hour drive) as the 3 hour drive to Portland is not feasible.  I will be seeing Dr. Beckerman in Portland but those trips will be infrequent and also a good excuse to see my Mom.

For now I'm released to rehab on my own...with caution...just walking for now.

Dr. Beckerman has a great sense of humor and his philosophy aligns very well with mine.  He spent an hour and a half answering my questions this morning! 

Now here is the Boston/running news.  Dr. Beckerman ran the Boston Marathon on a dare with no training in 1994.  He was a Senior at Harvard that year.  He claims that you could get a bib in those days...I didn't push the issue.  He hasn't run it since then.  He has run 7 marathons with a PR of 3:36 and can't qualify. Smile He went back to Boston in 2014 to work beside Dr. Baggish in the medical tent.  I think I mentioned that Dr. Baggish was at the finish line when the bombs went off in 2013 and suffered some temporary hearing loss and had a tough time coping with what he experienced that day.  He runs the marathon a week before the race so that he can work in the medical tent on race day.  Dr. Baggish had aspirations to be an Olympic runner.  He was training in Colorado when a running friend died from a cardiac event.  He vowed that day to become a cardiologist and gave up his running career.

There are times when I wonder "why me" and then there are times when I feel very, very lucky.  I feel lucky today.


Last edited by nkrichards on Thu May 14, 2015 9:27 am; edited 1 time in total
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Post  Mark B on Wed May 13, 2015 10:33 pm

Ooo. You just gave me goose bumps.

Great news. I'm looking forward to tracking your rehabilitation and return to running.

Lucky, indeed. Very Happy
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Post  Michele "1L" Keane on Fri May 15, 2015 8:53 am

Definitely lucky, Nancy.

As for the bibs - you used to (and maybe still can) score a bib as a physician - they used to even wear "red" numbers.  Those days may be gone, but I'm not sure about that.  So I believe that he ran.  It was so much easier to get a bib even as late as 2009 when I registered to run in March.
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Post  nkrichards on Sun May 17, 2015 3:11 pm

Michele \"1L" Keane wrote:Definitely lucky, Nancy.

As for the bibs - you used to (and maybe still can) score a bib as a physician - they used to even wear "red" numbers.  Those days may be gone, but I'm not sure about that.  So I believe that he ran.  It was so much easier to get a bib even as late as 2009 when I registered to run in March.


Oh I'm sure that he ran...just wondering how he got/if he had a bib.  It does sound like it was much easier to get a bib at the last minute back then.

I did get into the cardiac rehab program here in Bend...unfortunately the earliest date available to start is June 23rd.  I was hoping to be back to running long before that so I'm a bit disappointed.

I've been doing a bit more walking every day and it's going fine.  I walked up to get the paper today and dug out the Garmin.  I logged 1.1 mile @ 22:49 with an average HR of 75 and a max of 90 on the hill.  Thought it might be nice to have some idea where my HR was at so I'd have a better idea where it should be as I increased effort.
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Post  dot520 on Sun May 17, 2015 7:29 pm

I have a Dr friend who scored a bib for Boston back about 6 years ago.  Even then it cost her about $900 for it since she hadn't qualified on her own.
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Post  nkrichards on Wed May 20, 2015 10:44 am

Not a lot to update yet.  Monday I worked in the yard/garden and did some walking associated with that.

Yesterday I put my Garmin on and headed out for a more structured walk.  Got in 1.5 miles @ 19:38.  Not fast by any means but faster and longer than my Sunday walk.  The HR monitor didn't function well at first so my HR was higher before it started to register.  It ended up showing an average of 85 with a max of 103 which I think was a glitch.  I didn't see anything over the low 90's and that was on the hill.  That said I think that was probably plenty long and about the max effort I should be at for now.

I'll keep walking and tracking my progress and then see if I can get the OK to jog and/or swim next week.  Wish I was able to start the cardiac rehab sooner than June 23rd!!!
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Post  Mark B on Wed May 20, 2015 12:15 pm

Patience, grasshopper! Keep doing what you're doing, and that cardiac rehab will seem like an afterthought.

Glad you're making use of the HR monitor at this point. If you're having problems getting readings out of it (which is likely if you're walking at a pace not enough for you to break a sweat), you might have luck lubing the strap with some aloe vera gel. Less gross than slobbering all over it. Shocked
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Post  Nick Morris on Fri May 22, 2015 3:03 pm

@Mark B wrote:Patience, grasshopper! Keep doing what you're doing, and that cardiac rehab will seem like an afterthought.

