Tag Archives: atrial fibrillation

Run, Smile, Drink Water and Don’t Die – A Guest Post by JoAnna Brogdon

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Once upon a time there was a girl that loved to run just for the fun of it. She woke up early one morning on a cold and rainy March morning, excited to run the Rock Creek River Gorge Trail Run at Prentice-Cooper State Forest, just outside Chattanooga, Tennessee. She had run this race before and was wowed by the gorgeous gorge views and challenging single track trails.

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She signed up for the 10.2 mile run but wasn’t feeling exactly right that morning. She couldn’t put her finger on it. She was just a little off but that wasn’t going to stop her! She bounced out of bed and decided to do the 6.5 mile option instead of the 10.2—a decision that turned out to be one of the best she ever made.

The start was a little fast. Everyone was ready to get moving on the chilly and very wet morning. Soon the 158 runners headed into the woods and formed a single line, slowing the pace which was a good thing. The trails were incredibly slippery with tons of thick mud after much rain that winter. One runner took a face plant when crossing the creek and came up with a big gash on his forehead and blood dripping down his face.

“Are you OK said the girl?”

“Yes, I am just happy to be out here,” he responded.

“Me, too!” she replied. There were smiles on everyone’s faces as they headed up steep hills and carefully focused on the each step.

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At the half way mark, she was feeling OK but a little more tired than usual. No problem she said to herself, just having an off day. It was time to focus on other things, talk to people, make some jokes and carry on. She found a guy wearing a shirt that said, “Idiot Runner’s Club – Run, Smile, Drink Water and Don’t Die.” This sounds like my kind of runner thought the girl! They chatted and laughed about how slow they were going but how happy they were to be there instead of sitting on a couch or still sleeping in bed. The mud was so thick that their shoes nearly got sucked off but happily they went up yet another hill.

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Even though she wasn’t moving very quickly, her heart was starting to race quite fast. She slowed down and was walking more than running. She put her hands in the air a few times feeling like it was getting a little hard to breathe. Just focus on the gorgeous trails and it will be over soon, she told herself.

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There is that Idiot Runner again. He caught up and they were passing each other back and forth. It was time for more chatting and laughter. Only a few more hills and it will be time to relax and enjoy the day. One final push, climbing up through the narrow Indian Rockhouse and the race is almost over.

It is only 6.5 miles, she thought why does this feel so hard? She had run 50Ks and didn’t feel this bad. There goes a female racer. She will have to see if she can catch her but just felt so tired and ready to stop. Then she heard the crowd and knew that the end was near. She pushed as hard as she could one final time to make it to the finish line—she did it! And then she decided to sit down for a minute, she really didn’t feel so good … and then there was darkness …

…what is that noise?

She was waking up and heard a loud noise – it was her heart pounding at an incredible rate and a bright light in the distance. Someone was saying something to her, if she could only get to the light. She woke and found herself inside the medic tent with two physicians by her side. Her legs were cramping with the worst pain she had ever felt. Where was she? What had just happened? What was her name? Which hospital did she want to go to? So many questions…

She was being placed in an ambulance and sent to the local hospital. She was in rapid rate Atrial Fibrillation and needed a Cardizem drip to get her rate down. They admitted her to the hospital and the nurse came by to explain what A Fib meant. She drew a nice picture for the girl.

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She learned that A fib occurs when one or both of the upper chambers of the heart – called the atria – don’t beat the way they should. This can cause blood to pool in the left atrium, where a blood clot can form. If that clot breaks away, it can travel to the brain, where it can cause a type of stroke called an ischemic stroke.

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Two and half days in the hospital she waited for the meds to convert her heart back to normal sinus rhythm. They placed a band on her wrist that said “fall risk” – they had no idea.

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The doctor decided the only way to get her heart back to normal rhythm was to cardioconvert using an electric shock. She was wheeled down to the operating area and what a surprise– she saw the two doctors that were at the race. One was a cardiologist and the other was an anesthesiologist for cardiology. They were chatting and laughing and encouraging her that it was all going to be OK. Her cardiologist was running late and it delayed the procedure. He was known for this as he always took time with his patients. Right as the doctor arrived; the nurse looked at the monitor and said wait—she converted on her own! We don’t need to shock her heart. The girl was happy and believed that it was actually going to be OK— maybe not happily ever after but OK. She smiled as she remembered the new friend she had just met on the trail…

“Run, Smile, Drink Water and Don’t Die.” Now those were words to live by.

