Re A-Fib: 5 Things I’ve Learned in 10 years… A Guest Post by David Grayson Lees

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I’m a 64 year-old road/trail runner, marathoner and weight lifter diagnosed with atrial fibrillation more than a decade ago. I’ve had three ablations and as many cardioversions, plus I’ve swallowed the usual assortment of prescription meds. Now my a-fib has become paroxysmal atrial flutter—about one episode every two weeks or so, usually lasting a few hours—and while my running days seem to be over, I still regularly make it to the gym and I’m discovering the joys of walking and hiking.

Through trial and error—plenty of each, actually—as well as a fair amount of research, I’ve come to a handful of conclusions that may be useful. While I believe them to be true, keep in mind that my observations are true for me; your experience may well be different. Finally, since I’m not a physician, nothing here is intended as medical advice.

And now: 5 things I’ve learned in 10 years of dealing with the always-entertaining world of cardiac arrhythmia.

A-Fib won’t kill you…even though a diagnosis of a-fib—and its symptoms—can be very scary, barring underlying cardiac disease, a-fib is not inherently life-threatening. And so if you have just been diagnosed, relax as best you can.

…but a stroke could. Pay rigorous attention to your anti-coagulation regimen. Even if your CHAD score is zero, at least take a low-dose aspirin every day. Personally, I find Coumadin to be a true pain, what with blood monitoring, dietary restrictions and the like. I much prefer the newer meds, especially Xarelto. It acts quickly, and as an added bonus you don’t have to be continuously concerned with your INR numbers.

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Your EP isn’t interested in prevention. Typically, EP’s are all about fixing stuff rather than prevention. Which is weird, because unless you’re on the younger side of 40 and/or your a-fib has been freshly discovered, one ablation usually won’t do the trick. Of course, I’m grateful to my two EP’s, one rated among the best in California and the other acknowledged as one of the best in the world. It’s just that neither one has ever expressed any interest in the contours of my life, including what my exercise habits happen to be, what sorts of supplements I take, or what my days are like. Now, I’m not looking for a new best friend, but it’s clear that for them I’m a unique problem to be solved rather than a unique human being. I’m not angry about it; after all, these docs chose a field in which their major interaction with patients occurs when the patient is unconscious.

Still, I believe the implication is clear: you are pretty much on your own when it comes to figuring out how to modify your life style, exploring vitamin/mineral supplementation, and gathering the latest non-nutsy information.

(BTW, in terms of info, two websites I recommend are Dr. John Madrola and The A-Fib Report. Dr. John is a younger EP who always has a thought provoking take on new developments in a-f treatment and research and The A-Fib Report is a readable compendium of international a-f research, written in lay language. It requires a nominal membership fee that’s well worth it.)

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Supplementation could work for you. I haven’t thrown out my beta blocker (Sotalol AF, not regular Sotalol) but along the way I have had excellent results in controlling the frequency and duration of my atrial flutter episodes by supplementing with 200 mg of magnesium citrate in a pill taken at lunch and ¼ teaspoon of potassium citrate dissolved in water taken in the morning and again at dinnertime (Please note: ingesting too much potassium involves some quite severe health risks, so be careful.)

Life is good. But first, the bad news: as near as I can tell, nobody knows what causes atrial flutter. The gang of suspects spans endurance sports (!) to mysterious biochemical mechanisms that somehow encourage the formation of tissue substrates that make the electrical system of the heart go haywire. Researchers—and your EP, too–are just guessing, leaning on statistical correlations rather than employing demonstrable causal connections. Maybe cutting out caffeine will help you; maybe it won’t. Maybe abstaining from demon rum will prove to be the answer; maybe not. Obviously, if you are over-drinking, over stressing (like many of us who are into enduro sports) under sleeping or happen to be engaged in other deleterious deeds, changing your behavior is simply a good idea, a-fib or no a-fib. Just don’t expect that any one thing will be the answer.

The good news is, you can have a great life even with a-fib and a-flutter. No, I don’t love my a-flutter episodes; they are annoying and sometimes, even after a decade, still frightening. I don’t run anymore, but a long walk or a moderate—I know, I know, not my favorite word, either—hike turns out to be a lot of fun. No, I can’t put the same hemodynamic load on my heart that I used to, but I can still work up a nice funky sweat underneath the weight machines at the gym.

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Besides, working out is only a part of life. My friendships, relationship with my son, work, and my love life (I’m getting married again, and I’m stoked!) are just as satisfying as ever.

Maybe more so.

Those of us with a-fib or a-flutter aren’t sick, not truly. Nor do we need to afraid.

