Googling the future

Representing Croydon Harriers in a National League
3000m Steeplechase (4th, 9:43.8) at Brighton, England,
in May 1975.

Around 3pm yesterday, I had my DC Cardioversion (DCC) and Transoesophageal Echocardiogram (TOE).  Apparently the DCC went smoothly, and my heart is now beating regularly again (Sinus Rhythm).  It's a very routine procedure these days (you can see a video here), and the anaesthetist referred to it comfortingly as a "barbecue" as he prepped me.  I only saw the hospital cardiologist once, when he shook my hand before I went under, and I didn't get any feedback later apart from the discharge nurse who said my heartbeat was stable in Sinus Rhythm.  On the assumption that "no news is good news", I'm guessing the TOE, with which they were looking for clots and flaws in the heart structure, didn't reveal anything untoward.

I now have a follow-up appointment with my cardiologist in three weeks time, but don't really have any guide as to what I can do, or not do, before then, other than being told to take it very easy today.  Consequently, I have been Googling extensively, particularly on the subject of returning to running after DCC.

Competing in the VMC Marathon (2nd, 2:31) at Tyabb,
Victoria, in June, 1976.

There's no shortage of papers identifying long-term endurance athletes as having a much higher risk of Atrial Fibrillation or Flutter than people of similar age, but it's hard to determine what is the outlook for those returning to the sport after treatment.  There are opinions expressed that they are more likely to have future heart and related problems, but no studies I could find.  Every individual is different, and there would be few people in the world who have trained and run endurance events over as many years as me, so there are unlikely to be any specifically relevant medical studies, anyway.

A good friend and long-time endurance athlete, Bill, suggests I accept my lot and cut back to roughly an hour's non-competitive running a day and be thankful that I can do that.  Time and energy freed up can then be devoted to other interests, such as writing.  I can see the sense in this suggestion, but am not yet convinced that it is the best course for me.  I'm still in the "Bargaining" stage referred to in a previous post, and want to believe there's some middle ground.

Comparing hamstring flexibility with Bill after the VAAA
Marathon Championship (4th, 2:22) in March 1983.

Part of the problem is determining what sort of running increases the risks for me.  Racing, and training to race, definitely generates more heart stress than running as a non-competitive recreation.  A race gets my adrenalin pumping and I always perform significantly better than I could manage in a non-competitive time trial. Likewise, upcoming races, get me to training harder and longer than I probably would otherwise.  I love competition and the preparation for races, but believe I could live without it, if it lowered my risk of further heart problems.  I think I could be satisfied with moderate short runs during the week, the regular Saturday Trotters run without getting too competitive, and a relaxed long trail run on a Sunday.

I'll continue walking for the next couple of weeks and then try some jogging just before I see the Cardiologist.  The statistics show that DCCs are 99% successful, but have a 50% reversion rate.  I'm assuming that I will be one of those 50% reverting, and my Cardiologist has already said he thinks I may ultimately need a Catheter Ablation.

Over with

1982 Montreal International Marathon (46th, 2:29).

Motivation was low today, and after several days with less sleep because of early morning commitments, I stayed in bed procrastinating.  Not really sleeping, just dozing, with a mild headache giving me another excuse to dally.  Maybe it was my imagination, but I sensed my heart was racing some of the time, even when lying in bed, and that wasn't good news.

Eventually I rose, watched one of my favourite political programs over a late and light breakfast, and headed out for a 5km walk on a very warm and sunny morning.  The walk started with a moderate hill and I was a little disturbed to already feel out of breath and conscious of my heart racing.  After another hill on which I again struggled mildly, I had to stop and hold the railing on a short flight of steps and even toyed with the idea of returning home.

The leading bunch in the 1983
Victorian Marathon Championship
(4th, 2:22).

I feel my condition has gradually deteriorated over the six weeks since I was first diagnosed with problems.  Just a few days before my first doctor's visit, when I was already dealing with the symptoms of breathlessness and a racing heart, I had been able to run an easy-paced 30km along mountain trails without major issues.  It seems inconceivable that I could do that today.  As I walked this morning, it was pleasing to know my DC Cardioversion was scheduled for tomorrow, and that I wasn't still waiting for the originally scheduled specialists appointments in two weeks time.

I haven't been optimistic about the permanency of the cardioversion, but feel more hopeful after a discussion with a doctor friend last night at a social gathering.  She saw no reason why a cardioversion might not be a long-term solution and cited her own father as an example.  Nevertheless, I think it's prudent to be a little cautious.  I don't feel anxious about the procedure, though that may change as the hour approaches (2:30pm tomorrow afternoon).  I just want it to be over with.

The episode on the stairs passed after a minute or so, and I decided to continue with my walk and completed it safely, despite a few more minor occasions of breathlessness.

In a perfect world, the cardioversion will immediately improve my quality of life as my heart returns to normal, but it's not a perfect world.  Fingers crossed.

Nelse-Bogong Loop

Bogong High Plains near Mount Nelse.