The End.

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JoAnna Brogdon, forty-three years old, went into a fib several times since the race and was hospitalized twice. She has no underlying chronic conditions and the doctors are unable to tell her why she has had a fib. She believes the worst part of the condition was the emotional stress and not being able to exercise as she had in the past. She underwent a cardiac ablation recently and her heart has been beating normally since. She is hopeful that she has put a fib behind her at least for now and looks forward to running, traveling and feeling normal again. JoAnna wants to support those that struggle with a fib and may be contacted at joannabrogdon@hotmail.com.

Rejoice – Not All Runners in Atrial Fibrillation Are Slow

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Moore Mountain 1/2 Marathon

The thing I enjoy most about the afibrunner blog is comments from other athletes who are dealing with atrial fibrillation. A recent comment from a runner (we’ll call him “Lon”) really caught my attention – here is a runner who, while in atrial fibrillation, was able to race at six minute mile pace (or better).

Here are some excerpts from his comments:


Way to Go!!!
Since 1983 I’ve run/jogged 59 full marathons and have suffered with A-fib on and off for the last 12 years. I’ve finished the Boston (2001 in 3:23) and NY City (2005 in 4:15) marathons while in constant A-fib while carefully monitoring my heart rate. My cardiologists encouraged me to run marathons and also triathlons. One cardiologist told me that my heart is so strong that it laughs at A-fib and that I have the heart of an olympic cyclist. For the first 6 months of this year my heart was in constant A-fib that no drugs or multiple cardioversions could put it back into normal sinus rhythm. On July 9, 2013 I had the “Wolf Mini-Maze” (at the International A-fib Center of Excellence in Indianapolis) operation done on my heart. It was a great success and my heart has been in constant normal rhythm ever since (nearly 6 months now and I’m not taking any medications). In the Mini-Maze they removed my Left Atrial Appendage (LAA) so that if my heart ever goes back into constant A-fib I will NOT meed anticoagulant therapy. As you likely know life threatening blood clots tend to form in the LAA when your heart is in constant A-fib. The risk of stroke over the life time of an A-fib patient is huge. 3 out of 5 A-fib patients will suffer a stroke in their life even while taking anticoagulation meds like coumadin. That is a statistic that your doctor will not likely tell you about. Coumadin is over rated and is simply not very effective for some people which should be a terrifying realization to anyone dealing with A-fib. Anyway, as much as I love marathons, I’m laying off the long distance jogging for a while and am just jogging 10K’s (one per moth and 3 sprint triathlons this Summer) as well as several other physical activities.
Good health to you!
Lon

I have lamented that atrial fibrillation has made me slow, while openly admitting that I started out slow – I’ve only ran, as far as I know, one six minute mile in my entire life – and that was thirty years ago.

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Finish Line – Eugene Marathon

My understanding about atrial fibrillation is that the atria no longer preload the ventricles, and most people have a decrease of about 20% of their cardiac output. While sedentary people might not even notice this athletes certainly would. I do!

But I have heard that in some patients, certain athletes, there is little change in cardiac output and atrial fibrillation will not affect performance much. Lon seems like one of these fortunate people. Lon’s point about the increased risk of stroke (even if you take your Coumadin, Pradaxa, or Xarelto) is well taken – and I’m guessing that that is why he continued to pursue an effective treatment for his atrial fibrillation.

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Finish Line – Haulin’ Aspen Marathon

But after all those marathons Lon states he is no longer running endurance events – he goes on to elaborate:

Here’s a little more. I tried not to make a long story short above. I left out mentioning that I had a radio-frequency catheter ablation in June 2010 in Seattle that worked great in keeping my heart in normal rhythm until December 2012 when suddenly for no apparent reason went into persistent A-fib. (During that 2 1/2 year period I finished 9 full marathons and 8 sprint triathlons) My heart stayed in persistent A-fib even after 4 cardioversions and large doses of amiodarone. My cardiologists in Seattle told me that I should accept my persistent A-fib and they offered to ablate my hearts pace makers (AV and SA nodes) and give me an electronic pacemaker so that my heart rate can be controlled. That told me that I needed a second opinion so I started communications with Dr. Randall Wolf in Indianapolis about his Mini-Maze procedure. After consultations with an E.D. doctor (and a championship Iron Man triathlete) who had the Mini-maze operation and was very happy with the results, I decided to get the Wolf Mini-Maze and of course I informed my Seattle cardiologists of my intentions and they said to go for it. Absolutely the main reason that I went for the Wolf Mini-Maze is that it removes the left atrial appendage which brings my risk of stroke down to that of a healthy person with a normal healthy heart while not taking any anticoagulation drugs. The fact that I now enjoy a normal heart beat is just a huge plus factor.