So—live!

(Thanks to Linda for the inspiration. Thanks to you for reading.)

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Afibrunner: Patient Perspectives: Long-Distance Running and Mountain Biking in Permanent Atrial Fibrillation / EP Lab Digest

Patient Perspectives: Long-Distance Running and Mountain Biking in Permanent Atrial Fibrillation / EP Lab Digest

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I am honored to have had an article published in the December 2014 issue of EP Lab Digest, a monthly journal for electrophysiologists and allied health professionals who work in electrophysiology labs.

The managing editor, Jodie Elrod, had approached me about writing a “patient perspective” article as she was familiar with my afibrunner blog. The article is basically a synthesis of material already presented in this blog, particularly my article called Atrial Fibrillation – A Visit to the Electrophysiologist.

I am delighted to have this opportunity to communicate with the EP community and promote my plea for empathy with respect to the endurance athletes afflicted with atrial fibrillation.

Thanks EP Lab Digest!

Also interesting – my cousin Chuckie, (an electrophysiologist – I’m sure they don’t call him “Chuckie” at work), who I mention in my article, had an article published in the November 2014 issue of EP Lab Digest.

Bicycling the Rim Drive Crater Lake National Park and Atrial Fibrillation

I haven’t blogged for a while because we’ve been on vacation in Croatia for two and a half weeks, and of course after being gone for that long I’ve been incredibly busy at work. I am working on along blog entry (actually it’ll be a separate blog) about Croatia, so stay tuned.

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Me During a Brief Rest Stop

In my opinion bicycling around Crater Lake is one of the finest bike rides in the entire United States, and Crater Lake National Park will, from time to time, close of twenty-four of the thirty-three miles of the Rim Drive to allow bicyclists, hikers, and runners to have a relatively car free day. This year they had vehicle free days on two Saturdays: September 20 and 27, and I made time to be there for both days.

Since I live near Crater Lake N. P. I’ve had the opportunity to ride the rim several times, but this year was my first time doing it in permanent atrial fibrillation (and while on a beta blocker). Always a challenging ride under any circumstances, adding a fib and a beta blocker to mix changes things a bit.

Most riders start at the Steel Visitors Center (Park Headquarters) and ride clockwise. The first thing on the agenda is a three mile climb with 650 feet of elevation gain up to the Rim Village. This is actually the steepest hill along the route, but not the most difficult, in my opinion, mostly because the legs are still fresh. It is quite odd to pedal up a climb like that and find a lake at the top. There are several climbs and descents along the thirty-three mile route, and rarely is there any flat road, and the two toughest climbs, in my experience, are in the second half of the ride – the long easy climb to Cloud Cap (where most people stop to sigh and eat their Clif Bar) and the last grind up to Dutton Ridge. I might even say that you only need two gears to ride the rim – whatever you use as your easiest climbing gear and a big gear for coasting downhill.

Elevation varies from 6700 to 7700 above sea level. Personally I don’t have an issue with the elevation at Crater Lake because I’m used to living at higher elevation, but people coming from sea level might feel it.

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Bicycling in Croatia with Margo

To be honest, none of the climbs (going clockwise) are particularly steep, and there is only a total of about 3500 feet of climbing, but the climbs are so long and persistent that it seems like more. The descents can be fast and one could easily go 50 mph down the descent from Cloud Cap, but don’t. The speed limit is 35 mph and there are often surprising potholes encountered once you get up above 40 mph. The vehicle free days are great because you don’t have to worry about cars behind you. One day I was descending at 45 mph, a speed at which the wind in my ears prevents hearing anything, riding right down the middle of the lane, and was passed by a van. I thought, “What’s your hurry, bro? I’m already going 10 mph over the speed limit!”

The scenery is world class and seeing it slowly, up close on a bike, complete with the sounds and the smells is unimaginably beautiful. Being there on a vehicle free day with hundreds of bicyclists from all over Oregon is even better – there is an amazing energy in the air on the vehicle free days.

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Snowshoeing with Libo April 2013

If you are going to ride the rim, especially on a vehicle free day, keep in mind that once you are past the Visitor Center and the Rim Village (basically once you are past the first three miles) there is no water. I’m a heavy sweater so I’ll take three liters on a hot day. Actually along the last big climb there are some little “waterfalls” right along the roadside and I have seen people filling their water bottles there and it is probably fine; but it is definitely not tested and designated as potable water. Also keep in mind that there will be no SAG wagon trailing you so make sure you have the proper gear and tools for changing flat tubes and minor repairs.