Glad you're making use of the HR monitor at this point. If you're having problems getting readings out of it (which is likely if you're walking at a pace not enough for you to break a sweat), you might have luck lubing the strap with some aloe vera gel. Less gross than slobbering all over it. Shocked

Yes, patience is the key here.  You don't want to rush back to activity too soon.  I am glad that you are able to do some activity on your own.  Also, thanks for the update!!!
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Post  Julie on Sat May 23, 2015 4:21 pm

I think the end of June will be here before we all know it. It seems like things go so fast even when we're being impatient, in a way. I think you're doing great, but I just think back to after I had my boys and how I thought I had to run right away even though I had 6 weeks of bedrest prior to their birth and then a medical emergency c-section and still "when am I going to run? What, wait more than 3 weeks???" hahah. Now I think what was the rush but I know we love running and it feels good to do it so I'm not trying to be critical, I just look back and think why did I just not rest more and take my time getting back.
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Post  nkrichards on Mon May 25, 2015 10:39 am

Yes, Mark, Nick and Julie...I realize I need to be patient but it was running/training that helped me get through the last couple very stressful years and to not have that option is tough.  It's hard for me to get motivated to walk but I need to use the tools that I have.

I asked about jogging or swimming and the Dr. said he'd prefer to see me just walk until I started cardiac rehab later in June.  Disappointing to say the least but I now realize he was right.  I did a bit more work around the house than I've done since the "cardiac event" (that's the PC name that they use now) and I was really tired the next two days.  Probably need to increase my activity a bit more slowly.

All I heard back in Boston was how lucky I was and that I would be back to doing everything in time.  Now I'm hearing things like heart muscle damage, abnormal ECG, and beta blockers and blood thinners possibly for the rest of my life.  The statistics they report for the risk of a 2nd cardiac event are pretty scary.

The hardest part is not understanding.  Am I so tired because my heart is damaged and not pumping at full function or am I tired because of all the medication that I'm on that is supposed to be allowing my heart to relax and heal?  Will I/when will I feel better? Prior to the marathon I had all the testing done that they recommended and all indications were that my risk of having a heart attack were less than 1%.  The doctor's explanation was that I was that 1%.  He's trying to answer my questions but I realize that he can't tell me what will happen...only what might happen based on past experience/statistics.

Ok...enough feeling sorry for myself.  My oldest granddaughter is coming down later this morning to help me with some yard work.  I am very lucky.
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Post  Mark B on Tue May 26, 2015 12:08 pm

@nkrichards wrote:The hardest part is not understanding.  Am I so tired because my heart is damaged and not pumping at full function or am I tired because of all the medication that I'm on that is supposed to be allowing my heart to relax and heal?  Will I/when will I feel better? Prior to the marathon I had all the testing done that they recommended and all indications were that my risk of having a heart attack were less than 1%.  The doctor's explanation was that I was that 1%.  He's trying to answer my questions but I realize that he can't tell me what will happen...only what might happen based on past experience/statistics.

Sorry you're feeling so stressed right now, but I totally understand why. This is scary stuff.

But! Here's something to remember as you worry about why you feel so wiped out right now. It's almost certainly not just your heart.

Remember that you trained for and ran a marathon, which always requires recovery time after the fact due to the inherent strain it puts on the body. The fact that you completed that marathon while having a "cardiac event" has to have greatly increased the total stress you put on your body.

In other words, the damage to the heart muscle and the effects of the medication may be playing less a role than you think.

You beat the living cr@p out of your body out there. Really. Can you imagine how hard the rest of your body was working as it was trying to keep you going out there on the streets of Boston? You must have been red-lining it the whole time. Because of that, every part of you (including your endocrine system) has got to get back to normal. That takes time.

It's a lot like overtraining (physically, it's probably the same process), and the solution for it is low-intensity activity and lots of rest. Hopefully the doc is letting you do some nice, easy walking? That's not as fun as running, but it aids recovery and gets you out of the house.

As for the 1% odds, think of it this way: Yes, you may have been one of the 1% who have a "cardiac event" despite a clean bill of health... but what's the percentage of people who have a "cardiac event" while running a marathon who come through it as well as you did? So you're both unlucky, and very, very lucky. I'd suggest buying a lottery ticket one of these days, but you already won.

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Post  ounce on Tue May 26, 2015 2:31 pm

C
I'll go along with Mark on a lot of what he said, but I think all of the new chemicals are 'renovating' your body and the present occupants are trying to exist amongst all of the banging, cutting, and paint smell (Mark should remember that stuff LOL).

Blood thinners are not a wonderful thing to have for a runner.  But, you're only 45 days removed from the event?  Read up on what the meds do to your body.  I am not saying to not take the meds.  I would also research elite runners having heart attacks.  Also get copies of your medical reports and dissect them until you understand what happened.  Any runner that has had a heart attack probably didn't have what you had.  But there are similarities that can be gleaned to help your understanding.  

Be knowledgable enough to know much more than the average bear about your situation.  That way, you can converse some in doctor speak and understand it better in an emergency room or a doctors office.