From 1983 until December 2012 I completed 61 full marathons a most of which ran with all out efforts (I’ve averaged sub-6 minute pace all the way). I’m now finding out that long distance running is simply not good for the heart and most likely caused my A-fib problem.

Google Dr. John Mandrola’s 18 minute video called “Cycling Wed: I told you so…”. It is very illuminating and a must see for all endurance athletes. Please check that out.
Cordially,
Lon

I don’t know much about the Wolf Mini-Maze procedure and don’t necessarily advocate it for everybody, but clearly it worked in Lon’s specific situation. Here is some information regarding the Wolf Mini-Maze.

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Finish Line – Lake of the Woods 15K

No need to Google the video by Dr O’Keefe (posted on Dr Mandrola’s blog) I have the link right HERE.

Here’s the video:

If you don’t feel like watching the eighteen minute video I will summarize it for you – Exercise is good for you but in moderation. Too much or too intense exercise causes chronic inflammation of the heart and can ultimately harm the heart (atrial fibrillation, among other risks).

But if you are an endurance athlete dealing with atrial fibrillation you already know this – surely you have had a dozen or so friends and relatives, possibly sedentary and/or obese, kindly forward you information about the study he refers to – as if to justify their seemingly wise choice to avoid marathons and triathlons and replace it by watching other people play sports on television. Yes, this study was in all the newspapers and magazines last year.

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Finish Line – Avenue of the Giants Marathon

Please understand, and I paraphrase here, that Dr O’Keefe states that exercise is good for your heart, and being obese and sedentary is bad for your heart – but that overdoing it is a problem. He didn’t say people should avoid exercising.

My choice – I understand the concept of the “law of diminishing returns” as well as the next guy; but for me, well, I enjoy long, slow trail runs and mountain bike rides more than just about anything else I can think of – so I chose to continue.

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Finish Line – Bizz Johnson 50K (I completed the 50K in atrial fibrillation)

The Fear of Going Too Hard – Atrial Fibrillation Running

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One big difference between running in persistent atrial fibrillation and normal sinus rhythm is that, for me anyway, there is a lot of apprehension about over-doing it. The days of charging up a hill may be behind me at this point, and I haven’t done anything resembling a speed work-out in well over a year.

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Prior to atrial fibrillation I used to do interval work-outs once in a while. For certain marathons where I had a specific personal time goal I would do a work-out known as “Yasso 800s.” Although some expert dispute that this is actually the most effective speed work-out for marathon training, nobody would dispute that this is a difficult work-out. I would do them on Wednesday nights at a local college track and I always felt they were my most difficult work-out of the week – probably more challenging than my languorous week-end long runs. Certainly this was the work-out where most feared injury.

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To be honest I don’t miss Yasso 800s. I never have been a fast runner and never enjoyed short fast races like 5Ks.

But even during LSD (long slow distance) work-outs there usually comes a point where I will feel that the run is becoming difficult and I have to push through that. People often say “push through the pain,” but it isn’t really “pain” per se; but whatever it is it now makes me nervous!

But now that I am in persistent atrial fibrillation I think twice about pushing beyond any thresholds, however they are described. I have a fear in the back of my mind that I am going to make the atrial fibrillation worse, or pass out, or die, or . . . well who knows? This is all new territory for me.

I think this is why I “bonked out” of the second and third (out of seven planned) twenty mile runs I did during my build-up to this Sunday’s Bizz Johnson 50K. I just wasn’t willing to risk it. But if I’m unwilling to risk it it is obvious that I will only get slower and slower each year.

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RINGO SAYS RELAX

I’d love to hear from other endurance athletes about this topic whether you are in a fib or not, and whether you are risk averse or not. Please feel free to leave a comment.

Next Event: Bizz Johnson 50K – October 13, 2013, Susanville, California

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Race Director Wendel Doman gives pre-race instructions

My next event in the Bizz Johnson 50K – October 13, 2013 in Susanville, California – although at this point I am considering bagging it and just running one of the shorter events – maybe the marathon. Bizz Johnson has something for everybody – a 10K, two half marathons, a marathon, and a 50K.

