Changing expectations

Bouddi National Park coastline.

I can already sense my mindset changing, and much more quickly than expected.

When you can't run, you tell yourself you will be satisfied with just being able to jog 5km a day.  When you get to jogging 5km a day, you tell yourself you will be satisfied if you can just run 10km per day, with the occasional long run.  And so it goes.  Before long, you will just be satisfied if you can get back to the fitness level you enjoyed before sustaining the injury.

Lovely single-track in Bouddi
National Park.

This has always the pattern for me when dealing with a serious running injury, but somehow I thought the life-threatening health scare at Christmas might lead to an attitude change.  In some ways it's frightening, and in other ways comforting, to find that, post-injury, little has changed.  Scary, because it worries me that I'm not paying sufficient heed to the risks of reversion to heart arrhythmia and the impact that may have on my future quality of life.  Comforting, because it's good to know that my problems haven't changed me that much.

The fire-trail down to
Little Beach.

I made it around the 14km Trotters run on Saturday (see post titled Looking up) with no apparent ill-effects.  After two subsequent easier running days, I asked myself this morning why shouldn't I run a bit further today, and maybe hit one of my favourite local trails.  Part of my reasoning related to the psychological boost I would get from returning to my usual running haunts, and part of the reasoning was that the further I ran in training, the sooner I would regain fitness and the easier running would become.

The more I run, the less focussed I am on my heartbeat and breathing.  I'm finding that a conscious decision to run within myself is sufficient to keep my breathing controlled and my heartbeat within comfortable limits.  I'm wearing a heart monitor now for my runs and it confirms that my heart rate is averaging around 150bpm during runs, reaching a maximum of around 160bpm.  It seems to me that, though getting my heart rate higher would accelerate my return to fitness, I will still benefit from longer easier runs, healthwise and weightwise.

Little Beach this morning.

I ran about 13km today along trails to the deserted Little Beach on a warm and sunny morning.  I walked up the steepest hill, and stopped a couple of times for views and photos, but still worked up a very good sweat.  On the downside, my chronic right knee injury was quite painful at times.  It doesn't seem like the time off running, during which it was not painful at all, had done it any good.  But the pain is a price I'm happy to pay just to be running again.

Ouch!

Not good news!

After two months of no running, and despondency about my health problems, I know I have put on some weight.  The shorts are a little tighter, as are the T-shirts, and I can't see as many ribs in the mirror.  Up until today, I had tried not to worry about it too much.  Dealing with health concerns and the inability to run were stress enough without beating myself up about my eating or weight (see my blog post about Compensatory Eating).

On Saturday I managed to run 14km, and have now run every day for nearly two weeks.  Although not out of the woods, health-wise, it's time to get back to normal.  "Normal" includes weighing myself regularly and trying to stay at, or below, 68kg.  Not only do I feel healthier at that weight (and my clothes fit better), but it reduces the chances of injury.  I do have a chronic right knee problem (see post titled Adaptation), and it has been quite sore since I resumed running.  I firmly believe that weighing less will alleviate some of the strain.

Much faster and lighter at Croydon in the UK in 1975.

Anyway, after my run this morning, I stepped on the scales for the first time in over two months - 74.0kg!  It was demoralising to see this number, and a big wake-up call.  Even though I can't run the kilometres I would like, I can exert more discipline over what I eat.  It's time to get back onto my "no snacks, no desserts and no second helpings" diet with small breakfasts and lunches.  Occasional treats will be allowed, but I need to be much more strict overall.

My 5km run was a little faster and more comfortable this morning, though my right knee hurt and I'm still running slowly.

Looking up

Erina Valley is part of Woody's Wun.

The Terrigal Trotters Saturday morning run this week was the 14.2km "Woody's Wun".  Coincidentally, it was the last Trotters run I did while still fully functional, back in mid-December.  It was also 6km longer than my longest run since resuming training nine days ago, and incorporated some very steep and long hills.  That made me (and others) quite apprehensive about whether I should be attempting it.  On the other hand, there was a sort of appealing symmetry if I could get around the run OK.  I wouldn't be resuming where I left off, because last time I ran quite hard and well, but just completing the course without incident would be a significant step on the road back in my mind.

