My Heart Works!

I thought I'd put into writing what I went through earlier this year with doctors, big machines, and radioactive isotopes in my bloodstream.

Background:
I'd been running quite a bit over the course of winter '06-'07. I maxed out at 112 miles per week, and averaged over 100mpw for 4 weeks straight. Coming out of winter, I was feeling awesome. I had started adding tempo runs, and was hitting 5:40 pace with my heart rate below 175. I ran a 16:41 5k on the track while my wife filmed and timed me. A week later I ran a 27:01 8k.

One more week later I was toast. I couldn't run tempo anymore below 5:55 pace or so, and I felt like crap doing it. The temperatures were fine, but I couldn't muster aerobic runs below 7:30 pace without feeling like I was pushing it.

I scheduled a doctors appt, convinced I had a some early stage anemia. The numbers were:
RBC 4.70mil/mcL (a little on the low end of normal)
Hemoglobin 14.9 g/dL (right in the middle of normal)
Hematocrit 44.6 % (right in the middle again)

Iron panel:
Iron 88 mcg/dL (low end of normal)
IBC 277 mcg/dL (low end of normal)
% saturation 32 % (middle range)

Ferritin 27 (below normal range of 30-300)

This was all after about 2 weeks to a month of recovery period where I was just resting and recuperating. It looked like I might have had some mild anemia.

But...they also did an electrocardiogram to check my heart out, and there were some abnormal readings. This set off lots of warning bells for the doctor (they don't like having 27 year olds who have funny ECG's). So they had me go in for some more advanced testing.

The first test was a transthoracic (through the chest) echocardiogram, which is an ultrasound of the heart. This was maybe 2 weeks after the first visit where the bloodwork was done. They took all kinds of pictures and videos of my heart in action. I also brought along my own blank CD, and they gave me the complete data set as well (I was going to mail it on to other doctors in case there was bad news...and get a second opinion). This is fun to look at. Thankfully the test came back with normal results. No problems there. The doctor wanted to make absolutely sure though.

So I then went in one month later for a nuclear stress test. It sounds like something that goes on at Los Alamos National Lab...but the procedure was this:
At rest, they inject me with a trace isotope which follows blood flow, and they are able to see how blood gets to my heart at rest. Then when the imaging is done (under a rather claustrophobia inducing device). Then they put me on a treadmill and try to take me to maximum exertion. This was fun. I lasted 20 minutes on the TM before they decided I was done (I had at least 3 minutes more left in me!) and injected me again with a new isotope. They were really impressed with my treadmill test...apparently Michael Jordan only lasted 16 minutes. The imaging was repeated, and now they had a picture of how blood was getting to my heart when it really needed to do some work.

Again, no problems, and I was given the free and clear to run again. This was great news, although I was disappointed to lose so much fitness in the meantime. At any rate, the fatigue issues were mostly gone by this point, and now I was just out of shape. For completeness, I also got my cholesterol profile done:
Total 156 (optimal < 200)
HDL 54 (optimal > 60)
Triglycerides 74 (optimal < 150)
LDL 87 (optimal < 100)
Again, no issues, although it would be nice to get the HDL up higher.

After all this, I put in a month of decent training (50-60 miles a week). I ran a HM in 1:19:14 which wasn't that bad considering I hadn't been training very much. Then my son was born. A few days off, and I tried to get back. Then my little boy spiked a fever, setting off an awful chain of events that happily ended well, and will maybe make for another post later. But that killed running for another month.

I've been back running for 3 weeks now, with mileage of 52 - 63 - 52, and all seems to be going well. I'm trying to decide what exactly I'm training for at this point...do I run Boston, or do I hold off until fall for another marathon, and pick up where I left off this spring. That is, do I spend some months working on my speed while building up more base. I'm currently leaning towards the latter. I don't feel like running a marathon again until I think I can go under 2:40, and I don't think I can do that until I have a low to sub-16 5k, a 33:30ish 10k, and a 1:15ish HM.

Run this morning:
7:40am (late) about 55 deg. F medium wind
10.2 miles easy, 90% on grass
1h 15 min (about 7:20 pace)

I felt really tight and sore from the workout yesterday, so I started out pretty slow, but gradually found my stride about 3-4 miles in.