As far as trail 50Ks in the West are concerned this is probably the easiest course. Bizz Johnson is organized by Coastal Trail Runs, an organization that is headquartered in the San Francisco Bay Area, and it takes place primarily on a rail trail (Rails to Trails). That’s why the course is easy – trains are, I think, unable to go up or down any more than a one or two percent grade. Plus the trail is as wide as the railroad tracks it once was, and as smooth as a dirt road. Most 50Ks in Oregon and far Northern California are on technical single track that go up and down mountains and canyons.

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Along the course

This will be my seventh year running the Bizz Johnson – I’ve ran the marathon five times and the 50K just once – last year was the first year they even had a 50K. I even came in second place in my age group – but then again there were only two of us in that age group.

The entire rail trail is only about twenty-five miles so both the marathon and the 50K start with an appropriately measured “out and back” on an adjacent fire road to make the races end up being the proper distances. Last year this worked perfectly for me because the 50K started an hour before the marathon, so I ended up running into the back of the pack runners, who had just started. It was sort of like running a normal marathon . . . after going for a one hour morning jog.

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Last Minute Preparation

The race begins with a six mile out and back (three miles up and three miles down) on a non-technical fire road; then it joins the Bizz Johnson Trail. The first couple of miles on the Bizz Johnson are uphill and then there are essentially twenty miles of gentle downhill running. The trail is smooth and a delight to run and goes through a pine forest at first with final six miles going down the Susan River canyon ending in Susanville.

There is one canyon crossing at about the twenty-five mile marker (the twenty mile marker for the marathon) that looks easy on the course map but is in reality quite brutal – probably my perception is based on the fact that this is the point where the course often becomes pretty warm (lower elevation in a deeper canyon).

Also there are two tunnels late in the race that are fun, but freak some people out – very dark and cold in the tunnels!

Sorry if I seem to be about to die – this tunnel is at 24 miles in the marathon (29 miles in the 50K)

The race is a small, well-organized point-to-point event with no expo, and bus transport from Susanville to the starting line. There are aid stations every two miles along the marathon course. For me the altitude in no problem (5600 ‘ to 4200’) because I live and train at the same altitude – some folks from sea level complain about it, however.

The cool thing, at least as far as last year was concerned, is the mile markers were all based on the marathon distance so psychologically it was easier. For example – when I pass the eighteen mile marker while running the 50K I am actually at about twenty-three miles – but psychologically it seems like I am only at eighteen. It might have something to do with my being so familiar with the course.

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Twenty-three miles – but it only “seems like eighteen”

The race ends in a picnic area in a grove of tall pines and there is transport back where all the cars are parked.

The reason I am thinking about bagging it is that my training doesn’t seem as good this year as it was last year. I was in persistent atrial fibrillation last year, as I am this year – but my mileage was much higher last year. I was running fifty to sixty miles per week with one seventy-five mile week (my all time highest mileage week).

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Age Group – Second Place in my first 50K – but only two runners in my age group.

This year I bonked out on my first two long runs (I’d planned on two twenties and ended up only running sixteen and thirteen – that was five and six weeks ago). Over the past three weeks I have completed three twenty or twenty-one mile trail runs in the Sky Lakes Wilderness.

The reason I bonked out on those long runs may not have anything to do with my atrial fibrillation – I think it is more related to my intolerance to heat. Both of those days were too hot, especially later in the runs. For the past few weeks I have moved my long runs to high altitude mountain trails that are actually much more technical and hilly than the course of my upcoming race – in other words much more difficult training runs than the ones I bonked on – but I am able to complete them because it is shady and cool up there. I have one more long run scheduled this weekend (twenty-four miles?) and then I start my three week taper prior to the race. It’s supposed to be cold and rainy this weekend so I will probably do fine.

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Almost Done

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Finish Line

My biggest problem occurs when it is hot on race day. I should clarify that for me temperatures in the seventies qualify as hot. I think this is what I am going to do: If my last long run goes well I will go to the race and check the weather report. If it looks like it is going to be cool I will run the 50K, but if it looks like hot weather I’ll run one of the shorter events – either the marathon or the half marathon.