In December 2011, I decided to stop off for a few days on the Bogong High Plains on my way back from Melbourne to Copa after visiting relatives.  I booked a small apartment for my stay with the intention of getting in a few long runs at altitude on the High Plains as part of my preparation for the Bogong to Hotham 64km the following month.  I was coming back from injury and felt some long runs would build my stamina and confidence.

For the biggest long run, I mapped out a 50+ kilometre loop that incorporated part of the course of the upcoming race and set out at 7:00am on a cool sunny morning from near the Rocky Valley Storage Dam.  The half-way point was to be the summit of Mount Bogong (1986m), and although the last half of the course was along familiar trail, the first half of the loop wasn't, and I was excited about running some new trail.  I headed north towards the barren Mount Nelse for the first 8km which climbed gradually away from the Dam on easy running fire-trail.

Mount Bogong from Grey Hills.

I expected the run would take me seven to eight hours and I was wearing a Camelbak containing a couple of Snickers Bars, a map, my phone, a rain-jacket and a cup for getting water out of streams to drink.  Before leaving my apartment I had a slice of toast and jam and figured that the Snickers Bars would be sufficient nutrition for the time I would be out.

At Warby Corner, near Mount Nelse, I turned left onto the Spion Kopje track which followed a high spur westwards with expansive views north and south of fog-shrouded valleys in very still conditions.  I was fresh, the running was easy, and not a soul was in sight.  I felt privileged to have the place to myself, and lucky to be fit enough to do the run.

Quartz Ridge from Mount Bogong.

Things started to change after 5km when I turned north along the much harder to follow Grey Hills Track which followed a scrub covered spur over a series of knolls.  In many places the wiry scratching scrub obscured the track and the going was slow with the occasional short climbs sapping my energy in the thinner air.  The views were still good, but a lot of my time was devoted to watching where my feet were going, especially near the end of the track which descended steeply to Bogong Creek Saddle.  After a brief section of firetrail, I began the steady ascent of the Quartz Ridge Trail towards the summit of Bogong and the half-way point.

Around this time, the sky clouded over and the weather began to look more ominous, a common pattern in the high country.  It was also around this time that my lack of fitness and the harder work along the Grey Hills Track began to kick in, and I found myself walking the steeper sections.  As the trail approached the Hooker Plateau, near Bogong, it passed along an exposed ridge near Quartz Knob with sheer drops to the west.  It was quite runnable but the trail wasn't always obvious and a few times I just headed cross-country in what I surmised to be the correct direction until I again picked up the trail.

At the summit of Mount Bogong (1986m).

At the summit of Mount Bogong, rain seemed imminent and the wind was picking up, so I didn't stay long before heading south-east along the bare ridge to Cleve Cole Hut and some more sheltered trail.  It soon began to rain steadily and I donned my rain-jacket, starting to feel a little cold.  The rain continued on the long technical descent to Big River through the mountain forest.  This is a beautiful section of trail and the rain just made it more atmospheric.  There's nothing quite like running or hiking through rain in an Australian eucalypt forest.  Despite now being way behind schedule, I was still enjoying myself and stopped to get a drink from a small stream just after crossing the raging Big River, hanging onto the wire safety cable.

Roper Hut.

I knew the long climb up Duane Spur would be tough - it always is in the Bogong to Hotham race - and it did not disappoint.  I was soon walking and starting to feel very hollow.  My Snickers Bars were long gone and I had had nothing else to eat for eight hours.  Half way up the climb I began to feel light-headed and could feel myself bonking.  Fantasising about Mars Bars is always a sure sign I have exhausted my glycogen energy supplies and am starting to slowly burn fats, and I was ravenous for a Mars Bar.  I started to doubt my ability to finish inside of twelve hours, thinking I would have to walk all the way back to the car, when the trail passed near Roper Hut.

From experience, I knew that hikers sometimes left unused food in mountain huts and I wasn't disappointed, though the choice was limited.  There was a glass container containing a small amount of sultanas and nuts of uncertain age, and several small sealed sachets of dried apple, something I had never previously tried.  I started eating the sultanas and nuts, which definitely tasted very old, wondering what kinds of unseen fungus they might contain and what would be the health consequences.  After a few more, I decided I would be safer with the dried apple and left with the sachets.  They weren't very big and didn't last long, but I could feel my energy levels lifting and resumed running the level sections of trail with about 10km to go.  Before long, I was wishing I had taken all of the sultanas and nuts to eat, but was saved by the gradual downhill run after Mount Nelse and finished back at my car eleven hours after I had started.  I'm sure I could run this course a lot faster if fully fit and maybe a bit more nutrition en route, but it was satisfying nevertheless, and the completion of such runs often gives my training program a kick start.

I only managed a 4km walk this morning because of time constraints, but did it comfortably.

The other side

Running near Moab in Utah in 2012.

There's little doubt now that I will never run another sub-3 hour marathon.  So, you may ask, why is this blog continuing?

I always had at the back of my mind a plan to use these blog posts as raw material for a book that would organise the content more coherently, and hopefully, encourage people to run and explore their potential.  In a perfect world, the climax of the story would have been a sub-3 hour marathon, but life is seldom perfect, and this blog has morphed into a diary of ageing and its challenges to the obsessed runner.