I managed to fall over crossing these paddocks this morning.

I was last of the hundred or so runners climbing the first rise away from the Terrigal Surf Club, but that was a good place to be, and pretty much where I stayed for the first few kilometres.  Despite constantly self-assessing my respiration and heartbeat, it was a great pleasure to be running along in the pre-dawn darkness bantering with my club-mates again.  There have been times during the last two months when it seemed possible those days were over, and probable that the hiatus would be much longer.

Woody's Wun goes right through the Erina Fair
Shopping Mall.

On each of the solid climbs in the next two kilometres, I slowed to a walk with some of my colleagues, only resuming when the gradient eased.  Normally I would never walk up a hill during a Trotters run, but my expectations have changed, at least for the time being.  They were the kind of hills that would have brought me to a staggering halt with a heart rate of 230bpm before the Cardioversion eighteen days ago, so it was encouraging to get up them comfortably.  From there, I ran the whole way, apart from climbing a few fences and one fall while crossing a paddock.  I particularly enjoyed the steady slow climb up the side of forested Kincumba Mountain along a very technical kilometre of single track and the gentle descent which followed along a beautiful fire-trail.  Magic!

The fire-trail on Kincumba Mountain.

I even caught a few people over the last half of the run, as I settled into an easy unstressed pace, but had to keep reminding myself not to get competitive.  This will be one of my challenges going forward.  Although there were still some aches and pains, particularly in the knees, I was in better shape than a few days ago, and really enjoyed the run.  May there be many more!

Imagination?

Murray River.

Most of today was spent driving the 1,000km from Melbourne back to Copa.  I was on the road by 5:00am, after a night during which I woke several times.  I suspect the real reason for the disturbed sleep was that I knew I had an early start, but each time I woke, I found myself lying there, very conscious of my heartbeat and trying to determine whether the beat was regular.

After my 5km run yesterday morning, I was checking my pulse and it seemed that there was a double beat about every 20 to 30 seconds, although it could have been my imagination.  I hadn't experienced any breathlessness or palpitations while running, but nevertheless I'm now a bit worried that the double beat, if it's real, signals the early stages of the return of my Atrial Flutter.

Bike path along the Murray.

As I drove north along the Hume Highway in pre-dawn darkness, I wondered about the wisdom of running again today.  However, after three hours of driving and feeling a little tired, I stopped in Albury and set out along a bike path by the Murray River.  It was a pleasantly cool morning and I was pleased to feel more like a runner than earlier in the week, though somewhat apprehensive.  I wasn't running hard, but was moving faster with less stiffness in the muscles and joints.  The faster speed meant my lungs were working a little harder, and I was breathing in on two steps and out on one, but still controlled.  Nevertheless, I was constantly self-assessing myself, looking for any sign that my heart was racing or my blood pressure dropping.

Billabong at the turnaround.

After about 3km of following the full and fast-flowing river, I reached a billabong and the end of the bike path and turned round.  It was nice to see the Murray River looking so healthy after a number of dry years.

Hovell Tree Park.

The path returned through the Hovell Tree Park, where I had finished my 440km three-week hike along the Hume & Hovell Track about ten months ago.  The Hovell Tree was marked, nearly 190 years ago, by one of the explorers after whom the walking track was named.  I could vividly remember finishing there at dusk, completely exhausted after compressing the planned last two days walk into one 50km day.  Despite my exhaustion on that last day, I had a great trip, and being there again made me wish it was a year ago when I was preparing for the trip, with no heart or lung problems in sight.  Just another reminder to make the most of my time.

