Heart Attack, Triple Bypass

I had a heart attack on 3/12/2011, undiagnosed until 5/3/2011. I went in for an angiogram the next day. They woke me long enough from the angiogram to tell me that I needed a triple bypass and get my consent, then they put me back to sleep. I woke up in the ICU, gagging on a breathing tube. They took that out a little after I started breathing on my own. I spent a little less than 2 days in the ICU followed by 2 days in the Direct Observation Unit (DOU) and then got to go home. I've been recuperating at home since then and plan to go back to work next Wednesday, 4 weeks after my operation. I started walking once I got out of the ICU and didn't have cables attached. I had a couple of days where I got up to 8 miles of walking. However that seemed to have taxed me somewhat. So right now, I am walking 2 miles per day and getting on the stationary bike for 20 minutes. Otherwise, I am pretty useless around the house since I can't pick up anything heavier than 5 to 10 pounds and can't drive a car.

My cardiologist told me repeatedly that I don't know how lucky I am. He finally explained this by saying most people drop dead who run after having a heart attack (and with 2 coronary arteries 100% blocked and one 95% blocked). After having the heart attack I eventually ran the same workout where I got the attack. I ran 8 miles on Harding Truck Trail. I rode 24 miles home from work on my bike - twice. My last workout before the cardiologist appointment was 4x400 meters. However, we suspect that my running history helped me survive possibly by developing a somewhat redundant set of capillaries from other coronary arteries. Also my running history made it easier to operate on me (less than 4 hours where they sometimes take 6 hours) and helped my recovery. As to "Why me?", my cardiologist blames heredity (my father had a heart attack at 62 - but after decades of smoking) and I blame at least partially my affinity for stress.

I'm told that i have no other blockages other than those they fixed (bypassed). My ejection fraction was measured at 65% (normal) the day after my surgery. I never got an answer as to whether this (advanced atherosclerosis) could be detected without first having a heart attack.

My symptoms prior to the heart attack were

• Decreasing running abilities over the last 3.5 to 5 years.
  
• The general feeling that eating cheese strains my heart.
  
• Pale at the end of runs (at least when I end at the house).
  
• Angina (now I know what it is) 2 days prior to the heart attack.
  

Symptoms of my heart attack

• Tightness across chest
  
• Sense that it would be a really bad idea to keep running.
  
• Immediate drop in cardiovascular capacity. I had to walk slowly back to the car with several stops to sit down.
  
• General feeling of discomfort. The drive home was really a challenge.
  
• Flu-like symptoms the next few days.
  

Symptoms after my heart attack.

• Continued diminished cardiovascular capacity.
  
• Wierd EKG - dips instead of peaks - once I had it taken (on 4/4).
  
• Angina when jogging on flat ground. Oddly enough, I had light to no symptoms when riding a bike, running trails, running sprints up to 400 meters.
  
• I definitely improved over time. A 10 mile bike ride early on was tiring whereas 18 and 24 mile bike rides later on were not a problem. I ran the same route that I had run when I had the heart attack without a problem.
  

Expectations and Hopes

• Given my ejection fraction of 65% post-op and the fact that I could actually do something prior to my bypass, I expect my capabilities to return to what they were a few years ago.
  
• I expect to have little anomalies with my chest like popping ribs (due to the operation) for at least a year.
  
• I hope to be able to run by 8 weeks after the operation (end of June). I hope to be able to run hard 4 weeks after that.
  

Moral: Running does not prevent heart attacks but it did help me survive and recover faster.

Another disrupted week

I went to Arizona last weekend to cleanup my brother's house. As a result, I didn't get a run in on Friday or Saturday and only a short one on Sunday. I'm going back for a week in two more weeks but will try to get a regular workout in then.

• 10/26 - 10
  
• 10/27 - 11.3 (10 on track, 1.3 in morning)
  
• 10/28 - 9.64 on trails, 1942 vertical
  
• 10/29 - 11.7 (10 on roads, I guess 1.7 in am)
  
• 10/31 - 3.6 roads
  

The last two weeks - life (and death) intervenes

My mother and sister were visiting on the week on 10/4 since my niece was getting married out here. I just didn't feel like running on Tuesday of that week. That workout (long tempo on the track) has been suffering for a few weeks due to problems with my right soleus (see previous months) and disruptions (see previous weeks). I will be going to Arizona for 3 consecutive weekends starting Halloween weekend in order to clean up my brother's house. That will disrupt my long run on Saturday which has been progressing steadily. So I'm using this opportunity to move my workouts to more of a Lydiard schedule which I was pretty close to anyway. So the plan is to get the weekdays into that schedule over the 3 weeks when I will be in Arizona on weekends. Then I'll see where my long run is on the 3rd weekend in November. Hopefully I won't lose anything and I'll be able to resume with a long run around 26 miles.
So here are the last two weeks:

• 1st week
  
• 10/4 - 7, 5@7:34 pace
  
• 10/5 - 4 easy
  
• 10/6 - 2 just didn't feel like it.
  