My Bizz Johnson Photos (from the past several years) on Flickr 143 photos and two videos (including a tunnel video)

UPDATE: My final twenty went fine – I started getting sort of tired at mile thirteen but pushed through. I reviewed my training log and discovered that I had actually ran a twenty miler the week prior to the first of my failed twenties – so I have ran a total of five twenty mile training runs (three of which were more like twenty-one milers in the Sky Lakes Wilderness). I still haven’t decided whether to run the 50K or the 26.2. I’m going to see how I do during the taper (I always cheat and run too much) and also keep an eye on the race day weather.

Pacific Crest Trail on Atrial Fibrillation?

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I live near the Pacific Crest Trail. The famous, fabled, fabulous PCT. Just about twenty-five miles away. You can look out our back window and stare lovingly at the mountains where it courses through the Sky Lakes Wilderness.

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Heading out to run on the PCT

Although I come off in this blog as a marathoner, or an ultrarunner, what I really enjoy more than anything is trail running (and mountain biking – but mountain biking is forbidden on the PCT so forget about that). I simply love trail running and hiking, especially in the local Sky Lakes Wilderness and Mountain Lakes Wilderness; and the best part of being at my level of fitness and health is being able spend a weekend day doing a ten, fifteen, or even a twenty mile trail run. Although it is a slog now because of the atrial fibrillation I still love it – I love the movement through the wilderness and I love the trail itself.

Usually the only one who goes with me is my little trail dog – Ringo.

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Ringo on the PCT at Brown Mountain

At this time of year – late Summer – all the thru-hikers, or I should say the small percentage that have made it this far, are coming through Southern Oregon. Most thru-hikers are traveling from South to North; they start at the Mexican border and hike through California, Oregon, and Washington with the goal of reaching the Canadian border. There are a lot of hazards along the way that can cause hikers to drop out and fail to finish – including blisters, running out of money, running out of time, deep snow, diarrhea, boredom, and forest fires.

I try to spend time on the PCT this time of year and will often photograph thru-hikers and post the photos on my flickr page.

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PCT Thru-hikers

In addition to trail running on the PCT I am also an “armchair traveler,” meaning I’ve read a bunch of books about thru-hiking the PCT, including:

Cactus Eaters by Dan White – probably the best written PCT book and my most recent read.
Cascade Summer by Bob Welch – a middle aged Oregon newspaper writer hiked just the Oregon section. This might be more my speed.
Wild by Cheryl Strayed – the most well known and popular PCT book that will undoubtedly get more people on the trail. Also a well written and engaging read.
A Blistered Kind of Love by Angela Ballard – fascinating dual journal by a couple thru-hiking the PCT. It was interesting how the different genders report their trail experience. The male writes about where they went and what they did, and the woman writes about how she feels.
Skywalker – Highs and Lows on the Pacific Crest Trail by Bill Walker – the most endearing and charming PCT book ever.
Pacific Crest Trail Hiker’s Handbook by Ray Jardine – groundbreaking and controversial – Ray clearly changed the way people approach long distance hiking.
A Long Walk by Hap Vectorline – a whimsical journal of a partial through hike that started at the Canadian border and made it as far as Oregon.
In addition to the books I read various PCT blogs, and many of the youtube videos as well.

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Hikers

My dream is to someday thru-hike the PCT – but I don’t think it will ever happen for a number of reasons. I’m certainly in good enough shape, and strong enough, but at 53 am I too old? I don’t think so – I’ve met plenty of thru-hikers that were middle-aged. They tell me they are slower and have to leave earlier and hike longer to keep up – but that would be no problem. I think hiking for that long on anticoagulants might be an issue. On Pradaxa falling just isn’t what it used to be! The main problem is, of course, finding the time. I work full time and just don’t have the resources to take six months off from work.

Maybe some day I could just thru-hike the Oregon section. Or maybe just the Sky Lakes Wilderness (fifty-one miles) – that could be done in a weekend. Why not?

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Ringo Dingo

But I still love running in the Sky Lakes Wilderness. As far as falling out on the trail and bleeding out, or having a stroke out there, or being eaten by a bear, or whatever, I like to say that I’d rather die in the Sky Lakes Wilderness than in the Sky Lakes Medical Center.*

*Our local hospital, where I am on the surgical staff, is the Sky Lakes Medical Center. I like our hospital – I’m just saying that I’d prefer to die with my sneakers on, so to speak.

Running My First Marathon While In Persistent Atrial Fibrillation

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Not my first marathon, of course, I think it was my fourteenth marathon, and maybe not even my first marathon in a fib.