As far as riding the rim in a fib while on a beta blocker, well, it is much slower. I was able to ride it but it took me at least an extra hour. I had a triple chainring on my old road bike, and I used to be able to do the entire ride in the middle chainring (except for part of the first climb); but now I am using my easiest gear for most of the climbing (my new bike has compact double, but the gearing is similar). I think I need to be happy with being able to complete the ride without falling to pieces, and quit lamenting my slower speed.

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Photo by Margo

My personal preference, now that I am in a fib, is to keep going and minimize rest stops. It seems every time I stop it’s like starting over again. On the first Saturday I was riding with a group of friends, including my wife Margo (her first time doing the rim ride) and I told them I wouldn’t be stopping much and that they could catch up to me. The last I saw them was at the top of the first climb, and I actually completed the ride a half hour or so ahead of them – they had fun, stopped at the many overlooks, stopped for lunch. I was the tortoise to their hare; slogging up the hills and only stopping a few times.

Another difference is that now that I am on an anticoagulant I brake a lot on the descents. I’m usually the biggest rider in whatever group I’m riding in and consequently the slowest climber that makes up for that by being the fastest descender. No more. Now I think about how descending slowly will help me keep my blood inside my body and I was passed by dozens of riders on each hill. As a matter of fact I kept getting passed by the same groups over and over. They’d pass me on the climb, then I’d pass them at the top of each hill where they’d stop to look at the stunning view of the lake, then they’d pass me on the descent and I’d pass them again at the bottom of the hill where they’d evidently stop to chat. Over and over – sort of fun.

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Skiing with Jan (evidently I’m relying on old photos because I only took one photo for two days of riding around Crater Lake – like I said I don’t stop enough!)

I returned and rode the Rim Drive again the following weekend as well but my friends didn’t accompany me. It was a much cooler, windier day and looked like rain, and they had other plans. I ended up doing the first half and deciding to make it an out and back. I was thinking about the big descent down the other side of Cloud Cap in the heavy wind and thought that might not be the best idea on account of my being anti-coagulated. I learned that riding the rim counter-clockwise is not as safe as riding clockwise. When riding clockwise the lake is to your right; but when riding counterclockwise there was quite often a steep drop off and no shoulder and no guard rail. The drop offs weren’t a thousand feet or anything like that but they were certainly much further than I wanted to go over on my bike so I did the long descents towards the middle of the lane although I pissed off a few drivers I will live to ride again. There is no way I will ever ride the entire rim counterclockwise. Keep in mind that most drivers are looking toward the lake (why wouldn’t they) and if you are between the driver and the lake they are likely to see you. But when riding the other direction there is more risk of being unseen.


Carter Lake Century 2011 (not my video)

Another good time to ride around Crater Lake in the Crater Lake Century. I have never ridden with the organized century (I’ve always been training for something at that time – it’s held in August) but I have been told it is a blast. As far as I know the Rim Drive isn’t closed during the century but there are about 300 riders up there that day. The number of applicants is limited so register early if you want to get in. The century, obviously, involves more than the thirty-three mile Rim Drive and in addition to more climbing from Fort Klamath up to the Park Headquarters, there is some routing around the local farmlands near Fort Klamath to make it an even one hundred miles.

I would love to hear from other bicyclists, especially cyclists dealing with atrial fibrillation. Please feel free to comment below.

SOB Trail Run 15K Race Report: Atrial Fibrillation, Running, Beta Blockers – My First Impression

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SOB Trail Run

I have been in permanent atrial fibrillation for a couple of years now, but only been taking an anticoagulant (Pradaxa). But things have changed and for the past month I have been on a beta blocker, carvedilol.

Prior to starting the carvedilol, while in permanent atrial fibrillation, I had been able to run two marathons and one ultramarathon (50K) without any more trouble than the normal marathon type suffering, but over the past six months I have noticed things have been changing. I’ve slowed down, even for me, and distances are getting harder. My last half marathon was a joke and I was at the end of the pack within the first two miles. After a run or mountain bike ride of an hour or more I would have problems afterwards – my blood pressure would drop and my pulse would stay high. After a long run, especially if it was a hot day (which they all are, recently) I would get so light-headed after standing up I sometimes had to grip onto something to remain standing.

A visit to the cardiologist, and a subsequent echocardiogram, revealed that my heart rate was increasing and my ejection fraction was decreasing, and for that reason the cardiologist wanted me to start on a beta blocker.

