Wednesday, 18 February 2015

A different type of Valentine's Story.....

This Valentine's Weekend really has been all about affairs of the heart for me, but actually my story probably dates back a few weeks.....

A lot of runners are aware of their resting heartrate (and indeed, many know specific heart rate bands that they train in - though I'm not one of those!) and check it periodically, eg for early illness warning signs, or to check for overtraining. As people get fitter, their resting heart rate tends to get lower, and I know that mine is usually around 48-50bpm. This may be higher than that of many other runners (which may be another reason why I never have any confidence in my fitness) but it's normal for me, and so if I check it and it's in the mid-high 50's, I know that I should look for a reason why.

I've already described feeling lacklustre about my running this year, but add to that some extra lethargy, constantly feeling cold and out of sorts with some weight gain, and I decided to check my pulse at work. 46.....a bit lower than usual, so I rechecked it the next day.....44....and then 42. I know I have sloth-like tendencies but that was a significant drop.

Maybe my pulse oximeter was faulty.....that must be the answer....but then when I checked the pulse of a patient with 'flu, it was up at 118, so it seemed to be reading OK. Next step for a paranoid medic.......ECG and BP.
My ECG showed a rate of 38 (and that was after coffee and cake!!)and my BP was 96/56.

Bouncing these results off a colleague (as the bradycardia protocol suggests giving medication and admitting to hospital urgently if a pulse rate is <40), he commented that he'd never seen such a slow ECG in anyone who wasn't seriously unwell.....obviously said partly in jest, but still, "there's always truth in a joke"!!

I didn't think I had suddenly become much fitter overnight, so I started to think about any other symptoms.

I had gone for a run one afternoon and had to stop as I saw black spots in my visual fields at the end and thought I was going to faint. I had put it down to hypoglycaemia, but with hindsight it couldn't have been as I'd had lunch before going out (and wasn't out that long). I also had a few episodes of feeling dizzy when I got up to go from the living room to the kitchen, but had just blamed myself for lazing on the sofa for too long (my favourite habitat!).

Now I knew that my pulse and BP were lower than usual (for me), I started to feel weak and wobbly from time to time, so although I knew those were just psychological symptoms, I decided it was time to put my mind at rest and so took myself off to my own GP. Blood tests were OK (underactive thyroids run in the family so we checked for that), but then I got a call that the cardiologist wanted to see me...........eeeeeekkkk!!

Next up - 4 appointments at the hospital in a week (anymore and I'd need my own parking bay):

A better chest for viewing a 24hr monitor on
1. To be rigged up to a "24hr tape". This is to monitor your heart rate/ecg for 24 hours, so becomes your faithful friend. I wasn't keen to exercise anyway, but it was great to have a good excuse for being lazy (the stickers from the 3 electrodes might have come unstuck, and I couldn't shower for 24hrs). The box and it's wires become your faithful friend, so it becomes a challenge to find clothing that hides them hanging down/the bulk on your waistband - and you have to ensure that you don't keep turning over in the same direction in bed or you end up wrapping yourself up in the leads!!! There is a button to press to record "when you  feel symptoms", which is great for those with palpitations, but not so useful for me and my "feeling cold and tired".
My "Holter monitor"

2. To remove the 24hr tape - officially less of an issue as you disconnect it yourself and return it (along with your symptom diary). It was sooooooo nice to remove the sticky electrodes, as they aren't half itchy!

Diagrammatic representation of an ECHO (I'm
 not showing a pic of mine being done!!)

3. An echocardiogram - which is basically an ultrasound to look at the structure of your heart. This is a simple painless procedure, though I have to say it is a trifle unsettling to be stripped to the waist while a colleague (that you see at meetings) performs the exam and talks you through the results as you watch it on screen. Mind you, when I say painless, I did get a sore neck craning round to see everything that he was pointing out on the screen as I had to lie on my left hand side and the screen was behind and to the right! It was fascinating to see the walls, chambers, valves etc of my heart and see the blood flow through it.
Another version of an ETT