Writing a blog post almost every day is not necessary, of course, but it's a good discipline on me to generate content and it also serves as a diary to record my thoughts and emotions on this part of life's journey if I do ever come to write a book.

Running the half-marathon leg in a relay Half Ironman
with my siblings in Geelong in 2010.

You never know how you will deal with serious health issues when they arrive.  I have had recent first-hand experience of friends diagnosed with cancer and pulmonary embolisms and it's hard to know how they are feeling about their condition, or what to say to them without seeming patronizing or out-of-touch with their reality.  Now I'm starting to see it from the other side of the fence.

One thing that has surprised me is how fatalistic I feel about it all.  Of course, I will do everything I can to get well, run again and have a long life.  But, suddenly, it's conceivable that none of these things will happen.  When you learn that the mortality rate from undiagnosed pulmonary embolisms is 26% and you have episodes when you feel your heart beating at 235 beats per minute (that's nearly four beats per second!) and your blood pressure crashing, a new reality dawns.

A member of the Tiffin Boys Grammar School Cross-
Country team (sitting on the grass) in 1967 in London.

Much to Sharon's concern, I have started getting my life in order, making sure my records aren't in too much of a mess, that my will is current, and that everything important can be found relatively easily.  If the worst suddenly happened, and it could always be an ill-timed truck, rather than a health problem, I want the clean-up to be as easy as possible.

"What ifs" don't figure at all in my thinking.  I have always been an advocate, when decisions arise, of gathering as much information as feasible, making a careful analysis, and choosing the best apparent option.  Once done, no regrets and no looking back wondering "what if".  Although there are many things I still want to do, experience and see, I can honestly say that I have had a full and interesting life.  If the lights went out tomorrow, I would be more worried about the impact on my loved ones than any missed opportunities of my own.

My exercise for today consisted of nine holes of golf with friends, Dave and Bruce, on a beautiful sunny morning.  Sadly, the conditions were not matched by my form.  I played quite badly for the first six holes, and more worryingly, had some episodes when I could feel my heart pounding and my blood pressure dropping while dragging my buggy up small hills.  This was a new and disheartening (literally) experience on the golf course, but my mood lifted somewhat as I parred the last three holes, something I can never remember doing before.

Little nuisances

Terrigal Trotters doing leech inspections after a trail run.

After yesterday's somewhat heavy blog post, I thought I would talk about something lighter today, the little creepy crawlies that I have encountered while running.

Probably the worst are leeches, which are quite common on the NSW Central Coast where I now live.  In fact, I don't recall ever encountering them while running before moving here ten years ago.  You can get leeches on any long run in the nearby forests, but they are usually worst after rain and in the moist rainforest gullies.  Runners have various home remedies for keeping them at bay, but I don't think any are fool-proof.

One of the offenders.

The leech bites themselves are not painful, but the sight of an engorged leech, or one looking for somewhere to latch on, is always a gruesome find.  Getting them off can be tough, though I have usually managed to flick or pull them off.  Alternatives are salt or flame, I hear.  Often you do not know you have one until you see blood on a shoe or sock, and I have seen some very bloody socks revealed when shoes are removed.  There are also plenty of stories about leeches being found on other parts of the anatomy that I won't go into here.  Initially, the main problem is the anticoagulant used by the leech to facilitate feeding which causes their bites to bleed continuously.  However, the worst impact comes a few days later when the bites begin to itch savagely.  I have woken up at night scratching furiously at badly bitten, red and swollen ankles.  In some cases, the bites can even lead to blood poisoning and a trip to hospital, as happened to Sharon a few years ago.

A Golden Orb spider.

Spider webs are an occupational hazard for trail runners and it often pays to run behind someone else when you are the first runners along a trail.  I'm not aware of ever having been bitten by a spider while out running, but the encounters can be scary.  Locally, we have the Golden Orb spider which is quite large and builds strong and extensive webs, often across trails.  The large spider then sits in the web waiting for something to be caught.  They generally feed on moths, beetles and insects caught in their webs, but they have been known to catch and eat small birds and bats.  I have had the experience of running into one of the webs and then, while scrambling to extricate myself, finding the huge spider almost sitting on my face.  They're not dangerous, but can give you a good scare.

The country lane in Essex near where I was stung
by the wasp.

Perhaps the biggest scare I had from a small animal happened when I was out for a long Sunday morning run through the Essex countryside one Spring Sunday morning.  A wasp flew into my mouth and bit me on the very back of my tongue near my throat before I could spit it out.  Initially, it was just painful, and I continued running, but a few kilometres later, I could feel my tongue swelling up and my breathing becoming restricted.  I decided that discretion was the better part of valour and swallowing my pride (actually I couldn't swallow anything by this time), I found a public telephone in a small village and called my wife reverse charges to come and get me.  I was a bit anxious for the next couple of hours, but the swelling gradually subsided and there were no other symptoms.

Voyageurs Provincial Park, near Montreal in Canada.