A beta blocker, in this case carvedilol, is a drug that reduces stress on the heart by slowing the heart rate, decreasing the force with which the heart beats, and reduces the tone of the arteries throughout the body. The end result is that blood pressure is reduced, as is heart rate. The heart needn’t work so hard.

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SOB 50 Mile Course – tough!

Some non-endurance athletes actually use beta blockers as performance enhancing drugs – it is said that it calms a person, reduces performance anxiety, and is commonly used in less endurance specific sports such as golf, target shooting, archery, and even in music performance.

Clearly these drugs are performance diminishing for endurance sports like distance running and mountain biking. We like to stress the heart, raise the heart rate, and we don’t have very much stress – we’re long distance runners after all – the mellowest people around.

I generally am in at least half marathon shape year round. Even if I’m not training for anything my weekend long run is going to be between nine and twelve trail miles. Prior to starting the beta blocker I had signed up for the 15K at the SOB Trail Run at Mount Ashland (Oregon) – one of my favorite races. This relatively high altitude run is basically all up and down trails and fire roads (zero flat sections) and I have done it at least six times in the past, including completing it twice in atrial fibrillation. I was curious to see how being on the beta blocker would affect my race.

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DNF

The answer was I DNFed (did not finish) and dropped out fairly early in the race. That was terrible – most of my friends were running the 50K or the 50 mile and I DNFed the little 15K???

The course at the SOB is brilliant, really. A lot of trail races start out right away on singletrack, but the SOB has about a mile(?) of fire road at the start so everybody has plenty of time to figure out whether they are going to be running with the fast people or the slow people before they hit narrow Pacific Crest Trail. I ended up at the very back of the group that was running, but I was still in front of the few people who were walking the 15K.

I found that as soon as the course headed up hill I was unable to run. My chest felt funny – not chest pain, just felt weak, not right, and my legs felt dead. I wasn’t short of breath, I was just unable to do it. I decided, in my typical OCD mode, to continue running for five more songs on my iPod shuffle, and then turn around and drop out, thinking that I should at least get a little bit of a work out in, and that I could justify keeping the T-shirt I had paid extra for. I knew I could have walked the course, but that is not what I went there to do.

I was delighted that the fifth song on my iPod turned out to be an oldie from my high school days: Yours is No Disgrace by Yes. Not actually I song I still like very much, but in this context it seemed like a cosmic pat on the back.

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A Cosmic Pat on the Back

On the way back I met a woman who was also DNFing (sprained ankle) and we walked the last section of the race together, commiserated, and removed our numbers so they wouldn’t mistake us for the top finishers. At the finish line we informed the race officials that we had dropped out so they didn’t need to send a search and rescue team to find us.

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DNFing and commiserating together as we remove our race numbers

So this article is, basically, my first impression of being on a beta blocker, in addition to the atrial fibrillation, and trying to remain an endurance athlete.

So far I feel that the beta blocker is more of a hindrance to my running and cycling than the atrial fibrillation alone had been – but then again, because of the atrial fibrillation my heart function is gradually diminishing.

I should say, on a positive note, that the beta blocker is working, and is doing what it is supposed to do. I check my heart rate and blood pressure at least once per day and since I started the carvedilol I am right where the cardiologist wants me to be. And I can understand why people who aren’t trying to be athletes might like the med – it seems to have a mild calming effect. Furthermore I no longer feel like my heart is a fish flopping around in my chest, and my post work out blood pressure and heart rate has stabilized.

I am optimistic that the carvedilol will be worthwhile and will help me preserve and regain my ejection fraction. But really, what choice do I have?

So here is how things have changed so far (compared to just permanent a fib without the beta blocker):

1.) As far as mountain and road biking is concerned I have been able to ride all the hills that I used to be able to ride, although I am much slower. My wife now has to wait for me at the top of a climb, and that’s fine. I am delighted I can still ride and don’t have to get off and walk my bike.

2.) Running is more negatively influenced. My previous slow pace is even worse, and hills are quite difficult. Not surprisingly I do not like this one bit. A slow jog feels like a 5K effort. But I am still able to run – Yay!

3.) Long runs in heat are not possible. I am just not able to do a long run in heat, and lately every day has been warm. Understand that I am a big red-faced Irish-American who considers anything over sixty degrees to be hot running weather; plus I live in a very sunny place, a high desert climate without a lot of shade. It is not surprising that this is happening. A normal person running in heat will have a higher heart rate for a given pace, and will need to slow down. If you are on a beta blocker that reduces the maximum heart rate by a significant amount, well: “game over.”

