I'm too old to give up but too young to rest by Johnf

Where was I with my tale of woe?  Yes on the way to the cardiologist at Ipswich Hospital.

Wednesday afternoon when I left the surgery in my hand was a glyceryl trinitrate pump, those ones you squirt under your tongue for angina and oncoming heart problems.  Having read everything there is to read about heart problems in the last week I found out this is the medical equivalent of the explosive nitro glycerine.  Wonder if they let you on a plane with it?  In my head were the words from the GP saying that although they couldn’t be sure it looked like a coronary artery problem from their reading of the ECG and that I would hear quickly from the hospital about the first of the tests needed before, in the view they gave me, I would be heading off to Papworth Hospital for an angiogram and likely fitting of stents.  I also remember the GP still being somewhat amazed, perhaps almost disbelieving that I hadn’t felt any chest pain on the run, faint or breathless.  In fairness to them I suppose that is what most people that they see, who have similar ECG readings, probably will be suffering from; cardio vascular disease.

Of course this would all be brought forward rapidly if I actually suffered a heart attack.  I know some of you will have been in similar positions where your life is thrown into turmoil by something that looks life threatening, but it was a first for me.  I left there thinking a heart attack could be imminent, it might mean a considerable time in hospital, it could even be open heart surgery if really bad, or worse.  When if ever would I be able to run again?  Co-incidentally I bought a new pair of trainers the week before and even my other pair only have a few treadmill miles on them. Still they’ll be nice to walk around in!  Wednesday and Thursday were a real low for me; it’s not a great place for your head to be.  And of course Pat and my daughters feel it as well, a real worry for them.  Thursday I got a call from the hospital with a cardio appointment for Friday afternoon.

Book into the cardio clinic and start with another ECG, at least it’s becoming easier to stick the pads on as most of the body hair in the way has been sort of waxed off.  Then into see the cardiologist and my spirits are lightened by our discussion.  Now I have always thought having some nerdy stats was going to be useful one day.  I had printed off the Garmin stats for my half marathon at the start of September, those for a 5.3 mile run I did on the Wednesday before the Ipswich Half, and of course the Ipswich Half.  All the stats included the heart rate and speed graphs.  He was very interested in them and said it was great background information that of course they don’t normally see with heart problem patients.  He asked what model of Garmin I had and liked the look of the way they are displayed by the Garmin Training Centre on an Apple Mac.  He has a son who is in the British Duathlon team and two daughters who also run distance, so not only is he a heart expert but he also has a good understanding of times for half marathons etc.  His view is that the problem is a heart rhythm one, and with luck is a one off possibly triggered by a burst of adrenalin on the day.  He is as close to 100% certain as anybody could be that it is not cardio vascular disease.  Somebody with that sort of problem is just not going to be able to keep slamming their heart up to 200 – 230 bpm the 20 odd times I did and not feel intense pain.  In fact in his view it’s only going to be a fit person that can keep doing it without feeling dizzy and faint.

Next steps are to try to work out what triggered it and if possible to trigger it again while I have a portable ECG recorder on.  First off I have an echocardiogram on Wednesday morning, it is an ultrasound scan of the heart, which will check that structurally all looks sound in terms of size of heart, various chambers in it and valves working correctly.  Then another appointment, which I’ve not had confirmed yet, on a treadmill where they will try to trigger the rhythm again.  He says this could be difficult because it was close to 4 miles before it started in the half marathon.  They may send me for a run at the hospital as well if they can’t do it on the treadmill.  Of course they may just not be able to trigger it.  The idea of triggering again while I have the ECG on is that they can identify which chamber or area of the heart is causing the problem.

Once they have all the results from all the tests, ECG, 24 hours ECG, full bloods, echocardiogram and the stress test he will discuss the way forward.  If it does look like for some reason a rhythm problem has developed it could be that beta blockers will sort it though there are some downsides for running in that it does put an upper level heart rate inhibitor on you.  That gold in the Olympics definitely gets more difficult.  Or there is a treatment called ablation.  Some of you may remember Tony Blair having a procedure carried out many years ago to cure a similar problem.  A probe is fed into the heart and they make a change to the electrical circuitry by switching off the offending node.  There are of course risks with this, perhaps the biggest being if it goes wrong it might mean a pacemaker for life, and I don’t mean one of those little Kenyan guys that look like schoolboys you see at the start of the London Marathon.

Good news as well is that he is happy for me to start some training again, no racing but some steady miles is fine and especially as I can monitor my heart beat.   He kept my Garmin stats for my file, how good is that?

I’m going on the treadmill tonight, will use my Polar HRM so I can watch my rate on screen, and just keep it at a nice low level.  I don’t actually feel nervous, probably more excited that I can go for a run.  The new trainers aren't for sale just yet!