Flies and mosquitoes can also be irritating, but not particularly dangerous.  I can still remember a long run in a Voyageur Provincial Park near Montreal in Canada in the late spring when the mosquitoes were voracious and biting me incessantly through the back of my sweaty T-shirt, no matter how fast I ran.  You just have to try not to think about it or it drives you nuts.  Apparently caribou lose half a pint of blood a day to mosquitoes in the spring and early summer.

I walked about 6km today, taking care not to get my heart rate too high when walking up hills.  I learned that my Electrical Cardioversion procedure will be this coming Monday.

1:1 AV Conduction

One of my heart rate peaks, as measured by the
Holter Monitor.

Late today, I had my Cardiologist appointment to discuss my recent Echocardiogram and Holter Monitor results.  He was a fit-looking guy in his fifties and was sympathetic to my plight and my desire to resume running.

It seems that my efforts to give them something to look at while I was wearing the Holter Monitor a week ago were more successful, and risky, than I thought.  The two episodes I had of palpitating heart and lightheadedness while walking up a steep hill, matched recorded instances of my heart rate reaching around 230 beats per minute.

Diagram of the heart showing the path of the macro-reentry
circuit (wavy red line).

Normally, the upper (Atrium) and lower (Ventricle) chambers of the heart beat at the same rate.  However, with Atrial Flutter (AFl), the Atrium beats significantly faster than usual because of a sort of electrical short-circuit (macro-reentry circuit) and a proportion of these faster beats stimulate beats in the Ventricle.  The rate of conduction is determined by a physiological barrier between the chambers and is usually 2:1 for people with AFl (and sometimes 3:1 or 4:1).  When I walk too hard, or run, my ratio appears to change to 1:1 where every superfast beat in the Atrium stimulates a corresponding beat in the Ventricle.

One medical website I found says "Atrial flutter with 1:1 conduction is associated with severe haemodynamic instability and progression to ventricular fibrillation", so I need to keep my heart rate lower until I get treatment.  This diagnosis was a little more worrisome than I had anticipated.

The cardiologist is scheduling me for an Electrocardioversion within the next week aimed at resetting my heart's electrical system (in layman's terms) using externally-delivered electrical stimulus (the paddles, or similar).  The cardiologist warned that this procedure may not yield a long-lasting solution, so I shouldn't get my hopes up.  I will be able to resume my running, but the AFl could return, and I will have to stop again.

If that happens, then when I'm no longer considered at risk of further Deep Vein Thrombosis or Pulmonary Embolism, they will try a Cardiac Ablation using a catheter inserted into the heart through the femoral vein to cauterise the tissue where electrical short-circuit is occurring in the Atrium.  This procedure has a high success rate and provides a longer-lasting solution, but I know everybody is different and I'm not counting my chickens yet.

I walked about 5km today, with no significant hills, and felt fine.

[Disclaimer:  I have no medical qualifications at all and there may be significant errors in this blog post.]

Staring into the abyss

Queenstown, New Zealand.

Back in January of 1979, while touring New Zealand, three running friends and I decided to circumnavigate Ben Lomond, the mountain that overlooks Queenstown.  We planned the route on a road map in our campsite, but didn't have a good idea of how far the run would be, or what we might encounter.

We set off westwards at a good clip on the road following the shore of Lake Wakatipu.  However, the easy running ended as we turned north up Moke Lake Road, climbing 300 metres in just 3km.  At this point, 10km from Queenstown, Keith decided to turn back, and the three of us continued over the saddle and down to Moke Lake.  After the Lake, what was now just a four-wheel-drive track followed a gradually narrowing valley, frequently crossing back and forth across the shallow gravelly creek.  JB and I, both handy steeple-chasers and occasional long-jumpers, were keeping our feet dry with huge leaps across the widening creek, while enjoying the sight of the less agile Pratty occasionally landing short.  Our amusement waned further downstream when it became too wide for us to clear and we all continued on with wet feet.

Moke Creek valley.

We were now in remote and barren mountainous country with few tracks and no signposts, and began to get concerned about the route back to Queenstown.  I felt confident that we would be OK if we just kept Ben Lomond to our right, but without maps and a birds-eye view, we couldn't be sure of exactly where we were, or even our direction of travel.  After two hours, we reached a point where the track we were following veered leftwards to cross the creek and head in what I thought was the wrong direction.  High up on the mountain to our right, I could see a faint goat track crossing the slope that seemed to be going in my preferred direction.

JB and Pratty weren't too keen to climb up the steep heath-like mountainside to reach the track, preferring the four-wheel-drive track we were on.  After some good-natured debate, we split up and I began climbing the steep slope.  About half-way up, while scrambling on all fours across a patch of heath and vine, I became aware of a cold draft coming from below me.  Peering down through the vegetation, I was alarmed to see nothing but a black abyss, an old gold-mine shaft!  I inched forward, holding on to the most substantial stems and branches I could find, hoping they did not give way. After a few terrifying minutes, I reached terra firma, pondering the wisdom of the route I had chosen.  Too proud to follow my mates, I continued on very slowly up the steep slope, carefully making sure of the ground beneath my feet.