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My goal is to continue running and mountain biking on trails like this: Brown Mountain Trail

4.) I suspect that the beta blocker might be making me lazy. I don’t know if that is the right word, but I had a full day off in the middle of the week a while ago and I had planned on, among other things, writing this article and going for a trail run, and next thing I knew it was late afternoon and I hadn’t done a thing. What? By that time there was a thunderstorm so I was not going out for a run – but the article still hadn’t been started. I hope this is not going to be the case from now on. Being lazy and depressed is far from my idea of fun.

I am going to wait until I have had more experience with the beta blocker and write a better informed article. I’m going to sign up for a relatively flat (downhill, actually) trail half marathon and try to redeem myself.

In the meantime I would love hear about other people’s experiences with the dreaded beta blockers. Please post a comment below.

Joe’s Story: A Middle-aged Runner Deals with Atrial Fibrillation and Heart Failure – A Guest Post by Joe

This is Joe’s Story – a guest blog article based on Joe’s comment on this blog describing his fascinating experience with atrial fibrillation and subsequent heart failure. Joe has really demonstrated persistence and a positive attitude that, I think, a lot of athlete’s with atrial fibrillation possess. Joe is making a comeback from serious, life-threatening heart failure, and he has done a good job of accepting the new reality of his post a fib performance.

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Joe Triumphant

Hi Everyone – I’ve had A-Fib for about three years now.

I live in the tropics and cycle, run, do weights. I train five days a week but not hard or too easy. I believe I got into this mess when I cycled up our small mountain here on the island I live on three times a week back then. I would only drink reverse osmosis cleaned water consuming about four liters just going up the mountain. I’d do weights in the morning and cycle in the afternoon and believe me it gets hot and humid. It’d take me about two hours to cycle up to the top of this very very steep course. (approximately 5K to the top)

In hindsight now I guess I’d been over-training terribly and not putting back potassium and minerals into my body at all. I happened by luck (or fate) to be given a heart monitor and thought it was cool to use it on my cycle ride up the mountain. I set the max at 185 and started off – as soon as I started up the steep hill after a five kilometer preamble the damn thing started beeping – it was at 205 and I just started up the hill! Like an idiot (ha ha) I kept going and it would not shut up. Did it the whole way up and for the next month it was like that. Can’t believe it now I did that but as I’m in constant A-Fib now the reality speaks for itself.

Been put on beta blockers and have to take warfarin. I suffered a sever influenza sickness last year and it really took a toll on my ticker. My left ventricular ejection fraction (LVEF) was only 17% when I finally went to see the Cardiologist here as the echo showed.

Fast forward now to a month and a half and I’m back up to 35%. The goal is to get back to 55%! I love running and exercise and like some of you wrote would rather plonk on the trail then sit on the couch, so be it. I used to run with the goal of just finishing the run and was happy about it.

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This is Joe’s heart on heart failure

Then I got into times, was happy about that too. Before my illness last winter my times were at my all time best. Slow for a lot of runners but for me great. After all I run to please me so I accept what ever pace I come home at. Not a biggie. The doc was amazed at how fast my heart recovered and I even saw the difference on the screen of my heart’s movement. The echo I had before it looked like Jabba the Hutt sleeping. I think I attribute this to doing a LOT of research on the internet getting informed of what I was dealing with and trying it slowly with my Doctor always in the know. He was very skeptical of the supplements I was taking but has done an about face now. I also believe the coconut water I drink everyday now has helped in a big way. I noticed I don’t have an ammonia smell anymore when I sweat. I always had that smell when I drank the Osmosis water. I drink a mineral water now along with the Coconut water.

Anyways – I do prattle on. The thing is not to Panic and get informed!

I wear a Polar T-80 watch with GPS and follow the Zone rules. Yeah, I’m running about four minutes slower than normal but I feel great after a run now and do not dread the next one. Hoping my pace will kick up a notch as the info says it will as the body adapts.

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This forum is great may I add and it sure is reassuring to read of Peep’s in their 80′s who’s lived with A-Fib for 20 or so years and keep running. Hopefully one day soon someone will find a cure for this curiously annoying ailment.

When I had 17% ejection rate it happened really fast. The time line is like this: on a Friday I ran a very fast 5K run for me. One of my best times. Later that day flew to spend three days with a friend, and after returning home I got ill and by Wednesday was full blown into whatever ailment I had (Influenza?). I tried running a week later but could not even go further than 50 yards! Then I stopped and decided to rest a week, do nothing and fight this illness. Well, it got worse and worse – my lungs started filling up with fluid and at night I could hear bubbling in my lungs. Fast forward a week of no sleep, etc, etc, and went to a doctor was put on antibiotics. I didn’t get better, still the same symptoms. (Turns out the heart, because of it not beating properly causes the fluid to back up and then it seeps into the lungs so any of you with these symptoms see a doc. You can do a thumb press on your shin and if the indentation stays and is deep you’ve got fluid retention and need a diuretic).