I was again checking my pulse again after the run, and still wonder if there's an occasional double beat.  Generally, it seems regular and strong (and back under 50bpm at rest), but I still have a nagging concern.  I have an appointment with the cardiologist next week anyway, and he'll confirm one way or the other.  For the time being, I think I keep running daily.

Singapore

Looking towards Marina Bay, Singapore.

Another city I visited frequently for work during my 16 expatriate years was Singapore, which I found somewhat bland compared to, say, Hong Kong, in terms of topography, atmosphere and running opportunities.  The climate was also challenging, with the city state lying just north of the equator.  I remember one occasion, after flying in at noon and having no afternoon commitments, setting out in the early afternoon for a 12km run.  There was little shelter from the blazing sun and the humidity was extreme, but I considered myself indestructible.  Jet lag may also have been a factor, but for whatever reason, after about 8km I began to feel incredibly tired and light-headed and had to sit on a shaded park bench for ten minutes before I could continue.  I then slowly walked the remaining 4km back to the hotel.

The path along the Kallang River.

As hotel locations varied, so did my morning run routes, but the usual 11-12km started somewhere in downtown Singapore in pre-dawn darkness and headed down to Marina Bay from where I followed a path by the Kallang River northwards.  It was cooler in the dark, but that's relative, and it never took long to be dripping with sweat.  There would be a few early workers and exercisers about, but generally I had the place to myself.

East Coast Park.

After crossing the River, the run passed some darkened sports stadiums before entering a residential area of towering apartment blocks where the locals, including many schoolchildren, were setting out for their day.  At the manicured and verdant East Coast Park, which extends all the way to the airport, I turned right along a bike path back towards the city.  After crossing the river again, I ran past the historic Raffles Hotel into the CBD and the end of the run.  If I was smart, I had turned the air-conditioning up to the maximum in my room before I left, because it always took a long time to stop sweating, and it wasn't worth showering until I had.

Raffles Hotel.

I never tried a really long run in Singapore, but I'm sure it would be hard work, and I don't envy any serious distance runners living permanently in the country.

My 5km run went a little bit easier this morning, so I hope this is the start of feeling better.  I'm still checking my pulse all the time.  I don't know how long it will be before I take a regular heartbeat for granted again, if ever.

Warfarin?

My usual 5km while staying in Melbourne passes along
some of the leafy Malvern streets.

After six days of running about 5km a day, following two months of no running, I'm about where I expected to be in terms of cardio-vascular fitness.  My diagnosis of Deep Vein Thombosis, Pulmonary Embolism and Atrial Flutter at the start of January, had me worrying whether I would ever run again.  It was a scary time.  Now that my heart is back in sinus rhythm and I'm taking Warfarin to minimise the risk of further blood clots, running is again part of my life.

I have resumed running after injuries many times in 45 years, and generally know what to expect.  There will be two weeks, or longer if I have added a few kilograms, of feeling like a fish out of water.  After that, I will begin to feel like a runner again.  Then, the return to full fitness is generally a function of how long I had been unable to run.

The run passes by the John Landy Oval
(see post here).  

I'm mid-way through the initial couple of weeks and there's no problem with my cardio-vascular system.  I'm breathing easily and my heart rate seems to be behaving itself.  What is bothering me, is how stiff and sore my legs are.  Every morning, I feel like all my joints and muscles need lubrication as I set off.  I'm surprised I don't hear squeaking!  It's worse than I expected, and I have been tempted to blame it on the Warfarin I am taking.  If my blood is slow to coagulate, maybe the inflammation that must be occurring in my ageing and cartilage-poor joints is slower to repair and then dissipate?  Maybe there is some other side-effect?

Looking across John Landy Oval in Malvern's
Central Park.

I have searched high and low on the internet for information about the effects of Warfarin on runners, but instead of finding clues to explain my aches and pains, I have found stories of endurance athletes successfully returning to serious competition while continuing to take Warfarin.  Seems like I will have to accept the ageing process is the main culprit.

Just another 5km this morning at an easy pace, with no problems apart from the above-mentioned stiffness and soreness.