Moonlight Creek and Arthurs Point.

I finally reached the track I had seen, which turned out to be reasonably well-worn and quite runnable.  I followed it round the contour of the mountain, increasingly confident I had made the right choice, and eventually reached Arthurs Point and the road back to Queenstown.  I arrived back at the campsite just under four hours after I had left and spent the next few hours wondering and worrying about JB and Pratty, who I now knew had headed off in the wrong direction.  Finally, they appeared and told their story.  After they left me they eventually reached the old gold-mining area of Moonlight, where some four-wheel-drivers confirmed they were heading in the wrong direction.  Eventually, they got a series of lifts back to Queenstown.

My exercise today was literally more pedestrian.  I walked about 9km around Copa and Whinney Bay.  There were some long hills, but my cardio-vascular system stayed in the "green zone".  I see the Cardiologist late tomorrow afternoon and am getting a little anxious about what he will say.  I'm prone to optimism, but know I need to be ready to deal with some less-rosy scenarios.

American hype

Early morning on the Vermont 100 course.

Being retired has the advantage of letting me watch the American Super Bowl which is shown live on Monday daytime television in Australia.  In fact, I have probably watched more Super Bowls since retiring than I managed to watch during the eleven years I lived in the US while working.  It always seemed that I was catching a red-eye flight from the US to London when the Sunday night Super Bowl was on, and one of my parenting regrets is that I did not get to watch it with my son more often while he was growing up.

Apart from the game itself, I enjoy the hype which surrounds the Super Bowl.  It's something the Americans generally do very well, including at some of their running races.  In July 2000, I made my one and only attempt to run a 100 Mile race in the Vermont 100.  After driving up the day before the race to rural Vermont and camping in the designated farm field, I had a sleepless night in a small tent, punctuated by the late arrival of race supporters, several thunderstorms, and the very early rising of fellow competitors preparing for the 4:00am start.

A checkpoint on the Vermont 100.

I soon got up myself, readied for the race, and wandered down to the start line in the pitch darkness.  It began to rain steadily, and the 300 competitors, plus spectators, crammed into the large barn adjacent to the start while we waited for the start.  Just before 4:00am, we were herded outside in the heavy rain, and sent on our way down the farm road towards the country road along which the first part of the course ran.  The 300 runners splashing down the unlit track, accompanied torrential rain, bright lightning and crashing thunderclaps, was surreal enough, but it was upstaged by the sight and sound of a pianist in formal attire pounding out the theme from Chariots of Fire on a grand piano on the farm verandah as we passed.  I momentarily wondered whether I was dreaming, then grinned to myself.  What a great piece of theatre, some provided by nature, and some by the organisers.

A scene from the 2008 Vermont 100.

The race itself didn't go too well.  My inexperience at that distance showed when I treated it like a long marathon race, staying in the top 20 until the 60 mile mark, then totally losing control of my quads in the next few miles and withdrawing at 67 miles.  Injuries have prevented me tackling another 100 miler since then, but it's still on my bucket list.  I am now Race Director for a 100 Mile trail race myself, but haven't yet employed a pianist.

I just walked 5km today, and was a little troubled by heart palpitations and low blood pressure near the top of one flight of steps that I, perhaps, ascended too quickly.

Chilkoot Trail

Prospective miners ascend to the Chilkoot Pass during
the Klondike Gold Rush.

Apart from its health benefits, running has often helped me do things more quickly and efficiently.  I have talked about its use for commuting (see post titled Commuting), and running is a great way to journey through remote areas, but it's also been useful in facilitating one-way hiking trips in remote country.

Old boiler on the Chilkoot Trail.

In July of 1985, my then wife, Barb, and I were touring Canada and Alaska by campervan when we decided we would like to hike the famous Chilkoot Trail.  The Trail was the major access route from the sea at Dyea, near Skagway, to the Yukon goldfields during the 1890s Klondike Gold Rush.  The 33 miles of the Trail was only the start of the miners' journey to Dawson City.  It got them to the headwaters of the Yukon River where they then bought or built boats to float the remaining 560 miles downstream.  The Trail started in the US, but crossed into Canada at Chilkoot Pass (3075ft) where Canadian Mounties enforced a requirement that each miner have one ton of supplies with them (calculated to last a year).  This requirement meant that miners had to move their huge loads forward along the Trail in stages, and thriving camps grew up along the way, and much rubbish was discarded.

Chilkoot Trail.

These days, the Trail passes many rusting artifacts from those days and the abandoned locations of the towns and camps that sprouted during that time.  From the northern end of the Trail at Lindeman Lake, it is possible to hike a further 5 miles following a disused rail line to the nearest road access, the Klondike Highway.  We decided to take two days to hike the Trail and allocate half a day at the beginning and end to get to and from Skagway.

Near Chilkoot Pass.