4. An Exercise Tolerance Test - I always knew that would be a fun-filled experience bearing in mind my general dislike of the "treadmill"! The test consists of 3 minute sections with each one being faster and steeper than the previous. I didn't think it could be too strenuous if little old ladies with angina are put onto it, but by the end of my test it was going at 5mph with an incline of 18%. To make it more fun, I had all sorts of wires attached to my chest (more than for a normal ECG as the 4 limb leads are also attached to the chest, as otherwise they don't read properly due to movement artefacts) and a BP cuff on my arm which kept inflating and deflating (and catching on the treadmill itself). Oh yes.....and I was still in my work trousers and shoes!! At least I got to watch the screen throughout the entire 15minutes of test and 5 minutes of recovery while chatting away to the technicians, unlike on a treadmill in a gym.
By the end of it, I feel like I've been totally through the mill (though now I feel that I can explain the procedures a lot more clearly to my patients when I refer them) and have come out as an "athletic sloth"! My heart is structurally normal - no structural, valve or flow problems, no hypertrophy or cardiomyopathy, and there were no great rhythm problems. My resting rate is back up to its "usual" now, so whatever it was that caused me to feel unwell, wasn't too significant and I'm not going to perish imminently!! You can all put away the black funeral garb and I can get back to furring my heart up with cake and chocolate...or dilating it with alcohol!!!!

Tuesday, 3 February 2015

A Regression Run

The Carlisle Resolution 10K was rescheduled for Sunday Feb 1st - and I couldn't make up my mind whether to run it or not. I had the deferred place from 2 weeks previously, and I still really needed a race to "keep me honest" (as Ellie G put it) and see where I was at, but I've also been rather lacking in my Sunday long runs (due to the initial 10K plan, and then the masters' relay) and I couldn't decide which would benefit me more.
In the end I thought I should force myself to run the 10K and then, if I felt like it, add some miles on at the end. The bonus to this plan, was that the race would only be on if the roads were clear, and the roads at home are still a nightmare with snow and compacted snow frozen into ice.

Team DRC
The race organisers had delayed the start by an hour to allow for conditions to be as good as possible, but they needn't have worried as Sunday dawned bright and sunny, even if the wind was bitingly cold ("real temp 1 degree, feels like -4" according to the forecast). It was difficult to decide exactly what to wear to race in, and funnily enough, all 4 of us running for DRC ended up wearing a diffierent combination of vest, tshirt, longsleeve, shorts, tights, and gloves. I had done a few miles as a warm up and had thought it would be warm racing - and so stripped back to vest and shorts (and my fingers definitely felt chilly on the way round ;-( ).
I knew that the 2 guys from my club would be targetting me, and one had even said this to several people beforehand, but I tried to ignore them and just run my own race. I had hoped to be near the 37minute mark, and so they'd said that they might try to take a pace from me early on. The roads weren't closed for the race so we were milling about on one side of a road, letting cars go by etc, when suddenly a starting horn was fired (with no countdown). There was no chip mat to cross, and so I guessed our ankle timing bands were just to aid a fast upload of results after the race.

Trying to catch up to the lads...
Considering the pre-race chat, it was interesting to see the lads go out fast in front of me, but I drew alongside them in the first mile. One of them does almost all of his running on a treadmill, and unfortunately this meant that the race caught him out, as it was rathger "undulating". As soon as we started the first climb, he dropepd back from me and I didn't see him again (though I was expecting to for almost all the race, as I had thought that he would be faster than me on the day). I'd run the course several years previously (though it was then on a midweek summer's evening) and although I'd forgotten the sudden sharp descent and ascent on one of the backroads I definitely remembered miles 4-5.5. In the summertime, the road has just seemed to climb gradually on and on into a nice headwind, and in the wintertime it seemed no different.....eurgh!

Running in for the CR ;-)
Still, I had been told just prior the the race starting that the ladies' course record was 38:05, and so even though I felt like I was dying a death and really just wanted to stop - a quick look at my watch at the 5 mile mark reassured me that if I could only keep going, I would breat that time. Due to the sun in my eyes, it was almost impossible to see the finish (well, it would've been impossible anyway, as it involved a sharp left hand turn off the road into the racecourse, and then a sharp right around the front of the building) but I could see bodies and hear people cheering, and was greeted by the lovely words "Well done, a new ladies' CR".
I had a drink, congratulated the lads as they finished 40s apart from each other, put some tights and a jacket on, and then headed out again. The 10K route was like a lollipop, so as I ran out I could cheer on other friends running in. This time round the loop was considerably slower than the previous one, and so I made it back just after the prizegiving, but at least that gave me another excuse for a short break before I did one more tour of the loop of the lollipop.
All in all, a decent day.....clear roads, sunshine, a 10K race with a couple of extra laps round part of it (though as each loop was slower than the previous one, I think you'd term it a regression the opposite of a progression run) and a trip to a garden centre for a nice feed....and a return home to find my driveway and road still completely blocked with slippy compacted snow and ice!