Realising potential

This morning's run passed by the famous Melbourne
Cricket Ground.

In a previous post, I wrote about the attributes I consider keys to reaching the top as a runner (and most fields of endeavour) - the right genes (natural talent), hard work and luck.  This is simplistic, of course, but in my chosen sport of long-distance running, the champions seem to have all three.

For this morning's run, I travelled into the East Melbourne apartment of an old friend, Bill, and we ran about 8km down to, and around, the Tan Track and back.  Bill is a formidable performer in any field of endeavour he chooses.  I first met him at University where we were both doing our Masters degrees, and he was way ahead of the class.  He is also an accomplished musician, has reached the pinnacle of his chosen academic profession, and is a quality cyclist and runner.

Looking up Anderson Street Hill on Melbourne's
Tan Track.

In all these fields, he has leveraged some good genes with fierce dedication and focus to explore his considerable potential and reach elite levels.  He's not a person who's going to die wondering "What if?" or whether he got the best out of himself.  I have always respected his attitude and sometimes wondered whether I could have been a better runner if I had his self-discipline.

Luck wasn't on his side in running and cycling, with crippling injuries shortening his competitive career, but he was hard to beat, especially over distances from 10km to 25km.  Nowadays, he's content to run for an hour most days, chronic injuries permitting, and doesn't run competitively, reasoning that this will extend his running life.  He has advised me to do the same, and I can see the wisdom of this approach.  Maybe that is what I will end up doing.

Melbourne's Tan Track.

Bill took mercy on me this morning, and we jogged our 8km at the princely speed of 6 minutes per kilometre.  The run included the famed Anderson Street hill, about which I was somewhat apprehensive, but it passed without incident and my pulse was still beating regularly when we finished.  My right calf was sore and my joints and legs ached, but it was great to be running with an old friend on a picture perfect morning around some of our old haunts.

So far so good

Second from left, with the University of Melbourne
Cross-Country team in Canberra for the 1979
Intervarsity Championships.

It was with more than a little trepidation that I set off for this morning's 6km walk/run after supervising the 6:00am Trotters' track session at the Terrigal Haven.  I walked the first 500 metres, which included a solid hill, then jogged a few hundred metres before walking up a second, steeper and longer, hill.  So far, so good.  Once at the top, on Scenic Highway overlooking Terrigal, I decided to jog the remaining 4.5 kilometres of the 6 kilometre course if I felt OK.

I was very slow, and felt very unfit.  At one point, I was passed by ultra-running friend, Darren, who was himself running very slowly as he came back from injury.  How slow can you go, and still be running?  My joints creaked and my chronic bad knee hurt, but my breathing remained steady.  All the time, I was examining my heart and chest with my brain, looking for signs that something was amiss, but nothing happened.

When I reached the last few small hills, hills that I had originally intended to walk up, I chose to keep running.  I felt a little reckless, but was gaining confidence, that so long as my breathing was comfortable, I was not stressing my heart.  Back at The Haven, I reached my car and stopped running.  It hadn't been any tougher than other first runs after two months off, and I felt a glimmer of hope that I was on the way back to recreational running, if not competition.

Walking and pondering

The backlots of McMasters Beach on this morning's walk.

I walked about 10km this morning in misty, drizzly, and almost autumnal weather along some less-travelled roads and trails around nearby McMasters Beach.  Walking gives more time to look at your surroundings, and I've enjoyed a closer examination of the forests and properties that I often pass more cursorily on the run.  It's all relative, of course, with walking better than running, and running better than biking, if you want to absorb your environment.  All are better than driving.

The gravestone of Allan McMaster, the first European
settler in the area named after him.