The night before we started we camped at the trailhead in Dyea and in the morning unloaded our hiking gear before I drove our campervan back into Skagway where a kindly National Parks ranger had suggested we park it outside his house for safety.  I then ran the 9 miles back to Dyea along a road that followed the contours around forested hills overlooking the headwaters of Chilkoot Inlet.  On arrival at Dyea, we set out on our 48-hour hike which followed the very interesting Trail and included deep snow, occasional drizzle, thick fog and very cold weather.  We were glad we weren't carrying a ton of supplies each and had great admiration for the endurance of the miners.

Our hiking journey finished 38 miles later on the Klondike Highway, 28 miles north of Skagway, at 1:00pm on the third day.  We were both very tired and cold, and decided to try hitch-hiking back to Skagway, but gave up after an hour.  Plan B was that I run back to Skagway to retrieve the campervan.  The notes from our diary record that I donned "long thermal underwear, shorts, two extra tops, balaclava, gloves, passport, credit cards, money and car keys" before setting off southwards in the bitter cold.

White Pass.

The first miles were relatively flat, but very exposed, skirting several lakes beneath snow-covered peaks, before climbing a little to White Pass which marked the border between Canada and the US.  I stopped in at the very quiet border post to show my passport on a grey overcast afternoon to a US border guard who showed not the slightest interest in my strange garb or my lack transport, before beginning the steady descent towards Skagway.  Despite the greater protection provided by the thickening forest and deep valleys, and the slightly warmer conditions, I became very tired and was totally exhausted by the time I reached our van around 6:00pm.  I drove back to get Barb, picking her up about 7:00pm, and we continued onto the town of Whitehorse where we camped later that night.  Those three days of adventure still live large in my memory.

I walked 14km this morning through forests, exploring trails in the McMasters Firetrail area, in warm and sunny conditions.  I was a little breathless near the top of some of the longer climbs, but not too bad and enjoyed getting a bit hot and sweaty for a change.

Psychological effects

5:30am in Terrigal and the first Trotters begin checking
for the Saturday run or walk.

Like most Saturdays, today started with a 4:30am alarm and arrival at the Terrigal Surf Club fifty minutes later to join my Trotters club-mates for our weekly 6:00am run.  Only, I'm not running at the moment......but I'm not alone.

I have never analysed the stats, but my guess is that you could divide the Trotters population into quarters.  One quarter are fit and running well. Another quarter are running, but carrying an injury.  A third quarter are running, but coming back from injury, and the final quarter are unable to run because of illness or injury, some permanently.

Kurrawyba Avenue in Terrigal was on
my walk route this morning.

Many in that final quarter are not only dealing with pain associated with their ailment, but also dealing with the psychological impact.  Fortunately for me, there's no physical pain, but I do feel the psychological effects.

The easiest to deal with is the loss of routine.  Like most serious runners I have always relied on routine to help me fit training in with family and other commitments, and the loss of routine can be destabilising and depressing.  Replacing running with some other form of exercise, if at all possible, and using any additional spare time to work on other useful or meaningful projects has generally worked for me.

One of the most challenging impacts can be the loss of identity.  The thing that most people know about me is that I'm a reasonably good runner.  Although I like to think there are other dimensions to my character, I do also see myself as a runner.  In the last month, in my own eyes, and the eyes of those around me, I am morphing from a serious masters athlete to a senior citizen with cardiovascular problems.

Sunrise over Terrigal.

Along with the loss of identity can go a loss of self-esteem.  The podium finishes that I enjoyed in the past, and these days, just keeping up with younger runners, builds self-confidence.  Absorbing challenging training regimes and successfully planning and preparing for major races also contributes positively to self-esteem.  The longer I am unable to run, the less happy I am with myself, even when there's nothing I can do about it.  And the worse I feel about myself, the more likely I am to over-eat and put on weight and so the downward spiral goes.

I also have real fears that being unable to run for an extended period of time will lead to a deterioration in my overall health.  Of course, it seems likely that running caused my current cardio-vascular problems, and I recognise that running is not a guarantee of good health.  However, I have no doubt that the fitness gained through running has improved my quality of life and fended off other ailments that beset my demographic.  I now worry that all that good work will be undone if I can't get back to serious exercise.

Early morning stand-up paddle boarders.

Finally, I have always found that running refreshes me and helps me deal with life's stresses.  This was certainly true during my working life, where the morning run seemed reset my body clock and wipe away (or at least diminish) problems.  Maybe it's the lack of oxygen getting to the brain, but I always found it difficult to worry about things, or even do relatively simple mathematical calculations, while on the run.

While most of my club-mates ran this morning, I walked a comfotable 6km.  I'm still in a holding pattern.

JFK 50 Mile

Running the Appalachian Trail section of
the 2000 JFK 50 Mile.

I've never counted how many races I have run, but I'm sure it would be a four-figure number.  Some of those races stay in your memory for one reason or another.  One favourite, which I have only managed to run twice, is the JFK 50 Mile held each November in Maryland, USA, about an hour's drive north-west of Washington DC.

