28 Miles in Four Days

Thursday, July 28, 2016:

I've had such fun this week.  Today I just goofed off, walking and running all over, including parts of the town that I had never explored before.  This included two quarter-mile (400 m) runs on the old high school track at a 10-minute per mile pace, lots of fast walking, and even more moderate walking.  I went about nine miles in about two hours and 20 minutes, an average  pace of 15 to16 minutes per mile.

Those two quarter-mile runs are the farthest I've run without walking in months, perhaps years.  Today was the perfect day to ramp up a little, overcast with temperatures in the mid-60's.  That's enough for a day or two - push too hard and injury will slow me down again.  I want to get stronger and faster.

Wednesday, July 27:

Exploring   I followed some trails that I've never seen before, and had a great time.  7.5 miles in 1:46:32, for a pace of 14:12.

Monday, July 25:

Last Friday I felt more than a little sluggish in a 6-mile walk/run.  Today was just the opposite - I did 11 miles and felt as good at the end as I did at the start.  Warm weather, nearly 80 with high humidity.  I carried water and took a couple of Clif Shot gels.

Splits: 6.04 mi + 5.09 = 11.13 mi in 2:38:45, pace 14:12.

Confident Run

Now that I'm way less concerned about a possible heart attack, I can focus on the other possible cause of the angina-like symptom, exercise-induced reflux.  So this morning I went out for a nice little four-mile run before eating or drinking anything at all, and had a wonderful time, running whenever I felt like it and otherwise walking as fast as I could.  I wore the heart rate monitor and saw a maximum rate of 130.

Whining:  No pains of any kind, neither the pseudo-angina nor the right knee.

Splits: 25:07, 25:09, total 50:16, pace 12:34.

Healthy Heart

My primary care physician called last night with the results of Monday's treadmill stress test with nuclear imaging.  As I remember what he said:

• Nuclear scans showed no evidence of significant obstruction in any vessel of the heart.  This is a very good prognostic factor.
• Whereas 9 minutes on the treadmill is good for a man of 75, I went 14 minutes, which is much more difficult and an excellent prognostic factor.  (The treadmill exercise increases significantly in both speed and incline every 3 minutes). 
• The angina-like symptom could have been a clot that cleared by itself.  I doubt that, because it has lasted for months - I have notes back to April 20 at least, and even a note as far back as May, 2015. 
• It could also be a small-vessel ischemia, not visible on the scans.  This could cause the feeling of angina (but perhaps would not be especially dangerous?).  Again, why does it go all the way back to April or last year? 
• No reason to do an angiogram.  I agreed, especially since I know that an angiogram poses its own risks. 
• No reason for medication.  Nitroglycerin, in particular, is not really a treatment for heart disease, but is prescribed to alleviate pain.  To me, the pain may be a helpful signal to back off. 
• When running, it's OK to push until I feel the symptom, but then cut back until it goes away. 
• He asked if I was taking any blood thinners, and seemed satisfied when I told him I was taking an 82 mg aspirin twice per day.  
• He said that he would not be offended if I spoke next to a cardiologist.  I declined, but suggested I might like to get a second opinion on reading the scans.  He said that he and I could sit down and look through the images together, they are not difficult to read, and then I suggested that I might see if I can get a copy on DVD.  Perhaps I'll set up an appointment with him if I have questions after viewing the scans myself.

Though this is wonderful news, I understand that I might still have heart disease, despite the dandy "prognostic indicators."  However, I now believe that the most likely cause of the angina-like symptom is exercise-induced reflux.  Heartburn.  Indeed on one fairly recent run, a few minutes after feeling the symptom, some of my stomach contents did come up into my mouth.  No nausea, just reflux.

I think that dexamethasone (DEX) and prednisone make the reflux more likely, as does a recent meal, of course.  Looking back through my blogs, I find that every complaint about chest pain occurred while I was taking DEX, often (though not always) on the very day after I took it.  Although I haven't felt the symptom for two weeks now, I believe that it will appear again when I push harder, and I will take careful notes.  Can't wait to get out there and push a little harder.

Mad Dogs and Englishmen

Tuesday, July 19, 2016

Go out in the midday sun.  Part of a song by Noel Coward.  I am indeed half English, actually two fourths to be precise, but this run wasn’t quite midday - more like 10:00 am.  Nevertheless the temperature was 82 with a dew point of 71, for a heat index of 85.  Full sun didn’t help - I would have preferred rain, and my running clothes got totally wet just the same.  Soaked with sweat.

This was a new route for me, about 4.2 miles plus a couple of extra exploratory excursions, making it 4.7 miles in 1:11:19, for a pace of 15:10, not bad at ALL considering the weather and the amount of time that I had to wait for traffic lights.  I’m not above jaywalking, but not across busy 55 mph 4-lane highways, thank you.

My pulse rate reached 130 at one point, a new high since I started using the monitor a few days ago.  This surprises me, because I have worked quite a bit harder in some other runs in the last week.  The previous high was 123.  Perhaps it’s the DEX - I took 12 mg of dexamethasone last night - a weekly dose that’s part of my myeloma treatment.  Perhaps the heat contributed too, with the resulting dehydration.

The good news - the angina-like symptom did not appear, and the right knee didn’t complain much either.

