May 28, 2010

Cardiologist

I noticed last week that the curious decrease in speed I've experienced in the last few months corresponds with a curious increase in resting heart rate.

For the record:
  • I take resting heart rate by taking my pulse and counting 15 seconds, multiplying by 4.
  • I do this first thing in the morning, when I remember.
  • My RHR for the past few years has consistently been in the mid 40s. Lately, it's been 65-75.
  • In February, I pulled off a 3-mile run in under 25 minutes, which is under 8:20 per mile.
  • Now, I'm having a great day if I can manage 10 minutes per mile for 3 miles.
  • My training hasn't decreased, quite the contrary.
  • My weight hasn't significantly changed
(Note - this post was written on Thursday night, but now, on Friday morning, I'll add - this morning's run - 6.31 miles in 1:12, took a lot of effort. 4 months ago, I could do this same run in under an hour for that same amount of effort. That's a pretty dramatic decrease in speed.)

Sigh. I really wanted to avoid going to the doctor over this, because the fix might be simple. I went over the list of things that I thought could possibly cause this, and I came up with one thing that applied to me:
Steve-sized coffee mug
I probably drink a half-gallon of coffee every day, sometimes more. I thought I could attribute it to the large amount of caffeine I've been drinking for years, and always figured that sooner or later it would catch up to me. Figuring that was the case, I immediately cut back on my caffeine to 2-3 cups per day (next week I'll probably cut back more.)

At the same time, I posted a question on the ultrarunning listserv about it, adding that I'd like to avoid going to the doctor if it's a simple fix like decrease caffeine. People Who Are Smarter Than Me chimed in and of course said, "why take the chance?" Others threw out words like "endocarditis", "myocarditis", "hyperthyroidism", and "pericarditis." But what really convinced me to pick up the phone was a couple of people pointed out that the caffeine probably was not the culprit because I've been drinking it for so long.


So today, for the second time in my life, I stepped into a cardiologist's office. Heart doctor. Think about it. It sounds scary. The damned thing has got to keep ticking, day and night, without stopping, ever. Naturally I compare it to the endurance stuff I do. I've had cramps lock up a calf muscle into an immobile vice - if something like that ever happened to my heart, that would be it!


Anyway, she did an EKG and did whatever other tests they could then, and everything seems "perfect." Blood pressure was 115/70. Oxygen was great. Circulation at extremes was fine. The heart rate wasn't as elevated as it has been; around 60 (still dramatically higher than 45.) She basically has no idea why it's happening and ordered a bunch of tests - stress (treadmill) test and echo-cardiogram on June 24. Also, blood work: CBC (complete blood count), Lipid Panel, TSH (thyroid), and a "comprehensive metabolic panel" (whatever that is.) She said she's doing all of this to look for a cause because nothing was apparent in the exam room. Sounds good to me.

She also said it's a good idea to cut back on caffeine, but she'd rather I cut back on overeating. In fact, she pointed out that it's better to drink lots of coffee if it gets me to eat less (I wish). Interesting.


So, I guess on June 25th I'll have another blog post with the results of all of this. In the meantime, it's business as usual.

New entries for Steve's blog are published every Monday, Wednesday, and Friday at 10:00am NY time - NO POST ON MEMORIAL DAY, WE'LL BE OUT OF TOWN

4 comments:

  1. Steve, so to me it sounds like over-training, especially when you say "My training hasn't decreased, quite the contrary." My best guess based on my experiences. I would suggest taking a week off of running and see if your symptoms improve. Drastic I know but it can help. One of the telltale factors that you are over trained or not sufficiently recovered from a race or hard effort is that your heart rate is elevated in the morning.

    This is fresh on my mind because I just recently had what I hope to be a minor episode with over training. About 4 weeks ago I ran the Miwok 100k and ran all out. The following 6 days I took it real easy, ran only twice and about 4-miles each time. Felt great, tired but recovering but then that weekend I paced a friend for 19 miles at a 50 miler and earlier in the day I was hiking and running to the different aid stations to follow her progress as well as other friends running the race. Felt fine that day and the day after but the following week I was low energy, tired to bed, tired in the morning, runs were slow, sluggish and felt like major efforts, soreness in the legs and rapid heart rate which scared the crap out of me. At first I didn't think it was over-training because it's not unusual for me to race back to back weekends let alone race and pace. Moreover my training has been more comprehensive that it has been in the past, I am stronger than ever. I thought it was my new allergy medicine, cut it out and hoped to just shoulder on till things got better, even took two days off. That weekend I ran a 20 mile long run that felt like the last 20 of a long race. Still too stubborn to quit I shouldered on for the next week until the following Friday when mood swings started and I lost complete motivation about running and training. That was when I knew for sure I was over-trained. That was last Friday. I cut the running completely and didn't start running again until Tuesday evening and an easy 4 miles at that. I felt really good and ran it faster than I usually run the loop. Took a day off after that then ran again yesterday and felt great. I treated it like the flu; lots of rest, liquids, good healthy food and a slow return to running. I only have 2.5 weeks before the San Diego 100 so I really had to nip this quick.

    I'm not saying that you are definitely over-trained but that is my guess based on my experiences. Here are a couple of links and tell me if some of the symptoms match. If you are over trained the best thing is rest. How much is up to your body. The sooner you catch it the less rest you need. If you rest and you still feel like crap, rest some more. I think your wife has my number if you want to talk to someone about it. Hope it's that and nothing more serious.

    http://en.wikipedia.org/wiki/Overtraining

    http://sportsmedicine.about.com/cs/overtraining/a/aa062499a.htm

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  2. Rick - thanks for the note.

    Consider -
    1.) I did recently take 5 days off without any improvement
    2.) Can overtraining account for a whole 2:15 mins per mile slower on a 10K, after a rest day? That seems very dramatic..

    -steve

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  3. If it is over training and you have been struggling with it for sometime then 5 days won't help. In 2005 I was over trained by August but held on and kept training because I didn't want to give up the races I had already planned on running. Ran my last race Thanksgiving weekend, all the events sucked by the way. Two weeks later after no running I still felt the same way. I usually take December off anyway and by the time January came around I was fine.

    Recently a friend, a runner who won a 100-mile race this year, dealt with ongoing fatigue issues, even dropped from a race, and finally had blood work done. Blood work confirmed fatigue, not sure how, didn't know you can test for that in that way, and was put on rest and supplements and seems to be doing fine now.

    Maybe it's not over training at all but I'm hoping its not something worse.

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  4. I just went through a very similar experience 2-3 months ago except my RHR is almost twice yours. I got a echo-cardiogram, resting EKG, treadmill stress EKG, and blood test. Everything came out clean according to the doctors except I feel like I'm dying if I even run a 12min mile. My RHR is 95-100 and even when I wake up in the morning, it's above 90.

    During my treadmill test, my pulse was at 120bpm @ 1.2mph for 3 minutes, 150 @ 2.4mph for 3 minutes, 180 @ 3.6mph for 3 minutes, and 206 @ 4.2mph for 1 minute. It took 20 minutes of rest to get it down to 120 from 206. The EKG showed no issues with the heart (no arrhythmia, no valve issues etc.) So for now, I've just stopped worrying about it and just do as much as I can.

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