Another advantage of walking, for me at least, is that it is the best time for thinking.  I'm a stroller rather than a power walker, and the gentle perambulation seems to stimulate my analytical brain cells.  As I walked this morning, experiencing no breathlessness or heart palpitations, I wondered about the chances that my heart problems were behind me.  If not, how would the return of the Atrial Flutter (AFl) be triggered?  By running too hard?  And if it was triggered, would it suddenly be as debilitating as it was before the Cardioversion, or would the onset be slower?  What were the chances of reversion, and what were the risk factors?  Wouldn't the cells through which my heart was passing the errant electrical pulses still be there, just a dormant pathway waiting to be reactivated by stress or some other trigger?

Umbrellas were optional on a drizzly morning walk.

There was lots to think about, inconclusively, and I returned home to do some more Googling.  Nothing I could find gave me more certainty, but there were clues.  One study in particular, of men a similar age to me, found that 55% had recurrent AFl within six months of their Cardioversions.  Underlying heart disease, previous episodes of AFl, and enlarged left atriums all seemed to be statistically significant factors in those who reverted.  I'm not conscious of previous AFl events, and my cardiologist found no evidence of heart disease, but he did find "mild Left Atrial dilatation".

Cockrone Lagoon on an autumnal morning.

Other studies have found enlarged left atrial size to be more common in long-term endurance athletes, than others of a similar demographic, and that this seemed to be associated with great incidence of Atrial Fibrillation (AF) and AFl.  So, it seems reasonable to assume I remain at significant risk of reversion.  The great unknown for me, though, is whether the enlarged left atrium was the key factor in the development of my AFl, or was it the Pulmonary Embolism (PE) placing undue pressure on the heart's function that was the trigger.  Although I'm probably stuck with the enlarged left atrium, the PE should be gone soon, if not already.  Does that mean there's a good chance I won't have the problem again?  Probably not, but only time will tell, although there will never be a point at which I can say there is no further risk.

Gender differences

The Trotters assembled in Yarramalong before running the
28km to Somersby.

In a perfect world, today's Terrigal Trotters trail run from Yarramalong to Somersby would have been my last hit out before the Six Foot Track 45km trail race in two weeks time, where I had given myself some chance of breaking the 60+ age group record.  Alas, it's not a perfect world, but I still enjoyed following my club-mates during their run.

I had time to walk into a few locations and take photos, so racked up a couple of kilometres on a very humid and occasionally showery day.  Some of the walking involved significant climbs and there was no recurrence of my heart arrhythmia, giving me more confidence that last Monday's DC Cardioversion is doing the job.  Running in the next Trotters' trail run in five weeks time, even if slowly, may even be a possibility.

The runners approach the top of
Bumble Hill.

About fifty runners turned out today, and for the first time in fifteen or so of these runs, a female was the first person home.  It wasn't a race as such, but most of the runners try hard, and Melissa not only finished first, but also looked the freshest.  She is an up and coming distance runner, and already one of Australia's best adventure racers.

Her club-mates were pleased, but maybe not surprised, to see her do so well, and the run got me thinking about the differences I have observed between the genders in the way they train and race.  I'm generalising - it's more shades of grey than sharp contrast - and I am not suggesting Melissa is an exemplar.

Melissa nears the finish in Somersby.

Firstly, men tend towards overconfidence, while women seem often to lack belief in their running ability.  It's not uncommon to see men enter events for which they are under-prepared, believing that everything will work out, and finding otherwise.  On the other hand, females tend to underestimate their capabilities, and this perspective leads to more methodical and cautious preparation and planning for their big events.  I don't think it's fear of failure, more that they want to give themselves every chance of success by preparing properly.

The same gender characteristics also show up in races.  Males frequently start too fast, with visions of glory, or through fear of being left behind, or both, while females tend to start more conservatively, mindful of the distance ahead, and seem better at maintaining a steady pace and sticking to their race plans.

These differences may account for at least part of the observed convergence between female and male performances in races as the distances get longer.

Chorleywood

Chess Valley, England.