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Pre-Race

I should really re-title this as something about running my first marathon when I KNEW I was in atrial fibrillation. I recall one particular marathon, a couple of years ago, where I started out great and after twenty miles I totally fell to pieces. I would have quit if it hadn’t been a trail marathon with no easy way to DNF – I still had to get to the finish line. In retrospect I realize this was not “hitting the wall,” which I don’t generally tend to do, but I’m pretty sure I went into atrial fibrillation at that point. I don’t mind suffering but that was absurd. It was like eating your favorite food and inexplicably finding it tastes like $&!T.

That was before I even knew I was going into a fib, and I was probably still going in and out of a fib – but ever since May 12, 2012 I have been in persistent atrial fibrillation (meaning that I am always in a fib and have no expectation of NOT being in a fib).

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Lining Up At The Back For This One

In May of 2012 I was actually training for my first 50K (31 mile) race (Bighorn Mountain Wild and Scenic Trail Run, Buffalo, Wyoming) and I had been doing a lot of long runs – looking at my training log I see that I had already done six twenty-milers during my training for that race.

I asked my electrophysiologist, who I hadn’t yet seen for my appointment, if I could run the 50K and he said I shouldn’t; so I was effectively grounded as far as the 50K was concerned.

But being the incorrigible distance runner that I am I rationalized, “Well I didn’t specifically ask about running a regular marathon. I‘ve been running 50-60 miles per week for a couple of months – I sure wouldn’t want to waste all that training, would I?”

I looked at the online marathon calendars and discovered that there was a regular marathon (26.2 miles) that same weekend, and only a five hour drive – the Vancouver USA Marathon in Vancouver, Washington – just across the river from Portland, Oregon.

I admit that I was scared – this was unknown territory – running a marathon while in atrial fibrillation. Would I be able to complete it? Would I drop dead? Would I suffer like an animal, I mean, would I suffer even more than running a regular marathon?

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Along The Course

In a lot of ways the course for the Vancouver event was a lot safer than the Wyoming event. The Bighorn was up and down remote canyons in the Rocky Mountains whereas the Vancouver USA was a flat course through the suburbs of Portland. If I needed to drop out of the race, or if I needed medical assistance, that would be simple – go ring a doorbell.

But naturally I was still nervous when I started out. My plan was just to get through it. I decided not to try to beat anybody, to keep it slow and steady, and to walk up the few little hills that were part of the course.

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Marathons In All 50 States – EIGHT TIMES!!!!!

As stated previously the experience of being in persistent atrial fibrillation is different than that of going in and out of a fib. Persistent a fib isn’t as bad. I’m slower but stable. People who suddenly go into a fib in the middle of a race often find themselves unable to continue – it can be devastating. I know – I think it has happened to me (see above).

At any rate – I started running with the eleven minute mile pace group and hung out with them for most of the race. Eventually I realized that running this race in atrial fibrillation wasn’t that much different than any other marathon that I have done – except for being a bit slower. When I was into the final miles I was surprised that I felt fine – clearly much better than the race described above. I think my plan of keeping it slow and walking the one or two hills worked out – I had very little suffering.

Crossing the finish line was an emotional experience and even though I was there all alone I broke out in sobbing tears. Tears of joy, I guess, because I had finished the marathon and I hadn’t died! It really was just about like normal and I started wondering – just how many of these things had I done in fib?

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Large Man Crying At Finish Line

If you’re a runner in atrial fibrillation and you are reading this I want to make sure that you realize that I am NOT saying, “Go run a marathon in atrial fibrillation.” I am simply relating my personal experience. I am just one individual and, naturally, your experience is different. I stress that it is important that you agree with your cardiologist regarding running and atrial fibrillation. This blog is just my personal story – it isn’t peer reviewed and I am not a cardiologist.

By the way when I finally saw my electrophysiologist he cleared me to continue running and did go on to complete my first 50K four months after the Vancouver USA Marathon. At this point I am comfortable with distance running in atrial fibrillation and am not (too) afraid of dying out there – but that first marathon in (known) atrial fibrillation – well – that was huge.

My next event, incidentally, is the Bizz Johnson 50K in October.

Race Report – SOB Trail Run July 27, 2013 (Siskiyou Outback Trail Run)

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The SOB Trail Run has been one of my favorite runs and I think I have five T-shirts from the past ten years.

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Pre Race

Today was my first time running it in persistent atrial fibrillation.