I did have a stress test yesterday morning at the hospital, with nuclear imaging, but don’t have the results yet.  Do I have serious heart disease or not? My sweeties and I anxiously await the answer.  I’ll post about it, of course.

Sunday, July 17:

Nice walk with A & S, exploring new routes within a mile or two of our house.  About 2.5 miles.

Saturday, July 16:

Hospital Loop With My Sweeties   We three walked one of my favorite routes together - four miles that take us past both the hospital and the doctor’s office, plus at least four (other) places where a person could take a nature break in an emergency.

They did really well today - as I slow down, I wonder if the day will come that we all want to go about the same speed.

Splits: 35:44, 37:58, total 1:13:42, pace 18:26.

Eight Miles Today

After six yesterday.  I went out to do a four mile loop, but felt very good after the four and just kept going for another four on a different route.  The weather was perfect and I certainly enjoyed the walk/run.

Heart rate: I wore the monitor again today.  The typical reading on the flat was about 105 beats per minute, declining slightly in the second four mile loop.  The highest reading I saw was 118, going up a rather steep hill and breathing pretty hard.  No hint of the angina-like symptom.

The right knee complained just a little, but under the kneecap, not in the joint.  A little return of PFS, I suppose - not enough to cause a slowdown.  All in all a very enjoyable run.

Splits: 27:46 (2 mi), 28:26 (2 mi), 14:23, 15:03, 15:05, 14:35, total 1:55:18, overall pace 14:25.

Six Miles at Race Pace

Thursday, July 14, 2016:

More or less.  We do have another marathon coming up in September, only about two months away now, so it's time to start stretching out the runs toward a 20-mile run a few weeks before the marathon.  Longer runs have been on hold recently because of the occasional angina-like symptom, but that doesn't appear unless I push fairly hard.

Indeed, it may have appeared today after I jogged across a street, but the symptom was faint and went away when I slowed a bit.  It didn't reappear during this run.  No other problems today - the knee was fine.

Stress test coming up Monday - we'll find out more about the angina-like symptom.

Splits: 28:06, 28:38, 14:30, 14:50, total 1:26:04, pace 14:21

Wednesday, July 13:

This is a new chapter in my training, the first serious resistance training in years.  No running at all, just resistance.  This regimen is still under development, but here is the list of exercises so far:

• Stairs, 16 steps per flight, 10 flights per set, two sets.
• Pushups, as many as I can do per set, two sets.  Today 22 in set 1, 15 in set 2.
• Lateral arm raises, 10 lb weights, 15 raises per set, two sets.
• Arm curls, 15 lb weights, 20 curls per set, two sets.
• Hand grips, 20 squeezes per set, two sets.
• Situps, 20 per set, two sets.
• Standing stretches, four types, 12 seconds each, two sets.

This took about 30 minutes.  I got plenty sweaty and it raised my heart rate and breathing rate quite a lot.  Hopefully as time goes by I will be able to increase the amount of each the various exercises, and thus the total time.

Tuesday, July 12:

Yet another four miles on the hospital loop.  Cancer treatment (infusion) this morning, so the run was necessarily in the afternoon.  The temperature was 82 with bright sun, so I took it pretty easy, all walking, never running except across a few intersections.

Before the run I resurrected an old pulse rate monitor and put it on.  The highest heart rate I saw was 121, going up the steepest hill on the route.  A typical rate was 106, going fairly fast on the flat. Time was about 1:03:00, for a pace of about 15:45.  Good enough for a hot day.

Monday, July 11:

Another four miles.  No issues.

Sunday, July 10:

Four miles on the “hospital loop” with my sweeties.  They can really move along, too, though it wasn’t enough to cause my angina symptoms.  We took a few brief detours, and it took about an hour and a half.  I call it the hospital loop because it actually does go right past the hospital and, for extra credit, goes past my doctor’s office as well.

Saturday, July 9:

Four miles with George, the St Croix Valley Runners (walkers in this case).  No problems.  Took a little over an hour, actual distance probably about 4.1 mi.

Eight Runs

In the last two weeks, for a total of about 31 miles.  The angina-like symptom that appeared in the last marathon is still right there when I push hard, say faster than about 14 minutes per mile. I admit I'm a little afraid to push hard enough to feel it, because if it really is angina, it can precede a heart attack,

Indeed one of the runs was four miles at an overall pace of 13:36, and I definitely did feel the angina-like symptoms briefly at the end of the run, and for a few  minutes afterward.  I have a stress test scheduled, about ten days away now, and won't push so hard again until we get the results and a diagnosis.  Dr S, my primary, even suggested the possibility of stents.  Well, we have a ways to go before that.

Angina happens when the heart can't pump enough blood into its own arteries to meet its own needs.  Therefore, one of the complications could be related to my runner's heart rate.  Today I worked pretty hard, only walking, but sweating and breathing hard, finishing four miles at a pace of about 14:30.  I took my pulse rate several times along the way, and never saw more than 112 bpm, pretty slow for fairly strenuous exercise.  Assuming that I do have some narrowing of the coronary arteries, reducing the peak blood flow to the heart, I wonder if this low heart rate could contribute as well - the heart not beating fast enough to supply itself with enough blood.

Despite this complication we have scheduled three more marathons this year, starting in September. I expect to do them.  Currently at 97, that will take us to 100!  I hope it happens.