For two short years in the early 1990s, I lived in Chorleywood, a village in the Chiltern Hills north-west of London.  The reason I say "short" is that it remains the best place I have ever lived for interesting running courses, and I would have enjoyed living there for much longer.  There was no limit to the number of public footpaths, public bridleways and country lanes that could be cobbled together to make a course of any length, many of which avoided any significant road travel at all.  An added bonus were the tiny villages, hedgerows, country churches, historic mansions, fairy tale woods and rolling fields that made up the Chiltern landscape.  For those unfamiliar with English public footpaths and bridleways, they are historic rights of way, often crossing fields or passing through farmyards, that crisscross the English countryside.  Most are very runnable, though the less frequently used can become overgrown with weeds and nettles.

Chess Valley watercress beds.

It was easy to come up with a different and interesting course for every morning of the week, and despite my relatively short life there, the memories still live large.  All the morning "garbage" runs were good, but if I had to choose a favourite, it would be a regular 13km which captured all of the best local elements.

Starting from home in the village, the route ran along a lane and a couple of back streets before turning onto a farm road and passing by some stables.  From there it crossed the dark Carpenter Wood, with its leaf-littered undulating floor, and under the rail line to London through an old brick arch.  Much of today's Chorleywood village was built by the owners of the railway as a means of encouraging population growth and consequently commuters, though signs of settlement date back to the Paleolithic era.

Chorleywood Common.

The route then travelled along a bridleway which could get muddy after rain, before crossing a road and skirting the historic village of Chenies with its Manor House.  From there it followed a bridleway overlooking the Chess River Valley then descended through West Wood and over a field to cross the river beneath

historic Latimer House.  The next five kilometres followed the river downstream on beautiful and well-travelled public footpaths, through green pastures and passing a water cress farm before crossing the crystal clear river again on a small footbridge and climbing out of the valley through woods and parklands.

Chorleywood Common.

After crossing a busy road, it traversed the superb Chorleywood Common, to reach the village and a solid climb along Shire Lane to home, completing a run that changed with the seasons, and I never tired of doing.  One of the things on my bucket list is to go back and spend a few months, or longer, staying somewhere in Chorleywood, running and walking through the surrounding countryside, and making the easy commute into London to enjoy its attractions.

Today's exercise was the customary Friday golf game, and I was pleased to get around without any of the breathlessness and heart palpitations I experienced last Friday.  After the game, I visited the medical clinic to get my weekly blood coagulability tested, and the doctor checked my pulse.  She thought I was on some kind of medication, it was so slow, but seemed happy when I told her it was usually around 40bpm.  Her opinion was that I could exercise so long as I didn't get my heart rate near maximum, but I'll stick to my plan of only walking until the end of next week.

Marine encounters

Hatteras Island, North Carolina.

Yesterday, as I finished my walk along the Copa beach, I was lucky enough to see a pod of dolphins just beyond the breaking waves.  It's always a thrill to encounter wild animals when out running, and I have written about some of those rare encounters in other posts (Katahdin, More animal encounters, Yellowstone).  Meetings with sea life tend to be even more rare, and yesterday's sighting got me thinking about other such occasions.

Probably the most exciting encounter was thirty years ago when we were touring the U.S. and camped on Hatteras Island, a very long and extremely narrow barrier island off the coast of North Carolina.  Two islands just to the north were Nag's Head, famous for the historic Kill Devil Hills where the Wright Brothers took the first powered flight, and Roanoke, where one of the earliest groups of English colonists in America, comprising 150 people, disappeared without trace some time between ship visits in 1587 and 1590.  Despite the local history, the running options on Hatteras were very limited - either a run along the boring road that traversed the length of the island or along the sandy beach.

Hatteras Island beach.

I chose the latter, and having run a 25 miler the day before, was just cruising southwards along the empty and monotonous beach, when I got the feeling I wasn't alone.  Looking into the small surf to my left, there was a pod of fifteen to twenty dolphins, little more than 20 metres from the water's edge, travelling south at exactly the same speed as me.  I have to believe they knew I was there, because for the next half mile, they maintained their relative position as we eyed each other off.  They then peeled off into deeper water and I was on my own again.  I had another "marine" encounter a mile or two further on, with a very large and very dead hammerhead shark on the water's edge, but that doesn't really count as wildlife.