The race has an interesting history. In 1963, President John F Kennedy launched a national fitness drive that included a challenge to the nation's military officers to meet the standard set by Teddy Roosevelt in the early 20th Century of being able to cover 50 miles in 20 hours on foot.  Others were keen to test themselves against that standard and a number of 50 Mile races were organised around the US in that year.  Sadly, Kennedy was assassinated in November 1963, and the Maryland race changed its name from the JFK 50 Mile Challenge to the JFK 50 Mile Memorial in 1964 and has been run every year since.  It is the only surviving 50 Mile race from that time.

Looking over the Potomac near where the JFK 50 Mile
descends to the river.

Being so close to Washington DC and many US military bases, and with its military-related origins, the field always includes many service personnel, giving it another dimension.  For a long time it was the largest ultra race in the US, averaging around 1,000 finishers in the last decade or so.

The C&O Canal towpath.

Apart from my passion for trail ultra-running, the race appealed to me because a section was run along the famous 2,200 mile Appalachian Trail that I had hiked a decade earlier.  Being just half a day's drive from where I was living in Connecticut at the time was an added bonus.

The race is actually a varied mixture of terrain and surfaces.  It starts with a run down the main street of the small town of Boonsboro before climbing 1,172ft on mostly sealed road for the first 5.5 miles.  The field spreads out quite quickly.  The next 10 miles follows the lovely Appalachian Trail, paved with autumn leaves, southwards along a timbered ridge before descending 1,000ft to the C&O Canal towpath which follows the Potomac River upstream.  If you are going well, as I was in 1999, the first year I ran the race (64th, 8:02:17), the marathon-length dead flat towpath is an opportunity to gain time and places.  The second time I ran, in 2000 (118th, 8:48:47), the towpath stretch seemed demoralisingly endless.

The Potomac River along the JFK 50 Mile course.

After the towpath, there's an undulating 8.5 mile run through rural countryside, which can also be a tough stretch if you are running badly, to the finish in Williamsport.  The community support for the race, and the size of the field, along with the military dimension, help make it a special and memorable race, and I hope to do it again one day.

For my exercise today, I played my usual Friday morning 9 holes of golf.  Later, I was pleased to get a call from the Cardiologist's rooms offering me an appointment next week, three weeks earlier than scheduled.  I think I have the Respiratory Specialist I saw on Wednesday to thank for that, and am looking forward to finding what can be done about my heart arrhythmia, and when I can start running again.

Finding the boundaries

Coast Road in North Avoca tested my limits this morning.

The Holter Monitor involves having five electrodes, connected by wires to a battery-powered recording unit a bit larger than a smartphone, stuck to various parts of my chest for 24 hours.  The device will record my heart activity and I'm supposed to note the time of any periods when I feel breathless or notice heart palpitations.  I was worried the electrodes would become detached while I slept, but the technician did a good job of taping them down, and they were still there this morning.

Wamberal Beach from my walk this morning.

The Respiratory Specialist yesterday, while not encouraging me to run, implied that it wasn't necessarily dangerous, just that it would be difficult and uncomfortable.  I didn't want to confirm his prediction, but did want to get my heart-rate high enough today to provide good evidence of the occasional problems I have experienced in the last month.

Thursday, as usual, started with supervision of the 6:00am track session at Terrigal Haven on what was a beautiful sunny, and a little humid, morning.  I watched the twenty or so runners go through their paces (seven times 800m with a minute recovery between each) in the 45 minute session before they headed off to their breakfast coffees, or work, or to get their children ready for school, or all three.  I always feel a bit lazy, being retired, that they have to rush off while my day continues at a more leisurely pace.

Terrigal Beach this morning.

I returned to my car, donned my radio and headphones, and set out on a 7km walk that would include several hills I thought steep enough to test my impaired cardio-vascular system.  Rather than my usual stroll, I walked a little more briskly to encourage the symptoms.  The first significant hill climbs up the Scenic Highway out of Terrigal and I fully expected to succumb to breathlessness as I maintained a good pace, but I was surprised to reach the top without a problem.  It was good that I was feeling better than expected, but bad that there was no discernible heart arrhythmia for the Holter Monitor to record.  A little nonplussed, I continued on down Tramway into North Avoca, circled through the beachside streets and tackled the second steep hill, Coast Road.  This hill is steep enough to always be a serious challenge when running, and I couldn't envisage walking briskly up it without testing my current limits.

Terrigal Haven this morning.

Sure enough, after about 100 metres of serious climbing, I felt my heart racing and my blood pressure dropping.  I had to stop for fear of passing out, and just stood quietly for a minute, ready to sink gracefully to the side of the road if necessary.  After a minute or so, my equilibrium was restored and I continued on.  However, a few hundred metres later, at another short sharp little pinch, the same feeling enveloped me and I had to stop and stand still for a short period, again ready to cushion my fall to the road if I fainted.

It was encouraging, though, that once equilibrium was restored, I felt fine and could continue on at a good pace so long as the grade wasn't too steep.  I walked another couple of kilometres down into Terrigal before returning along the beach promenade to The Haven and my car, where I noted the times I felt unwell for the doctor to compare to the heart monitor.  I'm sure he will have something to look at now.