• 10/7 - 11.33 on trails, 2308 vertical
  
• 10/8 - 8.38 on trails, 1405 vertical
  
• 10/9 - 24.25 on trails, 4929 vertical, 13:06 pace
  
• 10/10 - nothing (niece's wedding)
  
• 2nd week
  
• 10/11 - 7, 5@7:27 pace
  
• 10/12 - 4 easy
  
• 10/13 - 1.25 (soleus complaint)
  
• 10/14 - 7.56 on trails, 1378 vertical
  
• 10/15 - 1 easy
  
• 10/16 - 25.93, 5405 vertical, 14:11 pace
  
• 10/17 - nothing (memorial service for my brother)
  

September

Summary:
I stopped struggling in September and started progressing. The keys to this were:

• 3 hill workouts per week
  
• Consistent schedule of track workouts on Mon and Wed, trail on Thu, Sat and Sun, easy on Tue and Fri
  
• Gradual increase of 1 mile per week for track workouts (combined) and 1 mile per week on long run.
  

Mon	Pace	Tue	Wed	Pace	Thu	Vert	Fri	Sat	Vert	Pace	Sun	Vert	Total	Vert
			4				5	16.93	2962	14:10	7.5	1378	48.5	5140
7	8:11	4	9	7:52	7.5	1378		18.18	3336	13:02	7.5	1378	53.3	6092
7	8:22	3.25	10	7:52	7.5	1378		19.86	3812	12:56	7.5	1378	55.2	6568
7	7:36	4	10	7:28	7.5	1378		21.88	4485	16:27	7.5	1378	58	7241
7	7:54	4			7.5	1378							49.7	7717

Note that I hit my goal pace of 7:30 for my long tempo run. Now all I have to do is double the distance.
Note also that I have 2 miles warmup/warmdown for my track workouts so the actual miles for Monday topped out at 5 and Wed at 8.

Weekly Update - 9/27 - 10/3

• Mon - (track) 7, 5 at 7:54
• Tue - (park) Easy 4
• Thu - (trails) 7.56 w/1378 vertical
• Sat - (trails) 23.56 w/ 4961 vertical (14:04 pace)
• Sun - (trails) 7.56 w/1378 vertical
• Total - 49.68 w/7717 vertical

Saturday was 1.7 miles farther than last week and I ran it 25 minutes faster with no big drop in energy at the end. This was due to eating sweet potatoes during the run and probably some conditioning from last week.

When I came back from my run on Tuesday, my wife told me that my brother had hung himself. I spent Wednesday talking with my younger daughter.

Weekly Status - 9/20 to 9/26

• Mon 7, 5 at 07:36 pace
• Tue easy 4
• Wed 10, 8 at 07:28 pace - Goal pace! mostly around 7:32 splits, last mile in 7:02
• Thu 7.56, 1378 vert.
• Fri off
• Sat 21.88, 4485 vert. last 3 miles went from pathetic excuse for running to almost blacking out. 16:27 pace
• Sun 7.56 1378 vert.
• Total 58 miles, 7241 vertical
  

Found out I had not been counting one segment correctly, hence my long run increased by 2 miles, not one. I'm actually not worried about dying at the end of the long run. It was a hot day and I got low on water. Also, I kind of expect to have long runs that end like this while my body is getting reacquainted with running longer distances. Right achilles/calf was tight earlier in the week (from the 7:02 mile) but otherwise, legs have been performing well.
I was quite pleased to hit my goal pace - over 20 seconds faster pace than last week. The hill workouts are definitely driving the faster pace of track workouts.
On the track workouts, I've evolved into this format:

• Ride bike two miles to track.
• 1 mile jog with maybe a stride at the end
• Stretch (soleus, gastrocnemius, touch toes, quads, 2 hip stretches, hurdle stretches)
• 1 lap with two strides
• Run tempo run
• 3 lap warmdown
• Ride bike two miles home
  

Weekly Report - 9/13 - 9/19/2010

• 9/13 7 miles, 3 at8:22 pace
• 9/14 3.25 miles (in flats - rt. soleus started bothering me)
• 9/15 10 miles, 8 at 7:52 pace
• 9/16 7.56 miles, 1378' vertical
• 9/17 0
• 9/18 19.02 miles, 3812 vertical, 13:30 pace
• 9/19 7.56 miles, 1378 vertical
• Total 54.39 miles, 6568 vertical

I'm happy with the progress. For the trail workouts, my pace has been aggressive on the flats and uphills and prudent on the downhills. I'm very happy to be running this well on the trails. The track workouts are doing fine too.