I’ve always been impressed with how well organized the race is, the quality of the course, and the low price. The 15K is still only $25 (that includes a finisher medal but no T-shirt – a T-shirt is extra). There are three events – a 15K, a 50K, and 50 mile race. I’ve only ever done the 15K but several of my local running friends did either the 50K or 50 mile today. The 50 mile has 7000 feet (2133 meters) of elevation change – that’s crazy!

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Along the course on the PCT

I think all the races start with the same nice 1/2 mile or so on a road that allows everybody to get sorted out as far as pace is concerned before getting on the narrow singletrack of the fabled Pacific Crest Trail. This is a good idea – races that start right off the bat on singletrack, like Haulin’ Aspen Marathon and 1/2 Marathon in Bend, Oregon – tend to develop bottlenecks because passing is so difficult. The truth is that passing is a problem on the SOB – I tend to be faster going uphill (as compared to the slow people I run with) and end up passing people who walk up the hills – but I’m relatively slower going downhill, especially on technical terrain like the PCT, and most of the people I passed going up want to pass me going down; and the 15K course is up / down / up / down.

After several miles of this the race transitions to a fire road and then re-enters the PCT for the last few miles.

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Amber and Nathan after the 50K

The race is fairly high elevation – starting at 6500 feet and climbing to about 7000 feet (??). I don’t notice it much because I live at 4200 feet and regularly run at similar elevations, but people coming from coastal cities will definitely notice the rarefied air.

As far as running it in atrial fibrillation was concerned I had the typical slow start – it takes me a mile or two to warm up now, and then I felt my normal self again. I didn’t even look at my time and I didn’t wear my Garmin 305 – why? I walked only a few particularly steep sections and other wise (slow) ran the entire race.

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Along the Course

As usual the start/finish line was great – nice people, good music, lots of post race food. I forgot to pick up my post-race swag bag so I don’t know what I missed there. I wish I would have checked the start time for today’s race because I ended up arriving about an hour and a half early – but I can’t think of a better place to hang out that Mount Ashland on race day.

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Race Hang Out Headquarters

Running and Mountain Biking with Atrial Fibrillation? Get a Road I.D.

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I used the see the Road I.D. commercials while watching the Tour de France and think, “Why would anybody buy a thing like that?” That was before I went into persistent atrial fibrillation and started taking a potent anticoagulant (Pradaxa).

Now something as ordinary and routine as falling down on a trail run or crashing on a mountain bike can become a big deal – maybe even a life and death situation.

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My Road I.D. has my name, year of birth, hometown, my wife’s number and my sister’s number. Also it indicates that I am in Atrial Fibrillation, have no drug allergies, and am taking Pradaxa – an anticoagulant.

This way if I am found dead they know who I am and who to call to come pick up the bike and the body. If I’m still alive they will know about the atrial fibrillation and the anticoagulant. Pradaxa doesn’t have a reversal agent but any medical personnel will know to watch for bleeding and start an IV to push fluids. It certainly couldn’t hurt.

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Wearing my Road I.D. at a pizza parlor

I wear mine whenever I ride or run, and also whenever I drive. I take it off at work.

I was half joking when I said “if I’m found dead” but somebody (I can’t recall who) recently noticed my Road I.D. and said he wished his friend (brother-in-law?) had had one. Evidently he had gone out for a run and died out there (for whatever reason) and had no identification. Nobody knew who he was so they put the body in the morgue for the weekend. I seem to recall that the wife was out of town and they had a hard time figuring out who he was. Eventually when they started to figure out who he was and one of his children had to come from out of town to identify the body. I wish I could remember the details more clearly – but at any rate a Road I.D. wristband would simplify a situation like that.

There’s nothing special or unique about a Road I.D. – any medical alert bracelet would be fine; but a Road I.D. just seems cooler. It’s durable, comes in cool colors, and is highly customizable, it cleans up well when worn in the post work out shower, and goes on and off easily.

Atrial Fibrillation at Altitude – High Elevation Hiking on the Lares Trek

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We’ve just returned from a trip to Peru which included quite a bit of time at higher elevations – most notably hiking on the Lares Trail at 4600 meters (15,000 feet) above sea level. The highest thing we have around here is the conspicuous, glacier topped Mount Shasta (4,322 meters = 14,179 feet) and I’ve never even been up to the top of it. I’ve been up Mount McLoughlin (2,894 meters = 9,495 ft) sixteen times and even back when I was in sinus rhythm I would take one breath per step near the top.