After a couple more weeks of this I decided because of previous symptoms I felt there was something wrong with my heart again. Seemed to be doing the same old symptoms of A-Fib. I thought I was free of it for almost two years or else it was Silent A-Fib and I did not know it!

My cardiologist gave me an echo and all he said was “What did you do?” Man, you don’t want to hear that from your doctor!

Like I said before I even could see my heart wasn’t doing anything. Just sort of sitting there: legs up – arms crossed!

He put me on meds again and the dreaded warfarin. They worked almost right away! I was on Codarone (amiodarone) for only a month and everyone should know that this is a dangerous drug! Long half life and it’s like shaking hands with the devil. Used a lot as a last resort. But! – for short periods it works miracles. Using it over six months or more can have repercussions.

Well, that day I came home from the doc’s I tuned up my mountain bike and went for a very short ride. I was out of breath the whole time. Did this for a couple of weeks and got stronger. Started weights again, and just started using the bars with no weights. Did this very very slowly and now after two months I’m almost back to benching 200. (ha ha – good for me anyways) The last check up the doc said my heart (Left ventricular ejection fraction) was up to 35% and I saw the difference in the video as well! Made me feel very very happy.

So now I’m trying something I never thought I’d do. I bought a Polar T-80 Heart monitor with GPS and run and cycle in the Zone. I exercise according to my heart rate. I’m finding I’m no longer exhausted during the rest of the day and overall feel better, stronger. It’s taking time to lose that competitive spirit though – ha ha ha – I’ve got friends who are in their 70′s running faster than me. My slowest times in years but I’ll stick to it and see if my times automatically come back up as the research suggests. This has to be done. I love being active but I hate being dead more so I have to accept and live accordingly. Don’t Panic!

A heart pumping at 33% efficiency feels a lot better than 17% I can tell you. I do more things than most of my friends. It still amazed me though how I can do weights for a hour, run for an hour then eat, chill and later in the day walking up a flight of stairs takes my breath away. It’s like a reminder – oh yeah I’ve got heart problems. A friend wisely told me that it could be like losing weight: fast in the beginning; then slower. I hope my ejection fraction % will keep increasing till 55%. Considered normal. Then I’ve got to deal with the A-Fib.

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Joe still the life of the party – but no more beer for this guy!

A very important footnote: I used to drink beer everyday for years! Love the amber fluid. After my first A-Fib about five years ago I stopped for about three months. Then about two years ago I only drank on Friday and Saturday. For two years I did this. No exceptions. I’m 51 now and even this was taking it’s toll I believe. Now I’ve cut it out completely and will go the distance – sort of sucks but I’m close to the three month period now and will keep going. My next visit to the docs is in August so I’ll hopefully remember to post what transpires.

If anyone is interested in what I’ve been taking for supplements, eating, drinking, and exercising please leave a message on this blog and I’ll be most happy to share. One thing I’ve always found frustrating with most blogs is when I’ve read what someone has done and it worked there was no follow up. I’ll try and keep posting on this one. Great site! Peace out…………… don’t Panic : )

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Update (from Joe)

Hi everyone. Went for my one month checkup at the cardiologist today and the results were better and improving. The Doctor said my heart has shrunk by a noticeable margin which is a good sign. (had an echo) It’s getting stronger. The ejection fraction went up a bit as well to around 37%. Getting nearer to 40% then in a few months hopefully 50 or 55%!! I was also able to wean off one med by half. I felt it in my run today – a really great run. Will continue on meds and supplements plus exercise and diet as is for another month. See ya then!

Running with Atrial Fibrillation – It’s Okay To Be Slow! Forget The Pearl Izumi Advertisements

I saw some recent Pearl Izumi ads posted on The Trail and UltraRunning group on Facebook and thought I’d comment.

There are a number of Pearl Izumi ads that make fun of slow runners, here are two examples:

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Pearl Izumi – Trying to sell shoes by denigrating slow marathoners

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Divide and Conquer – Pearl Izumi teasing “joggers”

The remaining ads can be found on this excellent blog:

Short, Round, and Fast

One of the nice things about endurance sports, from half marathon and up, is that most participants do not have this type of attitude. It is a live and let live culture. It seems like half marathons in particular are a plce where you generally see conspicuously non-athletic looking athletes – and good for them!