Perspicacious medicos

Cockrone Lagoon, between McMasters Beach and Copa,
and near our home, is one of my favourite places to walk.

I walked 5km this morning, and although not as bad as yesterday, still felt more breathless than has generally been the case in the last few weeks.  Maybe I've just had a bad couple of days.  I have read stories on the Web of runners coming back from Pulmonary Embolism (PE) who have bad patches.  Nevertheless, I was pleased I had an appointment scheduled for later in the morning with a Respiratory Specialist to get an expert opinion on my situation and some answers to questions.

Cockrone Lagoon.

As it turned out, the Specialist's opinion was that the worst of my Deep Vein Thrombosis (DVT) and PE was past, and that as long as I was taking the anti-coagulant, Warfarin, my prognosis was good.  In fact, if my heart wasn't an issue, he would have been OK for me to resume running, which was good news.  He spent some time checking my pulse, and said he was sure that the breathlessness I had been feeling was due to my heart which was beating irregularly, averaging about 60-70 beats per minute compared to my usual resting rate of low 40s.

Cockrone Lagoon.

He seemed keen that I see the Cardiologist (my appointment is four weeks away) as soon as possible and actually tried to get me an appointment today (they are in the same building).  I think the urgency was driven by his desire to help get me running again rather than any concern about my current condition, although he didn't actually say that.  He told me he was training for a triathlon, confirming to me the wisdom of getting a Specialist recommendation from my sports medicine friend, Dr Jon.  In my experience, medicos who participate in endurance sports have a much better understanding of obsessional distance runners such as myself.  They know how much it means if we cannot run, how much we test our physical limits, and how prone we are to ignore pain.

He prescribed another heart test, a Holter Monitor, and told me to call the Cardiologist when the results were available, mention his name, and I should be able to get an earlier appointment.  I called to arrange the test, and because they had a cancellation, was able to get an appointment this afternoon.  I'm now walking around with electrodes attached to various parts of my chest and connected to a battery powered recorder on a waist belt.  I have to note the time of any breathing or heart events I notice in the next 24 hours and return the device tomorrow afternoon.  Hopefully, I'll be able to get an appointment with the Cardiologist next week and make progress on the heart problem.  I sensed the Specialist I saw today thinks the heart arrhythmia will be correctable, but time will tell.

London

St Paul's Cathedral.

In total, I have lived ten years of my life in the UK and am very fond of the place.  In various blog posts (Frost Fairways,  Chappel, Isle of Dogs), I have described some of my favourite runs there.  The last time I lived in the UK was in 1992, but during the next eleven years when I lived in the US, I made many business trips there, frequently staying in hotels in central London.  Central London is a big place, and depending on where you are staying, the running options can vary.  During the latter part of my working life, when I was employed by Reuters, whose head office was in Fleet Street, my favourite place to stay was a business hotel close to St Paul's Cathedral.  It was easy walking distance from the office (passing an excellent Indian takeaway en route!), and close to the Thames River, a wonderful place to run.

HMS Belfast with Tower Bridge.

For my regular 10km run, I usually set out about 6:00am and headed east along Cannon Street past the imposing St Paul's Cathedral and then Mansion House, Cannon Street and Monument stations which were already disgorging early commuters before arcing around the northern side of the Tower of London and onto the iconic Tower Bridge.  I always enjoyed checking out the river traffic as I crossed the bridge and looking at the retired HMS Belfast anchored upstream.  On the southern side of the bridge, I descended a stairway to begin my journey westwards along the southern bank of the Thames.

Millennium Bridge and St Paul's Cathedral.

At first the route wound through some narrow back streets passing refurbished warehouses and stereotypical London pubs before joining the promenade along the river bank which I followed all the way to Westminster Bridge.  On the way it passed landmarks such as the Millennium Bridge, the Tate Modern, Southbank, and the London Eye, all the time providing superb views of the London skyline to the north across the river.  After crossing the river again beneath Big Ben, the route turned right to follow the Victoria Embankment downstream and back to the northern end of the Millennium Bridge from where it was a short run back to the hotel.

London Eye and Southbank.

It was a generally flat course along wide paved footpaths and promenades that made for a fast run if I was feeling good, which was often the case.  In summer, London had milder temperatures and lower humidity than my US abodes, and in winter, it was also milder and nice to run in shorts for a change after the winter gear required in the US.

I've been told that my recovery from the Pulmonary Embolism could be long and erratic.  Today served to emphasise the point when I struggled all of the way round what should have been an easy 5km walk in Copa.  I didn't feel my heart racing, maybe because I walked so slowly, but it was exasperating and a little alarming to feel so unfit.  My breathing was heavy and laboured and I even contemplated sitting down on a bench with a kilometre to go when I began to feel a little spaced out.  Instead, I just walked even more slowly and made it home OK.  The rest of the day was pretty sedentary and I had no problems.  On the plus side, I had a call from the office of the Respiratory Specialist I wasn't scheduled to see for another month to say they had a cancellation tomorrow, so I'm hopeful of getting a useful opinion about my situation and prognosis.