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Llamas Schlepping Our Gear

I have to admit I was worried prior to going on this trip.

I had no idea how the high elevation combined with my persistent atrial fibrillation would affect me. My wife Margo, who is a travel agent, arranged a terrific trip and we had a total of sixteen friends in our group. It was all bought and paid for and I was determined to go no matter what, so I didn’t even research how high elevation might effect my atrial fibrillation before leaving. That’s right – I didn’t even Google it!

I knew that our outfitter – G Adventures – had a mechanism by which people who had problems with altitude sickness could quickly return to Cusco – so I knew that I had an opportunity to bail out if need be.

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Saksaywaman

We had two or three days in Cusco, Peru, which is 3,400 meters (11,200 ft) above sea level, so I was able to acclimatize. I felt no different in Cusco than I did at home in Klamath Falls, Oregon (4200 ft) and I even went for a run up to Saksaywaman (3701 meters = 12,142 ft) and it went well – although frankly, because of endless steep hills, it did involve a lot of walking!

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The Lares Trek is a nice alternative to the extremely popular Inca Trail. It is shorter (only twenty-one miles) and higher elevation (4600 meters = 15,000 feet) but most importantly it was not nearly as crowded. There were sixteen in our group (plus porters and guides) and there was one other G Adventures group of ten who we would see once or twice per day – and that was it.

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Ipasayqocha Pass

In contrast, the Inca Trail hikers we spoke to at Machu Picchu told us there were 200 people camped at a single, large camp outside Machu Picchu who all entered Machu Picchu before dawn on the same morning causing quite a line for the checking of tickets and passports at the small Inca Trail entrance to the site.

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Machu Picchu at Sunrise

At any rate nobody in our group had serious trouble with the elevation, although everybody was gasping a bit. Margo was a little sick on the day we went up Ipasayqocha Pass but that was related to the usual traveler’s intestinal distress rather than altitude sickness. We were fortunate – the guides said that typically in a group our size they would expect three or four people to have trouble with some degree of altitude sickness.

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Hiking Over the Ipasayqocha Pass

Our group was older but fit – but I have been told that being fit or being a couch potato has no bearing on predicting who will develop altitude sickness. Some people get it and others do not. Like I said we were lucky.

As for me I had the same atrial fibrillation symptoms I have at home, perhaps a little worse. I was out of breath when I started out but after several minutes I was in no distress. It takes me a while to warm up. Even in Lima, at sea level, I would huff and puff if I picked up a couple of backpacks and marched up the stairs to our room – that’s just the way it is for me now.

The first 200 meters of the Lares Trail is, I think, the toughest, because it goes up a long section of steep stairs. I was breathing so hard at first that I thought for a bit that I would be turning back – but ten minutes later I felt no different than a normal hike here in Oregon.

The porters had an extra horse in case anybody became sick during the trek they could ride that horse. Nobody rode it but during Margo’s bad day they put her daypack on the “sick horse.”

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Margo’s Pack on the Extra Horse

So to sum it up my personal experience with hiking and running at significantly high elevation while in atrial fibrillation was unremarkable. Your experience may be different, of course. As far as I can tell nobody knows until they get there whether or not they will have issues with altitude sickness – so don’t get discouraged – give it a try.

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Machu Picchu at Sunrise

Next Event – SOB Trail Run – Ashland, Oregon July 27, 2013

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Here is my Race Report SOB Trail Run July 27, 2013

I’m signed up to run the 15K at SOB (Siskiyou Outback) Trail Run July 27, 2013. This is a terrific event and I have done it several times in the past – I’m not sure but I think I have maybe four T-shirts from the event. This will be my first time running it while in persistent atrial fibrillation. So far I have completed one 15K, one marathon, and one 50K while in (known) persistent atrial fibrillation – but of course I suspect that there have been other marathons when I was in a fib but didn’t know it.

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SOB Trail Run

The races begin at the parking lot of the Mount Ashland Ski Lodge and go up from there. In addition to the 15K there are also 50K and 50 mile events. There’s no way I’m in 50K shape right now.

The course for the 15K includes a portion of the Pacific Crest Trail.

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Running on the PCT

This will be my first time running the SOB in atrial fibrillation – but I’m not too worried about the elevation – not after trekking in the Andes last week at 4600 meters (15,000 feet).

This event has always been very well managed, inexpensive, with great music and great food and plenty of raffle prizes. Wait for me at the finish line – I hope to see you there.

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Post Race