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Half Marathon Participant – Right on!

As for me, I’m in permanent atrial fibrillation, which makes me slow, and now I have to take a beta blocker, which makes me even slower.

But I’m certainly not going to stay home, and I’m going to remain a trail runner, even if I’m slow, and I still plan on signing up for distance events. At my last half marathon I was very surprised to see almost the entire field, including people who would previously never had been in front of me, pass me, get smaller, and disappear from sight. In the first two miles. Not fun. I was thinking, “Whoa, where’d everybody go?”

Contrary to how it might appear to faster runners who are observing slower runners, it’s not always easy being slow. It might actually be more difficult. Yesterday on a four mile trail run, my first run on the beta blockers (more on that later), I rounded a corner and saw another runner behind me. He was an individual who I had seen at the trailhead, who appeared to be a bit older than me, and who was wearing jeans and a long sleeved shirt on a ninety degree day. I thought, “Oh man, I don’t want to get passed!” and I cranked up my speed. I don’t think I was running fast at all, maybe about a ten minute mile, but the burning in my lungs and legs felt like a fast 5K. “This is ridiculous!” I thought, saddened. This is “fast” for me now.

But that is my new reality.

As far as Pearl Izumi is concerned they evidently think that being assholes, and creating some controversy, will make their ads stand out. They may be correct. There are a lot of competitors out there, they have an extremely small market share, and it is said there is no such thing as “bad publicity.” I knew that they made shirts, and jackets; but until now I didn’t even know they sold shoes.

pearlizumi3 dog
Pearl Izumi Shoes – so fast you’ll kill your dog!

One of their ads last year, which featured a runner who ran so fast in his new Pearl Izumi shoes that he killed his dog, made quite an impression. Of course they apologized and had their (unfunny) ad featured in news stories and blogs for weeks.

By the way, my main nylon running jacket is made by Pearl Izumi. I like it, it’s a good jacket. I’m not going to boycott them or burn the jacket, or anything like that. I just want to say in this blog that slow runners are probably slow for a reason – and that reason isn’t necessarily poor character or laziness.

spraguerun
Me – Lazy jogger with atrial fibrillation after a twenty mile training run. I ran so slow that my dog survived!

Or even if the slow runner does have poor character, or is lazy, well, what’s it to you?

And guess what – Pearl Izumi got three of their ads posted in my little blog (and elsewhere) – for free!

Runner’s High – a Gift?

Is distance running therapeutic? Is mountain biking addictive? Is there such thing as a good addiction? If my atrial fibrillation worsens and I could no longer do long runs or bike rides – how hard would it be to kick the habit?

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High Lakes Trail – Southern Oregon

Today in the hospital lounge, while I was eating some potato chips, somebody was telling me how bad potato chips are for me. Whatever – I have given up almost everything in the world that is bad for me. I haven’t drank alcohol in several years, haven’t smoked a cigarette in decades, gave up meat and eggs a couple of years ago, I’m almost dairy free, and I haven’t taken recreational drugs since high school in the seventies. Potato chips, which I feel are good enough to be “worth it,” are about it for me. Well, that and diet soda, which is also an unhealthy habit that I have.

But what about “runner’s high?” Is that my addiction?

And what exactly is runner’s high? Does it even exist? I’ve been hearing about it for a long time, even before I started running in the early 80s.

Allegedly the athlete’s brain is “flooded with endorphins, more powerful than any street drugs!”

Many distance runners claim to experience euphoria during or after running, and some claim they’ve never had it happen – not even once.

The endorphin theory is the oldest, but more recently I’ve read about how endocannabinoids (naturally occurring neurochemicals related, in a way, to the active ingredient in cannabis) might be the cause of runner’s high.

Another article I recently read attributes runner’s high to “dopamine, serotonin, and endorphins.”

Whatever the cause, it certainly appears to be real.

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Pacific Crest Trail via Brown Mountain Trail – Klamath County, Oregon

Ultrarunner Dean Karnazes describes the role that running has in his life: “Some seek the comfort of their therapist’s office, other head to the corner pub and dive into a pint, but I chose running as my therapy”

“I’m convinced that a lot of people run ultramarathons for the same reason they take mood-altering drugs. I don’t mean to minimize the gifts of friendship, achievement, and closeness to nature that I’ve received in my running carer. But the longer and farther I ran, the more I realized that what I was often chasing was a state of mind – a place where worries that seemed monumental melted away, where the beauty and timelessness of the universe, of the present moment, came into sharp focus.”
― Scott Jurek, Eat and Run: My Unlikely Journey to Ultramarathon Greatness

Actually, a recent New York Times article states that on good experimental evidence it has been finally determined that exercise does indeed produce a flood of endorphins in the brain. Lucky us!