This is your new normal.  Learn and learn as it's your best weapon.
Edit:  Much like Charles adapted, so must you.  You are now 45 days into Nancy 2.0.  All you know about running, marathoning, and triathloning will be valuable but it's not applicable right now.  You have to learn and learn this new body you NOW have.
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Post  nkrichards on Thu May 28, 2015 12:35 pm

Thanks Mark...I understand the concept and why I'm struggling mentally but understanding and changing my outlook are two different things.  Good point concerning marathon recovery.  Even though it was a slow marathon for me it was probably harder on my body than any of my faster ones.  After all I did run as hard as I could for a full 5 hours.  I hadn't really considered that.  Thanks for the reminder.

Doug...very good suggestion.  I have done a bit of research off and on.  I tend to get one answer and it usually creates more questions and/or I'm discouraged with the new knowledge.  I will keep at it.  I hadn't thought about asking for a copy of my medical records.  It would take a bit of translation work to understand all the medical terms but knowledge is very powerful.  I can't be in control of my life if I don't understand the foundation that I have to build on can I? 

I'm learning more about the medications I'm on.  I'm happy with the anti-platelet that he's chosen and I'm on a newer very expensive beta-blocker that also sounds like a better option.  I am/was very anti-medication opting for lifestyle changes rather than medication but I think I'm going to have to change that attitude.  There is just to much risk of another cardiac event at this point in time.

Walked 1 3/4 mile on Tuesday.  2 miles yesterday.  I'm keeping the pace pretty easy...around 20 minute miles.  The HR monitor worked a bit better yesterday as it was warm.  I'm trying to be cautious and not get above 90bpm...I have to be careful on the hills.

I'm getting better at pacing myself in/around the house.  I'm learning that I need to stop and rest even if it means the job doesn't get done till the next day.

Progress is good...even if it is a bit slower than I'd like.
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Post  ounce on Thu May 28, 2015 2:23 pm

One or two other suggestions, if I may.

Create a medication sheet in Word.  Type name, DOB, & date of the list.  Then type the medication brand name, pill size, the chemical name (e.g.  Valium  5 mg (diazepam)), and dosage.  Bring a couple of copies of it and give one to the ER nurse or the doctor's nurse in the clinic.  Also type the pharmacy name and phone number.  They will LOVE you for it.

Have a copy of your discharge papers from Boston and even get them to burn a CD on any images they made.  And a surgical history & whenever you spent the night(s) in a hospital.

It will save so many questions that you don't want to answer or a loved one who isn't of a mind to answer them.
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Post  nkrichards on Mon Jun 01, 2015 4:12 pm

Once again great suggestion Doug.  I did put the medication list that they gave me on discharge in my wallet but I don't always carry my wallet...and it's already slightly outdated as some dosages have changed.  A Word document that I can update and include some additional information is a good suggestion.  I have to carry nitroglycerin at all times as well.  My jeans pocket works fine most of the time but I don't always have a pocket and need to figure out something that is convenient all the time.  Adding my medication list, ID, emergency numbers etc to this packet would be a good idea...easy to locate and accessible.

Haven't walked with the Garmin for a couple days but I've been getting in about a mile most days.  Some days it's up to the paper box and other days it's over to see the grandkids.  I'm doing more chores in/around the house.  I do still tire easily so have to be pretty careful.  I'm really curious to see how things go once I start cardiac rehab.  Three more weeks but we're busy on the farm so the time will pass quickly.

I've decided that as I transition to Nancy 2.0 I deserve to reset all my PRs.  I'll have before cardiac event PRs and after cardiac event PRs.  First race on the schedule is a 5K on July 4th (walking this one).
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Post  ounce on Mon Jun 01, 2015 5:57 pm

That's a good idea, 2.0. 

It seems like you're just off square one on the stamina scale or maybe a contestant on weight loss show, without having to lose the weight.  Well, persevere!
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Post  Mark B on Tue Jun 02, 2015 8:48 pm

If you can't hit the reset button for a cardiac event, then you can't hit it for anything.

So reset away! Enjoy the new PRs, starting with your new 5K record. Approval
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Post  Michele "1L" Keane on Wed Jun 03, 2015 11:25 am

Nancy - do you have a Road ID to wear? Seems less "old person" than one of those med alert bracelets.  You can link it to a website wear all your information is inputted (is that a word?) with medical, contacts, etc.

www.myroadid.com
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Post  Mark B on Thu Jun 04, 2015 9:41 am

Michele \"1L" Keane wrote:Nancy - do you have a Road ID to wear? Seems less "old person" than one of those med alert bracelets.  You can link it to a website wear all your information is inputted (is that a word?) with medical, contacts, etc.

www.myroadid.com

+1

That's a great idea. I've used a basic Road ID before but never made use of the medical database option they provide. But I can see how it'd be extremely useful for Nancy or others with medical conditions or special medications.
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