A whale passes South Point on Wilsons Promontory.

Although not a running encounter, another meeting that lives large in my memory was at the start of a mountain bike ride from the southernmost point of mainland Australia, South Point on Wilsons Promontory, to the northernmost, Cape York, in 2006.  It wasn't possible to ride my bike all the way to South Point for the start because of National Park regulations and difficult trail, so I set out early one morning from the settlement at Tidal River to hike the 42 kilometre round trip.  At the isolated South Point, large and slippery boulders washed by occasionally large swells made it quite difficult to clamber down to the water's edge to fill a small jar of water I was planning to carry for the 4300km journey north and empty into the sea at Cape York.  At one point I wondered whether my journey was going to end where it started, with my body never found, but eventually accomplished the task.  As I climbed back up to a point of relative safety, I heard an incongruous noise just to my right, and there, moving very slowly through the water about 20 metres offshore, and occasionally spouting, was a large black whale.  It was close enough for me to see its eye and it seemed to be looking right at me.  I took the sighting as a good omen, and as it turned out, had a great trip.

I walked 6km today, including some hills, without any difficulty or breathlessness.  However, I am constantly conscious of my heart beating, and although my pulse seems regular, can't escape the feeling that something is not quite right.  I woke in the small hours and couldn't go back to sleep, just lying there hyper-sensitive to my heart beat, trying to work out whether it was functioning properly, and looking for signs that it was not.  It may be, and I hope it is, just some post-procedure anxiety.  If that's right, then my sensitivity will diminish in the next couple of weeks and my confidence will grow, but at the moment I still feel like I am walking on eggshells.

Eggshells

Cockrone Lagoon on this morning's walk.

As I approached the first hill on my walk this morning, I felt my heart was racing in anticipation of whether it would start racing as my effort increased.  Then, as my cardiovascular system worked harder on the steepening grade, I was constantly assessing my body's reaction.

Part of my walk through McMasters
Beach this morning.

The symptoms I had experienced when walking up steep hills prior to Monday's Cardioversion included breathlessness, lightheadedness bordering on fainting, a hollow pressure in the centre of my chest and, as described on some medical websites, a real feeling of dread or impending doom.  There would be a sort of tipping point, where in a matter of seconds, I would go from the familiar feelings of mild fatigue associated with walking up a hill to a sense of the clutch slipping and my internal engine spinning faster and faster in a fruitless attempt to keep my body functioning.  It wasn't a pleasant experience, and I was hoping, rather than expecting, this morning that the Cardioversion had done the trick and my Atrial Flutter was gone.

Bounty Hill steps on this morning's walk
through McMasters Beach.

Since the procedure on Monday afternoon, it has been hard for me to tell whether or not the Cardioversion has made a difference.  I had been taking it easy, and a head cold, blocked sinuses, and a mild headache have made it hard to judge my overall well-being.  However, regular pulse-checking, and a vague feeling that my body was working more efficiently, have been encouraging signs.  The possibility of reversion to Atrial Flutter remains very real, though it will diminish over time, but it will be a while before I stop worrying about the consequences every time I start breathing harder on a walk or run.

Pumice stones on McMasters Beach which
have floated more than 4,000km from an
underwater volcanic eruption north of
New Zealand.

I didn't push it too hard on the hills this morning, and so far as I can tell, my heart is still beating normally.  The 6 kilometre walk passed easily enough, finishing with the bonus of watching a pod of dolphins gambolling just outside the shore break on the Copa beach.  I would like to think it was a good omen, but I don't believe in such things.  Now I need to work out a training plan that will gradually return me to running in a methodical way.  Such a plan will help prevent me trying to do too much too soon, if I feel that things are going well, but I also need to have the common sense to back off the plan if it appears too optimistic as time passes.

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.

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.