Researchers in Germany, using advances in neuroscience, report in the current issue of the journal Cerebral Cortex that the folk belief is true: Running does elicit a flood of endorphins in the brain. The endorphins are associated with mood changes, and the more endorphins a runner’s body pumps out, the greater the effect.

I won’t review the article here, but please read it – an elegant experiment, and solid conclusions.

But irrespective of the cause, what is runner’s high and what does it mean to endurance athletes? Can a person become addicted to it?

Personally I feel that the term runner’s “high” is a misnomer. I would describe it better as an altered state of consciousness rather than a high. Maybe I’m splitting hairs but I have never felt intoxicated by endurance sports.

Euphoria might even be too strong of a term – but maybe not. There are times during and after running when everything appears exceptionally crisp and beautiful. That’s why I love trail running, in Oregon, in the wilderness – does that happen to people in health clubs running on treadmills?

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After an hour or so even carb gels seem remarkably delicious!

Also – music becomes intensely enjoyable. I do run with an iPod and sometimes I feel I am going back to the days back in high school when I smoked pot and would listen, chemically enhanced, to suddenly amazing music on headphones. Except now instead of sitting in a darkened basement I’m moving through the woods. It’s funny – a lot of the music that, for me, is most enjoyable on long runs, is the same type of music that I believe would be most enjoyable to a person who is stoned. Sometimes a song sounds so good I’ll repeat play a song two or three times.

But another reason I don’t like the title “runner’s high” is it isn’t all euphoria, beauty, and music joy. I think the exercise induced altered state of consciousness can involve a certain amount of emotional lability. Here’s an example: once I was on a twenty mile trail run, and at mile sixteen an old song I hadn’t heard in years, Careful With That Axe, Eugene, started playing in my random shuffle. This very early, nine minute long Pink Floyd song is sort of a novelty song; a one chord song that slowly builds on a rising and falling bass line with a mellow organ playing over it. At one point a whispering voice says, “Careful with that axe, Eu-zhene.” And then there is this horrific screaming and dissonant guitar, and finally it evolves back to the mellow bass and organ. Back when I was in high school, if we had somebody over who had never heard the song before, we’d put it on and turn down the lights, and of course when the screaming began it would scare the crap out of the first time listener, and we’d all have a good laugh.

Well I knew all about what was going to happen during that song and wondered if I would start laughing when the “axe” section came up. Imagine my surprise when I burst into blubbering tears when the screaming began. I should state that this was shortly after my ex-wife (with whom I was still friendly) and her family had died in a horrible house fire – but honestly I wasn’t even thinking about that until the screaming in the song. I know I wouldn’t have been anywhere near that emotional if I hadn’t just put in sixteen hilly trail miles.

Other times while running something will strike me as funny I will begin laughing giddily – out there all by myself, or in the back of the pack at a marathon. Or an angry song will play and I’ll feel, like, GRRRRRRR!, become angry – quite a catharsis.

mywar
GRRRRRRRR!

So is exercise induced altered state of consciousness addictive? I’m thinking: yes.

A CAGE questionnaire is commonly used to assess alcoholism.

Try applying it to your running:

C – Have you ever felt you needed to cut down on your running?
A – Has anybody ever annoyed you or criticized your running?
G – Have you ever felt guilty about your running?
E – Have you ever felt you needed a run first thing in the morning (Eye-opener) to steady your nerves?

Well – I can honestly say I’ve never felt guilty about my running, but the rest of those questions, well . . . .

And I can state for the record that with my atrial fibrillation, and the likely progression of my a fib, including my upcoming need to be on a beta-blocker, I have been dreading the day when I am no longer able to run. Very depressing.

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Biking in A Fib – like riding through mud

Aside from that I have a theory. I think it is obvious that not everybody will experience anything like a runner’s high. Clearly many people hate the way running makes them feel, and they are the people who think distance runners are completely nuts. And why wouldn’t they? Based on the time they ran two miles and felt nothing but fatigue and pain, and interpolating that up to, say, thirty-one miles, their obvious conclusion would be “WTF?” to use the parlance of our times.

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Lyon’s Trail – Lava Beds National Monument

But as for myself, and I’m guessing most of the people who would be interested in this blog, the so-called runners high can be generally considered to be a gift.

Diversion: How to talk to your children about distance running: